Ethical reasoning through simulation: a phenomenological analysis of student experience

Background
Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students’ lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment.

Methods
This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data.

Results
Four main themes emerged from the analysis: (1) ‘Authentic on all levels?’, (2)‘Letting the emotions flow’, (3) ‘Ethical alarm bells’ and (4) ‘Voices of children and ghosts’. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences.

Conclusions
This study provided deep insights into medical students’ immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their personal responses to emotion, complexity and interprofessional working. This could assist them in framing and observing appropriate ethical and professional boundaries and help smooth the transition into clinical practice.

Exploring the Success of Student Experiential Learning through Entrepreneurial Opportunities

Academic literature has increasingly recognized the value of non-traditional higher education learning environments that emphasize action-orientated experiential learning for the study of entrepreneurship (Gibb, 2002; Jones & English, 2004). Many entrepreneurship educators have accordingly adopted approaches based on Kolb’s (1984) experiential learning cycle to develop a dynamic, holistic model of an experience-based learning process. Jones and Iredale (2010) suggested that entrepreneurship education requires experiential learning styles and creative problem solving to effectively engage students. Support has also been expressed for learning-by-doing activities in group or network contexts (Rasmussen and Sorheim, 2006), and for student-led approaches (Fiet, 2001). This study will build on previous works by exploring the use of experiential learning in an applied setting to develop entrepreneurial attitudes and traits in students. Based on the above literature, a British higher education institution (HEI) implemented a new, entrepreneurially-focused curriculum during the 2013/14 academic year designed to support and develop students’ entrepreneurial attitudes and intentions. The approach actively involved students in small scale entrepreneurship activities by providing scaffolded opportunities for students to design and enact their own entrepreneurial concepts. Students were provided with the necessary resources and training to run small entrepreneurial ventures in three different working environments. During the course of the year, three applied entrepreneurial opportunities were provided for students, increasing in complexity, length, and profitability as the year progressed. For the first undertaking, the class was divided into small groups, and each group was given a time slot and venue to run a pop-up shop in a busy commercial shopping centre. Each group of students was supported by lectures and dedicated class time for group work, while receiving a set of objectives and recommended resources. For the second venture, groups of students were given the opportunity to utilize an on-campus bar/club for an evening and were asked to organize and run a profitable event, acting as an outside promoter. Students were supported with lectures and seminars, and groups were given a £250 budget to develop, plan, and market their unique event. The final event was optional and required initiative on the part of the students. Students were given the opportunity to develop and put forward business plans to be judged by the HEI and the supporting organizations, which selected the winning plan. The authors of the winning business plan received a £2000 budget and a six-week lease to a commercial retail unit within a shopping centre to run their business. Students received additional academic support upon request from the instructor, and one of the supporting organizations provided a training course offering advice on creating a budget and a business plan. Data from students taking part in each of the events was collected, in order to ascertain the learning benefits of the experiential learning, along with the successes and difficulties they faced. These responses have been collected and analyzed and will be presented at the conference along with the instructor’s conclusions and recommendations for the use of such programs in higher educations.

Knowledge of the patients regarding leprosy and adherence to treatment

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It is known for its great disfiguring capacity and is considered an extremely serious disease to public health worldwide. The state of Ceará ranks 13th in number of cases of leprosy in Brazil, and fourth in Northeastern region, with an average of 2,149 new cases diagnosed every year. This study aimed to evaluate the knowledge of leprosy patients regarding treatment, and to assess the level of treatment adherence and its possible barriers. The study was conducted in the reference center for dermatology, from September 2010 to October 2010, in Fortaleza, Ceará. The study data were collected by means of a structured interview, along with the Morisky-Green test, in order to assess treatment adherence and barriers to adherence. A total of 70 patients were interviewed, out of whom 66 were new cases. The majority of patients were between 42 and 50 years old, and 37 (52.9%) were male. Most patients were clinically classified as presentingmultibacillary leprosy (80%), and 78.6% of them were from Fortaleza, Brazil. The Morisky-Green test indicated that 62.9% of patients presented a low level of adherence (p < 0.005), despite claiming to aware of the disease risks. However, it was observed that 57.1% of the patients had no difficulty adhering to treatment, while 38.6% reported little difficulty. This study shows that despite the patients claiming to be familiar with leprosy and its treatment, the Morisky-Green test clearly demonstrated that they actually were not aware of the principles of therapy, which is evidenced by the low degree of treatment adherence

The Impact of Student Response Systems on the Learning Experience of Undergraduate Psychology Students

Student response systems (SRS) are hand-held devices or mobile phone polling systems which collate real-time, individual responses to on-screen questions. Previous research examining their role in higher education has highlighted both advantages and disadvantages of their use. This paper explores how different SRS influence the learning experience of psychology students across different levels of their programme. Across two studies, first year students’ experience of using Turningpoint clickers and second year students’ experience of using Poll Everywhere was investigated. Evaluations of both studies revealed that SRS has a number of positive impacts on learning, including enhanced engagement, active learning, peer interaction, and formative feedback. Technical and practical issues emerged as consistent barriers to the use of SRS. Discussion of these findings and the authors’ collective experiences of these technologies are used to provide insight into the way in which SRS can be effectively integrated within undergraduate psychology programmes.

A Biocultural Examination of Student Learning Behaviors in Large Undergraduate Lectures

Thesis (Ph.D.)--University of Washington, 2016-08

"It's Equal but It's not Fair": The experiences of Teacher Candidates of Color in a Predominantly White Institution

Thesis (Ph.D.)--University of Washington, 2016-06

Evaluation of Tottenham Thinking Space Pilot: Final Report. Research Report 11.

This reports summarises research that began in March 2014 and was completed in October 2015 by an experienced inter-disciplinary research team from the Centre for Social Justice and Change and Psycho-Social Research Group, School of Social Sciences, the University of East London (UEL) and included Dr Yang Li from the Centre for Geo-Information Studies, UEL, for the first phase of the study. Tottenham ‘Thinking Space’ (TTS) was a pilot therapeutic initiative based in local communities and delivered by the Tavistock & Portman NHS Foundation Trust and funded by the London Borough of Haringey Directorate of Public Health. TTS aimed to improve mental health and enable and empower local communities. TTS was situated within a mental health agenda that was integral to Haringey’s Health and Wellbeing Strategy 2012-2015 and aimed to encourage people to help themselves and each other and develop confident communities. On the one hand TTS was well-suited to this agenda, but, on the other, participants were resistant to, and were trying to free themselves from labelling that implied ‘mental health difficulties’. A total of 243 meetings were held and 351 people attended 1,716 times. The majority of participants attended four times or less, and 33 people attended between 5 and 10 times and 39 people attended over 10 times. Attending a small number of times does not necessarily mean that the attendee was not helped. Attendees reflected the ethnic diversity of Tottenham; 29 different ethnic groups attended. The opportunity to meet with people from different cultural backgrounds in a safe space was highly valued by attendees. Similarly, participants valued the wide age range represented and felt that they benefited from listening to inter-generational experiences. The majority of participants were women (72%) and they were instrumental in initiating further Thinking Spaces, topic specific meetings, the summer programme of activities for mothers and young children and training to meet their needs. The community development worker had a key role in implementing the initiative and sustaining its growth throughout the pilot period. We observed that TTS attracted those whose life experiences were marked by personal struggle and trauma. Many participants felt safe enough to disclose mental health difficulties (85% of those who completed a questionnaire). Participants also came seeking a stronger sense of community in their local area. Key features of the meetings are that they are democratic, non-judgemental, respectful, and focussed on encouraging everyone to listen and to try to understand. We found that the therapeutic method was put in place by high quality facilitators and health and personal outcomes for participants were consistent with those predicted by the underpinning psychoanalytical and systemic theories. Outcomes included a reduction in anxieties and improved personal and social functioning; approximately two thirds of those who completed a questionnaire felt better understood, felt more motivated and more hopeful for the future. The overwhelming majority of survey respondents also felt good about contributing to their community, said that they were more able to cooperate with others and accepting of other cultures, and had made new friends. Participants typically had a better understanding of their current situation and how to take positive action; of those who completed a questionnaire, over half felt more confident to seek support for a personal issue and to contact services. Members of TTS supported each other and instilled hope and build community-mindedness that reduced social isolation.

Troublesome Knowledge of SoTL

This study explores the Scholarship of Teaching and Learning (SoTL) as a form of troublesome knowledge (Perkins 1999) that continues to trouble its practitioners. Forty-eight higher education professionals from six countries described their understanding of SoTL in an online survey; ten individuals participated in follow-up interviews to consider how SoTL experiences shape, support, or hinder academic identity and knowing. We categorize our findings according to the dynamic factors—personal, relational, and contextual—identified by Lieff et al (2012); we argue that SoTL serves to illuminate and expose tensions created by competing values and that these values can lead to, or create, a troublesome space wherein promoting SoTL can be enabling and disabling.

The sexual health knowledge of people with intellectual disabilities: A review.

There is a growing recognition that people with disabilities have the same sexual needs and rights as people without disabilities. However, less attention is paid to the sexuality of people diagnosed with intellectual disabilities. This narrative review summarises what is currently known about the level of sexual health knowledge of people with intellectual disabilities. A literature review was conducted of the published literature using Google Scholar, PubMed, PsychInfo, EBSCOhost, and Science Direct. Forty eight articles were identified that addressed the question about the level of sexual health knowledge of people with intellectual disabilities. Overall, studies demonstrate that people with intellectual disabilities are highly variable in levels of sexual knowledge, but on average have a range of deficits in knowledge compared to non-disabled individuals. More tailored education and support in accessing formal and informal sources of information are needed.

Technology strategies in the process of student retention and efficiency of academic management

This article discusses the application of Information and Communication Technologies and strategies for best practices in order to capture and maintain faculty students' attention. It is based on a case study of ten years, using a complete information system. This system, in addition to be considered an ERP, to support the activities of academic management, also has a strong component of SRM that provides support to academic and administrative activities. It describes the extent to which the presented system facilitates the interaction and communication between members of the academic community, using the Internet, with services available on the Web complementing them with email, SMS and CTI. Through a perception, backed by empirical analysis and results of investigations, it demonstrates how this type of practice may raise the level of satisfaction of the community. In particular, it is possible to combat failure at school, avoid that students leave their course before its completion and also that they recommend them to potential students. In addition, such a strategy also allows strong economies in the management of the institution, increasing its value. As future work, we present the new phase of the project towards implementation of Business Intelligence to optimize the management process, making it proactive. The technological vision that guides new developments to a construction based on Web services and procedural languages is also presented.

Abordagem da temática das plantas num contexto EDS orientado para o pensamento crítico no 1º CEB

Numa sociedade ocidental que se apresenta em constante mutação é impossível dominar todo o conhecimento, daí que haja a necessidade de se dotar os jovens alunos de ferramentas que lhes permitam enfrentar a incerteza do futuro. Uma ferramenta imprescindível para os ajudar a ultrapassar dificuldades com que se confrontem são as suas capacidades de Pensamento Crítico (PC), porquanto podem concorrer para tomarem decisões mais racionais. Neste sentido, este estudo, desenvolvido numa turma de 2.º ano do 1.º CEB com 18 alunos, tem como finalidade desenvolver (adaptar, conceber, produzir, implementar e avaliar) atividades promotoras de PC num contexto de Educação para o Desenvolvimento Sustentável (EDS), tendo por base a temática das plantas. Decorrente da finalidade, formularam-se as questões de investigação: Qual o contributo das atividades promotoras de PC na promoção deste tipo de pensamento dos alunos? Qual o contributo das atividades promotoras de PC para a construção/mobilização de conhecimentos dos alunos? Qual a opinião dos alunos acerca das sessões que envolveram atividades promotoras de PC? Quais as representações dos alunos acerca das atividades promotoras de PC? Neste estudo, optou-se por uma metodologia orientada para a prática, assente num plano de investigação-ação. Os alunos realizaram atividades promotoras de PC, num contexto EDS, relacionadas com a temática das plantas abordada na área disciplinar de Estudo do Meio. Recolheram-se dados através de vários instrumentos no âmbito de diferentes técnicas de recolha de dados, incluindo um instrumento de análise das produções dos alunos. Na análise de dados, a técnica privilegiada foi a análise de conteúdo. Os resultados obtidos sugerem que as atividades promotores de PC desenvolvidas no âmbito do estudo contribuíram para a mobilização/desenvolvimento de capacidades de PC dos alunos e para a mobilização/construção de conhecimentos científicos. Na opinião dos alunos, as aulas em que se implementaram atividades promotoras de PC foram mais motivadoras e mais produtivas que as outras aulas de Estudo do Meio. Pela perspetiva dos alunos, as sessões em que realizaram as atividades promotoras de PC contribuíram para a mobilização/desenvolvimento de capacidades de PC e para a mobilização/construção de conhecimentos científicos.

Evaluating Public Knowledge of the NCRMD Defence

The not criminally responsible on account of mental disorder (NCRMD) defence is used when claims can be made that offenders are not responsible for their actions due to symptoms of a mental disorder. Bill C-14, now enacted in Canada, has implemented changes making it more difficult for NCRMD defendants to be released back into the public. This enactment appears to have been primarily due to public perceptions rather than actual knowledge of the defence. Thus it seems important to assess what members of the public actually know about the defence. To assess this, 127 participants completed a survey assessing their knowledge of the illnesses generally involved in the NCRMD defence, crimes committed, and punishments received. On average, only 31.6% of responses were answered within 20% of the factual statistics. Results suggest a general lack of knowledge about the defence and demonstrate why important changes should be based on factual information rather than public opinion.

Technical and Didactical Scenarios of Student-centered Teaching and Learning

In this paper we envision didactical concepts for university education based on self-responsible and project-based learning and outline principles of adequate technical support. We use the scenario technique describing how a fictive student named Anna organizes her studies of informatics at a fictive university from the first days of her studies to make a career for herself.(DIPF/Orig.)

Knowledge of the patients regarding leprosy and adherence to treatment

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It is known for its great disfiguring capacity and is considered an extremely serious disease to public health worldwide. The state of Ceará ranks 13th in number of cases of leprosy in Brazil, and fourth in Northeastern region, with an average of 2,149 new cases diagnosed every year. This study aimed to evaluate the knowledge of leprosy patients regarding treatment, and to assess the level of treatment adherence and its possible barriers. The study was conducted in the reference center for dermatology, from September 2010 to October 2010, in Fortaleza, Ceará. The study data were collected by means of a structured interview, along with the Morisky-Green test, in order to assess treatment adherence and barriers to adherence. A total of 70 patients were interviewed, out of whom 66 were new cases. The majority of patients were between 42 and 50 years old, and 37 (52.9%) were male. Most patients were clinically classified as presentingmultibacillary leprosy (80%), and 78.6% of them were from Fortaleza, Brazil. The Morisky-Green test indicated that 62.9% of patients presented a low level of adherence (p < 0.005), despite claiming to aware of the disease risks. However, it was observed that 57.1% of the patients had no difficulty adhering to treatment, while 38.6% reported little difficulty. This study shows that despite the patients claiming to be familiar with leprosy and its treatment, the Morisky-Green test clearly demonstrated that they actually were not aware of the principles of therapy, which is evidenced by the low degree of treatment adherence