A realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective: To determine what, how, for whom, why, and in what circumstances educational interventions to improve the delivery of nutrition care by doctors and other healthcare professionals work?

Design: Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched Medline, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar, and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms, and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations.

Results: Over half of the 46 studies from which we extracted data originated from the US. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in both developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included: feeling competent; feeling confident and comfortable; having greater self-efficacy; being less inhibited by barriers in healthcare systems; and feeling that nutrition care was accepted and recognised.

Conclusion: These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.

External school evaluation : teachers’ perspectives : two case studies from Northern Portugal

The external evaluation of non-higher education schools in Portugal has been developed by the General Inspectorate of Education since 2006. A first cycle of evaluation was completed, covering all educational units in continental Portugal up to 2011. The model of evaluation has since been subject to alterations, and a second cycle of evaluation is now coming to an end. The current model of evaluation is based on documental analysis, analysis of students’ results, and panel interviews with a variety of representatives of the school community, and addresses three domains: results, provision of educational service and management. This paper is part of an ongoing research project, developed by 6 universities and supported by the Portuguese Foundation for Science and Technology (PTDC/CPE-CED/116674/2010) which intends to analyse the impacts and effects this process of external evaluation has had on Portuguese schools. This project includes a variety of perspectives and methodologies. In particular, we will focus on two case studies undertaken in two schools from the northern region of Portugal, and more specifically on the perspectives expressed by the teachers of those schools. These particular schools were chosen because they have been evaluated twice and represent different educational levels (basic and secondary), contexts and results. These case studies included the analysis of documental data, interviews to key informants and a questionnaire directed to teachers (n = 141) – the latter will be the main focus of this paper. Teachers are essential elements of the school community when considering the impacts of external evaluation, as any changes directed at teaching practices, student evaluation, among others are only possible through their direct action and implication. Therefore, their perceptions on the process and its impacts are crucial to the understanding of what does and does not change in schools as a consequence of external evaluation. Although teachers’ opinions are not homogenous and each school reveals a number of differences when it comes to teachers’ perceptions of School Evaluation, it was possible to stress some areas as the most and as the least consensual. Teachers in both schools agree External School Evaluation (ESE) is useful for the identification of the schools’ strengths and weaknesses, values students’ external evaluation results, imposes a model for schools internal evaluation (and in fact contributes to the very existence of internal evaluation practices), and contributes to schools improvement. However teachers in both schools do not believe ESE contributes to teachers’ autonomy produces changes in how curriculum is managed, or leads to innovative teaching practices. These results point to a greater emphasis on change at the levels of school management, self-evaluation and particularly internal evaluation, but little impact on the teaching practices. We believe the classroom is at the core of school practices and teaching processes are essential to any measure of school quality and to their impacts on student learning.

An innovative learning model for teaching architectural technology using building information modelling : a Queensland University of Technology perspective

In architecture courses, instilling a wider understanding of the industry specific representations practiced in the Building Industry is normally done under the auspices of Technology and Science subjects. Traditionally, building industry professionals communicated their design intentions using industry specific representations. Originally these mainly two dimensional representations such as plans, sections, elevations, schedules, etc. were produced manually, using a drawing board. Currently, this manual process has been digitised in the form of Computer Aided Design and Drafting (CADD) or ubiquitously simply CAD. While CAD has significant productivity and accuracy advantages over the earlier manual method, it still only produces industry specific representations of the design intent. Essentially, CAD is a digital version of the drawing board. The tool used for the production of these representations in industry is still mainly CAD. This is also the approach taken in most traditional university courses and mirrors the reality of the situation in the building industry. A successor to CAD, in the form of Building Information Modelling (BIM), is presently evolving in the Construction Industry. CAD is mostly a technical tool that conforms to existing industry practices. BIM on the other hand is revolutionary both as a technical tool and as an industry practice. Rather than producing representations of design intent, BIM produces an exact Virtual Prototype of any building that in an ideal situation is centrally stored and freely exchanged between the project team. Essentially, BIM builds any building twice: once in the virtual world, where any faults are resolved, and finally, in the real world. There is, however, no established model for learning through the use of this technology in Architecture courses. Queensland University of Technology (QUT), a tertiary institution that maintains close links with industry, recognises the importance of equipping their graduates with skills that are relevant to industry. BIM skills are currently in increasing demand throughout the construction industry through the evolution of construction industry practices. As such, during the second half of 2008, QUT 4th year architectural students were formally introduced for the first time to BIM, as both a technology and as an industry practice. This paper will outline the teaching team’s experiences and methodologies in offering a BIM unit (Architectural Technology and Science IV) at QUT for the first time and provide a description of the learning model. The paper will present the results of a survey on the learners’ perspectives of both BIM and their learning experiences as they learn about and through this technology.

Providing innovative planning education experience : teaching regional planning in an international context

Rapidly changing economic, social, and environmental conditions have created a need for urban and regional planning practitioners who are resilient, innovative, and able to cope with the increasingly complex and cosmopolitan nature of major metropolitan areas. This need should be reflected in planning education that allows students to experience a diverse range of approaches to problems and challenges, and that exposes students to the diverse array of perspectives on planning issues. This paper investigates the outcomes of a collaborative regional planning exercise organised jointly by planning academics from both Queensland University of Technology and the International Islamic University of Malaysia, and involving planning students from both universities. The regional planning exercise consisted of a regional appraisal and report topics of the area under investigation, Klang Valley – Kuala Lumpur, Malaysia. It culminated with the presentation of regional development strategies for the area, with a field trip to Malaysia being the cornerstone of the project. The collaborative exercise involved a series of workshops and seminars organised locally, in which both Australian and Malaysian planning students participated, as well as meetings with local and federal planning officials, and also a forum for Young Planners of Australian and Malaysian Planning Institutes. The experience attempted to bridge the teaching of theoretical concepts of regional planning and development and the regional, more professional knowledge of planning practice, as it relates to specific political, institutional and cultural contexts. A survey of participating students, from both Queensland University of Technology and the International Islamic University of Malaysia, highlights the benefits of such project in terms of leaning experience and exposure to different cultural contexts.

Innovative approaches to teaching engineering drawing at tertiary institutions

This paper arises from our concern for the level of teaching of engineering drawing at tertiary institutions in Australia. Little attention is paid to teaching hand drawing and tolerancing. Teaching of engineering drawing is usually limited to computer-aided design (CAD) using AutoCAD or one of the solid-modelling packages. As a result, many engineering graduates have diffi culties in understanding how views are produced in different projection angles, are unable to produce engineering drawings of professional quality, or read engineering drawings, and unable to select fits and limits or surface roughness. In the Faculty of Built Environment and Engineering at the Queensland University of Technology new approaches to teaching engineering drawing have been introduced. In this paper the results of these innovative approaches are examined through surveys and other research methods.

Northern Ireland and ‘The Troubles’, outlining an innovative approach to nursing/midwifery student teaching and module evaluation

This discussion paper outlines an approach to developing and evaluating an educative programme primarily delivered by lay `citizen trainers’ in educating student nurses, and student midwives to the impact of and experience of extended and extensive civil unrest within their communities (`the Troubles’ ). This is drawn from experience within the Northern Ireland `Troubles’ and all of the citizen trainers were directly affected physically/psychologically. The programme was intended to both educate but primarily to help facilitate student nurses and student midwives to better understanding to experience and context and to more effective care delivery to those affected by/damaged by `the Troubles’. Evaluation of the teaching and learning by the students was significantly positive.

Innovative interprofessional teaching session on labour and childbirth for undergraduate medical and midwifery students

There is an increasing recognition of the need to improve interprofessional relationships within clinical practice (Midwifery 2020, 2010). Evidence supports the assertion that healthcare professionals who are able to communicate and work effectively together and who have a mutual respect and understanding for one another’s roles will provide a higher standard of care (McPherson et al, 2001; Miers et al, 2005; Begley, 2008). The joint Royal College of Obstetrics & Gynaecologists(RCOG) / Royal College of Midwives (RCM) report (2008 Page 8) on clinical learning environment and recruitment recommended that “Inter-professional learning strategies should be introduced and supported at an early stage in the medical and midwifery undergraduate students' experience and continued throughout training.” Providing interprofessional education within a University setting offers an opportunity for a non-threatening learning environment where students can develop confidence and build collaborative working relationships with one another (Saxell et al, 2009).Further research supports the influence of effective team working on increased client satisfaction. Additionally it identifies that the integration of interprofessional learning into a curriculum improves students’ abilities to interact professionally and provides a better understanding of role identification within the workplace than students who have only been exposed to uniprofessional education (Meterko et al, 2004; Pollard and Miers, 2008; Siassakos, et al, 2009; Wilhelmsson et al, 2011; Murray-Davis et al, 2012). An interprofessional education indicative has been developed by teaching staff from the School of Nursing and Midwifery and School of Medicine at Queen’s University Belfast. The aim of the collaboration was to enhance interprofessional learning by providing an opportunity for medical students and midwifery students to interact and communicate prior to medical students undertaking their obstetrics and gynaecology placements. This has improved medical students placement experience by facilitating them to learn about the process of birth and familiarisation of the delivery suite environment and it also has the potential to enhance interprofessional relationships. Midwifery students benefit through the provision of an opportunity to teach and facilitate learning in relation to normal labour and birth and has provided them with an opportunity to build stronger and more positive relationships with another profession. This opportunity also provides a positive, confidence building forum where midwifery students utilise teaching and learning strategies which would be transferable to their professional role as registered midwives. The midwifery students were provided with an outline agenda in relation to content for the workshop, but then were allowed creative licence with regard to delivery of the workshop. The interactive workshops are undertaken within the University’s clinical education centre, utilising low fidelity simulation. The sessions are delivered 6 times per year and precede the medical students’ obstetric/gynaecology placement. All 4th year medical and final year midwifery students have an opportunity to participate. Preliminary evaluations of the workshops have been positive from both midwifery and medical students. The teaching sessions provided both midwifery and medical students with an introduction to inter professional learning and gave them an opportunity to learn about and respect each other’s roles. The midwifery students have commented on the enjoyable aspects of team working for preparing for the workshop and also the confidence gained from teaching medical students. The medical students have evaluated the teaching by midwifery students positively and felt that it lowered their anxiety levels going into the labour setting. A number of midwifery and medical students have subsequently worked with one another within the practice setting which has been recognised as beneficial. Both Schools have recognised the benefits of interprofessional education and have subsequently made a commitment to embed it within each curriculum.

The significance of innovative approaches to teaching in primary school for the new curriculum implementation. 'La importancia de accesos innovadores a enseñanza en escuela primaria para la nueva puesta en práctica de plan de estudios'.

Resumen tomado de la publicación. Monográfico con el título: Nuevas tecnologías y educación en medios