"I understood what she meant when she said '21st century medicine'": A qualitative analysis of patient responses for plans for colorectal cancer screening following a recommendation from their physician

Although physician recommendation has been significantly associated with colorectal cancer screening (CRCS), it still does not motivate all patients to get CRCS. Although improved physician recommendation for CRCS has been shown to increase patient CRCS screening, questions remain about what elements of that discussion may lead to screening. The objective of this study is to describe patients' perceptions and interpretations about their physician's recommendation for CRCS during their annual wellness exam. A subset of patients (n=51) participating in a supplement study of a behavioral intervention trial designed to increase CRCS completed a follow-up, open-ended interview two to four weeks after their annual wellness visit. Using qualitative methods, transcripts of these interviews were analyzed. Findings suggest that most patients would follow their physician's recommendation for CRCS despite not engaging in much discussion. Patients may refrain from CRCS discussion because of a commitment to CRCS, awareness of screening guidelines, and trust in physician's honesty and beneficence. Yet many patients left their wellness exams with questions, refraining because of future plans to consult with their physicians, perceived time constraints or a lack of a patient-physician relationship. If patients are leaving their wellness exams with unanswered questions, interventions should prepare physicians for patient reticence, teaching physicians how to assure patients that CRCS is a primary care activity where all questions and concerns, including cost and scheduling, may be resolved.^

A Coordinated Plan for Teaching Software Engineering in the University Rey Juan Carlos.

Un plan para organizar las enseñanzas de la ingeniería del software en las titulaciones de informática de la URJC. Nowadays both industry and academic environments are showing a lot of interest in the Software Engineering discipline. Therefore, it is a challenge for universities to provide students with appropriate training in this area, preparing them for their future professional practice. There are many difficulties to provide that training. The outstanding ones are: the Software Engineering area is too broad and class hours are scarce; the discipline requires a high level of abstraction; it is difficult to reproduce real world situations in the classroom to provide a practical learning environment; the number of students per professor is very high (at least in Spain); companies develop software with a maturity level rarely over level 2 of the CMM for Software (again, at least in Spain) as opposed to what is taught at the University. Besides, there are different levels and study plans, making more difficult to structure the contents to teach in each term and degree. In this paper we present a plan for teaching Software Engineering trying to overcome some of the difficulties above.

3D teaching: the ideal complement for professionals in design and construction

Today, the requirement of professional skills to university students is constantly increasing in our society. In our opinion, the content offered in official degrees need to be nourished with different variables, enriching their global professional knowledge in a parallel way; that is why, in recent years, there is a great multiplicity of complementary courses at university. One of the most socially demanded technical requirements within the architectural, design or engineering field is the management of 3D drawing software, becoming an indispensable reality in these sectors. Thus, this specific training becomes essential over two-dimension traditional design, because the inclusion of great possibilities of spatial development that go beyond conventional orthographic projections (plans, sections or elevations), allowing modelling and rotation of the selected items from multiple angles and perspectives. Therefore, this paper analyzes the teaching methodology of a complementary course for those technicians in the construction industry interested in computer-aided design, using modelling (SketchupMake) and rendering programs (Kerkythea). The course is developed from the technician point of view, by learning computer management and its application to professional development from a more general to a more specific view through practical examples. The proposed methodology is based on the development of real examples in different professional environments such as rehabilitation, new constructions, opening projects or architectural design. This multidisciplinary contribution improves criticism of students in different areas, encouraging new learning strategies and the independent development of three-dimensional solutions. Thus, the practical implementation of new situations, even suggested by the students themselves, ensures active participation, saving time during the design process and the increase of effectiveness when generating elements which may be represented, moved or virtually tested. In conclusion, this teaching-learning methodology improves the skills and competencies of students to face the growing professional demands of society. After finishing the course, technicians not only improved their expertise in the field of drawing but they also enhanced their capacity for spatial vision; both essential qualities in these sectors that can be applied to their professional development with great success.

How to measure healthiness in buildings: Experiences in teaching with BIM tools

Introducing teaching about healthy solutions in buildings and BIM has been a challenge for the University of Alicante. Teaching attached to very tighten study plans conditioned the types of methods that could be used in the past. The worldwide situation of crisis that especially reached Spain and the bursting of the housing bubble generated a lack of employment that reached universities where careers related to construction, Architecture and Architectural Technologist, suffered a huge reduction in the number of students enrolled. In the case of the University of Alicante, students’ enrolment for Architectural Technology reached an 80% reduction. The necessity of a reaction against this situation made the teachers be innovative and use the new Bologna adapted study plans to develop new teaching experiences introducing new concepts: people wellbeing in buildings and BIM. Working with healthy solutions in buildings provided new approaches for building design and construction as an alternative to sustainability. For many years sustainability was the concept that applied to housing gave buildings an added value and the possibility of having viability in a very complex scenario. But after lots of experiences, the approved methodologies for obtaining sustainable housing were ambiguous and at the end, investors, designers, constructors and purchasers cannot find real and validated criteria for obtaining an effective sustainable house. It was the moment to work with new ideas and concepts and start facing buildings from the users’ point of view. At the same time the development of new tools, BIM, has opened a wide range of opportunities, innovative and suggestive, that allows simulation and evaluation of many building factors. This paper describes the research in teaching developed by the University of Alicante to adapt the current study plans, introducing work with healthy solutions in buildings and the use of BIM, with the aim of attracting students by improving their future employability. Pilot experiences have been carried out in different subjects based on the work with projects and case studies under an international frame with the cooperation of different European partner universities. The use of BIM tools, introduced in 2014, solved the problems that appeared in some subjects, mainly building construction, and helped with the evaluation of some healthy concepts that presented difficulties until this moment as knowledge acquired by the students was hard to be evaluated. The introduction of BIM tools: Vasari, FormIt, Revit and Light Control among others, allowed the study of precise healthy concepts and provided the students a real understand of how these different parameters can condition a healthy architectural space. The analysis of the results showed a clear acceptance by the students and gave teachers the possibility of opening new research lines. At the same time, working with BIM tools to obtain healthy solutions in building has been a good option to improve students’ employability as building market in Spain is increasing the number of specialists in BIM with a wider knowledge.

Audit of consultant physicians' reply letters for referrals to clinics in a tertiary teaching hospital

Background: Doctors referring patients to consultant physicians seek reply letters which both educate and assist in ongoing patient management. Highly desirable attributes in specialist letters include clearly stated and justified: (i) diagnostic formulations, (ii) management regimens, (iii) use of clinical investigations, (iv) prog-nostic statements, (v) contingency plans and (vi) follow-up arrangements. Aim: To explicitly evaluate the quality of reply letters for new patients referred to clinics at a tertiary teaching hospital. Methods: Letters were sampled from outpatient clinics of 10 different medical specialties at Princess Alexandra Hospital in Brisbane, Australia. Reply letters for new patient referrals between 1 August 2000 and 31 October 2000 were retrieved, from which data were abstracted to calculate the proportion of letters satisfying prespecified quality attributes. Results: Of 297 new patient referrals, reply letters were retrieved for 204 (69%). Of these, 147 (72%) referrals were accompanied by a referral letter, mostly (113/147; 77%) from general practitioners. For 120 referrals involving diagnostic issues, 69 (56%) letters stated a diagnostic formulation. Of 114 letters recommending further clinical investigations, 61 (53%) described a rationale for such testing. In 125 cases where therapy was a key issue, 83 (66%) letters recommended changes to current treatment for which reasons were specified in 46 (55%) cases, and contingency plans provided in 13 (16%). Prognosis was mentioned in only 18 (9%) cases. Follow-up arrangements were detailed in 123 (60%) letters. Assessments of patient understanding and likely adherence to therapy were stated in less than 15% of -letters. Conclusions: Opportunities exist for improving quality of consultant physicians' reply letters in terms of greater use of problem lists, contingency plans, prognostic statements and patient-centred assessments, as well as more frequent enunciation of consultants' reasoning behind requests for further tests and changes to current management. Use of structured letter templates may facilitate more consistent inclusion of key information to referring doctors.

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. ^ Sanders CTI (1992) instrument was adapted for this study and pilot-tested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61% for part-time faculty (n = 55). ^ The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Full-time faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. ^ Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. ^ Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies. ^

Content and Methods of Teaching Literacy: The Effect of One-on-One Tutoring in Preservice Clinical Education in Two Low-Performing, Diverse School Settings on the Effectiveness of Preservice Teachers’ Reading Instruction

This is a study of preservice teachers’ ability to teach reading to struggling, diverse students, after participating in a school-embedded course incorporating a one-on-one tutorial directly supervised by reading experts. Changes in reading performance as well as plans to analyze changes in the preservice teachers will be discussed.

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. Sander's CTI (1992) instrument was adapted for this study and pilottested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61 % for part-time faculty (n = 55). The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Fulltime faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies.

EXAMINING SECONDARY MATHEMATICS TEACHER CANDIDATES’ LEARNING AND ENACTMENT OF MATHEMATICS TEACHING PRACTICES: A MULTIPLE CASE STUDY

This qualitative case study explored three teacher candidates’ learning and enactment of discourse-focused mathematics teaching practices. Using audio and video recordings of their teaching practice this study aimed to identify the shifts in the way in which the teacher candidates enacted the following discourse practices: elicited and used evidence of student thinking, posed purposeful questions, and facilitated meaningful mathematical discourse. The teacher candidates’ written reflections from their practice-based coursework as well as interviews were examined to see how two mathematics methods courses influenced their learning and enactment of the three discourse focused mathematics teaching practices. These data sources were also used to identify tensions the teacher candidates encountered. All three candidates in the study were able to successfully enact and reflect on these discourse-focused mathematics teaching practices at various time points in their preparation programs. Consistency of use and areas of improvement differed, however, depending on various tensions experienced by each candidate. Access to quality curriculum materials as well as time to formulate and enact thoughtful lesson plans that supported classroom discourse were tensions for these teacher candidates. This study shows that teacher candidates are capable of enacting discourse-focused teaching practices early in their field placements and with the support of practice-based coursework they can analyze and reflect on their practice for improvement. This study also reveals the importance of assisting teacher candidates in accessing rich mathematical tasks and collaborating during lesson planning. More research needs to be explored to identify how specific aspects of the learning cycle impact individual teachers and how this can be used to improve practice-based teacher education courses.

Developing reading sub-skills: 15 Lesson Plans Adapted from "The Canterbury Tales”for teenagers

Este trabajo enfatiza el uso de la literatura en Clases EFL. La literatura es usada como una técnica para enseñar las cuatro destrezas básicas: lectura, habilidad de escuchar, escritura y la producción oral. Provee herramientas para mejorar vocabulario, pronunciación y estructuras gramaticales. El leer literatura provee beneficios enlistados en este documento. Además, algunas desventajas también son presentadas. La falta de: capacitación de profesores, interés por parte de los estudiantes y material propio de lectura, hacen de la literatura una tarea difícil de completar. Seleccionar el material correcto para una Clase EFL es el aspecto más importante para generar el interés por la lectura en los estudiantes. En este caso los adolescentes son el objetivo de este estudio. “The Canterbury Tales” por Geoffrey Chaucer, es la obra en la cual este proyecto está basado. La obra literaria de Geoffrey Chaucer “The Canterbury Tales” le da al lector la oportunidad de imaginar una cultura diferente, el comportamiento de las personas, sentimientos, diversión y moralejas con las que las personas se identifican. Quince planificaciones de clase adaptadas de “The Canterbury Tales” es la mejor herramienta para cultivar el interés por la lectura. Las más importantes sub-destrezas son mostradas en estas planificaciones. Cada una de estas sub-destrezas demuestra actividades sugeridas que pueden ser practicadas dentro del aula. La incorporación de la lectura en una Clase EFL facilita el trabajo del profesor con estudiantes quienes encontraran en la lectura facilidad y diversión.

New challenges in making plans: putting design back into the applied science of planning

The origins of the ‘planning’ lie in the regional sciences and attempts to undertake social engineering of land use occupancy.
Over the last 100 years planning, as a discipline, has variously dabbled in design on the margins with urban design and neourbanism, but has stayed staunchly in the applied science and social science realms. This penchant detrimentally affects its graduates abilities to holistically appreciate and envision the consequences of their decisions-making and plan-making, to convey strength of conviction and expertise to the community, but also to establish a solid basis upon which its professional practice applications and decision-making paradigms successfully articulate equity and comprehensiveness of rational land use and development planning and decision-making. While planning re-learnt how to legitimately evaluate design and aesthetics into planning in the 1960s through the emergent McHargian ecological design paradigm, quickly embracing it as a consequence of major environmental land use disasters that occurred ‘on its watch’ that were demonstrable failures of its claimed insight and professional responsibilities, it has struggled as a discipline to embrace design as an integral technology in its daily operations and expressed ‘territory’ of professional responsibility. This paper reviews this legacy and then charts some emergent patterns in the teaching and practice of planning in Australia that are attempting to re-position design as a legitimate and integral part of the knowledge and skills of a professional planners.