Service quality in a higher education context : an integrated model

Purpose – The aim of this study is to develop and empirically test an integrated model incorporating the antecedents and consequences of service quality in a higher education context.

Design/methodology/approach – This research employed both qualitative and quantitative research methods. The data from three focus groups, conducted at the Central Queensland University (CQU), Rockhampton, Australia, generated key themes and their interrelationships. The theoretical model was then tested using structural equation modelling technique on a sample of 528 university students.

Findings – The findings show that information (marketing communications) is more statistically significant than past experience as the antecedents of service quality. The consequences of service quality are composed of trust, satisfaction, and image. Overall, the results suggest a good validity of the theoretical model and the key paths in the model are found statistically significant, except past experience affecting service quality.

Originality/value – The model provides a good explanation of a university brand image, and perceived service quality was found playing an important role in this model. Universities intending to enhance their image are encouraged to consider focusing their efforts on marketing communication information, service quality, student satisfaction and trust.

Communication pathways in community aged care: an Australian study

Background:
Health and social care practitioners collaborate in discharge planning for older people. Difficulties securing timely and quality discharge information and unclear role boundaries can be challenging. There are limited reports in the literature describing community-based practitioners' roles communicating client information.

Aim:
To describe the roles of community-based practitioners in communication of older clients' information in an Australian context.

Design:
A descriptive and exploratory qualitative research design was applied.

Methods:
Four focus groups were conducted in 2009 with a small sample (n = 16) of district nurses, practice nurses and aged care case managers.

Results:
All participants described communication as a core characteristic of their role focused on minimising risks for older people. Participants valued dialogue with other health and social care providers in real time with an emphasis on telephone communication, face-to-face meetings, and case conferences. Telephone communication was considered important where there was an urgent need to problem solve. Written communication was noted as less effective.

Conclusions:
There is an increasing need for stronger models of communication in community-based settings to facilitate safe, efficient and sustainable health and social outcomes for older people.

Implications for practice:
There is limited available research with this focus to guide practice. Findings from this exploratory study indicate a number of important areas for further research: (i) to understand how communication feedback systems and pathways between community and inpatient providers could improve information exchange and (ii) to describe community nurses' roles in communication and medication risks for older people.

Sustaining modified behaviours learnt in a diabetes prevention program in regional Australia : the role of social context

Background
The Greater Green Triangle diabetes prevention program was conducted in primary health care setting of Victoria and South Australia in 2004--2006. This program demonstrated significant reductions in diabetes risk factors which were largely sustained at 18 month follow-up. The theoretical model utilised in this program achieved its outcomes through improvements in coping self-efficacy and planning. Previous evaluations have concentrated on the behavioural components of the intervention. Other variables external to the main research design may have contributed to the success factors but have yet to be identified. The objective of this evaluation was to identify the extent to which participants in a diabetes prevention program sustained lifestyle changes several years after completing the program and to identify contextual factors that contributed to sustaining changes.

Methods
A qualitative evaluation was conducted. Five focus groups were held with people who had completed a diabetes prevention program, several years later to assess the degree to which they had sustained program strategies and to identify contributing factors.

Results
Participants value the recruitment strategy. Involvement in their own risk assessment was a strong motivator. Learning new skills gave participants a sense of empowerment. Receiving regular pathology reports was a means of self-assessment and a motivator to continue. Strong family and community support contributed to personal motivation and sustained practice.

Conclusions
Family and local community supports constitute the contextual variables reported to contribute to sustained motivation after the program was completed. Behaviour modification programs can incorporate strategies to ensure these factors are recognised and if necessary, strengthened at the local level.

Encouraging play in the natural environment : a child-focused case study of Forest School

There is concern that children are becoming disengaged from the natural environment and are not being afforded the opportunities to play in such environments. To examine children's perceptions, knowledge and experiences of play in the natural environment, 17 children from one school participated in small focus groups before and after a 12-week Forest School that took place within a school woodland area. Using two qualitative approaches, we found that Forest School had a positive influence on children's natural play and their knowledge of the natural world around them.

Leading the evaluation of institutional online learning environments for quality enhancement in times of change

This paper reports on findings from a nationally funded project which aims to design and implement a quality management framework for online learning environments (OLEs). Evaluation is a key component of any quality management system and it is this aspect of the framework that is the focus of this paper. In developing the framework initial focus groups were conducted at the five participating institutions. These revealed that, although regarded as important, there did not appear to be a shared understanding of the nature and purpose of evaluation. A second series of focus groups revealed there were multiple perspectives arising from those with a vested interest in online learning. These perspectives will be outlined. Overall, how evaluation was undertaken was highly variable within and across the five institutions reflecting where they were at in relation to the development of their OLE.

Construction of the descriptive system for the assessment of quality of life AQoL-6D utility instrument

Background
Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument.

Methods
The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements.

Results and Discussion
The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model.

Conclusions
The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs.

Sustainable development in the border region plan case study : Pengragoan village, Jembrana regency, Bali-Indonesia

Commonly, the border area is a countryside located far from city centre, so that such area gets less attention from government. This condition is seen from the condition of social and economic aspects that is left behind than other locations (Bappenas 2004). In Balinese Traditional perspective, countryside as border area is a non built environment as a symbol of an authority but it does not mean without activities. Asa regency area, border area is a gate of the regency that gives a first impression and attraction as well as represent of the regency characteristic. One of border areasbetween 2 regencies in Bali is Pengragoanareatraversed bythe main routeconnecting thecentreof the Bali Provinceand Gilimanuk Port. Not only is it as a border area betweenJembrana and Tabanan regencies, but also a coastal area that began to gain influence tourism development. The objective of this study is to find the strategies planning for border development that gives benefit to people, protect the local wisdom and meet with sustainable development issues. In order to achieve this objective, this research uses field study, focus groups discussion strategy and direct interview to collect data and descriptive analysis to analyse data. As an agriculture area, this area can be developed as agro-tourism area that focuses on agticultural activities and some support activities, " in limited number", such as home industries, outdoor recreation, agro tourism, restaurant, villa as well as stop over.

Youth and the communication of Risk: developing connections between cancer council Australia and contemporary online youth culture

Through two focus groups, the project investigated how youth culture perceives online communication of risk. In two 90-minute sessions, investigators gaged the range of online activities that nine 18 - 24 year old university students engaged with. Through a guided discussion the participants explored how they would relate to the communication of health risk more generally and cancer risk more specifically.
Participants’ online activity is very high and a range of social media forms are part of their everyday lives. In contrast, their use of traditional media is almost non-existent. Their relationship to accessing and being aware of health information demonstrated a range of views that pointed to quite new and different relationships to health and health professionals. To intersect with their online movements in the communication of health risk demands a sophisticated knowledge of their own searching patterns.
Key ideas generated from the focus groups include: that it might be advantageous to group health risk beyond the specificity of cancer for online success; that an online persona would be useful to provide a face for the communication of risk; that a multi-platform campaign to raise the profile of a persona would be useful; and that success means moving between the serious and the light-hearted in a way that makes the persona a complete person of interest for them.

Barriers to the detection and management of depression by palliative care professional carers among their patients : perspectives from professional carers and patients' family members

Introduction: Clinical depression is highly prevalent yet underdetected and poorly managed within palliative care settings.

Objectives: This qualitative study explored the identification, monitoring, and management of symptoms of depression in patients receiving palliative care from 2 juxtaposed perspectives that are of care providers and care recipients' family members. Examining the barriers that restrict professional carers detecting and managing depression in their patients was a central focus of the study.

Methods: Focus groups were held with 18 professional carers, including 8 holding managerial positions, across 2 palliative care services, 1 regional and 1 metropolitan, which provided both inpatient and community-based care. Individual interviews were conducted with 10 family members of patients who had received or were receiving palliative care through these services.

Results: Thematic analysis of these data identified that both professional carers and family members perceived that depression is a wide-spread concern for patients receiving palliative care; however, numerous barriers were identified that affect professional carers’ ability to identify depression. These included knowledge and training deficits, low self-efficacy, prioritization of physical concerns and time constraints, patient/family characteristics, and system/process issues. These themes (and related subthemes) are discussed in this article.

Conclusions: Specialized training in depression is recommended for professional carers in order to improve their depression-related knowledge, detection skills, and self-efficacy. The ultimate goal of such training is to increase the rate of recognition of depression that in turn will lead to appropriate treatment for depressed patients.

Science students' perceptions of engaging pedagogy

During their years of schooling, students develop perceptions about learning and teaching, including the ways in which teachers impact on their learning experiences. This paper presents student perceptions of teacher pedagogy as interpreted from a study focusing on students' experience of Year 7 science. A single science class of 11 to 12 year old students and their teacher were monitored for the whole school year, employing participant observation, and interviews with focus groups of students, their teacher and other key members of the school. Analysis focused on how students perceived the role of the teacher's pedagogy in constructing a learning environment that they considered conducive to engagement with science learning. Two areas of the teacher's pedagogy are explored from the student perspective of how these affect their learning: instructional pedagogy and relational pedagogy. Instructional pedagogy captures the way the instructional dialogue developed by the teacher drew the students into the learning process and enabled them to “understand” science. How the teacher developed a relationship with the students is captured as relational pedagogy, where students said that they learned better when teachers were passionate in their approach to teaching, provided a supportive learning environment and made them feel comfortable. The ways in which the findings support the direction for the middle years and science education are considered.

Adolescents' perception of the relationship between movement skills, physical activity and sport

Movement skill competence is important to organised youth physical activity participation, but it is unclear how adolescents view this relationship. The primary aim of this study was to explore adolescents’ perception of the relationship between movement skills, physical activity and sport, and whether their perceptions differed according to extent of participation in organised physical activities. We recruited 33 (17 male) Grade 11 and 12 students (aged 16 to 18) from two secondary schools in Australia. Focus groups were allocated according to whether or not students participated in organised physical activity, where ‘organised activity’ was defined as activity which involved regular classes, training or competition, was reasonably structured or formal, or had a teacher, instructor or coach. There were three all-male ‘organised’ groups, one mixed-gender ‘organised’ group and one all-female ‘not-organised’ group. Students were asked about their attitudes towards physical activity and sport, the relationship between childhood skill proficiency and later physical activity and their perceptions of the appropriate time taken to learn movement skills. Group discussions lasted for approximately 50 minutes, were recorded and were then transcribed verbatim. Transcripts were read using a constant comparison method, in which quotes were continually compared to other quotes. A thematic analysis was conducted in which the transcripts were analysed inductively. Participation in organised sport had no bearing on opinions regarding whether lack of childhood skill development would negatively impact latter participation. It did, however, subtly influence opinions regarding whether skill could be successfully acquired later in life. When asked whether not having well-developed skills as a child would negatively impact on participation in sport/physical activity later in life, the response was mixed, but this was not related to their involvement in organised sport or activities. Students who believed early skill proficiency related to subsequent activity thought this was due to skill ability and motivation. An alternate view was that subsequent activity did not need to be based on skill proficiency; also, one’s environment might change, resulting in differing opportunities/constraints. Students felt skills could be learnt at any time in life (dependent on motivation), but that learning skills at a younger age would be easier and that skills learnt later would not be as developed. Fear of failure was identified as a barrier to learning when older. We conclude that motivation towards participation in sport and physical activity is affected by adolescents’ perception of their own movement skill ability. Therefore, developing children’s actual and perceived movement skills may help to increase adolescent physical activity. Since those with intrinsic achievement orientations were not as inclined towards organised activity, we may also need to provide physical activity options that resonate with intrinsic achievement motivations.

Learning context in Australian universities - perceptions of Chinese accounting students

The study concentrates on how Mainland Chinese students perceive and respond to the learning in Australian universities. Students' satisfaction with their educational experiences and the Australian learning context such as teaching, teacher/student relationship, assessment, workload and English language is explored in this study. Using focus groups, the results show that teaching, teacher/student relationships and English language are areas of concern.

The caregiving role following percutaneous coronary intervention

Aim.  The aim of this study is to describe the experience of caregivers of individuals who have had a percutaneous coronary intervention (PCI). Background.  Decreased lengths of hospital stay and an increased emphasis on chronic disease self-management increase the importance of carers in assisting in recovery and lifestyle modification. Design.  Cross-sectional dual-moderated focus group design. Method.  Three focus groups using a dual facilitation approach were held in the cardiac rehabilitation setting of a tertiary referral hospital in metropolitan Sydney. All sessions were audio recorded, transcribed and thematically analysed. Results.  Four themes emerged from the data: (1) a gendered approach to health, illness and caring; (2) shock, disbelief and the process of adjustment following PCI; (3) challenges and changes of the carer–patient relationship and (4) the needs of the carer for support and information. Issues emerging from this study parallel other findings describing the experience, yet provide new insights into the issues surrounding PCI. Conclusion.  These findings highlight the need for including carers in care planning and decision-making and providing them with support and resources. Relevance to clinical practice.  • Emphasises the importance of preparing carers of the likely experience following a PCI.• Demonstrates the degree to which vigilance, deferment of carer-health needs and role conflict impact on the carer’s personal relationship.• Demonstrates the need for formal support interventions for carers of patients who have had PCI.

Parents' and children's views on whether active video games are a substitute for the 'real thing'

Background:
Research has examined the energy cost associated with playing seated and active video games (AVGs), but not whether AVGs may benefit fundamental movement skills (FMS) in typically developing children. Improving FMS proficiency is a priority given its association with physical activity. This study aimed to identify children’s and parents’ perceptions of: (1) AVGs as a tool for developing FMS and (2) whether any skills gained during AVG play had potential to transfer to real life.

Methods:
This qualitative descriptive study included 29 parents of children aged 9–10 years who participated in semi-structured telephone interviews and 34 children who participated in six group discussions at school. Interview and discussion group data were recorded, transcribed and analysed thematically.

Results:
Parents and children had different perspectives on the potential of AVGs for FMS, which largely rested on different views of ‘reality’. Parents felt AVGs were not a substitute for the ‘real thing’, and therefore had limited FMS benefits. Overall, parents thought any FMS gained through AVGs would have poor transferability to ‘real life’. In contrast, children had a more fluid and expansive view of reality which incorporated both ‘real life’ and ‘virtual’ space. Whilst children could articulate limitations of AVGs for skill learning, they still reported extensive use of AVGs as a learning tool for movement skill, and considered that skill acquisition was highly transferable.

Conclusions:
Despite contrasting beliefs from parents and children, children used AVGs for FMS learning. Future research needs to determine whether actual FMS benefits are gained through AVGs.

Leading the quality management of online learning environments in Australian higher education

The paper presents the findings of the first year of a nationally funded Australian Learning and Teaching Council (ALTC) project on the quality management of online learning environments by and through distributed leadership. The project is being undertaken by five Australian universities with major commitments to online and distance education. Each university, however, has a distinctive location, history and profile in the sector. The first year of the project has seen the development of a quality management framework with six interrelated elements. The framework is being applied, refined and validated in the second year of the project. Allied with the development of the framework, was the conduct of focus groups at each of the five partner institutions in the middle of the first year. These focus groups composed a range of staff involved collectively in the leadership of the organisation's online learning environment. Prominence was given to the nature and value of strategic planning, due diligence conducted in selecting and mainstreaming technologies, evaluation approaches informing decision making, and the various relationships between different leadership levels and domains. A number of key issues which emerged relating to the elements identified in the framework are examined.