Using the WWW to teach undergraduate nurses clinical communication

On-line learning is increasingly being used in nursing education. Nevertheless, there is still insufficient evidence to demonstrate: whether students respond positively when this form of learning is used to teach relatively practical or clinical subjects; whether it is effective; and whether it is fair to students with less access to, or familiarity with, computers and the internet. In 2003, an on-line Unit on clinical communication was developed for Australian undergraduate nurses in partnership between an Australian School of Nursing and the a Department of Clinical Psychology. Students were overwhelmingly positive in their evaluation of the Unit although some regretted the lack of face-to-face contact with tutors and peers. The best aspects of the Unit included the content and structure being perceived as interesting, fun and informative, the relevance of the material for them as nurses, flexibility to work independently, promotion of critical thinking and gaining an understanding of client issues. Neither their evaluation nor their final grades were related to students’ age or whether they preferred on-line or traditional learning. Students who had readily available computer access, however, had better final grades. Also, students’ grades were correlated with how often they accessed the Unit.

Afterschool MediaClub: Critical literacy in a high diversity, high poverty urban setting

In this chapter we present analyses of data produced with young people in an afterschool digital literacy program for 9 – 12 year olds. The young people were students at a high diversity, high poverty outer suburban elementary school in Queensland, Australia. The club was part of the URLearning research project (2010-14). In the classroom-based component of the project we worked with teachers to develop intellectually substantive and critical digital literacy practice. MediaClub was in some ways complementary to the classroom component; it was designed to skill up interested kids as digital media experts not only for their families and communities, but also for the classroom. Given the critical literacy traditions established in Australian schools, we approached MediaClub with certain critical expectations. In this chapter we look at what ensued, highlighting unanticipated critical outcomes at a time of heightened struggle over English curriculum. Critical literacy has been part of official English curriculum in Queensland since the early 1990s. The approach has been primarily text analytic, concerned with giving students access to genres of power and tools for understanding the ideological work of language through text. Many ideas for translating this normative critical project into classroom practice have been developed for use from the earliest elementary grades onwards. However, curricular space for critical literacy is under pressure. Amongst other things, this reflects both the development of Australia’s first national curriculum and the construction of a regimen of national literacy testing. At MediaClub we found a certain resistance to learning activities which were “too much like school”. However, in a context of increased control of teachers’ and students’ work in the classroom, MediaClub evolved as a learning space that can be understood in critical terms. Our experience in this regard might be of interest to teachers and researchers in high diversity high poverty settings that are strongly controlled through increasingly prescriptive – even scripted – pedagogies.

The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: A cross sectional study

BACKGROUND: Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. OBJECTIVES: To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. DESIGN: The study used a single-centre, cross-sectional survey design. SETTING and PARTICIPANTS: The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. METHODS: We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses’ Use of Physical Assessment scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value < .05 was considered significant for all analyses. RESULTS: Core skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F = 35.77, p < .001), lack of confidence (F = 5.52, p = .02), work area (F = 3.79, p = .002), and clinical role (F = 44.24, p < .001) were significant predictors of the extent of physical assessment skill use. CONCLUSIONS: The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses’ physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue comprehensive nursing assessment that could detect subtle changes in health status earlier in the patient's hospitalisation.

Class participation as a learning and assessment strategy in law : facilitating students’ engagement, skills development and deep learning

Assessment has widely been described as being ‘at the centre of the student experience’. It would be difficult to conceive of the modern teaching university without it. Assessment is accepted as one of the most important tools that an educator can deploy to influence both what and how students learn. Evidence suggests that how students allocate time and effort to tasks and to developing an understanding of the syllabus is affected by the method of assessment utilised and the weighting it is given. This is particularly significant in law schools where law students may be more preoccupied with achieving high grades in all courses than their counterparts from other disciplines. However, well-designed assessment can be seen as more than this. It can be a vehicle for encouraging students to learn and engage more broadly than with the minimums required to complete the assessment activity. In that sense assessment need not merely ‘drive’ learning, but can instead act as a catalyst for further learning beyond what a student had anticipated. In this article we reconsider the potential roles and benefits in legal education of a form of interactive classroom learning we term assessable class participation (‘ACP’), both as part of a pedagogy grounded in assessment and learning theory, and as a platform for developing broader autonomous approaches to learning amongst students. We also consider some of the barriers students can face in ACP and the ways in which teacher approaches to ACP can positively affect the socio-emotional climates in classrooms and thus reduce those barriers. We argue that the way in which a teacher facilitates ACP is critical to the ability to develop positive emotional and learning outcomes for law students, and for teachers themselves.

Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study

Objectives Medical and dental students experience poor psychological well-being relative to their peers. This study aimed to assess the psychological well-being among medical and dental students in Saudi Arabia, identify the high-risk groups and assess the association between the psychological well-being and the academic performance. Methods In this cross-sectional study, 422 preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia, were recruited to assess their depression, anxiety, stress, self-efficacy and satisfaction with life levels using 21-items Depression Anxiety Stress Scale (DASS-21), General Self-Efficacy (GSE) scale and Satisfaction With Life Scale (SWLS). Students’ academic weighted grades were obtained later. Descriptive statistics and univariate general linear model were used to analyse data. Results High levels of depression (69.9%), anxiety (66.4%) and stress (70.9%) were indicated, whereas self-efficacy (mean = 27.22, sd = 4.85) and life satisfaction (mean = 23.60, sd = 6.37) were within the normal range. Female medical students had higher psychological distress in contrast to dental students. In general, third-year students were more depressed and stressed in comparison with second-year students, except for stress among dental students. Moreover, all females had higher self-efficacy than males. Life satisfaction was higher within the second-year and high family income students. Depression was the only psychological variable correlated with the academic performance. Conclusion High levels of psychological distress were found. Female medical students had higher psychological distress than males, whereas male dental students had higher distress than female. Medical students at third year were more depressed and stressed. Dental students were more depressed in the third year, but more stressed in the second year. Attention should be directed towards reducing the alarming levels of depression, anxiety and stress among medical and dental students.

Regional versus urban differences in teenage alcohol use: Does parental disapproval account for these differences?

- Objective To investigate if parental disapproval of alcohol use accounts for differences in adolescent alcohol use across regional and urban communities. - Design Secondary data analysis of grade-level stratified data from a random sample of schools. - Setting High schools in Victoria, Australia. - Participants A random sample of 10273 adolescents from Grade 7 (mean age=12.51 years), 9 (14.46 years) and 11 (16.42 years). - Main outcome measures The key independent variables were parental disapproval of adolescent alcohol use and regionality (regional/ urban), and the dependent variable was past 30 days alcohol use. - Results After adjusting for potential confounders, adolescents in regional areas were more likely to use alcohol in the past 30 days (OR=1.83, 1.44 and 1.37 for Grades 7, 9 and 11, respectively, P<0.05), and their parents have a lower level of disapproval of their alcohol use (b=-0.12, -0.15 and -0.19 for Grades 7, 9 and 11, respectively, P<0.001). Bootstrapping analyses suggested that 8.37%, 23.30% and 39.22% of the effect of regionality on adolescent alcohol use was mediated by parental disapproval of alcohol use for Grades 7, 9 and 11 participants respectively (P<0.05). - Conclusions Adolescents in urban areas had a lower risk of alcohol use compared with their regional counterparts, and differences in parental disapproval of alcohol use contributed to this difference.

A probabilistic framework for analysing the compositionality of conceptual combinations

Conceptual combination performs a fundamental role in creating the broad range of compound phrases utilised in everyday language. While the systematicity and productivity of language provide a strong argument in favour of assuming compositionality, this very assumption is still regularly questioned in both cognitive science and philosophy. This article provides a novel probabilistic framework for assessing whether the semantics of conceptual combinations are compositional, and so can be considered as a function of the semantics of the constituent concepts, or not. Rather than adjudicating between different grades of compositionality, the framework presented here contributes formal methods for determining a clear dividing line between compositional and non-compositional semantics. Compositionality is equated with a joint probability distribution modelling how the constituent concepts in the combination are interpreted. Marginal selectivity is emphasised as a pivotal probabilistic constraint for the application of the Bell/CH and CHSH systems of inequalities (referred to collectively as Bell-type). Non-compositionality is then equated with either a failure of marginal selectivity, or, in the presence of marginal selectivity, with a violation of Bell-type inequalities. In both non-compositional scenarios, the conceptual combination cannot be modelled using a joint probability distribution with variables corresponding to the interpretation of the individual concepts. The framework is demonstrated by applying it to an empirical scenario of twenty-four non-lexicalised conceptual combinations.

Academic stress, parental pressure, anxiety and mental health among Indian high school students

This work investigates the academic stress and mental health of Indian high school students and the associations between various psychosocial factors and academic stress. A total of190 students from grades 11 and 12 (mean age: 16.72 years) from three government-aided and three private schools in Kolkata India were surveyed in the study. Data collection involved using a specially designed structured questionnaire as well as the General Health Questionnaire. Nearly two-thirds (63.5%) of the students reported stress due to academic pressure – with no significant differences across gender, age, grade, and several other personal factors. About two-thirds (66%) of the students reported feeling pressure from their parents for better academic performance. The degree of parental pressure experienced differed significantly across the educational levels of the parents, mother’s occupation, number of private tutors, and academic performance. In particular, children of fathers possessing a lower education level (non-graduates) were found to be more likely to perceive pressure for better academic performance. About one-thirds (32.6%) of the students were symptomatic of psychiatric caseness and 81.6% reported examination-related anxiety. Academic stress was positively correlated with parental pressure and psychiatric problems, while examination-related anxiety also was positively related to psychiatric problems. Academic stress is a serious issue which affects nearly two thirds of senior high school students in Kolkata. Potential methods for combating the challenges of academic pressure are suggested.

Do Students Not Care about Extra Credit Opportunities? Investigating Student Perceptions of Extra Credit Value vs. Effort

Giving “extra credit” work to students has been a controversial and hotly debated pedagogical issue for the last 20 years (Blood et al. 1993; Groves 2000; Muztaba Fuad and Jones 2012; Norcross et al. 1989; Weimer 2011). Previous work has focused on the faculty perspective discussing benefits and drawbacks associated with extra credit work (e.g. Hill et al. 1993; Norcross et al. 1989). Other scholars have investigated the use and effects of pop quizzes and other extra credit assignments on students’ final grades (Thorne 2000; Oley 1993). Some authors have criticized that the empirical exploration of understanding students’ motivational and performance efforts remains scarce and “rarely appears in the literature” (Mays and Bower 2005, p. 1). Besides a gap of empirical work it further appears that most existing studies stem from Psychology or Information Science. Yet it is surprising that, even though the topic of extra credit is considered a common practice in marketing education (Ackerman and Kiesler 2007), there is a wide gap within the marketing education literature. For example, a quick search in the Journal of Marketing Education for the keyword “extra credit” shows only 25 search results; yet none of those papers address motivational or performance effects of extra credit. A further search in Marketing Education Review yielded no results at all. To the authors’ knowledge, the topic has only been addressed once by Ackerman and Kiesler in the 2007 MEA Proceedings who conclude that for “such a common part of the marketing education curriculum, we know surprisingly little about its impact on students” (p. 123).

The impact of a self-development coaching programme on medical and dental students’ psychological health and academic performance: A randomised controlled trial

Background Psychological distress is well-documented worldwide among medical and dental students. Few studies have assessed the impact of self-development coaching programs on the students’ psychological health. The aim of the study was to evaluate the effect of a self-development coaching programme on the psychological health and academic performance of preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia. Methods Four-hundred and twenty-two participants (n = 422, 20–22 years) fulfilled the study requirements and were invited into a parallel-randomised controlled trial that was partially blinded. Participants were stratified by faculty, gender, and academic year, and then randomised. A total of 156 students participated in the intervention group (IG) and 163 students participated in the control group (CG). The IG received the selfdevelopment programme, involving skills and strategies aimed to improve students’ psychological health and academic performance, through a two-day workshop. Meanwhile, the CG attended an active placebo programme focussing on theoretical information that was delivered through a five-hour workshop. Both programmes were conducted by the same presenter during Week 1 of the second semester of the 2012–2013 academic year. Data were gathered immediately before (T1), one week after (T2) and five weeks (T3) after the intervention. Psychological health was measured using the Depression Anxiety Stress Scale (DASS-21), the General Self-Efficacy (GSE), and the Satisfaction With Life Scale (SWLS). Academic performance was measured using students’ academic weighted grades (WG). Student cognitive and emotional perceptions of the intervention were measured using the Credibility/Expectancy Questionnaire (CEQ). Results Data from 317 students, who completed the follow ups, were analysed across the three time periods (IG, n = 155; CG, n = 162). The baseline variables and demographic data of the IG and CG were not significantly different. The IG showed short-term significant reductions in depression and anxiety in compared to CG from T1 to T2. The short-term changes in stress, GSE and SWLS of the IG were not significantly different from those of the CG. While both groups showed a significant change on most of the psychological variables from T1 to T3, no significant differences were found between the groups in this period. In addition, no significant difference was found in WG between the IG and CG after the intervention. No harms relevant to the intervention were reported. Conclusion The investigated self-development coaching programme showed only a short-term improvement on depression and anxiety compared with an active control. There was no effect of the intervention on academic performance.

Mobile medical applications for melanoma risk assessment: False assurance or valuable tool?

With the smartphone revolution, consumer-focused mobile medical applications (apps) have flooded the market without restriction. We searched the market for commercially available apps on all mobile platforms that could provide automated risk analysis of the most serious skin cancer, melanoma. We tested 5 relevant apps against 15 images of previously excised skin lesions and compared the apps' risk grades to the known histopathologic diagnosis of the lesions. Two of the apps did not identify any of the melanomas. The remaining 3 apps obtained 80% sensitivity for melanoma risk identification; specificities for the 5 apps ranged from 20%-100%. Each app provided its own grading and recommendation scale and included a disclaimer recommending regular dermatologist evaluation regardless of the analysis outcome. The results indicate that autonomous lesion analysis is not yet ready for use as a triage tool. More concerning is the lack of restrictions and regulations for these applications.

Flow behavior of LDPE and its blends with LLDPE I and II: A comparative study

Studies on melt rheological properties of blends of low density polyethylene (LDPE) with selected grades of linear low density polyethylene (LLDPE), which differ widely in their melt flow indices, are reported, The data obtained in a capillary rheometer are presented to describe the effects of blend composition and shear rate on flow behavior index, melt viscosity, and melt elasticity. In general, blending of LLDPE I that has a low melt flow index (2 g/10 min) with LDPE results in a decrease of its melt viscosity, processing temperature, and the tendency of extrudate distortion, depending on blending ratio. A blending ratio around 20-30% LLDPE I seems optimum from the point of view of desirable improvement in processability behavior. On the other hand, blending of LLDPE II that has a high melt flow index (10 g/10 min) with LDPE offers a distinct advantage in increasing the pseudoplasticity of LDPE/LLDPE II blends.

Germination and hardseededness in desmanthus

The mechanisms and control of hardseededness in the 3 Australian cultivars of the genus Desmanthus were investigated in a series of experiments in which the effects of various seedsoftening treatments, particularly boiling water, were measured. Desmanthus seed is predominantly hard, only defective seeds being normally otherwise. As it has only very brief, early embryo dormancy, hardseededness is the only serious barrier to germination. Seed is most readily softened through rupture of the palisade at the lens (strophiole). The lens is of a typically mimosaceous type which is readily ruptured by immersion in boiling water or less readily by application of pressure to adjacent parts of the testa. Ruptures may consist only of separation of the palisade from underlying tissue, which alone does not confer permeability; mostly they also result in fractures to the palisade that then render seeds irreversibly permeable. The palisade becomes reflective as it separates, which allows the event to be witnessed at the moment of separation if suitable pressure is applied to the testa of an individual seed while it is viewed under magnification. Brief (4–10 seconds) immersion of highquality seed in boiling water consistently softened a high proportion of seeds without causing serious damage. Extending the duration of immersion led to a progressive increase in the proportion of seed deaths. Neither previous boiling water treatment nor scarification damage to the testa materially affected results of treatment, but immature and small seeds behaved differently, being more vulnerable to damage than mature seed, and less likely to undergo lens rupture. Adaptation of boiling water treatment to farm-scale seed handling was simple and reliable. Commercial treatment of seed by an alternative method suitable for greater bulks and consisting of passage through a rice-whitener was checked and found to be successful through a combination of gentle scarification and lens rupture, both attributable to the numerous minor impacts of the process. Percentage emergence of seedlings from soil in the greenhouse closely followed percentage laboratory germination, except when inferior seed grades were included in the comparison, when emergence was poor. Very little seed softened in soil. Already-permeable seed either germinated rapidly or died, while buried hard seed mostly remained hard and viable even more than a year after sowing.

The mycotoxins 4-deoxynivalenol, zearalenone and aflatoxin in weather-damaged wheat harvested 1983-1985 in south-east Queensland

A survey for various mycotoxins was carried out on samples of all wheat delivered to nine storage and marketing depots in south-eastern Queensland, selected as most likely to receive mycotoxin-contaminated grain. All wheat was surveyed during 1983, when the degree of weather damage was high. Samples of the poorest grade of wheat from these depots were also surveyed in 1984 and 1985. The surveys included all regions where head scab of wheat caused by Fusariurn graminearurn Schwabe Group 2 had been reported to occur at significant levels. 4-Deoxynivalenol was detected in nearly all pooled samples representing bulk wheat at concentrations ranging from traces of <0.01 up to 1.7 mg kg-1. The highest concentration of zearlenone detected in a pooled wheat sample was 0.04 mg kg-1. In a few samples representing individual wheat deliveries and with up to 2.8% by weight of pink grains, 4-deoxynivalenol concentrations ranged up to 11.7 mg kg-' and zearalenone up to 0.43 mg kg-l. Aflatoxins B,, B2, G1 and G2 were detected in only one pooled sample of wheat, at a total aflatoxin concentration of 0.003 mg kg-'. Ochratoxin A, sterigmatocystin and T-2 toxin were not detected. Higher concentrations of mycotoxins were found in the poorer grades of wheat.

Assessing performance in critical care nursing practice using the Benner Novice to expert model: A pilot study

Background It is often believed that by ensuring the ongoing completion of competency documents and life-long learning in nursing practice guarantees quality patient care. This is probably true in most cases where it provides reassurances that the nursing team is maintaining a safe “generalised” level of practice. However, competency does not always promise quality performance. There are a number of studies that have reported differences in what practitioners know and what they actually do despite being deemed competent. Aim The aim of this study was to assess whether our current competency documentation is fit for purpose and to ascertain whether performance assessment needs to be a key component in determining competence. Method 15 nurses within a General ICU who had been on the unit <4 years agreed to participate in this project. Using participant observation and assessing performance against key indicators of the Benner Novice to Expert5 model the participants were supported and assessed over the course of a ‘normal’ nursing shift. Results The results were surprising both positively and negatively. First, the nurses felt more empowered in their clinical decision making skills; second, it identified individual learning needs and milestones in educational development. There were some key challenges identified which included 5 nurses over estimating their level of competence, practice was still very much focused on task acquisition and skill and surprisingly some nurses still felt dominated by the other health professionals within the unit. Conclusion We found that the capacity and capabilities of our nursing workforce needs continual ongoing support especially if we want to move our staff from capable task-doer to competent performers. Using the key novice to expert indicators identified the way forward for us in how we assess performance and competence in practice particularly where promotion to higher grades is based on existing documentation.