Effects of two teaching interventions on nursing students’ acquisition of competence in ECG interpretation

Purpose: Nurse ability to recognise patient arrhythmias could contribute to preventing in-hospital cardiac arrest. Research suggests that nurses and nursing students lack competence in electrocardiogram (ECG) interpretation. The aim of this study was to compare the effects of two training strategies on nursing students’ acquisition of competence in ECG interpretation. Materials and methods: A controlled randomised trial with 98 nursing students. Divided in groups of 12–16, participants were randomly allocated to one of the following 3-h teaching intervention groups: 1) traditional instructor-led (TILG), and 2) flipped classroom (FCG). Participants’ competence in ECG interpretation was measured in terms of knowledge (%), skills (%) and self-efficacy (%) using a specifically designed and previously validated toolkit at pre-test and post-test. Two-way MANOVA explored the interaction effect between ‘teaching group’ and ‘time of assessment’ and its impact on participants’ competence. Within-group differences at pre-test and post-test were explored by carrying out paired t-tests. Between-group differences at pre- and post-test were examined by performing independent t-test analysis. Results: There was a statistically significant interaction effect between ‘teaching group’ and ‘time of assessment’ on participants’ competence in ECG interpretation (F(3,190) = 86.541, p = 0.001; Wilks’ Λ = 0.423). At pre-test, differences in knowledge (TILG = 35.12 ± 12.07; FCG = 35.66 ± 10.66), skills (TILG = 14.05 ± 10.37; FCG = 14.82 ± 14.14), self-efficacy (TILG = 46.22 ± 23.78; FCG = 40.01 ± 21.77) and all other variables were non-significant (p > 0.05). At post-test, knowledge (TILG = 55.12 ± 14.16; FCG = 94.2 ± 7.31), skills (TILG = 36.90 ± 16.45; FCG = 86.43 ± 14.32) and self-efficacy (TILG = 70.78 ± 14.55; FCG = 79.98 ± 10.35) had significantly improved, regardless of the training received (p < 0.05). Nonetheless, participants in the FCG scored significantly higher than participants in the TILG in knowledge, skills and self-efficacy (p < 0.05). Conclusion: Flipping the classroom for teaching ECG interpretation to nursing students may be more effective than using a traditional instructor-led approach in terms of immediate acquisition of competence in terms of knowledge, skills and self-efficacy. Further research on the effects of both teaching strategies on the retention of the competence will be undertaken.

Relationships between civil engineering students’ learning approaches and their perception of curriculum and teaching quality

BACKGROUND: Deakin University graduated its first cohort from four-year undergraduate civil engineering course/program in 2012. The internal annual Course Experience Survey, which has been running annually since 2012, targets to identify the graduating students’ learning approaches and students’ perceptions of the curriculum and teaching quality. Literature suggests that students’ learning outcomes can be achieved more efficiently when the students’ perceptions of curriculum and teaching quality are closely aligned with their learning approaches. Where the students’ approaches to learning and their perception of curriculum and teaching quality are mismatched, a series of frustrations can result for the students that may not only negatively impact their learning achievement but also their learning experience.
PURPOSE OR GOAL: This study explores the relationships between students’ learning approaches and their perception of curriculum and teaching quality in an undergraduate civil engineering program/course. This will help understand whether the curriculum and teaching quality provided by the university have actually accommodated ‘all’ enrolled students in the similar way.
APPROACH: To uncover these relationships, this study adopts questionnaire survey approach to collect response data over a two year period by asking students about their perception through a series of statements. 5-point Likert-scale questionnaire survey (strongly disagree, disagree, neutral, agree, strongly agree) is developed and responses are collected. The responses are then statistically analysed in order to uncover the relationships between students’ learning approaches and their perception of curriculum and teaching quality provided by the university.
DISCUSSION: Deep learners and surface learners had a statistically different perception of curriculum and teaching quality. These results contradict the assumption that learners will have uniform preferences on the curriculum, teaching quality and the way they deal with the demands of specific learning situations. Anecdotal belief that ‘good course/program curriculum and good teaching approaches are good for all students and vice-versa’ may not be strictly true for contemporary heterogeneous student cohorts.
RECOMMENDATIONS/IMPLICATIONS/CONCLUSION: This finding highlights the challenge for curriculum designer to design appropriate course curriculum and teaching staff to implement efficient teaching strategies that benefit both surface and deep learners, who are usually enrolled together. It may be beneficial to provide diversity and flexibility in the curriculum and teaching approaches (rather than a uniform approach). However, this may demand additional resources and may also be questioned for equity and consistency of education. It is also important to note that due to relatively a small dataset, these results may not be generalised.

Re-casting terra nullius design-blindness: better teaching of indigenous knowledge and protocols in Australian architecture education

This paper reviews the current status and focus of Australian Architecture programs with respect to Indigenous Knowledge and the extent to which these tertiary programs currently address reconciliation and respect to Indigenous Australians in relation to their professional institutions and accreditation policies. The paper draws upon the findings of a recently completed investigation of current teaching: Re-Casting terra nullius blindness: Empowering Indigenous Protocols and Knowledge in Australian University Built Environment Education. Three data sets from this investigation are analysed: a desktop survey of Australian Built Environment curricula; workshops with tertiary providers and students, professional practitioners and representatives of three Built Environment professional institutes; and an online survey of Australian Built Environment students (of which their discipline could be isolated) ascertaining what is currently being taught and learned and what changes would be feasible within the constraints of courses from their perspective. Detailed descriptions are also provided of pedagogic improvements informed by the project findings. The findings suggest minimal current exposure of Architecture students to Indigenous Knowledge content beyond voluntary engagement in self-chosen thesis projects and elective (including studio) subjects led by passionate but largely unsupported teachers championing Indigenous issues; a paucity of teaching echoed by practitioners and accreditors who acknowledge lack of expertise in this area across the profession. This paper discusses ways in which Indigenous Knowledge might be better acknowledged, respected and introduced to Australian Architecture students’ education. Also discussed are teaching strategies with global relevance.

Nursing students’ knowledge and practice of infection control precautions : an educational intervention

Aim. This paper is a report of the effectiveness of a purpose-designed education program in improving undergraduate nursing students’ understanding and practice of infection control precautions. Background. The severe acute respiratory syndrome outbreak in 2003 highlighted that healthcare workers were under-prepared for such an epidemic. While many in-service education sessions were arranged by institutions in response to the outbreak, preservice nursing education has overlooked preparation for handling such infectious disease epidemics. Method. A quasi-experimental design was used and a 16-hour, purpose-designed infection control education programme was implemented for preservice nursing students in southern Taiwan. Self-administered questionnaires were distributed at three time points during the period September 2005 to April 2006 to examine the sustainability and effectiveness of the intervention. Results. A total of 175 preservice nursing students participated in the study. Following the education programme, students in the intervention group showed a statistically significant improvement across time in their knowledge of these precautions [F(2, 180) = 13Æ53, P < 0Æ001] and confidence in resolving infectionrelated issues [F(1Æ79, 168Æ95) = 3Æ24] when compared with those in the control group. Conclusion. To improve nursing students’ capacity in responding to infectious epidemics, an educational programme that integrates the theme of infection precautions, learning theory and teaching strategies is recommended for all nursing institutes.

Fiji pre-service primary teachers' understanding of physical science : a cultural perspective

Science and technology are promoted as major contributors to national development. Consequently, improved science education has been placed high on the agenda of tasks to be tackled in many developing countries, although progress has often been limited. In fact there have been claims that the enormous investment in teaching science in developing countries has basically failed, with many reports of how efforts to teach science in developing countries often result in rote learning of strange concepts, mere copying of factual information, and a general lack of understanding on the part of local students. These generalisations can be applied to science education in Fiji. Muralidhar (1989) has described a situation in which upper primary and middle school students in Fiji were given little opportunity to engage in practical work; an extremely didactic form of teacher exposition was the predominant method of instruction during science lessons. He concluded that amongst other things, teachers' limited understanding, particularly of aspects of physical science, resulted in their rigid adherence to the text book or the omission of certain activities or topics. Although many of the problems associated with science education in developing countries have been documented, few attempts have been made to understand how non-Western students might better learn science. This study addresses the issue of Fiji pre-service primary teachers' understanding of a key aspect of physical science, namely, matter and how it changes, and their responses to learning experiences based on a constructivist epistemology. Initial interviews were used to probe pre-service primary teachers' understanding of this domain of science. The data were analysed to identify students' alternative and scientific conceptions. These conceptions were then used to construct Concept Profile Inventories (CPI) which allowed for qualitative comparison of the concepts of the two ethnic groups who took part in the study. This phase of the study also provided some insight into the interaction of scientific information and traditional beliefs in non-Western societies. A quantitative comparison of the groups' conceptions was conducted using a Science Concept Survey instrument developed from the CPis. These data provided considerable insight into the aspects of matter where the pre-service teachers' understanding was particularly weak. On the basis of these preliminary findings, a six-week teaching program aimed at improving the students' understanding of matter was implemented in an experimental design with a group of students. The intervention involved elements of pedagogy such as the use of analogies and concept maps which were novel to most of those who took part. At the conclusion of the teaching programme, the learning outcomes of the experimental group were compared with those of a control group taught in a more traditional manner. These outcomes were assessed quantitatively by means of pre- and post-tests and a delayed post-test, and qualitatively using an interview protocol. The students' views on the various teaching strategies used with the experimental group were also sought. The findings indicate that in the domain of matter little variation exists in the alternative conceptions held by Fijian and Indian students suggesting that cultural influences may be minimal in their construction. Furthermore, the teaching strategies implemented with the experimental group of students, although largely derived from Western research, showed considerable promise in the context of Fiji, where they appeared to be effective in improving the understanding of students from different cultural backgrounds. These outcomes may be of significance to those involved in teacher education and curriculum development in other developing countries.

Preservice teachers’ memories of their secondary science education experiences

Understanding preservice teachers’ memories of their education may aid towards articulating high-impact teaching practices. This study describes 246 preservice teachers’ perceptions of their secondary science education experiences through a questionnaire and 28-item survey. ANOVA was statistically significant about participants’ memories of science with 15 of the 28 survey items. Descriptive statistics through SPSS further showed that a teacher’s enthusiastic nature (87%) and positive attitude towards science (87%) were regarded as highly memorable. In addition, explaining abstract concepts well (79%), and guiding the students’ conceptual development with practical science activities (73%) may be considered as memorable secondary science teaching strategies. Implementing science lessons with one or more of these memorable science teaching practices may “make a difference” towards influencing high school students’ positive long-term memories about science and their science education. Further research in other key learning areas may provide a clearer picture of high-impact teaching and a way to enhance pedagogical practices.

Cyberbullying prevention : one primary school’s approach

Bullying in all its forms including cyberbullying is a continuing problem in schools. Given the severe consequences it can have on students (socially, psychologically and physically) it is not surprising that a number of intervention programs have been developed, with most advocating a whole school approach. The current study compared students’ self-reports on bullying between schools with and without a Philosophy for Children (P4C) approach. A sample of 35 students in the P4C school and a matched sample of 35 students in other schools between the ages of 10 and 13 completed the Student Bullying Survey. Results indicated that while there were significant differences in incidences of face-to-face bullying, there were similar results from both cohorts in relation to cyberbullying. Both groups of students felt that teachers were more likely to prevent face-to-face bullying than cyberbullying. Findings indicate that teachers and guidance counsellors need to be as overt in teaching strategies about cyberbullying as they are in teaching strategies about reducing face-to-face bullying.

Changing academic practice to prepare nursing undergraduates for an evidence-based approach

Evidence based practice (EBP) has been accepted as a process to assist health professionals in clinical decision making to improve patient outcomes. It requires applying skills in a prescribed sequence to critique existing practices. Many countries, including Australia, require nurses to demonstrate competencies in EBP skills to be registered. In the last ten years, this has lead to universities incorporating EBP in undergraduate nursing degree courses. The literature reports many challenges including students’ difficulties in critically appraising research evidence, and their need for both simplification of the process and extensive support. The purpose of our study was to investigate the effectiveness of a standalone introductory EBP subject for a diverse group of third-year undergraduates, based on a novel but challenging approach to assessment. Despite many changes made in the second iteration of the subject, most students’ perceptions of the subject’s difficulty remained unchanged. This research aligns with the issues identified in the literature and has wider applicability to the teaching of rapidly changing disciplines, where evidence-driven consumers have easy access to information and expect up-to-date practices.

Colin Marsh (2010) Becoming a Teacher : Knowledge, Skills and Issues. 5th edition, Frenchs Forrest : Pearson Education Australia, 459 pages. [Book Review]

In the preface to the fifth edition of Becoming a Teacher, Colin Marsh reminds us that teachers need to have passion, energy and a commitment to enhance students’ learning. This most recent edition certainly provides examples of the author’s wide ranging knowledge and depth of insights that reflect his own commitment to inspirational and dedicated teaching practice. The fifth edition shares those characteristics which made previous editions so worthwhile. Most notable is the subtle but significant dual theme of Marsh’s narrative. That is, first, teaching is a vehicle for increasing the life opportunities of students, and second, teaching is profession that requires continual commitment and critical reflection. These are very important messages for any course that develops teaching methodology. Becoming a Teacher continues to be structured in five readable sections, however the 2010 edition has some exciting new features that warrant the attention of teacher educators and their pre-service students.

Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

How does media play and ICT fit in the early childhood context?

In this chapter, Shaleen Prowse describes teaching strategies for media education and information communication technologies (ICT) and how young children’s experiences with tools of technology at home are an important starting point for building learning experiences within the classroom setting. She illustrates how digital cameras and computer editing software assist young children to share their learning.

Strategy use of children with Down syndrome in a delay of gratification situation

Background: The capacity to delay gratification has been shown to be a very important developmental task for children who are developing typically. There is evidence that children with Down syndrome have more difficulty with a delay of gratification task than typically developing children of the same mental age. This study focused on the strategies children with Down syndrome use while in a delay of gratification situation to ascertain if these contribute to the differences in delay times from those of typically developing children. Method: Thirty-two children with Down syndrome (15 females) and 50 typically developing children participated in the study. Children with Down syndrome had a mental age, as measured by the Stanford-Binet IV, between 36 and 66 months (M = 45.66). The typically developing children had a mean chronological age of 45.76 months. Children participated in a delay of gratification task where they were offered two or one small treats and asked which they preferred. They were then told that they could have the two treats if they waited for the researcher to return (an undisclosed time of 15 min). If they did not want to wait any longer they could call the researcher back but then they could have only one treat. Twenty-two of the children with Down syndrome and 43 of the typically developing children demonstrated understanding of the task and their data are included here. Sessions were videotaped for later analysis. Results: There were significant differences in the mean waiting times of the two groups. The mean of the waiting times for children with Down syndrome was 181.32 s (SD = 347.62) and was 440.21 s (SD = 377.59) for the typically developing children. Eighteen percent of the group with Down syndrome waited for the researcher to return in comparison to 35% of the typically developing group. Sixty-four percent of children with Down syndrome called the researcher back and the remainder (18%) violated. In the typically developing group 37% called the researcher back and 28% violated. The mean waiting time for the group of children with Down syndrome who called the researcher back was 24 s. Examination of strategy use in this group was therefore very limited. There appeared to be quite similar strategy use across the groups who waited the full 15 min. Conclusions: These results confirm the difficulty children with Down syndrome have in delaying gratification. Teaching strategies for waiting, using information drawn from the behaviours of children who are developing typically may be a useful undertaking. Examination of other contributors to delay ability (e.g., language skills) is also likely to be helpful in understanding the difficulties demonstrated in delaying gratification.

What information-related activities do people with ESKD use?

Background Information practice is an emerging area of research that seeks to reveal how people learn to connect with the complex multimodal information landscapes that informs their ability to make decisions. Previous research has identified that people with end stage kidney disease (ESKD) tend to adopt a ‘received’ or ‘engaged’ view of information but little is known about the activities of information practice. Objectives This research project sought to identify the: i) information-related activities; and ii) how information is used. Methods Using a constructivist qualitative methodology, ten people with ESKD living in a large metropolitan city were purposively selected and interviewed. Data was subject to thematic analysis by researchers from nursing and information science. Saturation of themes was achieved. Results Participants were between 38 and 72 years, had been receiving kidney replacement therapy from 2 weeks to 31 years. Eight participants reported having access to the internet but none participated in chat rooms. The activities were conceptualized into themes as listening, seeking, searching, sharing and observing. These activities enabled people to create, reflect on and evaluate the information needed to inform their decision-making Conclusion/Application to Clinical Practice The information practice research approach will enable a better understanding of the underlying relationship between information, knowledge and experience to be better understood. For renal nurses who are involved in patient education being able to recognise the way people use information will assist in individualizing educational sessions and tailoring teaching strategies to make it more meaningful.

A picture is worth a thousand words : an approach to learning about visuals

Students in the middle years encounter an increasing range of unfamiliar visuals. Visual literacy, the ability to encode and decode visuals and to think visually, is an expectation of all middle years curriculum areas and an expectation of NAPLAN literacy and numeracy tests. This article presents a multidisciplinary approach to teaching visual literacy that links the content of all learning areas and encourages students to transfer skills from familiar to unfamiliar contexts. It proposes a classification of visuals in six parts: one-dimensional; two-dimensional; map; shape; connection; and picture, based on the properties, rather than the purpose, of the visual. By placing a visual in one of these six categories, students learn to transfer the skills used to decode familiar visuals to unfamiliar cases in the same category. The article also discusses a range of other teaching strategies that can be used to complement this multi-disciplinary approach.

An integrated educational model for continuing nurse education

Aim This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Background Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. Methods A quasi experimental pre test, post test non–equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. Findings The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. Conclusion The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians.