Health care professionals' views of paediatric outpatient non-attendance:implications for general practice

Background. Non-attendance at paediatric hospital outpatient appointments poses potential risks to children's health and welfare. Prevention and management of missed appointments depends on the perceptions of clinicians and decision makers from both primary and secondary care, including general practitioners (GPs) who are integral to non-attendance follow-up. Objectives. To examine the views of clinical, managerial and executive health care staff regarding occurrence and management of non-attendance at general paediatric outpatient clinics. Methods. A qualitative study using individual semi-structured interviews was carried out at three English Primary Care Trusts and a nearby children's hospital. Interviews were conducted with 37 staff, including GPs, hospital doctors, other health care professionals, managers, executives and commissioners. Participants were recruited through purposive and 'snowball' sampling methods. Data were analysed following a thematic framework approach. Results. GPs focused on situational difficulties for families, while hospital-based staff emphasized the influence of parents' beliefs on attendance. Managers, executives and commissioners presented a broad overview of both factors, but with less detailed views. All groups discussed sociodemographic factors, with non-attendance thought to be more likely in 'chaotic families'. Hospital interviewees emphasized child protection issues and the need for thorough follow-up of missed appointments. However, GPs were reluctant to interfere with parental responsibilities. Conclusion. Parental motivation and practical and social barriers should be considered. Responsibilities regarding missed appointments are not clear across health care sectors, but GPs are uniquely placed to address non-attendance issues and are central to child safeguarding. Primary care policies and strategies could be introduced to reduce non-attendance and ensure children receive the care they require. © The Author 2013.

The UK MPharm (2) - Do we over assess?

Introduction-The pace of structural change in the UK health economies, the new focus on regulation and the breaking down of professional boundaries means that the Royal Pharmaceutical Society of Great Britain (RPSGB) has to continually review the scope, range and outputs of education provided by schools of pharmacy (SOPs). In SOPs, the focus is on equipping students with the knowledge, skills and attitudes necessary to successfully engage with the pre-registration year. The aim of this study [1] was to map current programmes and undergraduate experiences to inform the RPSGB debate. The specific objectives of this paper are to describe elements of the survey of final year undergraduates, to explore student opinions and experiences of their workload, teaching, learning and assessment. Material and methods-The three main research techniques were: (1) quantitative course document review, (2) qualitative staff interview and (3) quantitative student self completion survey. The questions in the survey were based on findings from exploratory focus group work with BPSA (British Pharmaceutical Students’ Association) members and were designed to ascertain if views expressed in the focus groups on the volume and format of assessments were held by the general student cohort. The student self completion questionnaire consisting of 31 questions, was administered in 2005 to all (n=1847) final year undergraduates, using a pragmatic mixture of methods. The sample was 15 SOPs within the UK (1 SOP opted out). The total response rate was 50.62% (n=935): it varied by SOP from 14.42% to 84.62%. The survey data were analysed (n=741) using SPSS, excluding non-UK students who may have undertaken part of their studies within a non-UK university. Results and discussion • 76% (n=562) respondents considered that the amount of formal assessment was about right, 21% (n=158) thought it was too much. • There was agreement that the MPharm seems to have more assessment than other courses, with 63% (n=463) strongly agreeing or agreeing. • The majority considered the balance between examinations and coursework was about right (67%, n=498), with 27% (n=198) agreeing that the balance was too far weighted towards examinations. • 57% (n=421) agreed that the focus of MPharm assessment was too much towards memorised knowledge, 40% (n=290) that it was about right. • 78% (n= 575) agreed with the statement “Assessments don’t measure the skills for being a pharmacist they just measure your knowledge base”. Only 10% (n=77) disagreed. • Similarly 49% (n=358) disagreed with, and 35% (n=256) were not sure about the statement “I consider that the assessments used in the MPharm course adequately measure the skills necessary to be a pharmacist”. Only 17% (n=124) agreed. Experience from this study shows the difficulty of administering survey instruments through UK Schools of Pharmacy. It is heavily dependent on timing, goodwill and finding the right person. The variability of the response rate between SOPs precluded any detailed analysis by School. Nevertheless, there are some interesting results. Issues raised in the exploratory focus group work about amount of assessment and over reliance on knowledge have been confirmed. There is a real debate to be had about the extent to which the undergraduate course, which must instil scientific knowledge, can provide students with the requisite qualities, skills, attitudes and behaviour that are more easily acquired in the pre-registration year. References [1] Wilson K, Jesson J, Langley C, Clarke L, Hatfield K. MPharm Programmes: Where are we now? Report commissioned by the Pharmacy Practice Research Trust., 2005.

Challenges of Teaching Written Communication in the Cloud

Report published in the Proceedings of the National Conference on "Education and Research in the Information Society", Plovdiv, May, 2014

Learner support and discovery in a virtual non-judgmental environment

This thesis is a qualitative case study that draws upon a grounded genre analysis approach situated within the social constructivist paradigm. The study describes the various obligatory, desired, and optional moves used by post-graduate students as they interacted within an online, non-judgmental environment in order to seek solutions to issues they were experiencing with their research projects or teaching. The postgraduate students or case participants met individually online with me at pre-arranged times to take part in Instant Messenger Cooperative Development (IMCD) (Boon, 2005) 30-minute to one hour sessions via the text-chat function of Skype. Participants took on the role of ‘Explorer’ in order to articulate their thoughts and ideas about their research. I took on the role of ‘Understander’ to provide support to each Explorer by reflecting my understanding of the ongoing articulations as the Explorers investigated their specific issues, determined possible ways to overcome them, made new discoveries, and formulated plans of action regarding the best way for them to move forward. The description of generic moves covers 32 IMCD sessions collected over a threeyear period (2009-2012) from 10 different participants (A-J). Data collected is drawn from live IMCD sessions, field notes, and post-session email feedback from participants. In particular, the thesis focuses on describing the specific generic moves of Explorers within IMCD sessions as they seek satisfactory resolutions to particular research or pedagogic puzzles. It also provides a detailed description of a longitudinal case (Participant A – four sessions), a one-session case (Participant B – one session), and an outlier case in which the Explorer underwent a negative IMCD experience. The thesis concludes by arguing that IMCD is a highly effective tool that helps facilitate the research process for both distance-learning and on-campus students and has the potential to be utilized across all disciplines at the tertiary level.

Transforming the relationship between staff and students to effect change

This opinion piece argues for the necessity of student-staff partnerships that go beyond the common rhetoric of ‘student engagement’, achieving a richer student and staff dialogue which results in more meaningful change in policy and practice. In particular, attention is drawn to the need for such partnerships when determining technology applications that are often missed out from, or treated in isolation from, the curriculum design process. This piece cites, as an example, a student-led taught day on the Post Graduate Diploma in Learning and Teaching at Aston University in July 2015. There was clear evidence that the staff participants designed their assessments with student partners in mind. It is therefore proposed that a partnership relationship offers an effective means of moving forward from common practices where technology simply replicates, or supplements, traditional activities.

Hiring Schedule: Deans Office, Finance and Administration, Teaching Faculty Y1 and Y2, Clinical Sciences

A hiring schedule for the Dean's Office based on a three year plan.

The choice not to use computers: A case study of community college faculty who do not use computers in teaching

The primary purpose of this investigation is to study the motives of community college faculty who decide not to use computers in teaching. In spite of the fact that many of the environmental blocks that would otherwise inhibit the use of the computers have been eliminated at many institutions, many faculty do not use a computer beyond its word-processing function. For the purpose of the study non-adoption of computers in teaching is defined as not using computers for more than word-processing. ^ The issues in the literature focus on resistance and assume a pro-innovation and pro-adoption bias. Previous research on the questions is primarily surveys with narrowly focused assumptions. This qualitative research directly asks the participants about their feelings, beliefs, attitudes, experiences, and behaviors in regard to computers in teaching. Through the interview process a number of other correlated issues emerge. ^ The investigation was conducted at Miami-Dade Community College, a large urban multicampus institution, in Miami-Dade, Florida. It was conducted through a series of in-depth phenomenological interviews. There were nine interviews; eight within the profile; two were pilots; and one was an extreme opposite of the profile. Each participant was interviewed three times for about 45 minutes. ^ The results indicate that the computer conflicts with the participants' values in regard to their teaching and their beliefs in regard to the nature of knowledge, learning, and the relationship that they wish to maintain with students. Computers require significant changes in the values, beliefs, and consequent behaviors. These are changes that the participants are not willing to make without overwhelming evidence that they are worth the sacrifice. For the participants, this worth is only definable as it positively improves learning. For even the experts the evidence is not there. Unlike the innovator, the high end computer user, these participants are not willing to adopt the computer on faith. ^

The effects of a professional development course on the teaching practices of P--12 classroom teachers

This follow-up study examined the long term effects of a staff development model on P–12 classroom teachers' instructional practices and dispositions regarding a curricular innovation. The sample, 44 private school practitioners who participated in the staff development program that used the model, was administered a survey at three checkpoints over a three year period to gather quantitative data regarding the participants' concerns about the curricular innovation. A comparison group of 19 practitioners also completed the survey. Qualitative data, gathered through interviews conducted with ten of the 44 participants, contributed to understanding the participants' perspectives on changes they perceived in their teaching practices as a result of the staff development. Elements of the model that were most instrumental in effecting those changes were identified. ^ The findings indicated that the participants demonstrated changes in the quality of their concerns, moving from self concerns and task concerns to impact concerns immediately following the training. The decrease in self concerns was sustained three years after the staff development, while task concerns increased and impact concerns returned to pre staff development levels. A significant difference in stages of concern between the participant and the comparison groups was noted at self and impact stages. ^ Findings revealed that participants changed their teaching practices and beliefs about instructional processes as a result of the staff development, becoming more collaborative and confident in implementing innovative approaches; they were perceived as leaders among their peers. Elements of the staff development model that participants identified as being influential in the change process included the opportunity for collaboration, authenticity of the training activities, and ongoing and comprehensive nature of the training. ^

Comparative Analysis of State and Non-State Higher Educational Institutions in Terms of their Adaptation to New Societal Conditions in Post-Soviet Russia

The present paper investigates post-Soviet non-state and state higher educational institutions in terms of students’ perceptions of school curriculum, quality of teaching, available educational resources and overall organization in their higher educational institutions.

A Professional Development Model to Promote Internet Integration in P-12 Teaching Practices

This mixed-methods study examined effects of a staff development model on instructional practices and dispositions of P-12 teachers. The model design was guided by participants’ varying developmental levels and their values and beliefs about teaching and learning. The study adds to our understanding of the need for teacher-centered professional development.

Roadblocks to Teaching English as a Foreign Language in a Climate of Accelerated Curricular Change

This paper examines the global "English craze," in which non-Englishspeaking countries, especially in Asia, East Asia, and the Middle East, are engaged in a concerted push to get the language taught more widely and at increasingly lower grade levels. The goal of this paper is to document how this phenomenon has impacted teachers of English as a Foreign Language and how they can try to alleviate these problems.

An Analysis of the Proposition Density, Sentence and Clause Types, and Non-Finite Verbal Usage in Two College Textbooks

This study investigated the proposition density, sentence and clause type usage and non-finite verbal usage in two college textbooks. The teaching implications are presented.

Evoking non-repertory verbal behavior across operant classes : the effects of motor echoic sign language training within the context of a motivating operation

The individual effects that echoic, mand, and sign language training procedures have on the acquisition of verbal behavior have been widely demonstrated, but more efficient strategies are still needed. This study combined all three treatment strategies into one treatment intervention in order to investigate the joint effects they may have on verbal behavior. Six participants took part in the study. Intervention totaled 1 hour/day for 5 days/week until mastery criterion for motor echoic behavior was achieved. Although motor echoic behavior were solely targeted for acquisition, significant increases in spontaneous motor mands were noted in all treatment participants. Additionally, 4 treatment participants also demonstrated significant gains in vocal echoics and spontaneous vocal mands. No significant increases were noted for the control participant. Results suggest that the aforementioned procedure may provide more efficient results as a first-step to teaching a functional repertoire of verbal behavior to developmentally delayed children.

An investigation of the relationships among self-care behaviors, health beliefs, and metabolic control in the non-insulin-dependent diabetic adult

Self-care and health beliefs have been found to be important concepts in the management of chronic diseases such as diabetes mellitus. Poor metabolic control has been associated with a higher incidence of complications in diabetic patients. This study sought to explore any relationships among perceptions of self-care behaviors, health beliefs and metabolic control. The sample consisted of 52 outpatients with non-insulin-dependent diabetes from a large teaching medical center. Interviews were done to obtain the patients' perceptions of their self-care behaviors, and their health beliefs concerning diabetes. Results of glycosylated hemoglobin and/or serum glucose levels were obtained from the medical records. Data were analyzed using Cochran-Mantel-Haenzel statistics, and Pearson's r. Results indicated no significant relationships among perceptions of self-care behaviors, health beliefs and metabolic control. Ethnicity, education and gender were found to be significantly associated with self-care behaviors and health beliefs.

Learning and accepting quantum physics. Re-analysis of a teaching proposal

Nella tesi è analizzata nel dettaglio una proposta didattica sulla Fisica Quantistica elaborata dal gruppo di ricerca in Didattica della Fisica dell’Università di Bologna, in collaborazione con il gruppo di ricerca in Fisica Teorica e con ricercatori del CNR di Bologna. La proposta è stata sperimentata in diverse classi V di Liceo scientifico e dalle sperimentazioni sono emersi casi significativi di studenti che non sono riusciti ad accettare la teoria quantistica come descrizione convincente ad affidabile della realtà fisica (casi di non accettazione), nonostante sembrassero aver capito la maggior parte degli argomenti e essersi ‘appropriati’ del percorso per come gli era stato proposto. Da questa evidenza sono state formulate due domande di ricerca: (1) qual è la natura di questa non accettazione? Rispecchia una presa di posizione epistemologica o è espressione di una mancanza di comprensione profonda? (2) Nel secondo caso, è possibile individuare precisi meccanismi cognitivi che possono ostacolare o facilitare l’accettazione della fisica quantistica? L’analisi di interviste individuali degli studenti ha permesso di mettere in luce tre principali esigenze cognitive (cognitive needs) che sembrano essere coinvolte nell’accettazione e nell’apprendimento della fisica quantistica: le esigenze di visualizzabilità, comparabilità e di ‘realtà’. I ‘cognitive needs’ sono stati quindi utilizzati come strumenti di analisi delle diverse proposte didattiche in letteratura e del percorso di Bologna, al fine di metterne in luce le criticità. Sono state infine avanzate alcune proposte per un suo miglioramento.