Mortality and cost outcomes of elderly trauma patients admitted to intensive care and the general wards of an Australian tertiary referral hospital

Mortality and cost outcomes of elderly intensive care unit (ICU) trauma patients were characterised in a retrospective cohort study from an Australian tertiary ICU. Trauma patients admitted between January 2000 and December 2005 were grouped into three major age categories: aged ≥65 years admitted into ICU (n=272); aged ≥65 years admitted into general ward (n=610) and aged <65 years admitted into ICU (n=1617). Hospital mortality predictors were characterised as odds ratios (OR) using logistic regression. The impact of predictor variables on (log) total hospital-stay costs was determined using least squares regression. An alternate treatment-effects regression model estimated the mortality cost-effect as an endogenous variable. Mortality predictors (P ≤0.0001, comparator: ICU ≥65 years, ventilated) were: ICU <65 not-ventilated (OR 0.014); ICU <65 ventilated (OR 0.090); ICU age ≥65 not-ventilated (OR 0.061) and ward ≥65 (OR 0.086); increasing injury severity score and increased Charlson comorbidity index of 1 and 2, compared with zero (OR 2.21 [1.40 to 3.48] and OR 2.57 [1.45 to 4.55]). The raw mean daily ICU and hospital costs in A$ 2005 (US$) for age <65 and ≥65 to ICU, and ≥65 to the ward were; for year 2000: ICU, $2717 (1462) and $2777 (1494); hospital, $1837 (988) and $1590 (855); ward $933 (502); for year 2005: ICU, $3202 (2393) and $3086 (2307); hospital, $1938 (1449) and $1914 (1431); ward $1180 (882). Cost increments were predicted by age ≥65 and ICU admission, increasing injury severity score, mechanical ventilation, Charlson comorbidity index increments and hospital survival. Mortalitycost-effect was estimated at -63% by least squares regression and -82% by treatment-effects regression model. Patient demographic factors, injury severity and its consequences predict both cost and survival in trauma. The cost mortality effect was biased upwards by conventional least squares regression estimation.

Characterising one-to-one conservatoire teaching : Some implications of a quantitative analysis

Despite the significant recent growth in research relating to instrumental, vocal and composition tuition in higher education, little is known about the diversity of approaches that characterise one-to-one teaching in the Conservatoire, and what counts as optimal practice for educating 21st-century musicians. Through analysis of video-recorded one-to-one lessons that draws on a ‘bottom up’ methodology for characterising pedagogical practices (Taylor, 2012; Taylor et al, 2012), this paper provides empirical evidence about the nature of one-to-one pedagogy in one Australian institution. The research aims (1) to enable a better understanding of current one-to-one conservatoire teaching; and (2) to build and improve upon existing teaching practice using authentic insights gained through systematic investigation. The authors hope the research will lead to a better understanding of the diversity and efficacy of the pedagogical practice within the specific context in which the study was conducted, and beyond, to Conservatoire pedagogy generally.

Food insecurity : is it an issue among tertiary students

Insufficient access to food is known to compromise tertiary studies. Students often belong to groups known to have poor food security such as those renting or relying on government payments. The present study administered a cross-sectional survey incorporating the USDA food security survey module (FSSM) to 810 students at a metropolitan university in Brisbane, Australia. One in four students indicated they were food insecure, this being double that previously reported for tertiary students and five times that previously reported for the general population. Factors associated with food insecurity included low income, reliance on government support and renting. Students from food insecure households were twice as likely to report only fair or poor general health and three times as likely to have deferred their studies due to financial difficulties. Further, at least 80 % of these students reported that their studies were compromised. Strategies to alleviate food insecurity among students could improve retention rates and educational outcomes.

Collaborative learning and critical thinking in technology-enhanced environments : an instructional design framework

The nature and characteristics of how learners learn today are changing. As technology use in learning and teaching continues to grow, its integration to facilitate deep learning and critical thinking becomes a primary consideration. The implications for learner use, implementation strategies, design of integration frameworks and evaluation of their effectiveness in learning environments cannot be overlooked. This study specifically looked at the impact that technology-enhanced learning environments have on different learners’ critical thinking in relation to eductive ability, technological self-efficacy, and approaches to learning and motivation in collaborative groups. These were explored within an instructional design framework called CoLeCTTE (collaborative learning and critical thinking in technology-enhanced environments) which was proposed, revised and used across three cases. The field of investigation was restricted to three key questions: 1) Do learner skill bases (learning approach and eductive ability) influence critical thinking within the proposed CoLeCTTE framework? If so, how?; 2) Do learning technologies influence the facilitation of deep learning and critical thinking within the proposed CoLeCTTE framework? If so, how?; and 3) How might learning be designed to facilitate the acquisition of deep learning and critical thinking within a technology-enabled collaborative environment? The rationale, assumptions and method of research for using a mixed method and naturalistic case study approach are discussed; and three cases are explored and analysed. The study was conducted at the tertiary level (undergraduate and postgraduate) where participants were engaged in critical technical discourse within their own disciplines. Group behaviour was observed and coded, attributes or skill bases were measured, and participants interviewed to acquire deeper insights into their experiences. A progressive case study approach was used, allowing case investigation to be implemented in a "ladder-like" manner. Cases 1 and 2 used the proposed CoLeCTTE framework with more in-depth analysis conducted for Case 2 resulting in a revision of the CoLeCTTE framework. Case 3 used the revised CoLeCTTE framework and in-depth analysis was conducted. The findings led to the final version of the framework. In Cases 1, 2 and 3, content analysis of group work was conducted to determine critical thinking performance. Thus, the researcher used three small groups where learner skill bases of eductive ability, technological self-efficacy, and approaches to learning and motivation were measured. Cases 2 and 3 participants were interviewed and observations provided more in-depth analysis. The main outcome of this study is analysis of the nature of critical thinking within collaborative groups and technology-enhanced environments positioned in a theoretical instructional design framework called CoLeCTTE. The findings of the study revealed the importance of the Achieving Motive dimension of a student’s learning approach and how direct intervention and strategies can positively influence critical thinking performance. The findings also identified factors that can adversely affect critical thinking performance and include poor learning skills, frustration, stress and poor self-confidence, prioritisations over learning; and inadequate appropriation of group role and tasks. These findings are set out as instructional design guidelines for the judicious integration of learning technologies into learning and teaching practice for higher education that will support deep learning and critical thinking in collaborative groups. These guidelines are presented in two key areas: technology and tools; and activity design, monitoring, control and feedback.

Building the computer mediated distance learning community: Issues and observations drawn from teaching and learning

This paper discusses computer mediated distance learning on a Master's level course in the UK and student perceptions of this as a quality learning environment.

Teaching end-user remote online searching

The Queensland University of Technology (QUT) Library bas recently commenced teaching higher degree students to search online systems such as BRS, ORBIT and STN. The emphasis is on education rather than training. with students being required to familiarise themselves with system commands and database structures whilst receiving necessarily limited tutorial help. The teaching strategies used and problems encountered in the program are outlined. Student responses to the experience of learning to online search are discussed.

Planning to Manage My Teaching in a Democratic Classroom

Preservice teachers consistently report that managing student behaviour is one of their major concerns prior to and during practicum (Capel, 1997; Kyriacou & Stephens, 1999). Not surprisingly, preservice teachers are keen to gain knowledge and understanding of effective classroom management approaches that facilitate the development of positive learning environments in which students are engaged in learning. Establishing democratic teaching practices that allow student choice, communicating in a positive, helpful manner, ensuring the right to teach and the right to learn without disruptions is upheld, and promoting self-discipline are important steps in preventing misbehavior and developing a democratic community of learners.

Community college faculty's teaching social networks and their implications for librarians

Collaboration between faculty and librarians is an important topic of discussion and research among academic librarians. These partnerships between faculty and librarians are vital for enabling students to become lifelong learners through their information literacy education. This research developed an understanding of academic collaborators by analyzing a community college faculty's teaching social networks. A teaching social network, an original term generated in this study, is comprised of communications that influence faculty when they design and deliver their courses. The communication may be formal (e.g., through scholarly journals and professional development activities) and informal (e.g., through personal communication) through their network elements. Examples of the elements of a teaching social network may be department faculty, administration, librarians, professional development, and students. This research asked 'What is the nature of faculty's teaching social networks and what are the implications for librarians?' This study moves forward the existing research on collaboration, information literacy, and social network analysis. It provides both faculty and librarians with added insight into their existing and potential relationships. This research was undertaken using mixed methods. Social network analysis was the quantitative data collection methodology and the interview method was the qualitative technique. For the social network analysis data, a survey was sent to full-time faculty at Las Positas College, a community college, in California. The survey gathered the data and described the teaching social networks for faculty with respect to their teaching methods and content taught. Semi-structured interviews were conducted following the survey with a sub-set of survey respondents to understand why specific elements were included in their teaching social networks and to learn of ways for librarians to become an integral part of the teaching social networks. The majority of the faculty respondents were moderately influenced by the elements of their network except the majority of the potentials were weakly influenced by the elements in their network in their content taught. The elements with the most influence on both teaching methods and content taught were students, department faculty, professional development, and former graduate professors and coursework. The elements with the least influence on both aspects were public or academic librarians, and social media. The most popular roles for the elements were conversations about teaching, sharing ideas, tips for teaching, insights into teaching, suggestions for ways of teaching, and how to engage students. Librarians' weakly influenced faculty in their teaching methods and their content taught. The motivating factors for collaboration with librarians were that students learned how to research, students' research projects improved, faculty saved time by having librarians provide the instruction to students, and faculty built strong working relationships with librarians. The challenges of collaborating with librarians were inadequate teaching techniques used when librarians taught research orientations and lack of time. Ways librarians can be more integral in faculty's teaching social networks included: more workshops for faculty, more proactive interaction with faculty, and more one-on-one training sessions for faculty. Some of the recommendations for the librarians from this study were develop a strong rapport with faculty, librarians should build their services in information literacy from the point of view of the faculty instead of from the librarian perspective, use staff development funding to attend conferences and workshops to improve their teaching, develop more training sessions for faculty, increase marketing efforts of the librarian's instructional services, and seek grant opportunities to increase funding for the library. In addition, librarians and faculty should review the definitions of information literacy and move from a skills based interpretation to a learning process.

Creative entrepreneurship education for graduate employability in the creative arts

The higher education sector in Australia is under increasing pressure to prove quality and efficacy of education provision, including graduate outcomes. One of the central tasks of higher education has become to prepare nascent professionals as far as possible for initial employment and future working lives beyond this (Boden & Nedeva, 2010). Tertiary educators in the creative arts face significant and distinctive challenges in demonstrating graduate employability, and creative graduates consistently have the poorest outcomes of any subject grouping. In part, this is because the national graduate destinations survey (Graduate Careers Council of Australia, 2012) does not cater to the distinctive ‘portfolio’ nature of creative careers, or take account of the fact that creative careers can take concerted effort over several years to establish (e.g., McCowan & Wyganowska, 2010). However, it is worth asking whether we as tertiary arts educators are doing enough to prepare creative arts students for the world of work, particularly given that the majority of them will be self-employed to some degree (Bureau of Labour Statistics, 2011, Throsby & Zednik, 2010), and will be challenged to build their own careers without recourse to the support of HR departments or intra-firm promotion schemes. It has been demonstrated empirically that career management and creative enterprise skills are among the most important graduate capabilities in determining early creative career success (Bridgstock, 2011), although these skills do not appear in the Learning and Teaching Academic Standards for the Creative and Performing Arts (2010). This paper explores the nature and development of enterprise capabilities for creative arts students (as distinct from students of the business school), examines best practice in the field internationally, and proposes a theoretically-driven creative arts-specific enterprise curriculum model which commences in first year, for demonstrable impact on student enterprise behaviours (such as grant seeking, professional networking and intention to start an enterprise) and employability.

An investigation of moderation practices within a faculty of education

Moderation of student assessment is a critical component of teaching and learning in contemporary universities. In higher education, moderation is usually governed by university-wide policies and practices. However, in Australia, moderation processes will now be guided by the new national university accreditation authority, Tertiary Education Quality and Standards Agency (TEQSA). In light of this reform, the purpose of this qualitative study was to identify and analyse current moderation practices operating within a faculty of education at a large urban university in eastern Australia.

Mixing higher education teaching and learning with mobile devices and social media

The use of mobile devices and social media technologies are becoming all-pervasive in society: they are both transformative and constant. The high levels of mobile device ownership and increased access to social media technologies enables the potential for ‘anytime, anywhere’ cooperation and collaboration in education. While recent reports into emerging technologies in higher education predict an increase in the use of mobile devices and social media technologies (Horizon Report, 2013), there is a lack of theory-based research to indicate how these technologies can be most effectively harnessed to support and enhance student learning and what the impacts of these technologies are on both students and educators. In response to the need to understand how these technologies can be better embraced within higher education, this study investigated how first year education students used mobile devices and social media technologies. More specifically, the study identified how students spent most of their time when connected online with mobile devices and social media technologies and whether the online connected time engaged them in their learning or whether it was a distraction.

Investigating the impact of a leadership development program for nurse unit managers on the satisfaction of nursing staff

Background and significance: Nurses' job dissatisfaction is associated with negative nursing and patient outcomes. One of the most powerful reasons for nurses to stay in an organisation is satisfaction with leadership. However, nurses are frequently promoted to leadership positions without appropriate preparation for the role. Although a number of leadership programs have been described, none have been tested for effectiveness, using a randomised control trial methodology. Aims: The aims of this research were to develop an evidence based leadership program and to test its effectiveness on nurse unit managers' (NUMs') and nursing staff's (NS's) job satisfaction, and on the leader behaviour scores of nurse unit managers. Methods: First, the study used a comprehensive literature review to examine the evidence on job satisfaction, leadership and front-line manager competencies. From this evidence a summary of leadership practices was developed to construct a two component leadership model. The components of this model were then combined with the evidence distilled from previous leadership development programs to develop a Leadership Development Program (LDP). This evidence integrated the program's design, its contents, teaching strategies and learning environment. Central to the LDP were the evidence-based leadership practices associated with increasing nurses' job satisfaction. A randomised controlled trial (RCT) design was employed for this research to test the effectiveness of the LDP. A RCT is one of the most powerful tools of research and the use of this method makes this study unique, as a RCT has never been used previously to evaluate any leadership program for front-line nurse managers. Thirty-nine consenting nurse unit managers from a large tertiary hospital were randomly allocated to receive either the leadership program or only the program's written information about leadership. Demographic baseline data were collected from participants in the NUM groups and the nursing staff who reported to them. Validated questionnaires measuring job satisfaction and leader behaviours were administered at baseline, at three months after the commencement of the intervention and at six months after the commencement of the intervention, to the nurse unit managers and to the NS. Independent and paired t-tests were used to analyse continuous outcome variables and Chi Square tests were used for categorical data. Results: The study found that the nurse unit managers' overall job satisfaction score was higher at 3-months (p = 0.016) and at 6-months p = 0.027) post commencement of the intervention in the intervention group compared with the control group. Similarly, at 3-months testing, mean scores in the intervention group were higher in five of the six "positive" sub-categories of the leader behaviour scale when compared to the control group. There was a significant difference in one sub-category; effectiveness, p = 0.015. No differences were observed in leadership behaviour scores between groups by 6-months post commencement of the intervention. Over time, at three month and six month testing there were significant increases in four transformational leader behaviour scores and in one positive transactional leader behaviour scores in the intervention group. Over time at 3-month testing, there were significant increases in the three leader behaviour outcome scores, however at 6-months testing; only one of these leader behaviour outcome scores remained significantly increased. Job satisfaction scores were not significantly increased between the NS groups at three months and at six months post commencement of the intervention. However, over time within the intervention group at 6-month testing there was a significant increase in job satisfaction scores of NS. There were no significant increases in NUM leader behaviour scores in the intervention group, as rated by the nursing staff who reported to them. Over time, at 3-month testing, NS rated nurse unit managers' leader behaviour scores significantly lower in two leader behaviours and two leader behaviour outcome scores. At 6-month testing, over time, one leader behaviour score was rated significantly lower and the nontransactional leader behaviour was rated significantly higher. Discussion: The study represents the first attempt to test the effectiveness of a leadership development program (LDP) for nurse unit managers using a RCT. The program's design, contents, teaching strategies and learning environment were based on a summary of the literature. The overall improvement in role satisfaction was sustained for at least 6-months post intervention. The study's results may reflect the program's evidence-based approach to developing the LDP, which increased the nurse unit managers' confidence in their role and thereby their job satisfaction. Two other factors possibly contributed to nurse unit managers' increased job satisfaction scores. These are: the program's teaching strategies, which included the involvement of the executive nursing team of the hospital, and the fact that the LDP provided recognition of the importance of the NUM role within the hospital. Consequently, participating in the program may have led to nurse unit managers feeling valued and rewarded for their service; hence more satisfied. Leadership behaviours remaining unchanged between groups at the 6 months data collection time may relate to the LDP needing to be conducted for a longer time period. This is suggested because within the intervention group, over time, at 3 and 6 months there were significant increases in self-reported leader behaviours. The lack of significant changes in leader behaviour scores between groups may equally signify that leader behaviours require different interventions to achieve change. Nursing staff results suggest that the LDP's design needs to consider involving NS in the program's aims and progress from the outset. It is also possible that by including regular feedback from NS to the nurse unit managers during the LDP that NS's job satisfaction and their perception of nurse unit managers' leader behaviours may alter. Conclusion/Implications: This study highlights the value of providing an evidence-based leadership program to nurse unit managers to increase their job satisfaction. The evidence based leadership program increased job satisfaction but its effect on leadership behaviour was only seen over time. Further research is required to test interventions which attempt to change leader behaviours. Also further research on NS' job satisfaction is required to test the indirect effects of LDP on NS whose nurse unit managers participate in LDPs.

Learner strategy instruction and student uptake of strategies in a Japanese as a foreign language context

The Japanese language is recognised as being more difficult than European languages, needing three times more tuition time to reach comparable levels of proficiency. Encouraging Japanese as a Foreign Language (JFL) students to become aware of, and effectively use, learner strategies is one way to assist them become more controlled, effective learners leading to enhanced language learning. This thesis investigates the development and implementation of a JFL curriculum implemented in a university course for students learning JFL. The curriculum was developed specifically to assist beginner university students with the development of learner strategies appropriate for a JFL reading context. The theoretical underpinning of the study was informed by Educational Criticism (Eisner, 1998), which aims to describe, interpret and evaluate the processes of interaction between the teacher, the learner and the curriculum and the students' learning processes in a tertiary JFL classroom. The study investigated the effect on student learning processes of a JFL reading program that incorporated explicit learner strategy instruction and identified factors that enhanced or impeded the development of learner strategy knowledge. The participants in the study were 29 students enrolled in the course, 10 of whom volunteered to undertake additional tasks, and the two teachers who implemented the curriculum. Data collection involved a number of different strategies to observe the students' participation in the classroom and learning experiences. Learning processes were investigated through TOL protocols, classroom observations, course evaluations, interviews, and learner strategy use measurement instruments (SILL, SILK and SORS) to document student uptake of learner strategies. The design of the study and its applied focus recognised my expertise as a JFL teacher, curriculum writer and researcher, an approach that aligns with the purpose of a Professional Doctorate. Four general thematics, or principles, were identified in this study: „h Explicit learner strategy instruction provides the context for students to develop awareness of learner strategies and take control of their learning; „h Collaborative learning and interaction with teachers offers students the opportunity for shared knowledge construction; „h Reflection offers teachers and students the opportunity to reflect on their own learning style and strategy knowledge, and raises awareness of other available strategies; and „h Diverse cultural and linguistic backgrounds have an impact on curriculum implementation and student uptake of learner strategies. The study¡¦s methodological contribution is that it is one of the first in Australia to use Educational Criticism (Eisner, 1998) as a research methodology. The findings contribute to theoretical knowledge in the fields of Applied Linguistics, Second Language Teaching and Learning, Second Language Acquisition and JFL Teaching and Learning by offering new knowledge on the importance of learner strategies in the beginner JFL classroom, the potential of explicit strategy instruction, the value of reflection for both teachers and students, and the important role of the teacher in the process of curriculum implementation. The general principles identified and the findings of this in-depth study of a JFL classroom can be drawn upon to inform other teaching practice situations, and invite practitioners from not just Japanese, but from other language areas and other disciplines, to examine and improve their own practices, and suggest further research questions to pursue this line of enquiry.