"Should I prioritize medical problem solving or attentive listening?": the dilemmas and challenges that medical students experience when learning to conduct consultations

Objective: Communication skills can be trained alongside clinical reasoning, history taking or clinical examination skills. This is advocated as a solution to the low transfer of communication skills. Still, students have to integrate the knowledge/skills acquired during different curriculum parts in patient consultations at some point. How do medical students experience these integrated consultations within a simulated environment and in real practice when dealing with responsibility?

Methods: Six focus groups were conducted with (pre-)/clerkship students.

Results: Students were motivated to practice integrated consultations with simulated patients and felt like 'real physicians'. However, their focus on medical problem solving drew attention away from improving their communication skills. Responsibility for real patients triggered students' identity development. This identity formation guided the development of an own consultation style, a process that was hampered by conflicting demands of role models.

Conclusion: Practicing complete consultations results in the dilemma of prioritizing medical problem solving above attention for patient communication. Integrated consultation training advances this dilemma to the pre-clerkship period. During clerkships this dilemma is heightened because real patients trigger empathy and responsibility, which invites students to define their role as doctor.

Practice Implications: When training integrated consultations, educators should pay attention to students' learning priorities and support the development of students' professional identity.

Engaging the Senses: Object-based learning in higher education

The use of museum collections as a path to learning for university students is fast becoming a new pedagogy for higher education. Despite a strong tradition of using lectures as a way of delivering the curriculum, the positive benefits of ‘active’ and ‘experiential learning’ are being recognised in universities at both a strategic level and in daily teaching practice. As museum artefacts, specimens and art works are used to evoke, provoke, and challenge students’ engagement with their subject, so transformational learning can take place. This unique book presents the first comprehensive exploration of ‘object-based learning’ as a pedagogy for higher education in a broad context. An international group of authors offer a spectrum of approaches at work in higher education today. They explore contemporary principles and practice of object-based learning in higher education, demonstrating the value of using collections in this context and considering the relationship between academic discipline and object-based learning as a teaching strategy.

Categorising Asynchronous Discussion Threads: Improving the Quality of Student Learning

My paper will focus on the generative potential of categorising asynchronous discussion threads as one strategy for improving the quality of students’ learning in a blended learning module. The approach to categorisation is based on social network analysis using intuitively simple descriptors of message posting patterns e.g. passive facilitator, dominant facilitator, unresponsive star and formulaic discussion. The intention is to produce descriptively vivid illustrative examples of the categories and to begin to suggest affordances of the different participation patterns. Looking forward to the beginning of the next module, it is anticipated that discussion during the module of approaches to participating in asynchronous discussion will contribute to effective engagement patterns and deeper learning.

Collaborative learning in a Japanese as a foreign language classroom /

This study examined the influence of training on Asian learners' beliefs, interaction, and attitudes during collaborative learning (CL) and explored the processes of their CL in pairs. The literature contains few studies on the effect of collaborative training in language learning. In addition, it shows gaps between SLA theory and practice resulting from learners' cultural differences. Although second/subsequent language acquisition (SLA) theory assumes that CL contributes to language learning, implementing CL in a multicultural classroom is often considered to be unsuccessful by teachers. The research questions designed to address this gap explore: (a) the extent to which tra~ng affects Asian learners' attitudes towards and interaction during CL; (b) how Asian learners accomplish collaborative tasks in pairs. In the quasi-experimental research design, the learners in the treatment group received special training in CL for 5 weeks while the learners in the comparison group did not receive similar training. Data were collected from 45 McMaster University students through pre- and posttests, pre- and postintervention questionnaires, student information, and informal classroom observations. To detennine the influence of training, the frequency of communication units (c-units), Language Related Episodes (LREs), Collaborative Dialogue (CD) from audio-taped data, and the fmal draft scores were compared between pre- and posttests. The learners' pre- and postintervention questionnaires were also compared. Transcripts from audio-taped data, students' information, their responses and comments from questionnaires, and informal observations served to investigate the processes of Asian learners' CL. Overall, this study found that training had significant influence on the frequency of c-units and CD, and considerable impact on the draft scores, although little influence on the frequency of LREs was observed. The results from the questionnaires in the treatment group showed positive changes in the learners' beliefs on pair work after training. On the other hand, analyses of the transcription data showed that the learners did not conduct enough discussion for a resolution of problems with peers. In conclusion, results suggested the need for teacher intervention, a longer period of collaborative training, and an implementation of self-evaluation into the course grade to encourage the learners to succeed in collaborative learning.

A study of self-directed learning at an Ontario college of applied arts and technology

Ontario Colleges of Applied Arts and Technology (CAATs) are currently in the process of restructuring to ensure quality, accountability, and accessibility of college education. References to learner involvement and self-directed learning are prevalent. "Alternative delivery" and "paradigm shift" are current buzzwords within the Ontario CAAT system as an environment is created supportive of change. Instability of funding has also dictated a need for change. Therefore, a focus has become quality of learning with less demand on public resources. This qualitative case study was conducted at an Ontario CAAT to gather descriptive, perceptual data from post-secondary community college educators who were identified as supportive of self-directed learning and from post-secondary, traditional-aged college students who were perceived by their educators to be selfdirected learners. This college was selected because of initiatives to modify its academic paradigm to encourage what was reputed in the Ontario CAAT system to be self-directed learning. The purpose of this study was to investigate how postsecondary, traditional-aged college students and their educators perceive self-directed learning as part of the teaching-learning experience within a community college setting. Educator participants of the study were selected based on the results of a teaching and learning survey intended to identify educators supportive of self-directed learning. A total of 317 surveys were distributed to every full-time educator at the sample college; 192 completed surveys were returned for a return rate of 61 %. Of these, 8% indicated instructional beliefs and values supportive of self-directed learning. A purposive sample of six educators was selected using a maximulp variation sampling strategy. A network selection sampling strategy was used to select a purposive sample of seven post-secondary students who were identified by the sample educators as selfdirected learners. The results of the study show that students and educators have similar perspectives and operating definitions of self-directed learning and all participants believe they either practice or facilitate self-directed learning. However, their perspectives and practices are not consistent with the literature which emphasizes learner autonomy or control in course structure and content. A central characteristic of the participants represented in this study is the service-oriented professions with which each is associated. Experientiallearning opportunities were highly valued for the options provided in increasing learner independence and competencies in reflective practice. Although there were discrepancies between espoused theory and theory in practice in terms of course structure, the process of self-directed learning was being practiced and supported outside the classroom structure in clinical settings, labs and related experiences.

What Matters? : the full-time graduate students' perceptions of teacher effectiveness

The purpose of this qualitative study was to explore the full-time graduate students' perceptions of teacher effectiveness at the graduate school level, to identify how graduate students perceive effective and ineffective teachers, and specifically to discover the main dimensions of teacher effectiveness that graduate students perceive as most significant. This topic was investigated because, although the teacher has been deemed as a crucial component in the teaching process, there is no common agreement on the definition and measure of teacher effectiveness. Graduate students' perceptions of teacher effectiveness have not been given much attention. The research design was based on a ground theory approach. It utilized qualitative data through interviews, field notes, andjournals. The findings ofthis study revealed that teacher effectiveness is markedly influential to graduate students. There is no universally consented definition or measure of teacher effectiveness due to the multidimensionality of teaching and learning. Nevertheless, several major dimensions ofteacher effectiveness were discovered and highlighted in this study. Such dimensions include good command of subject matter, presentation skills, challenging and motivating students, rapport with students, learning environment, course demands, as well as assessment and feedback. It was hoped that the study would move towards developing a theory that contributes to the knowledge base of graduate students' perceptions of teacher effectiveness. It was anticipated that the results would provide first-hand information for the instructor to improve teaching; for the administrator to promote the effective educational experiences and student achievements. It was intended that the findings would lay a theoretical and empirical groundwork for future research.

Support for International Students

International student experience video - this video is 20 minutes long and has been devised by Bill Brooks, Hazel Chauhan and Karin Frydenlund, with support from the University's Learning and Teaching Enhancement Fund. It includes contributions from a number of international students and from members of staff with particular expertise in this area.

Approaches to Learning

Looks at some of the models of learning and discusses how they apply to university students

Flipped classroom and learning strategies

This paper seeks to answer the research question "How does the flipped classroom affect students’ learning strategies?" In e-learning research, several studies have focused on how students and teachers perceive the flipped classroom approach. In general, these studies have reported pleasing results. Nonetheless, few, if any, studies have attempted to find out the potential effects of the flipped classroom approach on how students learn. This study was based on two cases: 1) a business modelling course and 2) a research methodology course. In both cases, participating students were from information systems courses at Dalarna University in Sweden. Recorded lectures replaced regular lectures. The recorded lectures were followed by seminars that focused on the learning content of each lecture in various ways. Three weeks after the final seminar, we arranged for two focus group interviews to take place in each course, with 8 to 10 students participating in each group. We asked open questions on how the students thought they had been affected and more dedicated questions that were generated from a literature study on the effects of flipped classroom courses. These questions dealt with issues about mobility, the potential for repeating lectures, formative feedback, the role of seminars, responsibility, empowerment, lectures before seminars, and any problems encountered. Our results show that, in general, students thought differently about learning after the courses in relation to more traditional approaches, especially regarding the need to be more active. Most students enjoyed the mobility aspect and the accessibility of recorded lectures, although a few claimed it demanded a more disciplined attitude. Most students also expressed a feeling of increased activity and responsibility when participating in seminars. Some even felt empowered because they could influence seminar content. The length of and possibility to navigate in recorded lectures was also considered important. The arrangement of the seminar rooms should promote face-to-face discussions. Finally, the types of questions and tasks were found to affect the outcomes of the seminars. The overall conclusion with regard to students’ learning strategies is that to be an active, responsible, empowered, and critical student you have to be an informed student with possibilities and mandate to influence how, where and when to learn and be able to receive continuous feedback during the learning process. Flipped classroom can support such learning.

Relationship between psychological factors and symptoms of TMD in university undergraduate students.

Temporomandibular disorders is a collective term used to describe a number of related disorders involving the temporomandibular joints, masticatory muscles and occlusion with common symptoms such as pain, restricted movement, muscle tenderness and intermittent joint sounds. The multifactorial TMD etiology is related to emotional tension, occlusal interferences, tooth loss, postural deviation, masticatory muscular dysfunction, internal and external changes in TMJ structure and the various associations of these factors. The aim of this study was to evaluate the prevalence of the relationship between signs of psychological distress and temporomandibular disorder in university students. A total 150 volunteers participated in this study. They attended different courses in the field of human science at one public university and four private universities. TMD was assessed by the Research Diagnostic Criteria (RDC) questionnaire. Anxiety was measured by means of a self-evaluative questionnaire, Spielberger's Trait-State anxiety inventory, to evaluate students'state and trait anxiety. The results of the two questionnaires were compared to determine the relationship between anxiety levels and severity degrees of chronic TMD pain by means of the chi-square test. The significance level was set at 5%. The statistical analysis showed that the TMD degree has a positive association with state-anxiety (p = 0.008; p < 0.05) and negative with trait-anxiety (p = 0.619; p < 0.05). Moreover a high TMD rate was observed among the students (40%). This study concluded that there is a positive association between TMD and anxiety.

English collocations extracted from a corpus of university learners and its contribution to a language teaching pedagogy

Taking into consideration the relevance of foreign language teaching and the learning of collocations (ALTENBERG; EEG-OLOFSSON, 1990; FONTENELLE, 1994; MEUNIER; GRANGER, 2008), this paper aims at showing results of an investigation on whether the teaching of collocations should be implicit or explicit to the Brazilian university students. Furthermore, the research has the purpose of presenting some collocational aspects from a corpus of the written language learners made up of intermediate, upper intermediate and advanced university students' argumentative essays at a public university in Brazil. With the help of WordSmith Tools (SCOTT, 2007), it was possible to raise students' most frequent collocational choices and patterns, the most/least used type of collocations, the influence of the mother tongue on their choices, among other aspects. With the purpose of motivating and involving students in classroom research, it was also introduced The Corpus of Contemporary American English (COCA), created by Mark Davies. By doing so, students could compare their collocational choices with the patterns found in the online corpus, extract more collocational patterns and, consequently, be aware of the potential of corpora for the foreign learning process, specifically for raising language awareness, with focus on prefabricated chunks.

Risk factors that may signify a propensity to the use of drugs in students at a public university

Introduction: We sought to evaluate the risk factors that may increase the propensity to use licit and illicit drugs among students at a public university. Methods: The project involved students (n = 268) enrolled in the first and fourth years of courses in the areas of the social and biological sciences at a public university. Data collection was conducted by means of self-administered, semistructured questionnaires, based on such standardized assessment instruments as Audit, Assist, Cage and Duse. Collected data were analyzed quantitatively by calculating the percentages and evaluating the data in terms of categories of risk, classifying them by age, gender, religion, schooling, use (before or after entering university) and contexts of use. By means of this survey the researchers were able to correlate the use of drugs to the risk factors that might increase the students’ propensity to use these substances. Results: The results revealed a high proportion of current drug-using students, but showed no significant differences between the first and fourth year students as regards contexts of use. However, 67% of students regarded the university environment as encouraging the use of drugs. Students pointed to such major risk factors as friends’ and fellow-students’ influence, university parties, excessive curiosity and desire to experiment. Conclusion: Due to the high rate of drug use among university students, by the determination of the risk factors related to the university environment and also knowing that the process of addiction is one of growing chemical dependence, the importance of the development and implementation of public health policies at all levels, especially in terms of approaches and specific interventions addressing this population, should be noted.

An empirical examination of the integration of causal attribution and social learning theories in achievement situations

Using path analysis, the present investigation sought to clarify possible operational linkages among constructs from social learning and attribution theories within the context of a self-esteem system. Subjects were 300 undergraduate university students who completed a measure of self-esteem and indicated expectancies for success and minimal goal levels for an experimental task. After completing the task and receiving feedback about their performance, subjects completed causal attribution and self-esteem questionnaires. Results revealed gender differences in the degree and strength of the proposed relations, but not in the mean levels of the variables studied. Results suggested that the integration of social learning and attribution theories within a single conceptual model provides a better understanding of students' behaviors and self-esteem in achievement situations.

THE RELATIONSHIP BETWEEN PARENTING STYLES, LEARNING AUTONOMY, AND SCHOLASTIC ACHIEVEMENT IN UNDERGRADUATE COLLEGE STUDENTS

Throughout the years, the role that parents play with regard to a child’s academic achievement has been the source of considerable research. The type of parenting style employed by parents, whether it is authoritarian, authoritative, or permissive, has and continues to be a major theme in these studies. One area of particular interest that has been overlooked in these studies, however, is the influence that parents may have on a student’s learning autonomy. Learning autonomy is the idea that a student has internal motivation to learn or achieve. The purpose of this study was to investigate therelationship among the three styles of parenting, learning autonomy, perceived parental autonomy support, and scholastic achievement in undergraduate college students. Sixty-one participants were recruited at a small liberal arts college in the northeastern United States to complete questionnaires, which measured perceived parental authority of the participants’ parents, perceived parental autonomy support, and students’ own learning autonomy. The participants were also asked to list their grade point average. The results revealed positive and negative correlations between many of the variables in the study;however, simple regression analyses did not yield any statistically significant relationships between parental authority, learning autonomy, perceived autonomy support, and scholastic achievement.

Improving learning by connecting chemistry curriculum to students' experiences

The purpose of the study was to design, implement, and assess the effects of a teaching unit about fuel sources and chemical energy on students’ learning. The unit was designed to incorporate students’ experiences in a way that was aligned with the Michigan High School Content Expectations. The study was completed with all of the students taking General Chemistry in a rural Michigan high school in the 2010-11 school year. There were 138 participants total. The participants were mostly Caucasian and the majority were in the 11th grade. Of these, 77 constituted the experimental group and were taught the unit. The additional 61 participants in the control group were given the posttest only. Data was derived from the results of pre/post tests, final assessment projects, and the researcher’s observations. A pretest that contained questions about the fuel sources was administered at the beginning of the unit. An identical posttest was administered at the completion of the unit. A final assessment project required students to choose the best fuel source for the area, and support their opinion with facts and data from their research or the learning activities and labs performed in class. The results of the study revealed that the teaching unit did produce significant learning gains in the experimental group. The results also indicated that the teaching unit added value to the current General Chemistry curriculum by expanding what students were learning. The instructional goals of the unit were aligned with the Michigan High School Content Expectations. The results also revealed that the students were able to learn to support their thinking and decisions with explanations based on the data and labs. These are essential science literacy skills. The study supported the view that connecting the required curriculum with students’ experiences and interests was effective, and that students can learn important science literacy skills, such as providing support for arguments and communicating scientific explanations, when given adequate teacher support.