Teaching motivational interviewing to medical students : a pre-post test pilot study

Objective: To test the efficacy of teaching motivational interviewing (MI) to medical students. Methods: Thirteen 4th year medical students volunteered to participate. Seven days before and 7 days after an 8-hour interactive training MI workshop, each student performed a videorecorded interview with two standardized patients: a 60 year old alcohol dependent woman and a 50 year old cigarette smoking man. Students' counseling skills were coded by two blinded clinicians using the Motivational Interviewing Treatment Integrity 3.0 (MITI). Inter-rater reliability was calculated for all interviews and a test-retest was completed in a sub-sample of 10 consecutive interviews three days apart. Difference between MITI scores before and after training were calculated and tested using non-parametric tests. Effect size was approximated by calculating the probability that posttest scores are greater than pretest scores (P*=P(Pre<Post)+1/2P(Pre=Post)), P*>1/2 indicating greater scores in posttest, P*=1/2 no effect, and P*<1/2 smaller scores in posttest. Results: Median differences between MITI scores before and after MI training indicated a general progression in MI skills: MI spirit global score (median difference=1.5, Inter quartile range=1.5, p<0.001, P*=0.90); Empathy global score (med diff=1, IQR=0.5, p<0.001, P*=0.85); Percentage of MI adherent skills (med diff=36.6, IQR=50.5, p<0.001, P*=0.85); Percentage of open questions (med diff=18.6, IQR=21.6, p<0.001, P*=0.96); reflections/ questions ratio (med diff=0.2, IQR=0.4, p<0.001, P*=0.81). Only Direction global score and the percentage of complex reflections were not significantly improved (med diff=0, IQR=1, p=0.53, P*=0.44, and med diff=4.3, IQR=24.8, p=0.48, P*=0.62, respectively). Inter-rater reliability indicated weighted kappa ranged between 0.14 for Direction to 0.51 for Collaboration and ICC ranged between 0.28 for Simple reflection to 0.95 for Closed question. Test-retests indicated weighted kappa ranged between 0.27 for Direction to 0.80 for Empathy and ICC ranged between 0.87 for Complex reflection to 0.98 for Closed question. Conclusion: This pilot study indicated that an 8-hour training in MI for voluntary 4th year medical students resulted in significant improvement of MI skills. Larger sample of unselected medical students should be studied to generalize the benefit of MI training to medical students. Interrater reliability and test-retests suggested that coders' training should be intensified.

Teaching cardiac auscultation to trainees in internal medicine and family practice: does it work?

BACKGROUND: The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program. METHODS: 1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible.2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study). RESULTS: 1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)]. CONCLUSIONS: The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching.

LEVERAGING SANDBOX IMMERSIVE 3D VIRTUAL WORLDS TO DEVELOP DO-IT- YOURSELF TEACHING GAMES: IMPLEMENTATION TO MARKETING CASE STUDY TEACHING IN SECOND LIFE

Games are powerful and engaging. On average, one billion people spend at least 1 hour a day playing computer and videogames. This is even more true with the younger generations. Our students have become the < digital natives >, the < gamers >, the < virtual generation >. Research shows that those who are most at risk for failure in the traditional classroom setting, also spend more time than their counterparts, using video games. They might strive, given a different learning environment. Educators have the responsibility to align their teaching style to these younger generation learning styles. However, many academics resist the use of computer-assisted learning that has been "created elsewhere". This can be extrapolated to game-based teaching: even if educational games were more widely authored, their adoption would still be limited to the educators who feel a match between the authored games and their own beliefs and practices. Consequently, game-based teaching would be much more widespread if teachers could develop their own games, or at least customize them. Yet, the development and customization of teaching games are complex and costly. This research uses a design science methodology, leveraging gamification techniques, active and cooperative learning theories, as well as immersive sandbox 3D virtual worlds, to develop a method which allows management instructors to transform any off-the-shelf case study into an engaging collaborative gamified experience. This method is applied to marketing case studies, and uses the sandbox virtual world of Second Life. -- Les jeux sont puissants et motivants, En moyenne, un milliard de personnes passent au moins 1 heure par jour jouer à des jeux vidéo sur ordinateur. Ceci se vérifie encore plus avec les jeunes générations, Nos étudiants sont nés à l'ère du numérique, certains les appellent des < gamers >, d'autres la < génération virtuelle >. Les études montrent que les élèves qui se trouvent en échec scolaire dans les salles de classes traditionnelles, passent aussi plus de temps que leurs homologues à jouer à des jeux vidéo. lls pourraient potentiellement briller, si on leur proposait un autre environnement d'apprentissage. Les enseignants ont la responsabilité d'adapter leur style d'enseignement aux styles d'apprentissage de ces jeunes générations. Toutefois, de nombreux professeurs résistent lorsqu'il s'agit d'utiliser des contenus d'apprentissage assisté par ordinateur, développés par d'autres. Ceci peut être extrapolé à l'enseignement par les jeux : même si un plus grand nombre de jeux éducatifs était créé, leur adoption se limiterait tout de même aux éducateurs qui perçoivent une bonne adéquation entre ces jeux et leurs propres convictions et pratiques. Par conséquent, I'enseignement par les jeux serait bien plus répandu si les enseignants pouvaient développer leurs propres jeux, ou au moins les customiser. Mais le développement de jeux pédagogiques est complexe et coûteux. Cette recherche utilise une méthodologie Design Science pour développer, en s'appuyant sur des techniques de ludification, sur les théories de pédagogie active et d'apprentissage coopératif, ainsi que sur les mondes virtuels immersifs < bac à sable > en 3D, une méthode qui permet aux enseignants et formateurs de management, de transformer n'importe quelle étude de cas, provenant par exemple d'une centrale de cas, en une expérience ludique, collaborative et motivante. Cette méthode est appliquée aux études de cas Marketing dans le monde virtuel de Second Life.

Gifts of Mars: Warfare and Europe's early rise to riches

Today, per capita income differences around the globe are large ? varying by as much as a factor of 35 across countries (Hall and Jones 1999). These differentials mostly reflect the "Great Divergence" (Sam Huntingon) ? the fact that Western Europe and former European colonies grew rapidly after 1800, while other countries grew much later or stagnated. What is less well-known is that a "First Divergence" preceded the Great Divergence: Western Europe surged ahead of the rest of the world long before technological growth became rapid. Europe in 1500 was already twice as rich on a per capita basis as Africa, and one-third richer than most of Asia (Maddison 2007). In this essay, we explain how Europe's tumultuous politics and deadly penchant for warfare translated into a sustained advantage in per capita incomes.

The study club program : suggestions relating to courses of study and aids furnished by the Traveling Library, 1909

This leaflet includes information on programs for Women's Clubs. Some possible subjects for the club's discussions are literature, history and fine arts. Several methods of study are covered. Groups are encouraged to use public libraries and the Iowa Traveling Library to obtain reference materials for their topics.

An Empirical Study on Faculty Perceptions and Teaching Practices of Wikipedia

Some faculty members from different universities around the world have begun to use Wikipedia as a teaching tool in recent years. These experiences show, in most cases, very satisfactory results and a substantial improvement in various basic skills, as well as a positive influence on the students' motivation. Nevertheless and despite the growing importance of e-learning methodologies based on the use of the Internet for higher education, the use of Wikipedia as a teaching resource remains scarce among university faculty.Our investigation tries to identify which are the main factors that determine acceptance or resistance to that use. We approach the decision to use Wikipedia as a teaching tool by analyzing both the individual attributes of faculty members and the characteristics of the environment where they develop their teaching activity. From a specific survey sent to all faculty of the Universitat Oberta de Catalunya (UOC), pioneer and leader in online education in Spain, we have tried to infer the influence of these internal and external elements. The questionnaire was designed to measure different constructs: perceived quality of Wikipedia, teaching practices involving Wikipedia, use experience, perceived usefulness and use of 2.0 tools. Control items were also included for gathering information on gender, age, teaching experience, academic rank, and area of expertise.Our results reveal that academic rank, teaching experience, age or gender, are not decisive factors in explaining the educational use of Wikipedia. Instead, the decision to use it is closely linked to the perception of Wikipedia's quality, the use of other collaborative learning tools, an active attitude towards web 2.0 applications, and connections with the professional non-academic world. Situational context is also very important, since the use is higher when faculty members have got reference models in their close environment and when they perceive it is positively valued by their colleagues. As far as these attitudes, practices and cultural norms diverge in different scientific disciplines, we have also detected clear differences in the use of Wikipedia among areas of academic expertise. As a consequence, a greater application of Wikipedia both as a teaching resource and as a driver for teaching innovation would require much more active institutional policies and some changes in the dominant academic culture among faculty members.

On-line life history calendar and sensitive topics : A pilot study

The use of the life history calendar (LHC) or the event history calendar as tools for collecting retrospective data has received increasing attention in many fields of social science and medicine. However, little research has examined the use of this method with web-based surveys. In this study, we adapted this method to an on-line setting to collect information about young adults' life histories, sexual behaviors, and substance use. We hypothesized that the LHC method would help respondents to date sensitive and non-sensitive events more precisely than when using a conventional questionnaire. We conducted an experimental design study comparing university students' responses to an on-line LHC and a conventional on-line question list. A test-retest design in which the respondents completed the survey again two weeks later was also applied to test the precision and reliability of the participants' dating of events. The results showed that whereas the numbers of sensitive and non-sensitive events were generally similar for the two on-line questionnaires, the responses obtained with the LHC were more consistent across the two administrations. Analyses of the respondents' on-line behavior while completing the LHC confirmed that respondents used the LHC's graphic interface to correct and reedit previous answers, thus decreasing data errors. (C) 2015 Elsevier Ltd. All rights reserved.

El aprendizaje reflexivo en la formación inicial del profesorado: un modelo para aprender a enseñar matemáticas = Reflective learning in the early formation of teachers: a model to learn to teach maths

In this study we analize the application of the reflective learning during initial formation mathematics teachers. This model is based on the sociocultural theories of the human learning and assumes that the interaction and the contrast make possible the coconstruction and the active reconstruction of knowledge.In order to make the study, it was left from a sample of 29 teaching students. The qualitative analysis allowed to identify factors that facilitate the incorporation of the reflective learning in university teaching, as well as the degree of effectiveness of this model to learn to teach mathematics

Early Childhood Mathematics Education: Research, Curriculum and Educational Practice

This article reviews data obtained through research into early childhood mathematics education in Spain. It analyses the current curricular directions in mathematics education with early learners. It also provides an overview of mathematical practices in early childhood education classrooms to analyse the commonalities and differences between research, curriculum and educational practice. A review of the research presented at SEIEM symposia from 1997 until 2012 demonstrates: a) very little research has been done, a trend that is repeated in other areas, such as the JCR-Social Sciences Edition or the PME; b) the first steps have been taken to create a more and more cohesive body of research, although until now there has not been enough data to outline the curricular directions; and c) some discrepancies still exist between the mathematical practices in early childhood education classrooms and the official guidelines

Developing an Understanding of Cultural Diversity: How an Experience Living in a Multicultural Nation and an Experience Teaching Abroad Contribute to Southern Ontario Teachers' Identities

This is a narrative design study focusing on the understandings that a group of 6 Southern Ontario teachers have of cultural diversity and how these understandings integrated into their development of teacher identity. Given the high culturally diverse population of Canada and its national multicultural values, conducting this study on Canadian pre-service and in-service teachers offers an interesting contribution to the field. In efforts to explore the participants’ understandings, the research examined a teaching abroad experience. The aim was to investigate how these participants gained insight from their experiences with cultural diversity and whether these insights stimulated a greater culturally conscious teacher identity. Narratives provided a description of the lived experiences of these 6 teachers and identified meanings made from these experiences. Participants included 2 pre-service teachers who were in a teacher education program at the time of the interview, and 4 certified teachers who graduated from a teacher education program within the past 5 years. One on one interviews focused on lived experiences within a participant’s home, school community, and teaching abroad. The researcher used grounded theory during the data analysis to assist in identifying themes, and then compared these themes among participants. Overall, this study suggests that even though these participants live in a multicultural nation, experiences varied greatly based on contributing factors such as heritage and exposure to cultural diversity through their home and school life. Despite their varying level of cultural competence, all participants gained insight from their teaching abroad experience, contributing to a teacher identity that considered inclusive practices. This study suggests that there are some important factors to consider when preparing teachers to teach in a multicultural society.

Regulatory History Material as an Extrinsic Aid to Interpretation: An Empirical Study on the Use of RIAS by the Federal Court of Canada

Since 1986, the Canadian Public Administration is required to analyze the socio-economic impact of new regulatory requirements or regulatory changes. To report on its analysis, a Regulatory Impact Analysis Statement (RIAS) is produced and published in the Canada Gazette with the proposed regulation to which it pertains for notice to, and comments by, interested parties. After the allocated time for comments has elapsed, the regulation is adopted with a final version of the RIAS. Both documents are again published in the Canada Gazette. As a result, the RIAS acquires the status of an official public document of the Government of Canada and its content can be argued in courts as an extrinsic aid to the interpretation of a regulation. In this paper, an analysis of empirical findings on the uses of this interpretative tool by the Federal Court of Canada is made. A sample of decisions classified as unorthodox show that judges are making determinations on the basis of two distinct sets of arguments built from the information found in a RIAS and which the author calls “technocratic” and “democratic”. The author argues that these uses raise the general question of “What makes law possible in our contemporary legal systems”? for they underline enduring legal problems pertaining to the knowledge and the acceptance of the law by the governed. She concludes that this new interpretive trend of making technocratic and democratic uses of a RIAS in case law should be monitored closely as it may signal a greater change than foreseen, and perhaps an unwanted one, regarding the relationship between the government and the judiciary.

Optical imaging and two-photon microscopy study of hemodynamic changes contralateral to ictal focus during epileptiform discharges

Il est relativement bien établi que les crises focales entraînent une augmentation régionale du flot sanguin dans le but de soutenir la demande énergétique en hémoglobine oxygénée des neurones épileptiques. Des changements hémodynamiques précoces ont également été rapportés dans la région homologue controlatérale, bien que ceci ait été moins bien caractérisé. Dans cette étude, notre objectif est de mieux caractériser, lors de crises focales, la nature des changements hémodynamiques précoces dans la région homologue controlatérale au foyer épileptique. L'imagerie optique intrinsèque (IOI) et la microscopie deux-photons sont utilisées pour étudier les changements hémodynamiques dans la région homologue controlatérale au site de crises focales induites par l’injection de 4-aminopyridine (4-AP) dans le cortex somatosensitif ipsilatéral de souris. Dans l'étude d'IOI, des changements de l’oxyhémoglobine (HbO), de la désoxyhémoglobine (HbR) et du débit sanguin cérébral ont été observées dans la région homologue controlatérale au site de crises focales lors de toutes les crises. Toutefois, ces changements étaient hétérogènes, sans patron cohérent et reproduisible. Nos expériences avec la microscopie deux-photons n’ont pas révélé de changements hémodynamiques significatifs dans la région homotopique controlatérale lors de trains de pointes épileptiques. Nos résultats doivent être interprétés avec prudence compte tenu de plusieurs limitations: d’une part absence de mesures électrophysiologiques dans la région d’intérêt controlatérale au foyer simultanément à l’imagerie deux-photons et à l'IOI; d’autre part, lors des expériences avec le deux-photons, incapacité à générer de longues décharges ictales mais plutôt des trains de pointes, couverture spatiale limitée de la région d’intérêt controlatérale, et faible puissance suite au décès prématuré de plusieurs souris pour diverses raisons techniques. Nous terminons en discutant de divers moyens pour améliorer les expériences futures.

The value of using short-format podcasts to enhance learning and teaching

This paper presents the findings of a podcasting trial held in 2007-2008 within the Faculty of Economics and Business at the University of Sydney, Australia. The trial investigates the value of using short-format podcasts to support assessment for postgraduate and undergraduate students. A multi-method approach is taken in investigating perceptions of the benefits of podcasting, incorporating surveys, focus groups and interviews. The results show that a majority of students believe they gained learning benefits from the podcasts and appreciated the flexibility of the medium to support their learning, and the lecturers felt the innovation helped diversify their pedagogical approach and support a diverse student population. Three primary conclusions are presented: (1) most students reject the mobile potential of podcasting in favour of their traditional study space at home; (2) what students and lecturers value about this podcasting design overlap; (3) the assessment-focussed, short-format podcast design may be considered a successful podcasting model. The paper finishes by identifying areas for future research on the effective use of podcasting in learning and teaching.

Developing materials for teaching early elementary fundamental skills to hearing-impaired children

This paper contains materials for teaching early elementary skills to hearing impaired children.

Chronic toxicity of ibuprofen to Daphnia magna: Effects on life history traits and population dynamics

The non-steroidal anti-inflammatory drug (NSAID) ibuprofen (IB) is a widely used pharmaceutical that can be found in several freshwater ecosystems. Acute toxicity studies with Daphnia magna suggest that the 48 h EC50 (immobilisation) is 10-100 mg IB l(-1). However, there are currently no chronic IB toxicity dataon arthropod populations, and the aquatic life impacts of such analgesic drugs are still undefined. We performed a 14-day exposure of D. magna to IB as a model compound (concentration range: 0, 20, 40 and 80 mg IB l(-1)) measuring chronic effects on life history traits and population performance. Population growth rate was significantly reduced at all IB concentrations, although survival was only affected at 80 mg IB l(-1). Reproduction, however, was affected at lower concentrations of IB (14-day EC50 of 13.4 mg IB l(-1)), and was completely inhibited at the highest test concentration. The results from this study indicate that the long-term crustacean population consequences of a chronic IB exposure at environmentally realistic concentrations (ng l(-1) to mu g l(-1)) would most likely be of minor importance. We discuss our results in relation to recent genomic studies, which suggest that the potential mechanism of toxicity in Daphnia is similar to the mode of action in mammals, where IB inhibits eicosanoid biosynthesis. (C) 2007 Elsevier Ireland Ltd. All rights reserved.