The development and evaluation of an innovative nursing practice model to improve undergraduate nursing students' competence in paediatric physical assessment

Introduction The purpose of this study was to develop, implement and evaluate the impact of an educational intervention, comprising an innovative model of clinical decisionmaking and educational delivery strategy for facilitating nursing students‘ learning and development of competence in paediatric physical assessment practices. Background of the study Nursing students have an undergraduate education that aims to produce graduates of a generalist nature who demonstrate entry level competence for providing nursing care in a variety of health settings. Consistent with population morbidity and health care roles, paediatric nursing concepts typically form a comparatively small part of undergraduate curricula and students‘ exposure to paediatric physical assessment concepts and principles are brief. However, the nursing shortage has changed traditional nursing employment patterns and new graduates form the majority of the recruitment pool for paediatric nursing speciality staff. Paediatric nursing is a popular career choice for graduates and anecdotal evidence suggests that nursing students who select a clinical placement in their final year intend to seek employment in paediatrics upon graduation. Although concepts of paediatric nursing are included within undergraduate curriculum, students‘ ability to develop the required habits of mind to practice in what is still regarded as a speciality area of practice is somewhat limited. One of the areas of practice where this particularly impacts is in paediatric nursing physical assessment. Physical assessment is a fundamental component of nursing practice and competence in this area of practice is central to nursing students‘ development of clinical capability for practice as a registered nurse. Timely recognition of physiologic deterioration of patients is a key outcome of nurses‘ competent use of physical assessment strategies, regardless of the practice context. In paediatric nursing contexts children‘s physical assessment practices must specifically accommodate the child‘s different physiological composition, function and pattern of clinical deterioration (Hockenberry & Barrera, 2007). Thus, to effectively manage physical assessment of patients within the paediatric practice setting nursing students need to integrate paediatric nursing theory into their practice. This requires significant information processing and it is in this process where students are frequently challenged. The provision of rules or models can guide practice and assist novice-level nurses to develop their capabilities (Benner, 1984; Benner, Hooper-Kyriakidis & Stannard, 1999). Nursing practice models are cognitive tools that represent simplified patterns of expert analysis employing concepts that suit the limited reasoning of the inexperienced, and can represent the =rules‘ referred to by Benner (1984). Without a practice model of physical assessment students are likely to be uncertain about how to proceed with data collection, the interpretation of paediatric clinical findings and the appraisal of findings. These circumstances can result in ad hoc and unreliable nursing physical assessment that forms a poor basis for nursing decisions. The educational intervention developed as part of this study sought to resolve this problem and support nursing students‘ development of competence in paediatric physical assessment. Methods This study utilised the Context Input Process Product (CIPP) Model by Stufflebeam (2004) as the theoretical framework that underpinned the research design and evaluation methodology. Each of the four elements in the CIPP model were utilised to guide discrete stages of this study. The Context element informed design of the clinical decision-making process, the Paediatric Nursing Physical Assessment model. The Input element was utilised in appraising relevant literature, identifying an appropriate instructional methodology to facilitate learning and educational intervention delivery to undergraduate nursing students, and development of program content (the CD-ROM kit). Study One employed the Process element and used expert panel approaches to review and refine instructional methods, identifying potential barriers to obtaining an effective evaluation outcome. The Product element guided design and implementation of Study Two, which was conducted in two phases. Phase One employed a quasiexperimental between-subjects methodology to evaluate the impact of the educational intervention on nursing students‘ clinical performance and selfappraisal of practices in paediatric physical assessment. Phase Two employed a thematic analysis and explored the experiences and perspectives of a sample subgroup of nursing students who used the PNPA CD-ROM kit as preparation for paediatric clinical placement. Results Results from the Process review in Study One indicated that the prototype CDROM kit containing the PNPA model met the predetermined benchmarks for face validity and the impact evaluation instrumentation had adequate content validity in comparison with predetermined benchmarks. In the first phase of Study Two the educational intervention did not result in statistically significant differences in measures of student performance or self-appraisal of practice. However, in Phase Two qualitative commentary from students, and from the expert panel who reviewed the prototype CD-ROM kit (Study One, Phase One), strongly endorsed the quality of the intervention and its potential for supporting learning. This raises questions regarding transfer of learning and it is likely that, within this study, several factors have influenced students‘ transfer of learning from the educational intervention to the clinical practice environment, where outcomes were measured. Conclusion In summary, the educational intervention employed in this study provides insights into the potential e-learning approaches offer for delivering authentic learning experiences to undergraduate nursing students. Findings in this study raise important questions regarding possible pedagogical influences on learning outcomes, issues within the transfer of theory to practice and factors that may have influenced findings within the context of this study. This study makes a unique contribution to nursing education, specifically with respect to progressing an understanding of the challenges faced in employing instructive methods to impact upon nursing students‘ development of competence. The important contribution transfer of learning processes make to students‘ transition into the professional practice context and to their development of competence within the context of speciality practice is also highlighted. This study contributes to a greater awareness of the complexity of translating theoretical learning at undergraduate level into clinical practice, particularly within speciality contexts.

E-learning and access : getting behind the hype

Rapid advances in information and communications technology (ICT) - particularly the development of online technologies -have transformed the nature of economic, social and cultural relations across the globe. In the context of higher education in post-industrial societies, technological change has had a significant impact on university operating environments. In a broad sense, technological advancement has contributed significantly to the increasing complexity of global economies and societies, which is reflected in the rise of lifelong learning discourses with which universities are engaging. More specifically, the ever-expanding array of ICT available within the university sector has generated new management and pedagogical imperatives for higher education in the information age.

Teaching and learning in a context-based chemistry classroom

Many current chemistry programs privilege de-contextualised conceptual learning, often limited by a narrow selection of pedagogies that too often ignore the realities of studentse own lives and interests (e.g., Tytler, 2007). One new approach that offers hope for improving studentse engagement in learning chemistry and perceived relevance of chemistry is the context-based approach. This study investigated how teaching and learning occurred in one year 11 context-based chemistry classroom. Through an interpretive methodology using a case study design, the teaching and learning that occurred during one term (ten weeks) of a unit on Water Quality are described. The researcher was a participant observer in the study who co-designed the unit of work with the teacher. The research questions explored the structure and implementation of the context-based approach, the circumstances by which students connected concepts and context in the context-based classroom and the outcome of the approach for the students and the teacher. A dialectical sociocultural theoretical framework using the dialectics of structure | agency and agency | passivity was used as a lens to explore the interactions between learners in different fields, such as the field of the classroom and the field of the local community. The findings of this study highlight the difficulties teachers face when implementing a new pedagogical approach. Time constraints and opportunities for students to demonstrate a level of conceptual understanding that satisfied the teacher, hindered a full implementation of the approach. The study found that for high (above average) and sound (average) achieving students, connections between sanctioned science content of school curriculum and the studentse out-of-school worlds were realised when students actively engaged in fields that contextualised inquiry and gave them purpose for learning. Fluid transitions or the toing and froing between concepts and contexts occurred when structures in the classroom afforded students the agency to connect concepts and contexts. The implications for teaching by a context-based approach suggest that keeping the context central, by teaching content on a "need-to-know" basis, contextualises the chemistry for students. Also, if teachers provide opportunities for student-student interactions and written work student learning can improve.

Realism and control : problem-based learning programs as a data source for work-related research

Problem-based learning (PBL) is a pedagogical methodology that presents the learner with a problem to be solved to stimulate and situate learning. This paper presents key characteristics of a problem-based learning environment that determines its suitability as a data source for workrelated research studies. To date, little has been written about the availability and validity of PBL environments as a data source and its suitability for work-related research. We describe problembased learning and use a research project case study to illustrate the challenges associated with industry work samples. We then describe the PBL course used in our research case study and use this example to illustrate the key attributes of problem-based learning environments and show how the chosen PBL environment met the work-related research requirements of the research case study. We propose that the more realistic the PBL work context and work group composition, the better the PBL environment as a data source for a work-related research. The work context is more realistic when relevant and complex project-based problems are tackled in industry-like work conditions over longer time frames. Work group composition is more realistic when participants with industry-level education and experience enact specialized roles in different disciplines within a professional community.

Applied theatre and organisational transformation

Applied Theatre is an umbrella term for a range of drama-based techniques, all of which align with a lineage of pedagogical theory and practice: (e.g.) Freire, Moreno, Heathcote. It encompasses methods and forms including Drama Education (O’Neill); Forum Theatre (Boal); and Process Drama (Haseman, O’Toole). Applied theatre often occurs in non-theatrical settings (schools, hospitals, prisons) with the aim of helping participants address issues of local concern. Increasingly, Applied Theatre practices are utilised in the corporate environment. Appied Theatre adopts artistic principles in production, but posits a practical utility beyond simple entertainment.

Settings for mental health care

The quality of the environment is important to client recovery and rehabilitation. • The preferred environment for the care of the mentally ill over time has been the home. • Environmental strategies in the care of the mentally ill became more important in the eighteenth century, when it was noticed that patients were more manageable in a pleasant environment. • Confinement of the mentally ill in large public asylums was largely an innovation of the nineteenth century. • The therapeutic milieu is a consciously organised environment. • Maxwell Jones in the United States and Thomas Main in the United Kingdom pioneered the concept of the hospital and environment as treatment tools. • The goals of the therapeutic milieu are containment, structure, support, involvement, validation, symptom management, and maintaining links with family and the community. • The principles on which the therapeutic milieu is based include: open communication, democratisation, reality confrontation, permissiveness, group cohesion and the multidisciplinary team. • The principle guiding the care of clients in the community is that of the least-restrictive alternative. • The therapeutic community residence is an environment that encourages the development of the client as a person in interaction with others, rather than as someone suffering from a health problem or disability. • The preferred contemporary setting for the provision of mental health care is the community. • The predominant form of service delivery in the community is case management, which has been found to be most effective for people with severe mental illnesses. • The principles of caring in the community are self-determination, normalisation, a focus on client strengths, and the community as a resource

MiLK. Mobile Learning Kit

The Mobile Learning Kit is a new digital learning application that allows students and teachers to compose, publish, discuss and evaluate their own mobile learning games and events. The research field was interaction design in the context of mobile learning. The research methodology was primarily design-based supported by collaboration between participating disciplines of game design, education and information technology. As such, the resulting MiLK application is a synthesis of current pedagogical models and experimental interaction design techniques and technologies. MiLK is a dynamic learning resource for incorporating both formal and informal teaching and learning practices while exploiting mobile phones and contemporary digital social tools in innovative ways. MiLK explicitly addresses other predominant themes in educational scholarship that relate to current education innovation and reform such as personalised learning, life-long learning and new learning spaces. The success of this project is indicated through rigorous trials and actual uptake of MiLK by international participants in Australia, UK, US and South Africa. MiLK was awarded for excellence in the use of emerging technologies for improved learning and teaching as a finalist (top 3) in the Handheld Learning and Innovation Awards in the UK in 2008. MiLK was awarded funding from the Australasian CRC for Interaction Design in 2008 to prepare the MiLK application for development. MiLK has been awarded over $230,000 from ACID since 2006. The resulting application and research materials are now being commercialised by a new company, ‘ACID Services’.

SCAPE sustainable urban design simulation

SCAPE is an interactive simulation that allows teachers and students to experiment with sustainable urban design. The project is based on the Kelvin Grove Urban Village, Brisbane. Groups of students role play as political, retail, elderly, student, council and builder characters to negotiate on game decisions around land use, density, housing types and transport in order to design a sustainable urban community. As they do so, the 3D simulation reacts in real time to illustrate what the village would look like as well as provide statistical information about the community they are creating. SCAPE brings together education, urban professional and technology expertise, helping it achieve educational outcomes, reflect real-world scenarios and include sophisticated logic and decision making processes and effects.---------- The research methodology was primarily practice led underpinned by action research methods resulting in innovative approaches and techniques in adapting digital games and simulation technologies to create dynamic and engaging experiences in pedagogical contexts. It also illustrates the possibilities for urban designers to engage a variety of communities in the processes, complexities and possibilities of urban development and sustainability.

The Creative Workforce : How to Launch Young People into High-Flying Futures

Creativity has become the economic engine of the 21st century. No longer the preserve of creative industries, 'creative capital' – in the form of novel thinking, navigation, interactivity and border-crossing – has become crucial to success and productivity. But are young people being equipped for a work future in which creativity is the defining feature of economic life? In this important book, Erica McWilliam argues that young people’s creative capacities are not being properly developed and that education, particularly in Australia, demands a massive pedagogical shift. Using both Australian and overseas examples, McWilliam describes what creative capacities are, why they've become important to our work futures, and what can be done to optimise the creative capacities of young people.

A constraints-led perspective to understanding skill acquisition and game play: A basis for integration of motor learning theory and physical education praxis?

Background: In order to design appropriate environments for performance and learning of movement skills, physical educators need a sound theoretical model of the learner and of processes of learning. In physical education, this type of modelling informs the organization of learning environments and effective and efficient use of practice time. An emerging theoretical framework in motor learning, relevant to physical education, advocates a constraints-led perspective for acquisition of movement skills and game play knowledge. This framework shows how physical educators could use task, performer and environmental constraints to channel acquisition of movement skills and decision making behaviours in learners. From this viewpoint, learners generate specific movement solutions to satisfy the unique combination of constraints imposed on them, a process which can be harnessed during physical education lessons. Purpose: In this paper the aim is to provide an overview of the motor learning approach emanating from the constraints-led perspective, and examine how it can substantiate a platform for a new pedagogical framework in physical education: nonlinear pedagogy. We aim to demonstrate that it is only through theoretically valid and objective empirical work of an applied nature that a conceptually sound nonlinear pedagogy model can continue to evolve and support research in physical education. We present some important implications for designing practices in games lessons, showing how a constraints-led perspective on motor learning could assist physical educators in understanding how to structure learning experiences for learners at different stages, with specific focus on understanding the design of games teaching programmes in physical education, using exemplars from Rugby Union and Cricket. Findings: Research evidence from recent studies examining movement models demonstrates that physical education teachers need a strong understanding of sport performance so that task constraints can be manipulated so that information-movement couplings are maintained in a learning environment that is representative of real performance situations. Physical educators should also understand that movement variability may not necessarily be detrimental to learning and could be an important phenomenon prior to the acquisition of a stable and functional movement pattern. We highlight how the nonlinear pedagogical approach is student-centred and empowers individuals to become active learners via a more hands-off approach to learning. Summary: A constraints-based perspective has the potential to provide physical educators with a framework for understanding how performer, task and environmental constraints shape each individual‟s physical education. Understanding the underlying neurobiological processes present in a constraints-led perspective to skill acquisition and game play can raise awareness of physical educators that teaching is a dynamic 'art' interwoven with the 'science' of motor learning theories.

Scaffolding an EFL (English as a foreign language) ‘effective writing’ class in a hybrid learning community

This study sought to establish and develop innovative instructional procedures, in which scaffolding can be expanded and applied, in order to enhance learning of English as a Foreign Language (EFL) writing skills in an effective hybrid learning community (a combination of face-to-face and online modes of learning) at the university where the researcher is working. Many educational experts still believe that technology has not been harnessed to its potential to meet the new online characteristics and trends. There is also an urgency to reconsider the pedagogical perspectives involved in the utilisation of online learning systems in general and the social interactions within online courses in particular that have been neglected to date. An action research design, conducted in two cycles within a duration of four months, was utilised throughout this study. It was intended not only to achieve a paradigm shift from transmission-absorption to socio-constructivist teaching/learning methodologies but also to inform practice in these technology-rich environments. Five major findings emerged from the study. First, the scaffolding theory has been extended. Two new scaffolding types (i.e., quasi-transcendental scaffolding and transcendental scafolding), two scaffolding aspects (i.e., receptive and productive) and some scaffolding actions (e.g., providing a stimulus, awareness, reminder, or remedy) for EFL writing skills in an effective hybrid learning community have been identified and elaborated on. Second, the EFL ‘Effective Writing’ students used the scaffolds implemented in a hybrid environment to enhance and enrich their learning of writing of English essays. The online activities, conducted after the F2F sessions most of the time, gave students greater opportunities to both reinforce and expand the knowledge they had acquired in the F2F mode. Third, a variety of teaching techniques, different online tasks and discussion topics utilised in the two modes bolstered the students’ interests and engagement in their knowledge construction of how to compose English-language essays. Fourth, through the scaffolded activities, the students learned how to scaffold themselves and thus became independent learners in their future endeavours of constructing knowledge. Fifth, the scaffolding-to-scaffold activities provided the students with knowledge on how to effectively engage in transcendental scaffolding actions and facilitate the learning of English writing skills by less able peers within the learning community. Thus, the findings of this current study extended earlier understandings of scaffolding in an EFL hybrid learning environment and will contribute to the advancement of future ICT-mediated courses in terms of their scaffolding pedagogical aspects.

Location-based games : transforming everyday environments into dynamic learning spaces

Location based games (LBGs) provide an opportunity to look at how new technologies can support a reciprocal relationship between formal classroom learning and learning that can potentially occur in other everyday environments. Fundamentally many games are intensely engaging due to the resulting social interactions and technical challenges they provide to individual and group players. By introducing the use of mobile devices we can transport these characteristics of games into everyday spaces. LBGs are understood as a broad genre incorporating ideas and tools that provide many unique opportunities for us to to reveal, create and even subvert various social, cultural, technical, and scientific interpretations of place, in particular places where learning is sometimes problematic.--------- A team of Queensland game developers have learnt a great deal through designing a range of LBGs such as SCOOT for various user groups and places. While these LBGs were primarily designed as social events, we found that the players recognised and valued the game as an opportunity to learn about their environment, it's history, cultural significance, inhabitants, services etc. Since identifying the strong pedagogical outcomes of LBGs, the team has created a set of authoring tools for people to design and host their own LBGs. A particular version of this is known as MiLK the mobile learning kit for schools.---------- This presentation will include examples of how LBGs have been used to improve the teaching and learning outcomes in various contexts. Participants will be introduced to MiLK and invited to trial it in their own classrooms with students.

Critical social theory and transformative learning : evidence in pre-service teachers' service-learning reflection logs

This paper reports on the opportunities for transformational learning experienced by a group of pre-service teachers who were engaged in service-learning as a pedagogical process with a focus on reflection. Critical social theory informed the design of the reflection process as it enabled a move away from knowledge transmission toward knowledge transformation. The structured reflection log was designed to illustrate the critical social theory expectations of quality learning that teach students to think critically: ideology critique and utopian critique. Butin's lenses and a reflection framework informed by the work of Bain, Ballantyne, Mills and Lester were used in the design of the service-learning reflection log. Reported data provide evidence of transformational learning and highlight how the students critique their world and imagine how they could contribute to a better world in their work as a beginning teacher.

Crossing the cultural divide : a contemporary holistic framework for conceptualising design studio education

While the studio is widely accepted as the learning environment where architecture students most effectively learn how to design (Mahgoub, 2007:195), there are surprisingly few studies that attempt to identify in a qualitative way the interrelated factors that contribute to and support design studio learning (Bose, 2007:131). Such a situation seems problematic given the changes and challenges facing education including design education. Overall, there is growing support for re-examining (perhaps redefining) the design studio particularly in response to the impact of new technologies but as this paper argues this should not occur independently of the other elements and qualities comprising the design studio. In this respect, this paper describes a framework developed for a doctoral project concerned with capturing and more holistically understanding the complexity and potential of the design studio to operate within an increasingly and largely unpredictable global context. Integral to this is a comparative analysis of selected cases underpinned by grounded theory methodology of the traditional design studio and the virtual design studio informed by emerging pedagogical theory and the experiences of those most intimately involved – students and lecturers. In addition to providing a conceptual model for future research, the framework is of value to educators currently interested in developing as well as evaluating learning environments for design.

Adventures in pedagogy : the trials and tribulations of teaching common law in China

China is now seen as arguably, the next economic giant of the 21st century. From a country closed in the past to the external world, the Chinese market now presents as one of the most lucrative in the world economy. One area that has drawn increasing international interest is education - it has been estimated that by 2020 there will be 25 million excess demands for higher education places that the Chinese tertiary educational system cannot meet. Many overseas institutions have developed programs to cater for this immense potential market. In 2000 the Law Faculty of the University of Technology, Sydney (UTS)introduced a new postgraduate program specifically targeting the Chinese market. This paper is a brief assessment of the program - it examines general issues in the pedagogical delivery of programs in LOTE (Language Other Than English) and the use of 'proxies' in the delivery of LOTE programs. The paper concludes that while the UTS program demonstrates that it is feasible to use proxy lecturers or interpreters in the delivery of programs in LOTE, the exercise entails significant problems that can undermine the integrity of such programs.