Identification of characteristics for successful university-company partnership development

The importance of university-company collaboration has increased during the last decades. The drivers for that are, on the one hand, changes in business logic of companies and on the other hand the decreased state funding of universities. Many companies emphasize joint research with universities as an enabling input to their development processes, which aim at creating new innovations, products and wealth. These factors have changed universities’ operations and they have adopted several practices of dynamic business organizations, such as strategic planning, monitoring and controlling methods of internal processes etc. The objective of this thesis is to combine different characteristics of successful university-company partnership and its development. The development process starts with identifying potential partners in the university’s interest group, which requires understanding the role of different partners in the innovation system. Next, in order to find a common development basis, matching the policy and strategy between partners is needed. The third phase is to combine the academic and industrial objectives of a joint project, which is a typical form of university-company collaboration. The optimum is a win-win situation where both partners, universities and companies, can get addedvalue. For the companies added value typically means access to new research results before their competitors. For the universities added value offers a possibility to carry on high level scientific work. The research output in the form of published scientific articles is evaluated by the international science community. Because the university-company partnership is often executed by joint projects, the different forms of this kind of projects is discussed in this study. The most challenging form of collaboration is a semi-open project model, which is not based on bilateral activities between universities and companies but on a consortium of several universities, research institutes and companies. The universities and companies are core actors in the innovation system. Thus the discussion of their roles and relations to public operators like publicly funded financiers is important. In the Finnish innovation system there are at least the following doers executing strategies and policies: EU, Academy of Finland and TEKES. In addition to these, Strategic Centres for Science, Technology and Innovation which are owned jointly by companies, universities and research organizations have a very important role in their fields of business. They transfer research results into commercial actions to generate wealth. The thesis comprises two parts. The first part consists of an overview of the study including introduction, literature review, research design, synthesis of findings and conclusions. The second part introduces four original research publications.

Comparison of the effectiveness of initial combined antiretroviral therapy with nelfinavir or efavirenz at a university-based outpatient service in Brazil

Since there are some concerns about the effectiveness of highly active antiretroviral therapy in developing countries, we compared the initial combination antiretroviral therapy with zidovudine and lamivudine plus either nelfinavir or efavirenz at a university-based outpatient service in Brazil. This was a retrospective comparative cohort study carried out in a tertiary level hospital. A total of 194 patients receiving either nelfinavir or efavirenz were identified through our electronic database search, but only 126 patients met the inclusion criteria. Patients were included if they were older than 18 years old, naive for antiretroviral therapy, and had at least 1 follow-up visit after starting the antiretroviral regimen. Fifty-one of the included patients were receiving a nelfinavir-based regimen and 75 an efavirenz-based regimen as outpatients. Antiretroviral therapy was prescribed to all patients according to current guidelines. By intention-to-treat (missing/switch = failure), after a 12-month period, 65% of the patients in the efavirenz group reached a viral load <400 copies/mL compared to 41% of the patients in the nelfinavir group (P = 0.01). The mean CD4 cell count increase after a 12-month period was also greater in the efavirenz group (195 x 10(6) cells/L) than in the nelfinavir group (119 x 10(6) cells/L; P = 0.002). The efavirenz-based regimen was superior compared to the nelfinavir-based regimen. The low response rate in the nelfinavir group might be partially explained by the difficulty of using a regimen requiring a higher patient compliance (12 vs 3 pills a day) in a developing country.

Identifying reasons for failure in biomedical research and publishing

The regular assessment of Brazilian scientific output means that individual university departments need to constantly improve the quantity and quality of their scientific output. A significant proportion of this output involves the work of Master’s and Doctoral students, but getting this work published in a suitable journal can often prove to be a challenge. Although students’ lack of fluency in English is a contributing factor, many of the problems observed have an early origin in the formulation of the research problem and its relevance to current research trends in the international literature. In short, more time needs to be spent in the library and less in the laboratory, and more effort needs to be made in teaching students basic research skills such as the effective use of bibliographic databases like PubMed, Web of Science and Scopus.

Vancomycin-dependent Enterococcus faecium vanA: characterization of the first case isolated in a university hospital in Brazil

In this study, we report the characterization of a strain of Enterococcus faecium vanA, which grows only in the presence of vancomycin (VDEfm-UEL). The bacterium was isolated from the feces of a female patient who had undergone surgical treatment of Reinke’s edema and was receiving intravenous vancomycin therapy for infection with methicillin/oxacillin-resistant Staphylococcus aureus, a postoperative complication. Antimicrobial dependence was further confirmed by the vancomycin E-test. VDEfm-UEL was also shown to be resistant to ampicillin, ciprofloxacin, chloramphenicol, erythromycin, levofloxacin, penicillin, rifampicin, and teicoplanin. The putative virulence genes efaA, gelE and esp were detected by PCR. The ddl gene from VDEfm-UEL was cloned and sequenced. Vancomycin dependence seems to be associated with the insertion of a nucleotide in that sequence, which results in a frame-shift mutation, introducing a premature stop codon. This is the first report of vancomycin-dependent E. faecium isolation in a university hospital in Brazil.

Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

We evaluated the outcome of 227 patients with acute myeloid leukemia during three decades (period 1 - 1980’s, N = 89; period 2 - 1990’s, N = 73; period 3 - 2000’s, N = 65) at a single institution. Major differences between the three groups included a higher median age, rates of multilineage dysplasia and co-morbidities, and a lower rate of clinical manifestations of advanced leukemia in recent years. The proportion of patients who received induction remission chemotherapy was 66, 75, and 85% for periods 1, 2, and 3, respectively (P = 0.04). The median survival was 40, 77, and 112 days, and the 5-year overall survival was 7, 13, and 22%, respectively (P = 0.01). The median disease-free survival was 266, 278, and 386 days (P = 0.049). Survival expectation for patients with acute myeloid leukemia has substantially improved during this 30-year period, due to a combination of lower tumor burden and a more efficient use of chemotherapy and supportive care.

Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

Basic life support knowledge of first-year university students from Brazil

We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data

Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients’ prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients’ weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients’ weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children.

Development of Measurement Systems in Scientific Research: Case Study

In recent years, technological advancements in microelectronics and sensor technologies have revolutionized the field of electrical engineering. New manufacturing techniques have enabled a higher level of integration that has combined sensors and electronics into compact and inexpensive systems. Previously, the challenge in measurements was to understand the operation of the electronics and sensors, but this has now changed. Nowadays, the challenge in measurement instrumentation lies in mastering the whole system, not just the electronics. To address this issue, this doctoral dissertation studies whether it would be beneficial to consider a measurement system as a whole from the physical phenomena to the digital recording device, where each piece of the measurement system affects the system performance, rather than as a system consisting of small independent parts such as a sensor or an amplifier that could be designed separately. The objective of this doctoral dissertation is to describe in depth the development of the measurement system taking into account the challenges caused by the electrical and mechanical requirements and the measurement environment. The work is done as an empirical case study in two example applications that are both intended for scientific studies. The cases are a light sensitive biological sensor used in imaging and a gas electron multiplier detector for particle physics. The study showed that in these two cases there were a number of different parts of the measurement system that interacted with each other. Without considering these interactions, the reliability of the measurement may be compromised, which may lead to wrong conclusions about the measurement. For this reason it is beneficial to conceptualize the measurement system as a whole from the physical phenomena to the digital recording device where each piece of the measurement system affects the system performance. The results work as examples of how a measurement system can be successfully constructed to support a study of sensors and electronics.

Application of exploratory factor analysis to assess fish consumption in a university community

The objective of this research was to use the technique of Exploratory Factor Analysis (EFA) for the adequacy of a tool for the assessment of fish consumption and the characteristics involved in this process. Data were collected during a campaign to encourage fish consumption in Brazil with the voluntarily participation of members of a university community. An assessment instrument consisting of multiple-choice questions and a five-point Likert scale was designed and used to measure the importance of certain attributes that influence the choice and consumption of fish. This study sample was composed of of 224 individuals, the majority were women (65.6%). With regard to the frequency of fish consumption, 37.67% of the volunteers interviewed said they consume the product two or three times a month, and 29.6% once a week. The Exploratory Factor Analysis (EFA) was used to group the variables; the extraction was made using the principal components and the rotation using the Quartimax method. The results show clusters in two main constructs, quality and consumption with Cronbach Alpha coefficients of 0.75 and 0.69, respectively, indicating good internal consistency.

Designing and validating the methodology for the Internet assessment of fish consumption at a university setting

Assessing fish consumption is complex and involves several factors; however, the use of questionnaires in surveys and the use of the Internet as tool to collect data have been considered promising approaches. Therefore, the objective of this research was to design a data collection technique using a questionnaire to assess fish consumption by making it available on a specific home page on the Internet. A bibliographical survey or review was carried out to identify the features of the instrument, and therefore pre-tests were conducted with previous instruments, followed by the Focus Group technique. Specialists then performed an analysis and conducted an online pre-test. Multivariate data analysis was applied using the SmartPLS software. The results indicate that 1.966 participants belonging to the University of São Paulo (USP) community participated in the test, and after the exclusion of some variables, a statistically significant results were obtained. The final constructs comprised consumption, quality, and general characteristics. The instrument consisted of behavioral statements in a 5-point Likert scale and multiple-choice questions. The Cronbach's alpha reliability coefficient was 0.66 for general characteristics, 0.98 for quality, and 0.91 for consumption, which indicate good reliability of the instrument. In conclusion, the results proved that the Internet assessment is efficient. The instrument of analysis allowed us to better understand the process of buying and consuming fish in the country, and it can be used as base for further research.

Finnish doctoral dissertations of nursing education research

Nursing education research has confirmed its place in the discipline of nursing and caring sciences being one of the most central research areas. However, extensive and systematic analysis of nursing education research has been lacking both nationally and internationally. The aim of this study was to describe the focus of nursing education research in Finnish doctoral dissertations in the field of nursing and caring sciences between the years 1990–2014. In addition, the characteristics (i.e. methods, study informants and reporting of validity, reliability, and research ethics) of the dissertations were described. Also, international reviews (N=39) focusing on nursing education research were analysed for a background literature. A literature review was carried out. Altogether 51 (=N) Finnish doctoral dissertations of nursing and caring sciences in the field of nursing education research were included in the final analysis. The data for this research was collected from the open publication lists of each university offering education in nursing and caring sciences in Finland. The dissertations were published in 1990–2014. The data were analysed by content analysis both deductively and inductively. This study consists of a scientific article manuscript and a background literature review. Nursing education research has focused both nationally and internationally on four main areas: structural factors in nursing education, nurse teacherhood, teaching activities, and learning and learning outcomes in nursing education. In Finland, the most central focus area was learning (84.3 %) whereas nurse teacherhood and structural factors in nursing education were studied the least. Students were the predominant study informant group while nurse staff including nurse mentors were next and nurse educators only the third. Surveys and interviews were the most common data collection methods. In the findings there were a lot of similarities with international reviews of nursing education research. Finnish nursing education research has been very student-centred yet studies focusing on the education of other nursing based professions or different levels of education are rare. Future research about nurse teacherhood, curricula and structural factors in nursing education is recommended. There is also a need for experimental designs. In addition, nursing education research should focus on the central phenomena of nursing education and working life. All in all, more nursing education research is needed. Nursing education dissertations cover only 12.3 % of all the dissertations of nursing and caring sciences in Finland.

Utilizing analytic modelling process in industrial retail context

Nykypäivän monimutkaisessa ja epävakaassa liiketoimintaympäristössä yritykset, jotka kykenevät muuttamaan tuottamansa operatiivisen datan tietovarastoiksi, voivat saavuttaa merkittävää kilpailuetua. Ennustavan analytiikan hyödyntäminen tulevien trendien ennakointiin mahdollistaa yritysten tunnistavan avaintekijöitä, joiden avulla he pystyvät erottumaan kilpailijoistaan. Ennustavan analytiikan hyödyntäminen osana päätöksentekoprosessia mahdollistaa ketterämmän, reaaliaikaisen päätöksenteon. Tämän diplomityön tarkoituksena on koota teoreettinen viitekehys analytiikan mallintamisesta liike-elämän loppukäyttäjän näkökulmasta ja hyödyntää tätä mallinnusprosessia diplomityön tapaustutkimuksen yritykseen. Teoreettista mallia hyödynnettiin asiakkuuksien mallintamisessa sekä tunnistamalla ennakoivia tekijöitä myynnin ennustamiseen. Työ suoritettiin suomalaiseen teollisten suodattimien tukkukauppaan, jolla on liiketoimintaa Suomessa, Venäjällä ja Balteissa. Tämä tutkimus on määrällinen tapaustutkimus, jossa tärkeimpänä tiedonkeruumenetelmänä käytettiin tapausyrityksen transaktiodataa. Data työhön saatiin yrityksen toiminnanohjausjärjestelmästä.

Utilizing hemicelluloses – the first step : controlled extraction with hot water

Människor utnyttjar ofta kemi mångsidigt i sitt vardagliga liv utan att närmare tänka på detaljerna. Nuförtiden kan man framställa en ökande mängd av produkter ur förnybara råmaterial och en av de mest mångsidiga nybara råmaterialet i Norden är barrträd. Den lyriska lägerelden eller spiselden och möbler av ved samt papper är en väsentlig del av vardagen. Också livsmedel och läkemedel kan innehålla föreningar ur ved. Ved som råmaterial består av tre huvudkomponenten: cellulosa, som är uppbyggd av druvsockermolekyler är en långkedjad, oförgrenad polymer; lignin, som sammanhåller fibrerna i vedmaterialet som lim samt hemicellulosor, som ofta är uppbyggda av olika sockerarter och är en förgrenad polymer. Följaktligen består vedmaterialet av 70 % socker. I detta arbete har vi koncentrerat på i hemicellulosa och dess extraktion ur gran, samt bestämning av hemicellulosans egenskaper. Den slutliga målsättningen i forskningen var att skapa nya produkter ur gran. Forskning i extraktionens hemligheter eller hur hemicellulosa kan effektivt extraheras i den önskade formen kräver nya typers experimentellasanläggningar och experiment samt matematisk modellering. Den långkedjade hemicellulosan är lämplig för att användas t.ex. i skyddshinnor eller i livsmedel. Medel- och småmolekylär hemicellulosa kan användas som utgångsämne för framställning av bränslen, smörjmedel, sockersyror och alkoholer, av vilka xylitol är mest känd för alla pga hälsobefrämjande effekter. Det är utomordentligt viktigt ur miljöns och energiekonomins synvinkel att sträva efter effektivering av utnyttjandet av den värdefullaste och största naturtillgången, skogen i vårt land, med alla möjliga sätt. Resultaten av denna forskning utnyttjar avsevärt den växande, nya, på skogen baserande biobaseradeindustrin, som framställer nya spetsprodukter samt skapar nya arbetsplatser. ----------------------------------------------------- Ihmiset hyödyntävät usein huomaamattaan kemiaa monipuolisesti jokapäiväisessä elämässä. Nykyään kasvava määrä tuotteista kyetään valmistamaan uusiutuvista raaka-aineista ja yksi monipuolisimmista uusiutuvista luonnonvaroistamme pohjolassa ovat havupuut. Tunnelmallinen nuotio tai takkatuli ja puiset huonekalut sekä paperi ovat olennainen osa arkea. Myös elintarvikkeet ja lääkkeet voivat sisältää puusta peräisin olevia yhdisteitä. Puu materiaalina koostuu rakenteeltaan pääosin kolmesta osasta; selluloosasta, joka on rypälesokerista koostuva pitkäketjuinen haaroittumaton polymeeri, ligniinistä, joka toimii puun koossa pitävänä liima-aineena ja hemiselluloosasta, joka on useista eri sokereista rakentunut haaroittunut polymeeri. Näin ollen puusta 70 % on sokeria. Tässä työssä olemme keskittyneet hemiselluloosaan ja sen uuttamiseen kuusesta, sekä ominaisuuksien kartoittamiseen. Tutkimusaiheen lopullinen tavoite on luoda uusia tuotteita kuusesta. Uuton salojen tutkiminen eli miten hemiselluloosa saadaan tehokkaasti uutettua halutunlaisena vaatii uudenlaisia koelaitteistoja ja kokeita, sekä matemaattista mallintamista. Suurikokoinen hemiselluloosa on sopivaa käytettäväksi esimerkiksi suojakalvoissa tai elintarvikkeissa. Keskikokoista ja pienimolekyylistä hemiselluloosaa voidaan käyttää lähtöaineena valmistettaessa polttoaineita, voiteluaineita, sokerihappoja ja sokerialkoholeja, joista xylitoli on terveysvaikutustensa vuoksi kaikille tuttu. Niin ympäristömme kuin myös energiataloutemme kannalta on ensiarvoisen tärkeää pyrkiä kaikin keinoin tehostamaan maallemme arvokkaan, sekä luonnonvaroistamme yhden suurimman, metsän, vastuullista hyödyntämistä. Tämän tutkimuksen tulokset hyödyntävät merkittävästi maahamme nousevaa uutta metsään pohjautuvaa biojalostusteollisuutta, joka valmistaa uusia huipputuotteita sekä luo työpaikkoja.

University students’ regulation of learning and text processing – examples from medical and teacher education

The general aim of the thesis was to study university students’ learning from the perspective of regulation of learning and text processing. The data were collected from the two academic disciplines of medical and teacher education, which share the features of highly scheduled study, a multidisciplinary character, a complex relationship between theory and practice and a professional nature. Contemporary information society poses new challenges for learning, as it is not possible to learn all the information needed in a profession during a study programme. Therefore, it is increasingly important to learn how to think and learn independently, how to recognise gaps in and update one’s knowledge and how to deal with the huge amount of constantly changing information. In other words, it is critical to regulate one’s learning and to process text effectively. The thesis comprises five sub-studies that employed cross-sectional, longitudinal and experimental designs and multiple methods, from surveys to eye tracking. Study I examined the connections between students’ study orientations and the ways they regulate their learning. In total, 410 second-, fourth- and sixth-year medical students from two Finnish medical schools participated in the study by completing a questionnaire measuring both general study orientations and regulation strategies. The students were generally deeply oriented towards their studies. However, they regulated their studying externally. Several interesting and theoretically reasonable connections between the variables were found. For instance, self-regulation was positively correlated with deep orientation and achievement orientation and was negatively correlated with non-commitment. However, external regulation was likewise positively correlated with deep orientation and achievement orientation but also with surface orientation and systematic orientation. It is argued that external regulation might function as an effective coping strategy in the cognitively loaded medical curriculum. Study II focused on medical students’ regulation of learning and their conceptions of the learning environment in an innovative medical course where traditional lectures were combined wth problem-based learning (PBL) group work. First-year medical and dental students (N = 153) completed a questionnaire assessing their regulation strategies of learning and views about the PBL group work. The results indicated that external regulation and self-regulation of the learning content were the most typical regulation strategies among the participants. In line with previous studies, self-regulation wasconnected with study success. Strictly organised PBL sessions were not considered as useful as lectures, although the students’ views of the teacher/tutor and the group were mainly positive. Therefore, developers of teaching methods are challenged to think of new solutions that facilitate reflection of one’s learning and that improve the development of self-regulation. In Study III, a person-centred approach to studying regulation strategies was employed, in contrast to the traditional variable-centred approach used in Study I and Study II. The aim of Study III was to identify different regulation strategy profiles among medical students (N = 162) across time and to examine to what extent these profiles predict study success in preclinical studies. Four regulation strategy profiles were identified, and connections with study success were found. Students with the lowest self-regulation and with an increasing lack of regulation performed worse than the other groups. As the person-centred approach enables us to individualise students with diverse regulation patterns, it could be used in supporting student learning and in facilitating the early diagnosis of learning difficulties. In Study IV, 91 student teachers participated in a pre-test/post-test design where they answered open-ended questions about a complex science concept both before and after reading either a traditional, expository science text or a refutational text that prompted the reader to change his/her beliefs according to scientific beliefs about the phenomenon. The student teachers completed a questionnaire concerning their regulation and processing strategies. The results showed that the students’ understanding improved after text reading intervention and that refutational text promoted understanding better than the traditional text. Additionally, regulation and processing strategies were found to be connected with understanding the science phenomenon. A weak trend showed that weaker learners would benefit more from the refutational text. It seems that learners with effective learning strategies are able to pick out the relevant content regardless of the text type, whereas weaker learners might benefit from refutational parts that contrast the most typical misconceptions with scientific views. The purpose of Study V was to use eye tracking to determine how third-year medical studets (n = 39) and internal medicine residents (n = 13) read and solve patient case texts. The results revealed differences between medical students and residents in processing patient case texts; compared to the students, the residents were more accurate in their diagnoses and processed the texts significantly faster and with a lower number of fixations. Different reading patterns were also found. The observed differences between medical students and residents in processing patient case texts could be used in medical education to model expert reasoning and to teach how a good medical text should be constructed. The main findings of the thesis indicate that even among very selected student populations, such as high-achieving medical students or student teachers, there seems to be a lot of variation in regulation strategies of learning and text processing. As these learning strategies are related to successful studying, students enter educational programmes with rather different chances of managing and achieving success. Further, the ways of engaging in learning seldom centre on a single strategy or approach; rather, students seem to combine several strategies to a certain degree. Sometimes, it can be a matter of perspective of which way of learning can be considered best; therefore, the reality of studying in higher education is often more complicated than the simplistic view of self-regulation as a good quality and external regulation as a harmful quality. The beginning of university studies may be stressful for many, as the gap between high school and university studies is huge and those strategies that were adequate during high school might not work as well in higher education. Therefore, it is important to map students’ learning strategies and to encourage them to engage in using high-quality learning strategies from the beginning. Instead of separate courses on learning skills, the integration of these skills into course contents should be considered. Furthermore, learning complex scientific phenomena could be facilitated by paying attention to high-quality learning materials and texts and other support from the learning environment also in the university. Eye tracking seems to have great potential in evaluating performance and growing diagnostic expertise in text processing, although more research using texts as stimulus is needed. Both medical and teacher education programmes and the professions themselves are challenging in terms of their multidisciplinary nature and increasing amounts of information and therefore require good lifelong learning skills during the study period and later in work life.