Search

Background and purpose Spirometry is often technically challenging for patients. Previous studies have demonstrated the potential benefits of spirometry in the community pharmacy setting. This study compared pharmacy students' perceptions and attitudes toward performing spirometry, as well as implementing spirometry in clinics and community pharmacies through experiencing spirometry first-hand versus completing paper-based active learning exercises. Educational activity and setting First-year (N = 102) and second-year (N = 70) pharmacy students were provided with the same pre-class materials to learn about the spirometry process. During class, first-year (P1) students performed spirometry tests, while second-year (P2) students completed paper-based active learning exercises about spirometry without performing the test. A survey was provided to each group at the end of the class to: (1) compare students’ perception of the difficulty of performing spirometry, and (2) identify patient, clinic, and pharmacy barriers to implementing spirometry testing. Findings P1 students perceived performing spirometry as significantly more difficult compared to P2 students. Both P1 and P2 students perceived correct posture and breathing technique, and patient discomfort as the most difficult parts of performing spirometry. Significantly more P1 students (91.1%) perceived spirometry as a “helpful and noninvasive tool to screen for pulmonary diseases” than P2 students (54.1%). Summary Students who experienced spirometry perceived it to be more difficult than those who completed paper-based active learning exercises. Incorporating spirometry into a pharmacy curriculum could be an opportunity to increase students’ insight of the difficulty of performing spirometry and their appreciation for the clinical services pharmacists can provide.

This paper describes how an anatomy and physiology laboratory class transitioned from a paper-based lab to an online learning platform that updated the curriculum to rely more on face-to-face small group collaboration and peer teaching. Student perceptions of the new format were positive, but halfway through the transition a global pandemic challenged the new instruction method. The face-to-face curriculum had to be adjusted to a virtual format that lacked in-person interaction between the instructor and the students. This switch to virtual labs had an adverse effect on both student perception and student performance in the second half of the semester. Our observations underscore the importance of creating an interactive community when teaching virtually.

Objectives Compassionate care is a core value of healthcare practice. In the post-Francis arena, the Shape of Caring review scrutinised healthcare education and training. The aim of the review was to better enable healthcare providers in delivering compassionate care and support to people with complex challenging health needs today and in the future. The review also reiterated the role of educators and universities in developing curricula capable of promoting compassionate care. Despite the review focussing upon the nursing profession, this paper suggests there is a similar role for radiography educators in delivering curricula suitable for promoting compassionate care. Potential pedagogic methods and their suitability within the radiography education setting will be considered. Key findings Relationships and emotions were noted as important aspects of promoting compassionate care. The themes ‘practising compassionately’ and ‘individual and relationship factors …’ are of particular relevance to education. Conclusions Compassion remains a priority in policy which must be promoted to students as an integral aspect of healthcare education. A facilitated discussion of students' reflections around practice experiences to promote compassion is suggested. Supplemented by service user stories, students would be able to develop the skills needed to ‘practise compassionately’.

Item does not contain fulltext Sports cardiology is a new and rapidly evolving subspecialty. It aims to elucidate the cardiovascular effects of regular exercise and delineate its benefits and risks, so that safe guidance can be provided to all individuals engaging in sports and/or physical activity in order to attain the maximum potential benefit at the lowest possible risk. The European Society of Cardiology (ESC) advocates systematic preparticipation cardiovascular screening in an effort to identify competitive athletes at risk of exercise-related cardiovascular events and sudden cardiac death. However, the implementation of preparticipation screening is hindered because of lack of structured training and as a result lack of sufficient expertise in the field of sports cardiology. In 2008 the European Society of Cardiology published a core curriculum for the general cardiologist, in which sports cardiology was incorporated within the topic 'Rehabilitation and Exercise Physiology'. However, the exponential rise in knowledge and the growing demand for expertise in the field of sports cardiology dictates the need to systematically structure the knowledge base of sports cardiology into a detailed curriculum. We envisage that the curriculum would facilitate more uniform training and guideline implementation throughout Europe, and safeguard that evaluation and guidance of competitive athletes or individuals who wish to engage in leisure-time sports activities is performed by physicians with expertise in the field. The current manuscript provides a comprehensive curriculum for sports cardiology, which may serve as a framework upon which universities and national and international health authorities will develop the training, evaluation and accreditation in sports cardiology.

Objective. To determine whether using standardized patients dressed in moulage improves pharmacy students' ability to assess skin disorders compared to using picture-based paper cases. To determine pharmacy student preferences when learning assessment of skin disorders through these two educational methods. Methods. Faculty members investigated student assessments of drug-induced skin disorders and contact dermatitis by using picture-based paper cases compared with using standardized patients dressed in moulage in a patient assessment course. Faculty members measured student knowledge via multiple-choice questions before laboratory, immediately after laboratory, and during a final examination 3 weeks later. Student preferences were measured immediately after laboratory via survey instrument in this randomized, non-blinded, crossover design educational study. Results. No significant differences in knowledge scores related to skin disorders were found after laboratory or 3 weeks later when comparing the two educational methods. However, survey results suggested student preferences for using standardized patients dressed in moulage for drug-induced skin disorders. No significant differences were found for contact dermatitis cases. Conclusion. Using standardized patients dressed in moulage did not improve pharmacy students' ability to assess skin disorders compared to using picture-based paper cases. Pharmacy students preferred standardized patients dressed in moulage only when learning assessment of drug-induced skin disorders.

“The viscosity of the blood in narrow capillary tubes” by Robin Fåhraeus and Torsten Lindqvist ( Am J Physiol 96: 562–568, 1931) can be a valuable opportunity for teaching basic hemorheological principles in undergraduate cardiovascular physiology. This classic paper demonstrates that a progressive decline in apparent viscosity occurs when blood flows through glass capillary tubes of diminishing radius, which was later designated as the “Fåhraeus-Lindqvist effect.” Subsequent studies have shown that apparent viscosity continues to decline at diameters that correspond to the arteriolar segments of the systemic vascular tree, where the majority of the total peripheral resistance resides and is actively regulated in vivo. The Fåhraeus-Lindqvist effect thus reduces microvascular resistance, thereby maintaining local tissue perfusion at a relatively lower blood pressure. The paper by Fåhraeus and Lindqvist can be used as a platform for a plenary discussion of these concepts as well as of the relationships among hematocrit, vessel diameter, red blood cell deformability, and resistance to blood flow and how these factors may affect the work of the heart.

Many studies have emphasized the incorporation of active learning into classrooms to reinforce didactic lectures for physiology courses. This work aimed to determine if presenting classic papers during didactic lectures improves the learning of physiology among undergraduate students. Twenty-two students of health information technology were randomly divided into the following two groups: 1) didactic lecture only (control group) and 2) didactic lecture plus paper presentation breaks (DLPP group). In the control group, main topics of gastrointestinal and endocrine physiology were taught using only the didactic lecture technique. In the DLPP group, some topics were presented by the didactic lecture method (similar to the control group) and some topics were taught by the DLPP technique (first, concepts were covered briefly in a didactic format and then reinforced with presentation of a related classic paper). The combination of didactic lecture and paper breaks significantly improved learning so that students in the DLPP group showed higher scores on related topics compared with those in the control group ( P < 0.001). Comparison of the scores of topics taught by only the didactic lecture and those using both the didactic lecture and paper breaks showed significant improvement only in the DLPP group ( P < 0.001). Data obtained from the final exam showed that in the DLPP group, the mean score of the topics taught by the combination of didactic lecture and paper breaks was significantly higher than those taught by only didactic lecture ( P < 0.05). In conclusion, the combination of paper presentation breaks and didactic lectures improves the learning of physiology.

This framework paper provides an overview of what matters most for school autonomy and accountability. The focus is on public schools at the primary and the secondary level. This paper begins by grounding School Autonomy and Accountability in its theoretical evidence base (impact evaluations, lessons learned from experience, and literature reviews) and then discusses guiding principles and tools for analyzing country policy choices. The goal of this paper is to provide a framework for classifying and analyzing education systems around the world according to the following five policy goals that are critical for enabling effective school autonomy and accountability: 1) level of autonomy in the planning and management of the school budget; 2) level of autonomy in personnel management; 3) role of school councils in school governance; 4) school and student assessment, and 5) accountability to stakeholders. This paper also discusses how country context matters to school autonomy and accountability and how balancing policy goals matters to policy making for improved education quality and learning for all.

Classroom discussion of the classic article by Walter B. Cannon in 1914, entitled “The emergency function of the adrenal medulla in pain and the major emotions,” is an excellent tool to teach graduate students the interaction between stress, emotions, and cardiovascular function. Using this article, we are able to review important early research by Dr. Cannon, including discussion of his scientific methods and results and how they hold true today. This article outlines how this classic paper is used to allow students to explore basics principles of cardiovascular control during stress. The teaching points that are presented illustrate how students can be directed to understand the interrelationship between chronic stress and cardiovascular disease.

This teaching paper utilizes the materials presented by Dr. Fabiato in his review article entitled “Calcium-induced release of calcium from the cardiac sarcoplasmic reticulum.” In the review, supporting evidence of calcium-induced calcium release (CICR) is presented. Data concerning potential objections to the CICR theory are discussed as well. In closing, technical issues associated with the skinned cell model are mentioned. Based on this review article, teaching and learning points are put forth in this article to highlight two concepts: 1) the regulatory mechanisms of CICR in cardiomyocytes and 2) the recognition of contradicting hypotheses and limitations in experimental design. The first concept is certainly an important one for physiology students. The second concept is universally applicable to researchers in all fields of science. It is thus the aim of this article to cultivate a rewarding teaching and learning experience for both instructors and students.

Many pathological conditions exist where tissues exhibit hypoxia or low oxygen tension. Hypoxic hypoxia arises when there is a reduction in the amount of oxygen entering the blood and occurs in healthy people at high altitude. In 1946, research sponsored by the United States Navy led to the collection and subsequent publication of masses of data demonstrating the physiological consequences and adaptations of ascent to high altitude. This article describes how a figure from a 1947 paper from the American Physiological Society Legacy collection (Houston CS, Riley RL. Respiratory and circulatory changes during acclimatization to high altitude. Am J Physiol 149: 565–588) may be used to allow students to review their understanding of some of the generalized effects of hypoxia on the body. In particular, this figure summarizes some of the adaptive responses that take place in the oxygen transport system as a consequence of prolonged hypoxia.

SUMMARY The Permanent Working Group of European Junior Hospital Doctors (PWG) represents the interests, in international matters, of trainees from 23 member states. The PWG recognizes the importance of postgraduate training (PGT) in the maintenance of high quality health care delivery, and in this paper presents its current policy on PGT. This replaces its policy previously published in Medical Education 1989, 23, 339–47. The paper examines the context within which PGT occurs, and calls for an urgent review of its provision and funding. Basic principles, such as PGT existing within a continuum of medical education and the application of a quality assurance-based model, underpin the development of later sections on the structure, process and outcomes of PGT. These recommend the establishment of structured training programmes which should incorporate modern educational practice in the provision and monitoring of PGT. Emphasis is placed on the opportunities for training in the clinical setting and the utilization of a range of educational techniques. Evaluation and guidance by and of clinical supervisors and designated trainers is linked with the responsibilities of the trainee, and is placed within the context of a system of accountability, thus closing the quality assurance cycle. It is recommended that the views of the consumers of PGT, the trainees, are more fully considered in the development of training programmes. Finally, the potential for further harmonization is considered, with cautious advances being proposed.

Two significant benefits derived from reading and discussing classic scientific papers in undergraduate biology courses are 1) providing students with the realistic perspective that science is an ongoing process (rather than a set of inarguable facts) and 2) deepening the students' understanding of physiological processes. A classic paper that is useful in both of these regards is by I. E. Lawton and N. B. Schwartz (A circadian rhythm of luteinizing hormone secretion in ovariectomized rats. Am J Physiol 214: 213–217, 1968). The primary objective of the study is to determine whether tonic (pulsatile) secretion of luteinizing hormone (LH) from the pituitary gland exhibits a circadian rhythm. While this hypothesis seems relatively straightforward, its in vivo investigation necessitates an awareness of the multitude of factors, in addition to the circadian clock, that can influence plasma LH levels (and a consideration of how to control for these factors in the experimental design). Furthermore, discussion of the historical context in which the study was conducted (i.e., before the pulsatile nature of LH secretion had been discovered) provides students with the realistic perspective that science is not a set of facts but rather a systematic series of attempts by scientists to understand reality (a perspective that is difficult to convey using a traditional textbook alone). A review of the historical context in which the study was conducted, and a series of discovery learning questions are included to facilitate classroom discussions and to help deepen students' understanding of the complex nature of pituitary hormone regulation.

Question-asking is a basic skill, required for the development of scientific thinking. However, the way in which science lessons are conducted does not usually stimulate question-asking by students. To make students more familiar with the scientific inquiry process, we developed a curriculum in developmental biology based on research papers suitable for high-school students. Since a scientific paper poses a research question, demonstrates the events that led to the answer, and poses new questions, we attempted to examine the effect of studying through research papers on students' ability to pose questions. Students were asked before, during, and after instruction what they found interesting to know about embryonic development. In addition, we monitored students' questions, which were asked orally during the lessons. Questions were scored according to three categories: properties, comparisons, and causal relationships. We found that before learning through research papers, students tend to ask only questions of the properties category. In contrast, students tend to pose questions that reveal a higher level of thinking and uniqueness during or following instruction with research papers. This change was not observed during or following instruction with a textbook. We suggest that learning through research papers may be one way to provide a stimulus for question-asking by high-school students and results in higher thinking levels and uniqueness.

This paper presents the results of a UK national survey of Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) training for undergraduate medical students. In all responding medical schools, undergraduates are taught BLS at least once during their course but the assessment and refresher aspects of BLS training are not uniformly covered. There are inconsistencies in ACLS teaching, with some schools providing formal courses, some teaching specific techniques and others providing no ACLS teaching. Most interestingly, of those completing the questionnaire, only 52% considered present undergraduate training adequate to enable junior house officers to provide an effective resuscitation service. We recommend that all aspects of BLS and ACLS training for medical undergraduates be improved and standardized throughout the UK.

Two formats of delivering clinical simulations for nurse practitioners were evaluated in this study. The two formats included paper-and-pencil, latent-image format, and computer-assisted instruction. Twelve students in a graduate family nurse practitioner curriculum were the subjects. They reported no preference for type of format nor were any differences observed in student performance when comparing the two formats. The cost for the latent-image format was estimated at approximately $8500 and the cost for computer simulation at approximately $10,500. The implications of these findings for nursing curriculums are discussed.

For gerontological educators, topics such as mortality, loss, and end-of-life issues often emerge or are central in their courses. However, the COVID-19 pandemic has raised our awareness of loss and death on a global scale and teaching during the pandemic has raised questions about how educators, communities, or systems of higher education can support students’ learning while simultaneously experiencing losses during intense times of uncertainty. In this mixed-method study of 246 students enrolled in undergraduate thanatology courses, we explored their levels of death anxiety and their experiences with pandemic-related losses. We found that students’ death anxiety increased significantly during the pandemic, in comparison to the years prior (p < .001). We also conducted a content analysis in a subset of students’ written narratives (n = 44) regarding their pandemic experiences. We identified three themes. Participants desired: (a) more flexibility from instructors, no questions asked; (b) more compassion and understanding; and (c) specific, targeted support resources. The voices of students were filtered through the authors’ interpretation as educators to provide several teaching recommendations that support student learning during challenging times. The recommendations align with a trauma-informed approach, given the high rates of death anxiety and ambiguous loss among students, and have immediate implications for educators teaching during the pandemic, and for years to come. Finally, we also advocate for more university and community-based thanatology, and gerontology education offerings in general, to help normalize conversations about death, loss, and bereavement.

Key summary points Aim UK medical schools are required to teach about frailty but the term is open to interpretation. This national survey aims to understand how frailty has been perceived and approached by schools. Findings Frailty is perceived and approached in a broad variety of ways ranging from a long term condition to geriatric medicine in its entirety. A range of educational approaches have been used to teach and assess, with little constructive alignment to match learning outcomes. Teaching is most commonly opportunistic, by a student observing geriatric ward rounds. Message Frailty is open to individual interpretation. Expert consensus should be reached regarding the core areas to include in UGME around the topic of frailty. It would be prudent to explore which frailty-related educational strategies enhance student knowledge, attitudes and values towards frailty., Purpose All UK medical schools are required to include frailty in their curriculum. The term is open to interpretation and associated with negative perceptions. Understanding and recognising frailty is a prerequisite for consideration of frailty in the treatment decision-making process across clinical specialities. The aim of this survey was to describe how frailty has been interpreted and approached in UK undergraduate medical education and provide examples of educational strategies employed. Methods All UK medical schools were invited to complete an electronic survey. Schools described educational strategies used to teach and assess frailty and provided frailty-related learning outcomes. Learning Outcomes were grouped into categories and mapped to the domains of Outcomes for Graduates (knowledge, skills and values). Results 25/34 Medical schools (74%) participated. The interpretation of what frailty is vary widely and the diversity of teaching strategies reflect this. The most common Learning outcomes included as “Frailty” are about the concept of frailty, Comprehensive Geriatric Assessments and Roles of the MDT. Frailty teaching is predominantly opportunistic and occurred within geriatric medicine rotations in all medical schools. Assessments focus on frailty syndromes such as falls and delirium. Conclusion There is variation regarding how frailty has been interpreted and approached by medical schools. Frailty is represented in an array of teaching and assessment methods, with a lack of constructive alignment to related learning outcomes. Consensus should be agreed as to what frailty means in medical education. Further research is required to explore which frailty-specific educational strategies in undergraduate medical education enhance learning.

This White Paper shares guidance on the important principles of training endoscopy teachers, the focus of an American Society for Gastrointestinal Endoscopy (ASGE)/World Endoscopy Organization Program for Endoscopic Teachers and Leaders of Endoscopic Training held at the ASGE Institute for Training and Technology. Key topics included the need for institutional support and continuous skills development, the importance of consensus and consistency in content and approach to teaching, the role of conscious competence and content breakdown into discreet steps in effective teaching, defining roles of supervisors versus instructors to ensure teaching consistency across instructors, identification of learning environment factors and barriers impacting effective teaching, and individualized training that incorporates effective feedback and adapts with learner proficiency. Incorporating simulators into endoscopy teaching, applying good endoscopy teaching principles outside the endoscopy room, key principles of hands-on training, and effective use of simulators and models in achieving specific learning objectives were demonstrated with rotations through hands-on simulator stations as part of the program. A discussion of competency-based assessment was followed by live sessions in which attendees applied endoscopy teaching principles covered in the program. Conclusions highlighted the need for the following: formal training of endoscopy teachers to a level of conscious competence, incorporation of formal training structures into existing training curricula, intentional teaching preparation, feedback to trainees and instructors alike aimed at improving performance, and competency-based trainee assessment. The article is intended to help motivate individuals who play a role in training other endoscopists to develop their teaching abilities, promote discussions about endoscopy training, and engage both endoscopy trainers and trainees in a highly rewarding learning process that is in the best interest of patients.

Background The middle ear is a complex anatomical space which is difficult to interpret from two-dimensional imagery. Appropriate surgical knowledge of the area is required to operate, yet current anatomical teaching methods are costly and hard to access for the trainee. Methods A papercraft 3D design involving anatomical elements added separately to a model was designed, and then peer-validated by medical students and junior doctors. Preliminary quantitative assessment was performed using an anatomical labelling questionnaire, with six students given a lecture to act as a control. Qualitative feedback was also gathered. Results 18 participants were recruited for the study. A total of 12 models were constructed by 6 medical students and 6 junior doctors. 6 medical students received a lecture only. Qualitative feedback was positive and suggested the model improved knowledge and was useful, yet timing and complexity were issues. Students scored, on average, 37% higher after completing the model, with junior doctors also improving anatomical knowledge, though these differences were not significant (p > 0.05). Conclusions In this initial investigation, the model was shown to be an engaging way to learn anatomy, with the tactile and active nature of the process cited as benefits. Construction of the model improved anatomical knowledge to a greater extent than a classical lecture in this study, though this difference was not significant. Further design iterations are required to improve practical utility in the teaching environment, as well as a larger study.

OBJECTIVE: To disseminate knowledge to mental health nurse educators regarding a course that is successfully preparing registered nurse (RN) students to pass the psychosocial integrity portion of the National Council Licensing Exam for Registered Nurses (NCLEX-RN). METHOD: Following the implementation of a new concept-based nursing program curricular design, faculty teaching in a psychiatric mental health nursing course embarked on converting lecture-based, content-saturated teaching strategies into active learning strategies. In this article, the overall conceptual framework for the course and specific examples of active learning teaching strategies related to nursing concepts in mental health are described. Information on objectives, clinical placements, testing, class organization, and curricular content are provided. Outcomes are shared revealing success in helping students pass the psychosocial integrity section of the NCLEX-RN. RESULTS: Predictive scores on the HESI RN Psychiatric Mental Health Specialty Exam have been consistently higher than the national average for the United States, and the NCLEX-RN pass rate for the cohort of 90 students was 97%. The majority of student evaluations of the course were positive. CONCLUSIONS: Results suggest that the integration of conceptual and active learning in a psychiatric mental health nursing course may increase the likelihood of student success.

Background Short instructional videos can make learning more efficient through the application of multimedia principles, and video animations can illustrate the complex concepts and dynamic processes that are common in health sciences education. Commercially produced videos are commonly used by medical students but are rarely integrated into curricula. Objective Our goal was to examine student engagement with medical education videos incorporated into a preclinical Cardiovascular Systems course. Methods Students who took the first-year 8-week Cardiovascular Systems course in 2019 and 2020 were included in the study. Videos from Osmosis were recommended to be watched before live sessions throughout the course. Video use was monitored through dashboards, and course credit was given for watching videos. All students were emailed electronic surveys after the final exam asking about the course’s blended learning experience and use of videos. Osmosis usage data for number of video views, multiple choice questions, and flashcards were extracted from Osmosis dashboards. Results Overall, 232/359 (64.6%) students completed surveys, with rates by class of 81/154 (52.6%) for MD Class of 2022, 39/50 (78%) for MD/MPH Class of 2022, and 112/155 (72.3%) for MD Class of 2023. Osmosis dashboard data were available for all 359 students. All students received the full credit offered for Osmosis engagement, and learning analytics demonstrated regular usage of videos and other digital platform features. Survey responses indicated that most students found Osmosis videos to be helpful for learning (204/232, 87.9%; P=.001) and preferred Osmosis videos to the traditional lecture format (134/232, 57.8%; P Conclusions Commercial medical education videos may enhance curriculum with low faculty effort and improve students’ learning experiences. Findings from our experience at one medical school can guide the effective use of supplemental digital resources for learning, and related evaluation and research.

This paper examines whether export participation matters for job training. The paper draws on longitudinal worker-firm data for Brazilian manufacturing, linked with detailed records on training activity from the main provider. The analysis uses industry-specific exchange rate movements to generate exogenous variation in export status at the firm-level. The findings indicate that export participation tends to increase the share of workers who receive technical upgrading. The results also reveal that technical upgrading has positive returns to trainees within exporting firms. These findings support the hypothesis that exporting requires skill upgrading, and suggest that this is partially achieved by training firms' existing workforce.

This paper seeks to find an empirical explanation of Vietnam's outstanding performance on the Programme for International Student Assessment (PISA) in 2012. Only a few developing countries participate in the assessment. Those who do, with the unique exception of Vietnam, are typically clustered at the lower end of the range of the Programme for International student Assessment scores. The paper compares Vietnam's performance with that of a set of seven developing countries from the 2012 assessment's data set, using a cut-off per capita GDP (in 2010 purchasing power parity dollars) of $10,000. The seven developing countries' average performance lags Vietnam's by more than 100 points. The "Vietnam effect" is difficult to unscramble, but the paper is able to explain about half of the gap between Vietnam and the seven countries. The analysis reveals that Vietnamese students may be approaching their studies with higher diligence and discipline, their parents may have higher expectations, and the parents may be following up with teachers regarding those expectations. The teachers themselves may be working in a more disciplined environment, with tabs being kept on their own performance as teachers. Vietnam may also be benefiting from investments in pre-school education and in school infrastructure that are disproportionately higher when compared with Vietnam's per capita income level.

Sri Lanka is increasingly seeking to ensure that its public school system not only delivers greater shares of students who have completed higher secondary and tertiary education, but also that all students obtain a much better education. Raising teacher effectiveness is considered as crucial for achieving these aims. This paper reviews the literature on teacher management in Sri Lanka, and points to what may be critical teacher management issues. The paper also outlines considerations and options for addressing these issues, informed by international evidence on approaches to improve teacher effectiveness.

To address the educational gap, many Latin American countries are focusing on extension of the school day and enrichment of the curriculum. In Brazil, a nationwide policy -- Mais Educação -- was implemented in 2008 with this objective. This paper explores the nationwide rollout of the program across the country and compares the performance of schools before and after implementation of the program. The paper quantifies the impacts of the program on student learning and dropout rates in urban areas, and investigates the heterogeneity of impacts by several characteristics of the program's implementation. Participating schools are compared with nonparticipating schools after controlling for school selection into the program based on observable characteristics using propensity score matching. The analysis finds that participation in Mais Educação has on average no impacts on school dropout rates and average negative impacts on mathematics test scores. The negative impacts on student achievement are stronger in the short term, which suggests that the negative effects may be reduced as the program improves its implementation. In addition, especially for fifth-grade schools, the level of student spending is associated with reduced dropout rates. Interestingly, in schools choosing the fields of Portuguese and/or sports in the added hours, the program is associated with lower test scores in Portuguese and mathematics. Finally, for the sample of fifth-grade schools, heterogeneous impacts are seen in the program according to the GDP per capita of the city where the school is located. The higher the GDP per capita, the greater the positive impact of the program on mathematics test scores and on dropout rates.

Improving the quality of education is one of today's main challenges for governments in the developing world. Based on a unique matched student-to-teacher panel data set on test scores this paper presents two empirical results for Indonesia. First, through detailed inspection of teacher-level responses to test questions, the paper concludes that subject matter knowledge of primary school teachers in Indonesia is low on average and that a 1.0, but also a 2.0 standard deviation increase in teachers' subject matter knowledge seem to be achievable medium-term goals for education policy making in Indonesia. Second, the paper presents the results of three types of value-added regressions, a (standard) level specification, a school fixed-effects specification, and a flexible student-teacher fixed-effects specification. The student-teacher fixed-effects approach estimates the parameters of a value-added model using test score variation within each student-teacher pair across three different subjects, mathematics, science and Indonesian language. The results suggest that a 1.0 (and 2.0) standard deviation increase in teachers' subject matter knowledge across-the-board can yield increases in student achievement by 0.25 (and 0.50) student-level standard deviations by the time students complete the six-year primary school cycle.

Countries throughout Latin America and the Caribbean are reforming their education systems with the view of adding more hours to the school day. This paper examines the existing evidence on the relationship between instructional time and student learning, and reviews 15 studies measuring the effects of longer school days. It draws on examples throughout the region to characterize differences in the implementation of extended school day programs, and provides one detailed case study and cost-effectiveness exercise (for Uruguay). While the evidence suggests positive impacts across a range of outcome variables, including gains in student learning, reductions in repetition and dropout, and reductions in teenage pregnancy, there is considerable heterogeneity across programs and studies. Even using the most optimistic impact estimates, a cost-effectiveness exercise suggests that there are likely many more cost-effective reforms to achieve similar effects. The paper concludes with a discussion of the implications for policy makers and practitioners considering an extension of the school day.

Technical education and training has been dramatically expanding in Brazil recently. However, there remains no evidence on the cost effectiveness of this alternative track to a more general education. This paper quantifies the wage returns of completing technical and vocational education and training compared with the returns of completing the general education track, for individuals with similar observable characteristics. Exploring data from the Brazilian National Household Sample Survey, the paper profiles the students taking up this track and quantifies the impact of different types of technical and vocational education and training courses on individuals’ hourly wages. After controlling for selection on observables with propensity score matching, the analysis shows positive and statistically significant wage premiums for students completing technical school at the upper secondary level (on average 9.7 percent ) and for those completing short-term training courses (2.2 percent on average). The paper also documents significant heterogeneity of impacts depending on the courses and the profile of students. For realistic unitary costs of providing technical and vocational education and training, the evidence suggests technical education is a cost-effective modality. The courses offered by the publically financed and privately managed “Sistema S,” together with courses in the manufacturing area have the highest positive impacts.

This paper seeks to understand what drove the trends in learning outcomes in Argentina between 2000 and 2012, using data from four rounds of the Program for International Student Assessment. A year-specific education production function is estimated and its results used to decompose the changes in learning outcomes into changes in inputs, parameters, and residuals via microsimulations. Estimates of the production function show the importance of socioeconomic status, gender, school autonomy, and teacher qualifications to determine learning outcomes. Despite an important increase in the level of resources invested in public education, learning outcomes in public schools decreased vis-à-vis private schools. According to the results presented here, the increase in the number of teachers in the system, pushing the pupil-teacher ratio in Argentina to 11, had no effect on learning outcomes. The microsimulation further confirms that changes in the system’s ability to transform inputs into outcomes accounted for most of the changes in test scores. Overall, the study shows the ineffectiveness of input-based education policies to improve learning outcomes in Argentina.