The effectiveness of health education using the teach-back method on adherence and self-management in chronic disease: A systematic review protocol

Review question/objective What is the effect of using the teach-back method for health education to improve adherence to treatment regimen and self-management in chronic disease? Inclusion criteria Types of participants This review will consider all studies that include adult patients (aged 18 years and over) in any healthcare setting, either as inpatients (eg acute care, medical and surgical wards) or those who attend primary health care, family medical practice, general medical practice, clinics, outpatient departments, rehabilitation or community settings. Participants need to have been diagnosed as having one or more chronic diseases including heart failure, diabetes, cardiovascular disease, cancer, respiratory disease, asthma, chronic obstructive pulmonary disease, chronic kidney disease, arthritis, epilepsy or a mental health condition. Studies that include seriously ill patients, and/or those who have impairments in verbal communication and cognitive function will be excluded. Types of intervention This review will consider studies that investigate the use of the teach-back method alone or in combination with other supporting education, either in routine or research intervention education programs; regardless of how long the programs were and whether or not a follow-up was conducted. The intervention could be delivered by any healthcare professional. The comparator will be any health education for chronic disease that does not include the teach-back method. Types of outcomes Primary outcomes of interest are disease-specific knowledge, adherence, and self-management knowledge, behavior and skills measured using patient report, nursing observation or validated measurement scales. Secondary outcomes include knowledge retention, self-efficacy, hospital readmission, hospitalization, and quality of life, also measured using patient report, nursing observation, hospital records or validated measurement scales.

New media and the transformation of higher education

One set of public institutions that has seen growing discussion about the transformative impact of new media technologies has been universities. The higher education sector, historically one of the more venerable and stable areas of public life, is now the subject of almost continuous speculation about whether it can continue in its current form during the 21st century. Digital media technologies are often seen as being at the forefront of such changes. It has been widely noted that moves towards a knowledge economy generates ‘skills-biased technological change’, that places a premium upon higher education qualifications, and that this earnings gap remains despite the continuing increase in the number of university graduates. As the demand for higher education continues to grow worldwide, there are new discussions about whether technologically-mediated education through new forms such as Massively Open Online Courses (MOOCs) are broadening access to quality learning, or severing the vital connection between teacher and student seen as integral to the learning process. This paper critically appraises such debates in the context of early 21st century higher education. It will discuss ten drivers of change in higher education, many of which are related to themes discussed elsewhere in this book, such as the impact of social media, globalization, and a knowledge economy. It will also consider the issues raised in navigating such developments from the perspective of the ‘Five P’s’: practical issues; personal issues; pedagogical issues; policy issues; and philosophical issues. It also includes a critical evaluation of MOOCs from the point of view of their educational qualities. It will conclude with the observation that while universities will continue to play a significant – and perhaps growing – role in the economy, society and culture, the issues raised about what Clayton Christensen and Henry Eyring term the ‘disruptive university’ (Christensen and Eyring 2011) are nonetheless pressing ones, and that cost and policy pressures in particular are likely to generate significant institutional transformations in higher education worldwide.

Mixing higher education teaching and learning with mobile devices and social media

The use of mobile devices and social media technologies are becoming all-pervasive in society: they are both transformative and constant. The high levels of mobile device ownership and increased access to social media technologies enables the potential for ‘anytime, anywhere’ cooperation and collaboration in education. While recent reports into emerging technologies in higher education predict an increase in the use of mobile devices and social media technologies (Horizon Report, 2013), there is a lack of theory-based research to indicate how these technologies can be most effectively harnessed to support and enhance student learning and what the impacts of these technologies are on both students and educators. In response to the need to understand how these technologies can be better embraced within higher education, this study investigated how first year education students used mobile devices and social media technologies. More specifically, the study identified how students spent most of their time when connected online with mobile devices and social media technologies and whether the online connected time engaged them in their learning or whether it was a distraction.

Vocational education in science, technology, engineering and maths (STEM) : Curriculum innovation through school industry partnerships

Governments have recognised that the technological trades rely on knowledge embedded traditionally in science, technology, engineering and mathematics (STEM) disciplines. However, there is substantial evidence that students are turning away from these subjects in schools because the school curriculum is seen as irrelevant, with clear implications for not just vocational education but also higher education. In this paper, we report preliminary findings on the development of two curricula that attempt to integrate science and mathematics with workplace knowledge and practices. We argue that these curricula provide educational opportunities for students to pursue their preferred career pathways. These curricula were co-developed by industry and educational personnel across three industry sectors, namely, mining industry, aerospace and wine tourism. The aim was to provide knowledge appropriate for students moving from school to the workplace as trade apprentices in the respective industries. The analysis of curriculum and associated policy documents reveals that the curricula adopt applied learning orientations through teaching strategies and assessment practices which focus on practical skills. However, although key theoretical science and maths concepts have been well incorporated, the extent to which knowledge deriving from workplace practices is included varies across the curricula. The extent to which applications of concepts are included in the models depends on a number of factors not least the relevant expertise of the teacher as a practitioner in the industry. Our findings highlight the importance of teachers having substantial practical industry experience and the role that whole school policies play in attempts to align the range of learning experiences with the needs of industry.

School industry partnerships : An innovative strategy for vocational education

One of the challenges confronting contemporary education internationally is to ensure that students are provided with opportunities to make informed choices about future careers and to acquire the capacity to transition into these careers. Schools need to manage their curricula, teacher capacity, timetables, and diversity of student populations by offering pathways that are seen as engaging and meaningful to life beyond schooling. Traditionally, education in the senior years has privileged those students who intend to progress to advanced studies at university or in other professional careers. In more recent times, in response the need for more sophisticated technical knowledge in the trades and a growing skills shortages in these fields, schools have paid more attention to vocational education. It has been argued that the vocational aspect of the school curriculum is less well understood and poorly implemented in comparison with the traditional academic curricula. One attempt to address this issue is through the establishment of school-industry partnerships. This paper explores the process of knowledge transfer between industry and schools in these partnerships. The paper theorises how knowledge that is valued and foundational in workplace employment can inform school curricula and pedagogical practices. The paper draws on theories of organisational knowledge, workplace learning and experiential learning to explore strategies that enhance school-to-employment transition outcomes.

Protocol for a randomised blocked design study using telephone and text-messaging to support cardiac patients with diabetes : a cross cultural international collaborative project

Background The prevalence of type 2 diabetes is rising internationally. Patients with diabetes have a higher risk of cardiovascular events accounting for substantial premature morbidity and mortality, and health care expenditure. Given healthcare workforce limitations, there is a need to improve interventions that promote positive self-management behaviours that enable patients to manage their chronic conditions effectively, across different cultural contexts. Previous studies have evaluated the feasibility of including telephone and Short Message Service (SMS) follow up in chronic disease self-management programs, but only for single diseases or in one specific population. Therefore, the aim of this study is to evaluate the feasibility and short-term efficacy of incorporating telephone and text messaging to support the care of patients with diabetes and cardiac disease, in Australia and in Taiwan. Methods/design A randomised controlled trial design will be used to evaluate a self-management program for people with diabetes and cardiac disease that incorporates the use of simple remote-access communication technologies. A sample size of 180 participants from Australia and Taiwan will be recruited and randomised in a one-to-one ratio to receive either the intervention in addition to usual care (intervention) or usual care alone (control). The intervention will consist of in-hospital education as well as follow up utilising personal telephone calls and SMS reminders. Primary short term outcomes of interest include self-care behaviours and self-efficacy assessed at baseline and four weeks. Discussion If the results of this investigation substantiate the feasibility and efficacy of the telephone and SMS intervention for promoting self management among patients with diabetes and cardiac disease in Australia and Taiwan, it will support the external validity of the intervention. It is anticipated that empirical data from this investigation will provide valuable information to inform future international collaborations, while providing a platform for further enhancements of the program, which has potential to benefit patients internationally.

The role of nurse educators in student clinical education in Saudi Arabia

Introduction: Clinical education is considered a significant part of the learning process for nursing students. There is, however, no research that has explored this area of learning in Saudi Arabia. Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the role of nurse educators in student clinical education in Saudi Arabia. Method: Using Glaserian grounded theory methods the data were derived from 14 face-to-face interviews with nurse educators from both hospital and faculty settings in King Abdu-Aziz University (KAU) and King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category Redefining Identity Work and its two constituent categories Questioning the Situation and Creating Role Identity. The core and sub- categories were generated through a theoretical exploration of the identity work of nurse educators in Saudi Arabia. Conclusion: The social identity of the nurse educators was mediated culturally and socially within the hospital and university contexts and Saudi Arabian culture. In light of an increased understanding of the identity and role of nurse educators in clinical education in Saudi Arabia, the research presents implications and recommendations that may contribute to the development of nursing education as a coherent health care profession that is perceived as a desirable career option for Saudi women and men.

ICT and internet usage in early childhood education : a comparative study of Australian and Malaysian teachers' beliefs and current practices

The thesis is a comparative study of ICTs and Internet use of Australian and Malaysian early childhood teachers in terms of their personal and professional comfort with ICTs, pedagogical beliefs, and their reported classroom practice. The study discovered teachers from both countries as relatively comfortable with digital technologies and the Internet, with most teachers held positive beliefs about ICT usage. The structural barriers in classrooms include lack of Internet access and the wide gap that exists between teachers’ positive beliefs and classroom practice. The study suggests the need for strategic and targeted professional development for teachers.

Understanding VET teachers' dilemmas in providing quality education to international students in Brisbane

In the past fifteen years, increasing attention has been given to the role of Vocational Education and Training (VET) in attracting large numbers of international students and its contribution to the economic development of Australia. This trend has given rise to many challenges in vocational education, especially with regard to providing quality education that ensures international students' stay in Australia is a satisfactory experience. Teaching and learning is continuously scrutinized, teaching quality and student assessment are subject to regular audit (Takerei, 2010). VET teachers are key stakeholders in international education and share responsibility for ensuring international students gain quality learning experiences and positive outcomes, however, their experiences are generally not well understood. Therefore, this thesis, investigates particular challenges and associated dilemmas that VET teachers experience when teaching international students. The research participants were 15 teachers from several public and private VET institutions in Brisbane, Australia. The method involved responsive interviewing and inductive data analysis to identify and categorize teachers' challenges and dilemmas. The research reveals qualitatively different ways in which the 15 VET educators experienced challenges and associated dilemmas in their culturally diverse teaching context. The research shows that VET teachers experience numerous challenges and various inter-related professional, educational and personal dilemmas. These dilemmas result from ethical tensions teachers experience in their interactions with international students, teaching colleagues and their employment institutions. The dilemmas are often influenced by current economic and political conditions of international education. The dilemmas raised in the study by 15 VET teachers might be familiar to other teachers in VET and universities but to date they have received limited attention by researchers. This study's findings indicate significant implications for VET teachers, students, VET institutions and the government at a time of rapid economic, political, cultural and educational change. The findings are of potential interest to VET policy makers, managers and teachers. By giving voice to VET teachers, who are key stakeholders in the sustainability and future growth of VET, they contribute evidence for ongoing review and development of quality learning and teaching in the culturally diverse VET sector.

Virtual worlds in Australian and New Zealand higher education : remembering the past, understanding the present and imagining the future

3D virtual reality, including the current generation of multi-user virtual worlds, has had a long history of use in education and training, and it experienced a surge of renewed interest with the advent of Second Life in 2003. What followed shortly after were several years marked by considerable hype around the use of virtual worlds for teaching, learning and research in higher education. For the moment, uptake of the technology seems to have plateaued, with academics either maintaining the status quo and continuing to use virtual worlds as they have previously done or choosing to opt out altogether. This paper presents a brief review of the use of virtual worlds in the Australian and New Zealand higher education sector in the past and reports on its use in the sector at the present time, based on input from members of the Australian and New Zealand Virtual Worlds Working Group. It then adopts a forward-looking perspective amid the current climate of uncertainty, musing on future directions and offering suggestions for potential new applications in light of recent technological developments and innovations in the area.

Not losing the plot : creating, collecting and curating qualitative data through a web-based application

Collecting regular personal reflections from first year teachers in rural and remote schools is challenging as they are busily absorbed in their practice, and separated from each other and the researchers by thousands of kilometres. In response, an innovative web-based solution was designed to both collect data and be a responsive support system for early career teachers as they came to terms with their new professional identities within rural and remote school settings. Using an emailed link to a web-based application named goingok.com, the participants are charting their first year plotlines using a sliding scale from ‘distressed’, ‘ok’ to ‘soaring’ and describing their self-assessment in short descriptive posts. These reflections are visible to the participants as a developing online journal, while the collections of de-identified developing plotlines are visible to the research team, alongside numerical data. This paper explores important aspects of the design process, together with the challenges and opportunities encountered in its implementation. A number of the key considerations for choosing to develop a web application for data collection are initially identified, and the resultant application features and scope are then examined. Examples are then provided about how a responsive software development approach can be part of a supportive feedback loop for participants while being an effective data collection process. Opportunities for further development are also suggested with projected implications for future research.

How can Australia sustain middle school education?

Middle school is a crucial area of education where adolescents experiencing physiological and psychological changes, and require expert guidance. As more research evidence is provided about adolescent learning, teachers are considered pivotal to adolescents’ educational development. Reform measures need to be targeted at the inservice and preservice teacher levels. This quantitative study employs a 40-item, five part Likert scale survey to understand preservice teachers’ (n = 142) perceptions of their confidence to teach in a middle school at the conclusion of their tertiary education. The survey instrument was developed from the literature, with connections to the Queensland College of Teachers' professional standards. Results indicated that they perceived themselves as capable of creating a positive classroom environment with seven items greater than 80%, except with behaviour management (< 80% for two items), and they considered their pedagogical knowledge to be adequate (i.e., 7 out of 8 items > 84%). Items associated with implementing a middle school curriculum had varied responses (e.g., implementing literacy and numeracy were 74%, while implementing learning with real world connections was 91%). This information may assist coursework designers. For example, if a significant percentages of preservice teachers indicate that they believe they were not well prepared for assessment and reporting at the middle school level, then course designers can target these areas more effectively.

Enhancing teacher education : the School-Community Intergrated Learning (SCIL) pathway

National Australian reviews advocate exploring new models for preservice teacher education. This study investigates the outcomes of the School-Community Integrated Learning (SCIL) pathway as a model for advancing preservice teachers’ understandings of teaching. Thirty-two final-year preservice teachers were surveyed with extended written responses on how the SCIL pathway advanced their understandings of teaching. Results indicated 100% agreement on 6 of the 27 survey items. Indeed, 78% or more preservice teachers agreed that they had a range of experiences across the five categories (i.e., personal-professional skill development, understandings of system requirements, teaching practices, student behaviour and reflective practices). Extended responses suggested they had developed understandings around setting up classrooms, whole school planning processes with professional development, the allocation of teacher responsibilities (e.g., playground duties), parent-teacher interviews, diagnostic testing for literacy and numeracy, commencing running records of students’ assessment results, and the development of relationships (students, teachers and parents). Although a longitudinal study is required to determine long-term effects, the SCIL pathway may be viewed as a positive step towards preparing final-year preservice teachers for their first year as fully-fledged teachers.