Barriers and enablers to learning during team-based clinical simulations: reflective interviews with final year undergraduate nursing students

Background: Contemporary approaches to clinical simulation can enhance educational outcomes. However, simulation approaches do have limitations with possible compromises for learning and teaching. This paper aims to identify barriers
and enablers to learning in simulated clinical settings.
Methods: A generic qualitative design was applied. Semi-structured group video debriefing interviews were held with Australian final-year nursing students who completed three patient deterioration scenarios with a standardized patient.
Audio-recorded interviews were transcribed and analysed to identify emergent themes.
Results: Interviews with 15 teams of three students (n = 45) from three universities were analysed. Learning enablers were ‘Realism of the simulated environment’; ‘Practicing: we should do this at uni’; ‘Learning from reflection and expert feedback’, and ‘How to become competent: know the gaps’. Barriers to learning included ‘Increased stress from inexperience; ‘Expectations when pretending’ and ‘Lack of assistance’. Skills practice in team-based settings with applicable reflection and debriefing was regarded as beneficial. Simulated patients enhanced fidelity but were unable to replicate actual clinical signs. High stress levels were perceived as a barrier to learning.
Conclusions: Applicably designed high fidelity simulations with video-based reflective review offer repeated rehearsal of clinical situations to enable learning. This educational strategy may reduce the time it takes undergraduate students to
reach competency.

Sport-for-development: an integrated literature review

Despite the significant increase of published research in sport-for-development (SFD), to date there have been no attempts to rigorously review and synthesize scholarly contributions in this area. To address this issue, we conducted an integrative review of SFD literature to portray an overarching and holistic picture of the field. Through a comprehensive literature analysis following Whittemore and Knafl’s (2005) five-step process, we provide evidence of the status quo of current SFD research foci, authorship, geographical contexts, theoretical frameworks, sport activity, level of development, methodologies, methods, and key research findings. Our study shows an increasing trend of journal publications since 2000, with a strong focus on social and educational outcomes related to youth sport and with football (soccer) as the most common activity. A large majority of SFD research has been conducted at the community level, where qualitative approaches are dominant. The geographical contexts of authorship and study location present an interesting paradox: Although the majority of SFD projects are carried out in Africa, Asia, and Latin America, 90% of SFD authors are based in North America, Europe, and Australia. We conclude our study by providing new perspectives on key issues in SFD and by outlining current research and theoretical gaps that provide the basis for future scholarly inquiry.

Doing the right thing at the right time: Assessing responses to patient deterioration in electronic simulation scenarios using course-of-action analysis

International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.

New evidence of the causal effect of family size on child quality in a developing country

This paper presents new evidence of the causal effect of family size on child quality in a developing-country context. We estimate the impact of family size on child labor and educational outcomes among Brazilian children and young adults by exploring the exogenous variation of family size driven by the presence of twins in the family. Using the Brazilian Census data for 1991, we nd that the exogenous increase in family size is positively related to labor force participation for boys and girls and to household chores for young women. We also and negative e ects on educational outcomes for boys and girls and negative impacts on human capital formation for young female adults. Moreover, we obtain suggestive evidence that credit and time constraints faced by poor families may explain the findings.

The long-term effects of conditional cash transfers on child labor and school enrollment

This paper investigates the long-term e ects of conditional cash transfers on school attainment and child labor. To this end, we construct a dynamic heterogeneous agent model, calibrate it with Brazilian data, and introduce a policy similar to the Brazilian Bolsa Fam lia. Our results suggest that this type of policy has a very strong impact on educational outcomes, sharply increasing primary school completion. The conditional transfer is also able to reduce the share of working children from 22% to 17%. We then compute the transition to the new steady state and show that the program actually increases child labor over the short run, because the transfer is not enough to completely cover the schooling costs, so children have to work to be able to comply with the program's schooling eligibility requirement. We also evaluate the impacts on poverty, inequality, and welfare.

Life expectancy and human capital investment: the arrival of AIDS treatment in Brazil

This paper provides microevidence on the relationship between life expectancy and educational investment decisions. Human capital theory predicts an increase in life expectancy should lead to an augmenting in schooling investment. This paper uses an unique data set on AIDS patients among Brazilian inhabitants in an attempt to estimate the impact of the arrival of Antiretroviral therapy (ART) on educational outcomes. The availability of ART offsets the negative relationship between vertical HIV-transmission and schooling, around 68% and 57% for elementary and high school completion, respectively. Robustness tests indicate the results are not driven by convergence effects.

What schools teach us about educating poor children in Chile?

Includes bibliography

O plano de desenvolvimento da escola (PDE-Escola): instrumento de autonomia para as unidades escolares?

Pós-graduação em Educação - IBRC

Os impactos do sistema ‘CAPES’ de avaliação sobre o trabalho docente na pós-graduação: o caso da UFPA

Este estudo tem como objetivo central analisar os impactos do sistema ‘CAPES’ de avaliação da pós-graduação sobre o trabalho docente na Universidade Federal do Pará. Para tanto, o estudo se utiliza de documentos oficiais que versam sobre a política de avaliação da pós graduação no Brasil e de entrevistas com professores de três programas de pós-graduação da UFPA. Parte-se da premissa de que o processo de reestruturação produtiva e a reforma do estado brasileiro têm induzido mudanças no ensino superior com centralidade para as políticas de avaliação e para o trabalho do professor. Essas mudanças no ensino superior consolidam um projeto de universidade pensado desde os organismos internacionais do capital que pressupõem a diluição de fronteiras entre o público e o privado no que toca à expansão, ao financiamento, à avaliação, à autonomia e à produção do conhecimento. A pós-graduação é o locus privilegiado da implementação da reforma do ensino superior no Brasil, visto que as influências do mercado são claramente visíveis no modelo de avaliação dos programas de pós-graduação da CAPES. Trata-se, pois, de um processo que se dá em âmbito continental de conformação de uma nova regulação educativa assentado no tripé financiamento per capita, gestão local e avaliação sistêmica. Nesse contexto, o trabalho docente, entendido como o principal responsável pelos resultados educacionais, passa por um profundo processo de reestruturação com repercussões em sua natureza, finalidade e sentidos. A investigação demonstra que o sistema ‘CAPES’ de avaliação dos programas de pós-graduação, como expressão da nova regulação educacional na América Latina, confere centralidade ao trabalho do professor no processo de avaliação dos programas e o responsabiliza pelos resultados com base em critérios formulados de acordo com interesses externos à lógica e ao tempo da produção do conhecimento científico. O resultado da implantação dessa lógica na pósgraduação para os professores é a intensificação do trabalho por meio de um surto produtivista jamais visto, a precarização das condições de produção e o adoecimento docente. Para a instituição educacional, vê-se uma transformação em seu ethos e em sua identidade que têm modificado a cultura acadêmica de modo a aproximá-la cada vez mais em sua estrutura, funcionamento e atividade-fim das empresas privadas.

Democratization, Education Reform, and the Mexican Teachers' Union

This study examines the effect of democratization on a key education reform across three Mexican states. Previous scholarship has found a positive effect of electoral competition on social spending, as leaders seek to improve their reelection prospects by delivering services to voters. However, the evidence presented here indicates that more money has not meant better educational outcomes in Mexico. Rather, new and vulnerable elected leaders are especially susceptible to the demands of powerful interest groups at the expense of accountability to constituents. In this case, the dominant teachers' union has used its leverage to exact greater control over the country's resource-rich merit pay program for teachers. It has exploited this control to increase salaries and decrease standards for advancement up the remuneration ladder. The evidence suggests that increased electoral competition has led to the empowerment of entrenched interests rather than voters, with an overall negative effect on education.

Postgraduate training program

BACKGROUND: Faculties face the permanent challenge to design training programs with well-balanced educational outcomes, and to offer various organised and individual learning opportunities. AIM: To apply our original model to a postgraduate training program in rheumatology in general, and to various learning experiences in particular, in order to analyse the balance between different educational objectives. METHODS: Learning times of various educational activities were reported by the junior staff as targeted learners. The suitability of different learning experiences to achieve cognitive, affective and psychomotor learning objectives was estimated. Learning points with respect to efficacy were calculated by multiplication of the estimated learning times by the perceived appropriateness of the educational strategies. RESULTS: Out of 780 hours of professional learning per year (17.7 hours/week), 37.7% of the time was spent under individual supervision of senior staff, 24.4% in organised structured learning, 22.6% in self-studies, and 15.3% in organised patient-oriented learning. The balance between the different types of learning objectives was appropriate for the overall program, but not for each particular learning experience. Acquisition of factual knowledge and problem solving was readily aimed for during organised teaching sessions of different formats, and by personal targeted reading. Attitudes, skills and competencies, as well as behavioural and performance changes were mostly learned during caring for patients under interactive supervision by experts. CONCLUSION: We encourage other faculties to apply this approach to any other curriculum of undergraduate education, postgraduate training or continuous professional development in order to foster the development of well-balanced learning experiences.

COGNITIVE IMPACT OF INTERACTIVE MULTIMEDIA

Technology has been gradually introduced in heath education. One of the most attractive features of this technology-based education is the use of multimedia. In this article we explore the research evidence about the role that multimedia is playing in education. From that analysis we describe the most relevant features of this technology to prepare a common ground of discussion about the evaluation of its impact on educational outcomes. As part of this analysis, we organize current research evidence on the use of technology in medical education, distinguishing diverse variables involved in the process, like knowledge (declarative, procedural), learner characteristics, curricular scenario, etc. This article presents an overview of the Distributed Representations theory and its relationship with research on educational outcomes and multimedia. Next we discuss the relationship between media and diverse learning theories, proposing a theory based taxonomy for educational multimedia.

The Role for Virtual Patients in the Future of Medical Education

The medical education community is working-across disciplines and across the continuum-to address the current challenges facing the medical education system and to implement strategies to improve educational outcomes. Educational technology offers the promise of addressing these important challenges in ways not previously possible. The authors propose a role for virtual patients (VPs), which they define as multimedia, screen-based interactive patient scenarios. They believe VPs offer capabilities and benefits particularly well suited to addressing the challenges facing medical education. Well-designed, interactive VP-based learning activities can promote the deep learning that is needed to handle the rapid growth in medical knowledge. Clinically oriented learning from VPs can capture intrinsic motivation and promote mastery learning. VPs can also enhance trainees' application of foundational knowledge to promote the development of clinical reasoning, the foundation of medical practice. Although not the entire solution, VPs can support competency-based education. The data created by the use of VPs can serve as the basis for multi-institutional research that will enable the medical education community both to better understand the effectiveness of educational interventions and to measure progress toward an improved system of medical education.

Zum Einfluss vorschulischer Kinderbetreuung auf den Bildungsweg und den erwarteten Erfolg am Arbeitsmarkt

In dem Beitrag wird der Frage nachgegangen, welchen Einfluss die Inanspruchnahme frühkindlicher Bildungs- und Betreuungsangebote auf den späteren Schulbesuch von Kindern hat und wie sich dies längerfristig auf die zu erwartenden Lebenseinkommen und damit einhergehend den langfristigen volkswirtschaftlichen Nutzen auswirkt. Untersucht werden Kinder in Deutschland der Jahrgänge 1990 bis 1995. Die Datengrundlage liefert das Sozio-oekonomische Panel (SOEP). Der Schwerpunkt der Analysen liegt auf der Bestimmung des Effekts des Krippenbesuchs auf die spätere Einstufung in die verschiedenen Schultypen in Abhängigkeit der sozialen Herkunft und des Migrationshintergrunds der Kinder. Ausgehend von diesen Schätzungen werden dann die zu erwartenden, über den Bildungsabschluss vermittelten Auswirkungen des Krippenbesuchs auf das spätere Lebenseinkommen bestimmt, um einen Eindruck der langfristigen volkswirtschaftlichen Folgen vorschulischer Kinderbetreuung zu erhalten. Der Beitrag zeigt, dass der Krippenbesuch die Wahrscheinlichkeit einer Einstufung ins Gymnasium nach Kontrolle relevanter Drittvariablen im Schnitt um rund 14 Prozentpunkte erhöht. Dieser Einfluss entspricht einem erwarteten Lebenseinkommenszuwachs von rund 27000 Euro. Wird dieser Ertrag auf den Zeitpunkt des Krippenbesuchs abdiskontiert und den Kosten eines durchschnittlichen Krippenbesuchs in der Höhe von rund 8000 Euro gegenübergestellt, so ergibt sich ein Kosten-Nutzen-Verhältnis von 1 zu 2.7. (DIPF/Orig.).

Competence assessment of final year projects for undergraduate telecommunication students

The value of project-based learning has lead to the inclusion of project development activities in engineering courses, being the Final Year Project (FYP) the most remarkable one. Several approaches have been proposed for assessing and grading FYPs but, among them, rubrics are becoming a standard for such type of assessment. However, due to the different characteristics and orientations of the projects (some are more practically oriented, some more theoretically), and the high amount of different competences to be evaluated (knowledge, working capability, communication skills, etc.), the definition of one unique rubric suitable for the evaluation of all FYPs presented in different degree programs, is a big challenge. In a former work, the educational outcomes expected from the FYP were defined and resulted in a proposal for their assessment. Afterwards, the proposal has been tested during one year within an educational innovation-project at the Universidad Politécnica de Madrid which involved the follow-up of 8 undergraduate telecommunication students elaborating their FYPs. In this publication, our experience will be described, based on the emerging work taking place through the formalisation of the process which consisted in the following steps: i) establishment of a schedule for the whole process (publication of FYPs topics, selection of applying students and their enrolment, assignation of a jury to each FYP, elaboration and follow-up of FYPs, final report submission, oral presentation, etc.); ii) design of rubrics for each of three assessment parts: working process, final report and oral presentation; and iii) follow-up and evaluation of the involved FYPs. Finally, problems that appeared during this experience (e.g. administrative aspects, criticisms and suggestions from the students, tutors and juries involved) are discussed and some modifications in the assessment system will be proposed in order to solve or minimize these problems.