Association between education in EOL care and variability in EOL practice: a survey of ICU physicians

This study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU. Physicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics. The response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 +/- A 8 years, with a mean of 14 +/- A 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply "full code" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P < 0.001], than physicians who would withdraw life-sustaining therapies. Forty-four percent of respondents would not do what they believed was best for their patient, with 98% of them believing a less aggressive attitude preferable. Legal concerns were the leading cause for this dichotomy. Physician education about EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient.

Developing a model of library user education for freshman science students

Discusses the cooperative effort between librarians and science faculty at Bucknell University in developing an effective library use education course for incoming undergraduate science and engineering students. Describes course structure and activities, and includes a library instruction bibliography. (five references) (EA)

AAC&U's Integrative Liberal Learning and the CAS Standards: Advising for a 21st Century Liberal Education

The Association of American Colleges and Universities presented and promoted integrative liberal learning as a collaborative goal that all institutions of higher education must strive to achieve. The similarities between the goals of integrative liberal learning and the Standards for Academic Advising by the Council for the Advancement of Standards in Higher Education are discussed with emphasis placed on the critical role that academic advising plays in support of an integrative liberal learning education, and in turn, future success for all students.

Tolerance and Critical Thinking

Post-soviet countries are in the process of transformation from a totalitarian order to a democratic one, a transformation which is impossible without a profound shift in people's way of thinking. The group set themselves the task of determining the essence of this shift. Using a multidisciplinary approach, they looked at concrete ways of overcoming the totalitarian mentality and forming that necessary for an open democratic society. They studied the contemporary conceptions of tolerance and critical thinking and looked for new foundations of criticism, especially in hermeneutics. They then sought to substantiate the complementary relation between tolerance and criticism in the democratic way of thinking and to prepare a a syllabus for teaching on the subject in Ukrainian higher education. In a philosophical exploration of tolerance they began with relgious tolerance as its first and most important form. Political and social interests often lay at the foundations of religious intolerance and this implicitly comprised the transition to religious tolerance when conditions changed. Early polytheism was more or less indifferent to dogmatic deviations but monotheism is intolerant of heresies. The damage wrought by the religious wars of the Reformations transformed tolerance into a value. They did not create religious tolerance but forced its recognition as a positive phenomenon. With the weakening of religious institutions in the modern era, the purely political nature of many conflicts became evident and this stimulated the extrapolation of tolerance into secular life. Each historical era has certain acts and operations which may be interpreted as tolerant and these can be classified as to whether or not they are based on the conscious following of the principle of tolerance. This criterion requires the separation of the phenomenon of tolerance from its concept and from tolerance as a value. Only the conjunction of a concept of tolerance with a recognition of its value can transform it into a principle dictating a norm of conscious behaviour. The analysis of the contemporary conception of tolerance focused on the diversity of the concept and concluded that the notions used cannot be combined in the framework of a single more or less simple classification, as the distinctions between them are stimulated by the complexity of the realty considered and the variety of its manifestations. Notions considered in relation to tolerance included pluralism, respect and particular-universal. The rationale of tolerance was also investigated and the group felt that any substantiation of the principle of tolerance must take into account human beings' desire for knowledge. Before respecting or being tolerant of another person different from myself, I should first know where the difference lies, so knowledge is a necessary condition of tolerance.The traditional division of truth into scientific (objective and unique) and religious, moral, political (subjective and so multiple) intensifies the problem of the relationship between truth and tolerance. Science was long seen as a field of "natural" intolerance whereas the validity of tolerance was accepted in other intellectual fields. As tolerance eemrges when there is difference and opposition, it is essentially linked with rivaly and there is a a growing recognition today that unlimited rivalry is neither able to direct the process of development nor to act as creative matter. Social and economic reality has led to rivalry being regulated by the state and a natural requirement of this is to associate tolerance with a special "purified" form of rivalry, an acceptance of the actiivity of different subjects and a specification of the norms of their competition. Tolerance and rivalry should therefore be subordinate to a degree of discipline and the group point out that discipline, including self-discipline, is a regulator of the balance between them. Two problematic aspects of tolerance were identified: why something traditionally supposed to have no positive content has become a human activity today, and whether tolerance has full-scale cultural significance. The resolution of these questions requires a revision of the phenomenon and conception of tolerance to clarify its immanent positive content. This involved an investigation of the contemporary concept of tolerance and of the epistemological foundations of a negative solution of tolerance in Greek thought. An original soution to the problem of the extrapolation of tolerance to scientific knowledge was proposed based on the Duhem-Quine theses and conceptiion of background knowledge. In this way tolerance as a principle of mutual relations between different scientific positions gains an essential epistemological rationale and so an important argument for its own universal status. The group then went on to consider the ontological foundations for a positive solution of this problem, beginning with the work of Poincare and Reichenbach. The next aspect considered was the conceptual foundations of critical thinking, looking at the ideas of Karl Popper and St. Augustine and at the problem of the demarcation line between reasonable criticism and apologetic reasoning. Dogmatic and critical thinking in a political context were also considered, before an investigation of critical thinking's foundations. As logic is essential to critical thinking, the state of this discipline in Ukrainian and Russian higher education was assessed, together with the limits of formal-logical grounds for criticism, the role of informal logical as a basis for critical thinking today, dialectical logic as a foundation for critical thinking and the universality of the contemporary demand for criticism. The search for new foundations of critical thinking covered deconstructivism and critical hermeneutics, including the problem of the author. The relationship between tolerance and criticism was traced from the ancient world, both eastern and Greek, through the transitional community of the Renaissance to the industrial community (Locke and Mill) and the evolution of this relationship today when these are viewed not as moral virtues but as ordinary norms. Tolerance and criticism were discussed as complementary manifestations of human freedom. If the completeness of freedom were accepted it would be impossible to avoid recognition of the natural and legal nature of these manifestations and the group argue that critical tolerance is able to avoid dismissing such negative phenomena as the degradation of taste and manner, pornography, etc. On the basis of their work, the group drew up the syllabus of a course in "Logic with Elements of Critical Thinking, and of a special course on the "Problem of Tolerance".

Re-thinking Teaching About Atrocity: Human Rights Comparative History and Critical Pedagogy

This paper will explore re-framing historic atrocity and its relationship to Holocaust and Genocide education. The origins of genocide studies and its links to Holocaust studies will be traced to discuss the impact of new scholarship and framings on genocide education in the classroom.

Software Engineering Education Needs More Engineering

To what extent is “software engineering” really “engineering” as this term is commonly understood? A hallmark of the products of the traditional engineering disciplines is trustworthiness based on dependability. But in his keynote presentation at ICSE 2006 Barry Boehm pointed out that individuals’, systems’, and peoples’ dependency on software is becoming increasingly critical, yet that dependability is generally not the top priority for software intensive system producers. Continuing in an uncharacteristic pessimistic vein, Professor Boehm said that this situation will likely continue until a major software-induced system catastrophe similar in impact to the 9/11 World Trade Center catastrophe stimulates action toward establishing accountability for software dependability. He predicts that it is highly likely that such a software-induced catastrophe will occur between now and 2025. It is widely understood that software, i.e., computer programs, are intrinsically different from traditionally engineered products, but in one aspect they are identical: the extent to which the well-being of individuals, organizations, and society in general increasingly depend on software. As wardens of the future through our mentoring of the next generation of software developers, we believe that it is our responsibility to at least address Professor Boehm’s predicted catastrophe. Traditional engineering has, and continually addresses its social responsibility through the evolution of the education, practice, and professional certification/licensing of professional engineers. To be included in the fraternity of professional engineers, software engineering must do the same. To get a rough idea of where software engineering currently stands on some of these issues we conducted two surveys. Our main survey was sent to software engineering academics in the U.S., Canada, and Australia. Among other items it sought detail information on their software engineering programs. Our auxiliary survey was sent to U.S. engineering institutions to get some idea about how software engineering programs compared with those in established engineering disciplines of Civil, Electrical, and Mechanical Engineering. Summaries of our findings can be found in the last two sections of our paper.

Landscapes of Education and the New Role of Social Work International Models of How to Combine Formal, Non-formal and Informal Education

Landscapes of education are a new topic within the debate about adequate and just education and human development for everybody. In particular, children and youths from social classes affected by poverty, a lack of prospects or minimal schooling are a focal group that should be offered new approaches and opportunities of cognitive and social development by way of these landscapes of education. It has become apparent that the traditional school alone does not suffice to meet this need. There is no doubt that competency-based orientation and employability are core areas with the help of which the generation now growing up will manage the start of its professional career. In addition and by no means less important, the development involves individual, social, cultural and societal perspectives that can be combined under the term of human development. In this context, the Capability Approach elaborated by Amartya Sen and Martha Nussbaum has developed a more extensive concept of human development and related it to empirical instruments. Using the analytic concept of individual capabilities and societal opportunities they shaped a socio-political formula that should be adapted in particular to modern social work. Moreover, the Capability Approach offers a critical foil with regard to further development and revision of institutionalised approaches in education and human development.

Distance education in transition

In his most recent publication, Against the Tide: Critics of Digitalisation, Otto Peters brings together some of the most formidable and critical voices and compelling perspectives on the potential hazards of digitalization. The viewpoints presented range from personal, anthropological, and pedagogical to more scientific and technical, and arise from multiple disciplines. Peters has long been a respected scholar in the field of distance education, and while Peters’ earlier work has advocated the affordances of digitalization, this latest book is an abrupt shift to the darker side of digitalization. The assembly of critics Peters has gathered come from around the world and different walks of life: journalists, educators, scientists, philosophers, lawyers, mathematicians, and computer scientists, to name a few. Their one shared bond is a deep-seated belief that digitalization will have a profound and lasting impact on humankind – and not only in positive ways. ...

The Critical Friends Group: An Innovative Way to Build Intercultural Competence Among Student and Faculty Groups

Introduction Few physicians involved in medical education are likely to have had formal training in teaching. One pedagogical method that can enhance relationships, thus improve teaching and learning is the Critical Friends Group (CFG). The CFG is a collegial support team that offers improved understanding of others. Unconditional high regard for team members frames the interactions in the CFG. These teams could be used to reduce bias and enhance intercultural competence among student CFGs and faculty CFGs. [See PDF for complete abstract]

Implications for Adoption and Implementation of Effective Sexual Health Education Programs

Research on school-based sexual health education programs is at a critical juncture. With the growing number of evidenced-based programs, more focus is needed on how to help schools adopt and implement these programs. The article in this issue titled “Sexual Health Education from the Perspectives of School Staff: Implications for Adoption and Implementation of Effective Programs in Middle School” provides data on individual cognitive factors that may influence adoption and implementation. This commentary explores another framework, Concerns Based Adoption Model, as a tool for examining and supporting change associated with adoption and implementation of sexual health education programs.

Income disparity among persons with disabilities assessed by education and sex : findings from a field survey conducted in Metro Manila, the Philippines

How do persons with disabilities (PWDs) earn a living? From the view point of poverty reduction, this question is quite critical in developing countries. This paper presents an investigation of economic activities of PWDs in the Philippines where, among developing countries, disability-related legislation is relatively progressive. In 2008, a field survey was conducted in cooperation with Disability People’s Organizations (DPOs) using a tailor-made questionnaire in four representative cities of Metro Manila. The level and determinants of income of PWDs were examined with Mincer regression. Conclusions are as follows: (1) The incidence and depth of poverty are greater among sample PWDs than that of the total population in Metro Manila. (2) There is remarkable income disparity among PWDs which is associated with education and sex. (3) After controlling individual, parental, and environmental characteristics, it was found that female PWDs are likely to earn less than male PWDs due to fewer opportunities to participate in economic activities. It is suggested that female PWDs are doubly handicapped in earning income.

Web-based education in Spanish Universities. A Comparison of Open Source E-Learning Platforms

Web-based education or „e-learning‟ has become a critical component in higher education for the last decade, replacing other distance learning methods, such as traditional computer training or correspondence learning. The number of university students who take on-line courses is continuously increasing all over the world. In Spain, nearly a 90% of the universities have an institutional e-learning platform and over 60% of the traditional on-site courses use this technology as a supplement to the traditional face-to-face classes. This new form of learning allows the disappearance of geographical barriers and enables students to schedule their own learning process, among some other advantages. On-line education is developed through specific software called „e-learning platform‟ or „virtual learning environment‟ (VLE). A considerable number of web-based tools to deliver distance courses are currently available. Open source software packages such as Moodle, Sakai, dotLRN or Dokeos are the most commonly used in the virtual campuses of Spanish universities. This paper analyzes the possibilities that virtual learning environments provide university teachers and learners and offers a technical comparison among some of the most popular e-learning learning platforms.

Towards the Consideration of the U.S. Community College Model to Address the Need for Higher Education Reforms in Ghana

ABSTRACT The higher education systems throughout the continent of Africa are undergoing unprecedented challenges and are considered in crisis. African countries, including Ghana, all have in common ties to their colonial legacy whereby they are confronted with weak policies put in place by their colonizers. Having gained their independence, Africans should now take responsibility for the task of reforming their higher education system. To date, nothing substantial has been accomplished, with serious implications for weakening and damaging the structures of the foundation of their educational systems. This qualitative, single case study utilized a postcolonial theory-critical pedagogy framework, providing guidance for coming to grips with the mindset posed by Ghana's colonial heritage in the postcolonial era, especially in terms of its damaging effects on Ghana's higher education system. The study explores alternative pathways for secondary school students to transition to tertiary education--a problematic transition that currently hinders open access to all and equality in educational opportunity, resulting in a tremendous pool of discontinued students. This transitional problem is directly related to Ghana's crisis in higher education with far reaching consequences. The alternative pathway considered in this study is an adaptation of the U.S. community college model or an integration of its applicable aspects into the current structures of the higher education system already in place. In-depth interviews were conducted with 5 Ghanaian professors teaching at community colleges in the United States, 5 Ghanaian professors teaching at universities in Ghana, and 2 educational consultants from the Ghanaian Ministry of Education. Based on their perspectives of the current state of Ghanaian higher education, analyzed in terms of pedagogy, structure/infrastructure, and curriculum, the participants provided their perceptions of salient aspects of the U.S. community college model that would be applicable to Ghana's situation, along with other recommendations. Access to all, including equality of educational opportunity, was considered essential, followed by adaptability, affordability, practicality, and quality of curriculum content and delivery. Canada's successful adaptation of the U.S. model was also discussed. Findings can help guide consideration of alternative pathways to higher education in Ghana and Africa as a whole.

Everything in di Dark Muss Come to Light: A Postcolonial Investigation of the Practice of Extra Lessons at the Secondary Level in Jamaica's Education System

Despite the vast research examining the evolution of Caribbean education systems, little is chronologically tied to the postcolonial theoretical perspectives of specific island-state systems, such as the Jamaican education system and its relationship with the underground shadow education system. This dissertation study sought to address the gaps in the literature by critically positioning postcolonial theories in education to examine the macro- and micro-level impacts of extra lessons on secondary education in Jamaica. The following postcolonial theoretical (PCT) tenets in education were contextualized from a review of the literature: (a) PCT in education uses colonial discourse analysis to critically deconstruct and decolonize imperialistic and colonial representations of knowledge throughout history; (b) PCT in education uses an anti-colonial discursive framework to re-position indigenous knowledge in schools, colleges, and universities to challenge hegemonic knowledge; (c) PCT in education involves the "unlearning" of dominant, normative ideologies, the use of self-reflexivity, and deconstruction; and (d) PCT in education calls for critical pedagogical approaches that reject the banking concept of education and introduces inclusive pedagogy to facilitate "the passage from naïve to critical transitivity" (Freire, 1973, p. 32). Specifically, using a transformative mixed-methods design, grounded and informed by a postcolonial theoretical lens, I quantitatively uncovered and then qualitatively highlighted how if at all extra lessons can improve educational outcomes for students at the secondary level in Jamaica. Accordingly, the quantitative data was used to test the hypotheses that the practice of extra lessons in schools is related to student academic achievement and the practice of critical-inclusive pedagogy in extra lessons is related to academic achievement. The two-level hierarchical linear model analysis revealed that hours spent in extra lessons, average household monthly income, and critical-inclusive pedagogical tents were the best predictors for academic achievement. Alternatively, the holistic multi-case study explored how extra-lessons produces increased academic achievement. The data revealed new ways of knowledge construction and critical pedagogical approaches to galvanize systemic change in secondary education. Furthermore, the data showed that extra lessons can improve educational outcomes for students at the secondary level if the conditions for learning are met. This study sets the stage for new forms of knowledge construction and implications for policy change.

Distance Education and the Evolution of Online Learning in the United States

Online education is no longer a trend, rather it is mainstream. In the Fall of 2012, 69.1% of chief academic leaders indicated online learning was critical to their long-term strategy and of the 20.6 million students enrolled in higher education, 6.7 million were enrolled in an online course (Allen & Seaman, 2013; United States Department of Education, 2013). The advent of online education and its rapid growth has forced academic institutions and faculty to question the current styles and techniques for teaching and learning. As developments in educational technology continue to advance, the ways in which we deliver and receive knowledge in both the traditional and online classrooms will further evolve. It is necessary to investigate and understand the progression and advancements in educational technology and the variety of methods used to deliver knowledge to improve the quality of education we provide today and motivate, inspire, and educate the students of the 21st century. This paper explores the atioevolution of distance education beginning with correspondence and the use of parcel post, to radio, then to television, and finally to online education.