Enhancing delivery of health behaviour change interventions in primary care: a meta-synthesis of views and experiences of primary care nurses

Objective To systematically find and synthesise qualitative studies that elicited views and experiences of nurses involved in the delivery of health behaviour change (HBC) interventions in primary care, with a focus on how this can inform enhanced delivery and adherence to a structured approach for HBC interventions. Methods Systematic search of five electronic databases and additional strategies to maximise identification of studies, appraisal of studies and use of meta-synthesis to develop an inductive and interpretative form of knowledge synthesis. Results Nine studies met the inclusion criteria. Synthesis resulted in the development of four inter-linking themes; (a) actively engaging nurses in the process of delivering HBC interventions, (b) clarifying roles and responsibilities of those involved, (c) engaging practice colleagues, (d) communication of aims and potential outcomes of the intervention. Conclusion The synthesis of qualitative evidence resulted in the development of a conceptual framework that remained true to the findings of primary studies. This framework describes factors that should be actively promoted to enhance delivery of and adherence to HBC interventions by nurses working in primary care. Practice implications The findings can be used to inform strategies for researchers, policymakers and healthcare providers to enhance fidelity and support delivery of HBC interventions.

From therapeutic to political education: the centrality of affective sensibility in critical pedagogy

While the need for humanising education is pressing in neoliberal societies, the conditions for its possibility in formal institutions have become particularly cramped. A constellation of factors – the strength of neoliberal ideologies, the corporatisation of universities, the conflation of human freedom with consumer satisfaction, and a wider crisis of hope in the possibility or desirability of social change – make it difficult to apply classical theories of subject-transformation to new work in critical pedagogy. In particular, the growth of interest in pedagogies of comfort (as illustrated in certain forms of ‘therapeutic’ education and concerns about student ‘satisfaction’) and resistance to critical pedagogies suggest that subjectivty has become a primary site of political struggle in education. However, it can no longer be assumed that educators can (or should) liberate students’ repressed desires for ‘humanisation’ by politicising curricula, pedagogy or institutions. Rather, we must work to understand the new meanings and affective conditions of critical subjectivity itself. Bringing critical theories of subject transformation together with new work on ‘pedagogies of discomfort’, I suggest we can create new ways of opening up possibilities for critical education that respond to neoliberal subjectivities without corresponding to or affirming them.

Heritage and innovative learning approaches:an alternative approach to engineering education

Over recent years, the role of engineering in promoting a sustainable society has received much public attention [1] with particular emphasis given to the need to promote the future prosperity and security of society through the recruitment and education of more engineers [2,3]. From an employment perspective, the Leitch Review [4] suggested that ‘generic’ transferable employability skills development should constitute a more substantial part of university education. This paper argues that the global drivers impacting engineering education [5] correlate strongly to those underpinning the Leitch review, therefore the question of how to promote transferable employability skills within the wider engineering curriculum is increasingly relevant. By exploring the use of heritage in the engineering curriculum as a way to promote learning and engage students, a less familiar approach to study is discussed. This approach moves away from stereotypical notions of the use of information technology as representing the pinnacle of innovation in education. Taking the student experience as its starting point, the paper draws upon the findings of an exploratory study critically analysing the pedagogical value of using heritage in engineering education. It discusses a teaching approach in which engineering students are taken out of their ‘comfort zone’ - away from the classroom, laboratory and computer, to a heritage site some 100 miles away from the university. The primary learning objective underpinning this approach is to develop students’ transferable skills by encouraging them to consider how to apply theoretical concepts to a previously unexplored situation. By reflecting upon students’ perceptions of the value of this approach, and by identifying how heritage may be utilised as an innovative learning and teaching approach in engineering education, this paper makes a notable contribution to current pedagogical debates in the discipline.

Forging futures? Engineering in the primary school curriculum

Starting with the research question, "How can the Primary School Curriculum be developed so as to spark Children's Engineering Imaginations from an early age?" this paper sets out to critically analyse the issues around embedding Engineering in the Primary School Curriculum from the age of 5 years. Findings from an exploratory research project suggest that in order to promote the concept of Engineering Education to potential university students (and in doing so begin to address issues around recruitment / retention within Engineering) there is a real need to excite and engage children with the subject from a young age. Indeed, it may be argued that within today's digital society, the need to encourage children to engage with Engineering is vital to the future sustainable development of our society. Whilst UK Government policy documents highlight the value of embedding Engineering into the school curriculum there is little or no evidence to suggest that Engineering has been successfully embedded into the elementary level school curriculum. Building on the emergent findings of the first stage of a longitudinal study, this paper concludes by arguing that Engineering could be embedded into the curriculum through innovative pedagogical approaches which contextualise project-based learning experiences within more traditional subjects including science, history, geography, literacy and numeracy.

Designing a mobile transcriber application for adult literacy education:a case study

Functional illiteracy rates amongst 16 to 65 year-olds in the world’s richest countries are alarmingly high. This research looks at the use of mobile technology to support experiential adult literacy education whereby adult literacy students are able to construct knowledge throughout their daily activities whilst being supported in their daily literacy challenges. This research has two primary goals: (a) to design a mobile application to support adult literacy education; and (b) to identify appropriate processes by which this design could be achieved given the nature and specific requirements of the target users. The means by which both go also were achieved, together with lessons learned, are discussed. A prototype mobile application to meet the needs of adult literacy students is also introduced.

Resisting the final word:challenging stale media and policy representations of students’ performative technological encounters in university education

This article explores powerful, constraining representations of encounters between digital technologies and the bodies of students and teachers, using corpus-based Critical Discourse Analysis (CDA). It discusses examples from a corpus of UK Higher Education (HE) policy documents, and considers how confronting such documents may strengthen arguments from educators against narrow representations of an automatically enhanced learning. Examples reveal that a promise of enhanced ‘student experience’ through information and communication technologies internalizes the ideological constructs of technology and policy makers, to reinforce a primary logic of exchange value. The identified dominant discursive patterns are closely linked to the Californian ideology. By exposing these texts, they provide a form of ‘linguistic resistance’ for educators to disrupt powerful processes that serve the interests of a neoliberal social imaginary. To mine this current crisis of education, the authors introduce productive links between a Networked Learning approach and a posthumanist perspective. The Networked Learning approach emphasises conscious choices between political alternatives, which in turn could help us reconsider ways we write about digital technologies in policy. Then, based on the works of Haraway, Hayles, and Wark, a posthumanist perspective places human digital learning encounters at the juncture of non-humans and politics. Connections between the Networked Learning approach and the posthumanist perspective are necessary in order to replace a discourse of (mis)representations with a more performative view towards the digital human body, which then becomes situated at the centre of teaching and learning. In practice, however, establishing these connections is much more complex than resorting to the typically straightforward common sense discourse encountered in the Critical Discourse Analysis, and this may yet limit practical applications of this research in policy making.

Assessing the effectiveness of five-year mechanical engineering technology programs of junior colleges in Taiwan, R.O.C.: An application of the CIPP evaluation model

The purpose of this study was to evaluate the mechanical engineering technology curriculum effectiveness at the junior college in Taiwan by using the CIPP evaluation model. The study concerned the areas of the curriculum, curriculum materials, individualized instruction, support services, teaching effectiveness, student achievement, and job performance. A descriptive survey method was used with questionnaires for data collection from faculty, students, graduates, and employers.^ All categories of respondents tended to agree that the curriculum provides appropriate occupational knowledge and skills. Students, graduates, and faculty tended to be satisfied with the curriculum; faculty tended to be satisfied with student achievement; graduates tended to be satisfied with their job preparation; and employers were most satisfied with graduates' job performance.^ Conclusions were drawn in the context, input, process, and product of the CIPP model. In Context area: Students were dissatisfied with curriculum flexibility in students characteristics. Graduates were dissatisfied with curriculum design for student's adaptability in new economic and industrial conditions; practicum flexibility in student characteristics; and course overlap. Both students and graduates were dissatisfied with practicum credit hours. Both faculty and students were dissatisfied with the number of required courses.^ In Input area: Students, faculty, and graduates perceived audiovisuals and manipulative aids positively. Faculty and students perceive CAI implementation positively. Students perceived textbooks negatively.^ In Process area: Faculty, students, and graduates perceived all support service negatively. Faculty tended to perceive the ratios of graduates who enter advanced study and related occupation, and who passed the professional skills certification, negatively. Students tended to perceive teaching effectiveness in terms of instructional strategies, the quality of instruction, overall suitability, and receivable, negatively. Graduates also tended to identify the instructional strategies as a negative perception. Faculty and students perceived curriculum objectives and practicum negatively. Both faculty and students felt that instructors should be more interested in making the courses a useful learning experience.^ In Product area: Employers were satisfied with graduates' academic preparation and job performance, adaptability, punctuality, and their ability to communicate, cooperate, and meet organization needs. Graduates were weak in terms of equipment familiarity and supervisory ability.^ In sum, the curriculum of the five-year mechanical engineering technology programs of junior college in Taiwan has served adequately up to this time in preparing a work force to enter industry. It is now time to look toward the future and adapt the curriculum and instruction for the future needs of this high-tech society. ^

Influence, policy formation, and higher education in Florida: 1989--1994

This study examined the perceptions of state governmental officials and administrators from the state university system, community college system, and independent institutions concerning the ability of various groups to influence state-level higher education policy formation. The study was conducted in Florida for the period 1989-94. Florida has a history of legislative involvement in higher education, a unique system of state universities and community colleges, and a limited number of private institutions of higher education. This study was grounded in the works of Mortimer and McConnell (1978), Millett (1987), Marshall, Mitchell, and Wirt (1989) and Finitfer, Baldwin, and Thelin (1991).^ The study represented the application of an embedded, single-case design. A survey was the primary collection instrument. Respondents were asked questions concerning: (a) personal involvement in higher education, (b) perceptions of the ability of various groups to influence higher education policy, (c) the names of particular individuals considered key players in higher education policy formation, (d) important state-level documents, (e) personal knowledge of key areas of policy formation, and (f) emerging higher education issues in Florida. Quantitative and qualitative methods were used to analyze the different sections of the survey.^ The findings indicated that a power and influence hierarchy exists among the various groups that attempt to influence higher education policy and that this hierarchy is recognized by state government officials and higher education administrators. While an analysis of variance of the various groups revealed a few differences between state government officials and higher education personnel, the high overall agreement was an important finding. Leading members of the legislature, especially the Chair of the Senate Higher Education Committee, and key staff members, especially from the Senate Ways & Means Committee, were considered the most influential. Representatives from higher education institutions and research organizations were considered among the least influential. Emerging issues identified by the respondents included: (a) the political nature of state-level policy formation, (b) the role of legislative staff, (c) the competition for state moneys, (d) legislative concern for state-wide budgetary efficiency, and (e) legislative attempts to define quality and supervise academic program development for higher education. ^

An analysis of the on-time graduation rate in the two-year program at National Taipei Institute of Technology in Taiwan

Taiwan's technical vocational educational system includes three levels: (1) institutes of technology (two and four year programs), (2) junior colleges (two, three and five year programs), and (3) senior vocational schools. Two-year junior colleges enroll their students through two channels: (1) based on results of the Particular Screening Entrance Examination (PSEE), (2) based on the Joint College Entrance Examination (JCEE). The PSEE has two categories: Category I includes on-time graduates with excellent performance, which means that they are within the top ten of their classes; Category II students include award-winning students in talent contests who have achieved a minimum grade point average of 75%. The JCEE is a regular entrance examination given to any senior vocation school graduate.^ Basic courses have a great impact on the students' academic performance. The purpose of the study was to focus on the effectiveness of teaching mathematics in two-year junior colleges and to analyze and correlate the results of two-year junior college students' performance in calculus and on-time graduation. The target group consisted of 521 students enrolled at National Taipei Institute of Technology in 1993.^ Calculus is a very important course for engineering majors in two-year junior colleges and has a great impact on the students' academic performance. This retrospective study showed that there was a correlation between students' performance in calculus and on-time graduation after two years of study.^ The conclusions of the study urge the Ministry of Education to reform two-year junior college curriculum standards to emphasize basic rudimentary courses. It is recommended that engineering majors receive three hours of calculus per week as the current requirement of only two hours per week is inadequate. The future job market will require a technologically advanced labor force that can be trained in a higher education system. More channels of higher education for two-year junior college graduates should be made available for those wishing to pursue bachelor degrees. Additional work in calculus will not only enhance the opportunities for two-year junior college graduates to continue their pursuit of an advanced academic degree, but also serve them well as they seek career advancement. ^

The effect of mastery learning on a course in accounting information system (AIS): A comparison within public and private universities in Taiwan

The Accounting Information System (AIS) is an important course in the Department of Accounting (DoAc) of universities in Taiwan. This course is required for seniors not only because it meets the needs of the profession, but also because it provides continual study for the department's students.^ The scores of The National College and University Joint Entrance Examination (NUEE) show that students with high learning ability are admitted to public universities with high scores, while those with low learning ability are admitted only to private universities. The same situation has been found by the researcher while teaching an AIS course in DoAc of The Public Chun Shin University (CSU) and The Private Chinese Culture University (CCU).^ The purpose of this study was to determine whether low ability students enrolled in private universities in Taiwan in a mastery learning program could attain the same level as high ability students from public universities enrolled in a traditional program. An experimental design was used. The mastery learning method was used to teach three groups of seniors with low learning ability studying in the DoAc at CCU. The traditional method was used to teach the control group which consisted of senior students of DoAc of CSU with high learning ability. As a part of the mastery learning strategy, a formative test, quizzes, and homework were completed by the experimental group only, while the mid-term examination was completed by both groups as part of the course. The dependent variable was the summative test, the final examination. It was completed by both groups upon the course's completion.^ As predicted, there were significant differences between the two groups' results on the pretest. There were no significant differences between the two groups' results on the posttest. These findings support the hypothesis of the study and reveal the effectiveness of mastery learning strategies with low learning ability students. ^

An evaluation of English language instruction in universities/colleges in Taiwan

The purpose of this study is about to survey the effectiveness of English teaching in universities/colleges in Taiwan and provide suggestions to the educational authorities for upgrading or improving the English language teaching techniques or methods currently in use. On the one hand, the suggestions of English teachers in universities/colleges are the main concerns in this study. On the other hand, equal attention is given to the opinions and learning attitudes of the students, including the interaction between the teachers and the students.^ A social investigation methodology, consisting of questionnaire and data analysis, is devoted to this evaluation and analysis of teaching effectiveness. Among the significant findings reported in this study is the fact that both students and teachers consider evaluation of teaching effectiveness as a very important aspect of English Language programs at the university/college level. Another significant finding is that students are less concerned about the grades earned or awarded in English Language courses and more concerned about how much they learned in these classes.^ The analysis and suggestions based on the results for English teaching evaluation of universities/colleges in this dissertation can help teachers modify their teaching techniques and methods, the students to adjust their learning attitudes, and the authorities to schematize the English teaching plan that can facilitate the teaching goals to be realized. ^

A history of the presidency of National Taiwan University: The relationship between the university and an evolving democratic nation

Higher education always plays an important role in the development of a nation. Taiwan is no exception. Graduates of the National Taiwan University have occupied most of the important positions in this country and today many devote themselves to the development of Taiwan since the central government of the Republic of China (ROC) withdrew from Mainland China and re-located to Taiwan in the winter of 1949. The higher education system in Taiwan, including university and junior colleges, received special attention from the government except from 1945 to 1949 during the transitional period; the time of the early restoration year and the central government's retreating period from Mainland China.^ The five presidents of National Taiwan University who served from 1949 to 1993, Fu Szu-nien, Chien Seu-liang, Yen Chen-Hsing, Yu Chao-chung, and Sun Chen, are the subject of this research. All of the presidents were appointed by the government which established a direct connection between the government and the university leadership. The purpose of this study is to understand how each president balanced politically assigned roles and expectations with personal visionary academic responsiveness to the principles which define the university.^ Each president and his tenure were analyzed using historical research, a developed leadership model, an integration of role theory, Locke's leadership model, Wiles and Bondi curriculum leader tasks, and Burn's leadership style. Results of analyses of documents showed that all presidents of the National Taiwan University were highly respected due to their academic background, personal characteristics, and contribution to the university as a leader. Meanwhile, implementation and achievement of the presidents led to the conclusion that appointed university presidents had significant relationships with government policy. Their leadership style was affected strongly by their personal traits and knowledge and the social and political climate of the time. ^

A comparative analysis of school satisfaction and dropout risk of middle school students attending programs for students with emotional handicaps, severe emotional disturbance and general education students attending center schools and satellite schools

This study evaluated school satisfaction as an indicator of dropout risk of students with Emotional Handicaps (EH) and students with Severe Emotional Disturbance (SED). The students attended two different kinds of middle schools in a largely urban school district in South Florida. One hundred eight students in grade 8 (ages 13-16) participated in this study. Participants were administered the National Dropout Prevention Assessment (NDPA). Forty participants with EH and SED attended a special center school. Thirty-one participants with EH and SED attended satellite programs in a regular middle school. Thirty-seven general education participants attended the same regular middle school. Overall school satisfaction scores were generated, as well as three primary factors (school, environment and personal) and 16 subscales (school atmosphere, future income, difficulty level of classwork, teacher relationships, peer relationships, intrinsic interest in classwork, school hours, classwork stress, general attitude towards school, family influence, perceived opportunity for career, future goals, travel distance, leisure time, self-appraisal of performance, and self-esteem).^ Comparison of students with EH and SED revealed that both groups of students were rated at "low risk" of becoming dropouts on the Environmental factor and the Difficulty of Schoolwork subscale. Students with EH were rated at "caution risk" risk on the Travel Distance subscale. Students with SED were rated at "high risk" on this subscale.^ There were no significant differences in school satisfaction and dropout risk between different program delivery models. There were also no significant differences for category of students (EH, SED) by school type (center school, satellite program). All students were rated at "low risk" of dropping out of school.^ There were significant differences between general education students and students with EH and SED attending satellite programs. Students with EH and SED were rated at "caution risk" for dropping out on the Travel Distance and the Leisure Time subscales. Discussion of results, implications for practice and recommendations for further research are included. ^