Nursing student-patient relationship and associated factors

The purpose of this study was to analyse the nursing student-patient relationship and factors associated with this relationship from the point of view of both students and patients, and to identify factors that predict the type of relationship. The ultimate goal is to improve supervised clinical practicum with a view to supporting students in their reciprocal collaborative relationships with patients, increase their preparedness to meet patients’ health needs, and thus to enhance the quality of patient care. The study was divided into two phases. In the first phase (1999-2005), a literature review concerning the student-patient relationship was conducted (n=104 articles) and semi-structured interviews carried out with nursing students (n=30) and internal medicine patients (n=30). Data analysis was by means of qualitative content analysis and Student-Patient Relationship Scales, which were specially developed for this research. In the second phase (2005-2007), the data were collected by SPR scales among nursing students (n=290) and internal medicine patients (n=242). The data were analysed statistically by SPSS 12.0 software. The results revealed three types of student-patient relationship: a mechanistic relationship focusing on the student’s learning needs; an authoritative relationship focusing on what the student assumes is in the patient’s best interest; and a facilitative relationship focusing on the common good of both student and patient. Students viewed their relationship with patients more often as facilitative and authoritative than mechanistic, while in patients’ assessments the authoritative relationship occurred most frequently and the facilitative relationship least frequently. Furthermore, students’ and patients’ views on their relationships differed significantly. A number of background factors, contextual factors and consequences of the relationship were found to be associated with the type of relationship. In the student data, factors that predicted the type of relationship were age, current year of study and support received in the relationship with patient. The higher the student’s age, the more likely the relationship with the patient was facilitative. Fourth year studies and the support of a person other than a supervisor were significantly associated with an authoritative relationship. Among patients, several factors were found to predict the type of nursing student-patient relationships. Significant factors associated with a facilitative relationship were university-level education, several previous hospitalizations, admission to hospital for a medical problem, experience of caring for an ill family member and patient’s positive perception of atmosphere during collaboration and of student’s personal and professional growth. In patients, positive perceptions of student’s personal and professional attributes and patient’s improved health and a greater commitment to self-care, on the other hand, were significantly associated with an authoritative relationship, whereas positive perceptions of one’s own attributes as a patient were significantly associated with a mechanistic relationship. It is recommended that further research on the student-patient relationship and related factors should focus on questions of content, methodology and education.

Social justice in education : how the function of selection in educational institutions predicts support for (non)egalitarian assessment practices

Educational institutions are considered a keystone for the establishment of a meritocratic society. They supposedly serve two functions: an educational function that promotes learning for all, and a selection function that sorts individuals into different programs, and ultimately social positions, based on individual merit. We study how the function of selection relates to support for assessment practices known to harm vs. benefit lower status students, through the perceived justice principles underlying these practices. We study two assessment practices: normative assessment-focused on ranking and social comparison, known to hinder the success of lower status students-and formative assessment-focused on learning and improvement, known to benefit lower status students. Normative assessment is usually perceived as relying on an equity principle, with rewards being allocated based on merit and should thus appear as positively associated with the function of selection. Formative assessment is usually perceived as relying on corrective justice that aims to ensure equality of outcomes by considering students' needs, which makes it less suitable for the function of selection. A questionnaire measuring these constructs was administered to university students. Results showed that believing that education is intended to select the best students positively predicts support for normative assessment, through increased perception of its reliance on equity, and negatively predicts support for formative assessment, through reduced perception of its ability to establish corrective justice. This study suggests that the belief in the function of selection as inherent to educational institutions can contribute to the reproduction of social inequalities by preventing change from assessment practices known to disadvantage lowerstatus student, namely normative assessment, to more favorable practices, namely formative assessment, and by promoting matching beliefs in justice principles.

Proactive and Preventive Student Welfare Activities in Finnish Preschool and Elementary School: Handling of Transition to Formal Schooling and a National Anti-Bullying Program as Examples

Prerequisites and effects of proactive and preventive psycho-social student welfare activities in Finnish preschool and elementary school were of interest in the present thesis. So far, Finnish student welfare work has mainly focused on interventions and individuals, and the voluminous possibilities to enhance well-being of all students as a part of everyday school work have not been fully exploited. Consequently, in this thesis three goals were set: (1) To present concrete examples of proactive and preventive psycho-social student welfare activities in Finnish basic education; (2) To investigate measurable positive effects of proactive and preventive activities; and (3) To investigate implementation of proactive and preventive activities in ecological contexts. Two prominent phenomena in preschool and elementary school years—transition to formal schooling and school bullying—were chosen as examples of critical situations that are appropriate targets for proactive and preventive psycho-social student welfare activities. Until lately, the procedures concerning both school transitions and school bullying have been rather problem-focused and reactive in nature. Theoretically, we lean on the bioecological model of development by Bronfenbrenner and Morris with concentric micro-, meso-, exo- and macrosystems. Data were drawn from two large-scale research projects, the longitudinal First Steps Study: Interactive Learning in the Child–Parent– Teacher Triangle, and the Evaluation Study of the National Antibullying Program KiVa. In Study I, we found that the academic skills of children from preschool–elementary school pairs that implemented several supportive activities during the preschool year developed more quickly from preschool to Grade 1 compared with the skills of children from pairs that used fewer practices. In Study II, we focused on possible effects of proactive and preventive actions on teachers and found that participation in the KiVa antibullying program influenced teachers‘ self-evaluated competence to tackle bullying. In Studies III and IV, we investigated factors that affect implementation rate of these proactive and preventive actions. In Study III, we found that principal‘s commitment and support for antibullying work has a clear-cut positive effect on implementation adherence of student lessons of the KiVa antibullying program. The more teachers experience support for and commitment to anti-bullying work from their principal, the more they report having covered KiVa student lessons and topics. In Study IV, we wanted to find out why some schools implement several useful and inexpensive transition practices, whereas other schools use only a few of them. We were interested in broadening the scope and looking at local-level (exosystem) qualities, and, in fact, the local-level activities and guidelines, along with teacherreported importance of the transition practices, were the only factors significantly associated with the implementation rate of transition practices between elementary schools and partner preschools. Teacher- and school-level factors available in this study turned out to be mostly not significant. To summarize, the results confirm that school-based promotion and prevention activities may have beneficial effects not only on students but also on teachers. Second, various top-down processes, such as engagement at the level of elementary school principals or local administration may enhance implementation of these beneficial activities. The main message is that when aiming to support the lives of children the primary focus should be on adults. In future, promotion of psychosocial well-being and the intrinsic value of inter- and intrapersonal skills need to be strengthened in the Finnish educational systems. Future research efforts in student welfare and school psychology, as well as focused training for psychologists in educational contexts, should be encouraged in the departments of psychology and education in Finnish universities. Moreover, a specific research centre for school health and well-being should be established.

Integrating Student Learning into the Repository Ecosystem

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Can course format influence the performance of students in an advanced cardiac life support (ACLS) program?

Advanced cardiac life support (ACLS) is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003) and Model 2 (N = 2085; 2003-2007). Model 2 increased practical skill activities to 75% of the total versus 60% in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85% in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given). Compared to Model 1, Model 2 presented odds ratios (OR) indicating better performance in the theoretical (OR = 1.34; 95%CI = 1.10-1.64), practical (OR = 1.19; 95%CI = 0.90-1.57), and combined (OR = 1.38; 95%CI = 1.13-1.68) outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.

Responding to Changing Student Demographics in Finland: A Study of Teachers’ Developing Cultural Competence

The aim of this dissertation was to examine the skills and knowledge that pre-service teachers and teachers have and need about working with multilingual and multicultural students from immigrant backgrounds. The specific goals were to identify pre-service teachers’ and practising teachers’ current knowledge and awareness of culturally and linguistically responsive teaching, identify a profile of their strengths and needs, and devise appropriate professional development support and ways to prepare teachers to become equitable culturally responsive practitioners. To investigate these issues, the dissertation reports on six original empirical studies within two groups of teachers: international pre-service teacher education students from over 25 different countries as well as pre-service and practising Finnish teachers. The international pre-service teacher sample consisted of (n = 38, study I; and n = 45, studies II-IV) and the pre-service and practising Finnish teachers sample encompassed (n = 89, study V; and n = 380, study VI). The data used were multi-source including both qualitative (students’ written work from the course including journals, final reflections, pre- and post-definition of key terms, as well as course evaluation and focus group transcripts) and quantitative (multi-item questionnaires with open-ended options), which enhanced the credibility of the findings resulting in the triangulation of data. Cluster analytic procedures, multivariate analysis of variance (MANOVA), and qualitative analyses mostly Constant Comparative Approach were used to understand pre-service teachers’ and practising teachers’ developing cultural understandings. The results revealed that the mainly white / mainstream teacher candidates in teacher education programmes bring limited background experiences, prior socialisation, and skills about diversity. Taking a multicultural education course where identity development was a focus, positively influenced teacher candidates’ knowledge and attitudes toward diversity. The results revealed approaches and strategies that matter most in preparing teachers for culturally responsive teaching, including but not exclusively, small group activities and discussions, critical reflection, and field immersion. This suggests that there are already some tools to address the need for the support needed to teach successfully a diversity of pupils and provide in-service training for those already practising the teaching profession. The results provide insight into aspects of teachers’ knowledge about both the linguistic and cultural needs of their students, as well as what constitutes a repertoire of approaches and strategies to assure students’ academic success. Teachers’ knowledge of diversity can be categorised into sound awareness, average awareness, and low awareness. Knowledge of diversity was important in teachers’ abilities to use students’ language and culture to enhance acquisition of academic content, work effectively with multilingual learners’ parents/guardians, learn about the cultural backgrounds of multilingual learners, link multilingual learners’ prior knowledge and experience to instruction, and modify classroom instruction for multilingual learners. These findings support the development of a competency based model and can be used to frame the studies of pre-service teachers, as well as the professional development of practising teachers in increasingly diverse contexts. The present set of studies take on new significance in the current context of increasing waves of migration to Europe in general and Finland in particular. They suggest that teacher education programmes can equip teachers with the necessary attitudes, skills, and knowledge to enable them work effectively with students from different ethnic and language backgrounds as they enter the teaching profession. The findings also help to refine the tools and approaches to measuring the competencies of teachers teaching in mainstream classrooms and candidates in preparation.

Utilising student profiles in mathematics course arrangements

This thesis develops a method for identifying students struggling in their mathematical studies at an early stage. It helps in directing support to students needing and benefiting from it the most. Thus, frustration felt by weaker students may decrease and therefore, hopefully, also drop outs of potential engineering students. The research concentrates on a combination of personality and intelligence aspects. Personality aspects gave information on conation and motivation for learning. This part was studied from the perspective of motivation and self-regulation. Intelligence aspects gave information on declarative and procedural knowledge: what had been taught and what was actually mastered. Students answered surveys on motivation and self-regulation in 2010 and 2011. Based on their answers, background information, results in the proficiency test, and grades in the first mathematics course, profiles describing the students were formed. In the following years, the profiles were updated with new information obtained each year. The profiles used to identify struggling students combine personality (motivation, selfregulation, and self-efficacy) and intelligence (declarative and procedural knowledge) aspects at the beginning of their studies. Identifying students in need of extra support is a good start, but methods for providing support must be found. This thesis also studies how this support could be taken into account in course arrangements. The methods used include, for example, languaging and scaffolding, and continuous feedback. The analysis revealed that allocating resources based on the predicted progress does not increase costs or lower the results of better students. Instead, it will help weaker students obtain passing grades.

Instructor support for self-directed learning in higher education

This study addressed the problem of instructor support for self-directed learning, specifically, learner-directed program planning, within a classroom setting in higher education. A combination of survey, interview, document analysis, and observation was used to assess and evaluate the attitudes and practices of a sample of full-time faculty at an Ontario university. Eighty-seven percent of the study sample reported instructional beliefs, values, and expectations that were not supportive of self-directed learning, especially in terms of student participation in program planning. Planning was seen as the responsibility of the instructor. Instructors were least open to student participation in the planning of the evaluation of learning. However, there was considerable stated support for other of the basic principles of adult education. The remaining 13% of the study sample reported instructional beliefs, values, and expectations that were fully supportive of self-directed learning. Instructional practices were analyzed in relation to the instructors' stated beliefs. Although practices reflected, in many instances, instructors' statements of support, there were some significant discrepancies between apparent support for the concept of self-directed learning and actual classroom practice. Both beliefs and practice were compared to a research model of self-directed learning. Most instructors did not have a concept of self-directed learning as comprehensive as that described in the research model. Instructor support for self-directed learning was profoundly influenced by the university setting. It was concluded that more strenuous attempts to research, enhance, and promote instructional and institutional support for self-directed learning in higher education are warranted.

The effect of schooling on student self-concept /|nRonald S. Cowley. -- 260 St. Catharines [Ont. : s. n.],

The following research paper was a study into change in student academic and general self-concept with increase in grade level and age# The majority of literature found by this researcher dealt with self-concept and its relationship to achievement and interactions with others, Review, then, was in these two areas-particularily within the academic setting, but outside of it as well. It wrs hypothesized that there would be a decrease in both academic and general student self-concept with increase in grade level and age. Self-Appraisal inventories, measuring general and academic selfconcept, and Inferential Self-Reports, measuring only academic selfconcept, were the instruments used* Subjects were students, Trade 1 to 13, and ranging in age from 5 to 21„ Although al] Self-Appraisal inventories and all Self-1?eports were very similar, they differed according to three Grade levels: Primary (Grades 1 to 3)> Intermediate (Grades L to 8), and Secondary (Grades 9 to 13) • Students in the Primary division received only their respective Self-Appraisal inventory, while others v/ere administered both inventories designed for their grade level. Scores on the inventories were computed to percents and then mean percents were arrived at for epch grade, each of the three grade levels, each age, and each of three age intervals. In all of these instances Spearman1 s rank order coefficients (!lpff) were calculated and significance, at the *05 level, was determined by referring to a table of critical values for one-tailed tests* Similarily fftff scores were computed, but only for individual grades and ages, and significance was determined at the *0b level* In only one instance, the General Dimension for individual grades, was significance of overall decrease found* Consequently the hypotheses put forth did not gain support* The fltff scores, however, revealed some isolated significant changes for the Academic Dimension, which were generally decreases in mean percents from the last grade of one level to the first grade of the next* For age mean percents, significant changes generally took place at early (5 or 6) and late (20 or 21) ages* A number of reasons for the results were presented and were generally based upon the studentfs encounters, or lack of encounters, with achievement or success* No definite conclusions, relevant to the hypotheses stated^ could be made, although a number of isolated ones were drawn on the basis of significant fltff scores* As well, mention was made of the possible trends or tendencies that were revealed by the results, but that could not, or were not, proven significant by "t's11 or "p's"* Teaching methods stressing improvement in academic, as well as socially related, situations, were recommended and a model teaching approach was presented in Appendix B#

Adult perceptions of student involvement in schoolyard gardening /

The purpose of this research is to investigate through adult perceptions what factors have enabled and limited student participation in schoolyard gardening, and how to support student involvement in schoolyard gardening. It is a collective case study of three schools in the Toronto District School Board (TDSB, Ontario, Canada) that are currently running a schoolyard gardening project. Sixteen interviews were conducted during May and June, 2005, and photos of the three schoolyard gardens were taken. The results show that the common factors that have enabled student participation in schoolyard gardening at the three schools are teacher's initiative and commitment, principal's leadership and support, parental involvement and donations, and the TDSB's EcoSchools program and workshops. The common limiting factors are time, money, and the unions' "work-to-rule" issue. The ways to support student involvement include teachers integrating the gardening into the curriculum; parents making donations to the school and creating a family gardening culture; principals supporting in money or budget and taking the lead; the TDSB providing funding, awards, incentives, and more maintenance; and the Ontario Ministry of Education supplying funding, curriculum link, and teacher training.

Enhancing Student Learning: Study of a Motivational Resource for Educators

This study surveyed practicing classroom teacher’s perceptions of a proposed educational resource “Avatar Academy” designed to enhance students’, particularly young boys, motivation and general attitude towards learning. The Avatar Academy resource is an instructional guide for implementing a classroom reward system based on common game mechanics. The resource emphasizes the modification of current pedagogies to exploit the use of game design to engage boys. A survey of recent literature indicated an opportunity to study teachers’ perceptions of the possible applications of game design mechanics to support the enhancement of student motivation and learning in the classroom. As a result the Avatar Academy handbook and blog resource were developed to assist teachers with the integration and administration of a program designed to enhance student motivation, especially boys, using avatars and a point based reward system. The resources were initially distributed to several practicing teachers for their review, and their feedback formed the basis for revisions of the Avatar Academy resource. After implementing changes to the resource based on initial teacher feedback, an updated Avatar Academy was redistributed and teacher opinions and perceptions of the tool’s possible impacts on classroom learning were collected.

Student Perspectives of the Context of Recess; Implications for Student Well-Being

With most students in Canada spending approximately 180 days a year in school, averaging more than six hours a day (Morrison & Kirby, 2011), Wei, Szumilas and Kutcher (2011) argue that this places educational institutions in an unique position in terms of influencing the health and well-being of students. This brings forth the need for school environments to be utilized in ways that are conducive to promoting student development. Much of the educational and developmental components embedded within the school system as well as experiences within greatly influence student’s health and well-being. A national statement was made a concerning American children’s education and mental health that is greatly applicable to the Canadian school system. It was stated that schools “must be active partners in the mental health care of our children” because of the “important interplay between emotional health and school success” (Lazarus & Sulkowski, 2011, pp. 15-16). This identifies the need to ensure that all students, as much as possible, are being provided with safe environments and sufficient support in order to encourage positive developmental trajectories of student health and well-being.

Innovating in Teaching Collaborative Practice with a Large Student Cohort at Université de Montréal

Université de Montréal implemented an interprofessional education (IPE) curriculum on collaborative practice in a large cohort of students (>1,100) from 10 health sciences and psychosocial sciences training programs. It is made up of three one-credit undergraduate courses (CSS1900, CSS2900, CSS3900) spanning the first 3 years of training. The course content and activities aim for development of the six competency domains identified by the Canadian Interprofessional Health Collaborative. This paper describes the IPE curriculum and highlights the features contributing to its success and originality. Among main success key factors were: administrative cooperation among participating faculties, educators eager to develop innovative approaches, extensive use of clinical situations conducive to knowledge and skill application, strong logistic support, close cooperation with health care delivery organizations, and partnership between clinicians and patients. A distinguishing feature of this IPE curriculum is the concept of partnership in care between the patient and caregivers. Patients’ representatives were involved in course planning, and patients were trained to become patients-as-trainers (PT) and cofacilitate interprofessional discussion workshops. They give feed- back to students regarding integration and application of the patient partnership concept from a patient’s point of view. Lire l'article/Read the article : http://openurl.ingenta.com/content?genre=article&issn=0090-7421&volume=42&issue=4&spage=97E&epage=106E

Romantic attachment and perception of partner support to explain psychological aggression perpetrated in couples seeking couples therapy

Essai doctoral présenté à la Faculté des études supérieures en vue de l’obtention du grade de Docteur en psychologie (D.Psy.), option clinique

Student self-assessment a feedback seeking strategy through competence evaluation

There is a body of literature that suggests that student self-assessment is a main goal in higher education (Boud et al., 1995; Tan, 2008); moreover new forms of work organization require a high level of skills and competences. The efforts to deal with competence gaps could be developed at many levels, such as employers, educational institutions, individuals and public agents. Employers could put into practice competence development programs to moderate these gaps. Educational institutions can restructure the curriculum to support students in attaining the competences that are essential in the labour market. Individuals themselves may deploy their resources (time and money) in general or specific competence training. Further, government agencies could fund competence promotion programs. Such challenges for education drive change in learning curricula and method, to properly include the competences required for developing global workers who can move beyond basic competence, to enhanced flexibility and adaptability. In performance assessment methods, there is a shift from the traditional exam-based assessments to more innovative task assessment, which considers performance in multiple different tasks carry out by students. ICTs make it technologically feasible to carry out a complete and complex selfassessment of competences, which provides immediate results to students or other recipients. In the case of students, the evaluation of competences is relevant as developing competences is part - if not all - of the objectives of education. Therefore, it is an important element of the quality of educational organizations (e.g., universities), and of their organizational success. Further, educational organizations may put special emphasis on some differentiating competences, which can be a means of positioning and differentiation from competitors. Competence assessment is an instrument to make students conscious of their strengths and weaknesses, leading to higher motivation to develop their own learning career