Search

Background: Formative online multiple‐choice tests are ubiquitous in higher education and potentially powerful learning tools. However, commonly used feedback approaches in online multiple‐choice tests can discourage meaningful engagement and enable strategies, such as trial‐and‐error, that circumvent intended learning outcomes. These strategies will not prepare graduates as self‐regulated learners, nor for the complexities of contemporary work settings. Objectives: To investigate whether providing only a score after formative online multiple‐choice test attempts (score‐only feedback) increases the likelihood of students to engage in self‐regulated learning compared with more directive feedback. Measurable outcomes included deeper learning, collaboration, information seeking, and satisfaction. Methods: Data in this mixed methods study were collected from nursing students through surveys, test results, focus groups, and student discussion board contributions. A quasi‐experimental design was used for quantitative data, and qualitative data were analysed thematically against domains of self‐regulated learning. Results and Conclusions: Students receiving score‐only feedback were more cognitively engaged with the content, collaborated constructively, and sought out richer sources of information. However, it was also associated with lower satisfaction. In this study, minimal feedback created states of uncertainty, which resulted in the activation of self‐regulatory actions. Implications for Practice: Providing overly directive feedback for formative online multiple‐choice tests is conducive to surface‐level learning strategies. By minimising feedback and allowing for extended states of uncertainty, students are more likely to regulate their learning through self‐assessment and problem‐solving strategies, all of which are required by graduates to meet the challenges of real‐world work settings. Lay Description: What is already known about this topic: Formative online multiple‐choice tests are widely used in higher education.Feedback is a critical element in the design of effective online multiple‐choice tests.Formative feedback should promote self‐regulated learning.Feedback types used in multiple‐choice tests facilitate strategies not conducive to self‐regulation. What this paper adds: Online multiple‐choice test feedback can influence how students self‐regulate their learning.Less feedback can result in greater self‐evaluation and performance in summative assessment.Less feedback can encourage richer help‐seeking strategies (collaboration and information seeking).However, less feedback can result in student dissatisfaction. Implications for practice and/or policy: Judicious use of feedback is required in the design of online multiple‐choice tests.Educators should consider providing less feedback to promote learner self‐regulation.Satisfaction with online multiple‐choice tests does not necessarily equate to greater learning. [ABSTRACT FROM AUTHOR]

Background: Dysphagia impacts negatively on quality of life, however there is little in‐depth qualitative research on these impacts from the perspective of people with dysphagia. Aims: To examine the lived experiences and views of people with lifelong or ongoing dysphagia on the impacts of dysphagia and its interventions on quality of life, and barriers and facilitators to improved quality of life related to mealtimes. Methods & Procedures: Nine adults with lifelong or acquired chronic dysphagia engaged in in‐depth interviews and a mealtime observation. The observations were recorded and scored using the Dysphagia Disorders Survey (DDS). Interviews were recorded, transcribed and de‐identified before content thematic and narrative analysis, and verification of researcher interpretations. Outcomes & Results: Participants presented with mild to severe dysphagia as assessed by the DDS. They viewed that dysphagia and its interventions reduced their quality of life and that they had 'paid a high price' in terms of having reduced physical safety, reduced choice and control, poor mealtime experiences, and poor social engagement. As part of their management of dysphagia, participants identified several barriers to and facilitators for improved quality of life including: being involved in the design of their meals, being adaptable, having ownership of swallowing difficulties, managing the perceptions of others and resisting changes to oral intake. Conclusions & Implications: This research improves understanding of the primary concerns of people with dysphagia about their mealtime experiences and factors impacting on their quality of life. Clinicians working with people with dysphagia need to consider how self‐determination, autonomy and freedom of choice could be improved through involvement in food design of texture‐modified foods. It is important that future research considers the views of health professionals on how these findings could impact on policy and practice particularly in ways to address the barriers and enhance facilitators to improved quality of life for people with dysphagia. What this paper adds: What is already known on the subject: Dysphagia impacts on quality of life, particularly as the severity of the dysphagia increases. Research to date has focused on people with dysphagia associated with an acquired health condition and has used quantitative assessment methods to measure quality of life. What this paper adds to existing knowledge: This study provides a qualitative examination of the impacts of dysphagia on quality of life from the perspective of people with lifelong or ongoing acquired dysphagia and their supporters. This study also provides qualitative insights into the barriers and facilitators of mealtime‐related quality of life. What are the potential or actual clinical implications of this work?: Health professionals should engage in open communication with their clients with dysphagia regarding the impacts of dysphagia on their lifestyle and quality of life. By considering these impacts, health professionals may be able to recommend interventions that are more acceptable to the person with the dysphagia which may have a positive impact on their mealtime experience. [ABSTRACT FROM AUTHOR]

Background This paper explores the role of providing structure for students within a new blended-learning family medicine curriculum at Saarland University. This study intends to clarify the role of different structural elements for different learning approaches (deep vs. structured vs. surface learning). Methods This study is based on a mixed-methods approach. Fifth year medical students' (n = 84) learning approaches, measured by a shortened version of the ASSIST questionnaire, were correlated with students' academic performance in state exams and the family medicine exam. Based on learning approaches and age, participants were purposefully sampled into two semi-structured group interviews with seven participants each. Results Although surface approach learning weakly correlated with lower performance in the first state exam (rho = 0.231), surface approach learning did not correlate with lower performance in the family medicine assessment. Based on qualitative results, the structural design of the curriculum seemed to have a high impact on students' satisfaction and motivation to learn. The reduction of extraneous cognitive load was identified as effective in motivating students to study. Deep-learning students highlighted the positive effects of curriculum activities that foster germane cognitive load through schema- based learning. Conclusions Especially for surface approach learners it may be important to provide structured guidance and provide a clear alignment of course content in a blended-learning curriculum, even in higher education. Deep and structured approach learners also benefit from a clear course structure that keeps extraneous cognitive load low and fosters schema acquisition. [ABSTRACT FROM AUTHOR]

Reflection journals (RJs) have been recognised as a vital tool in promoting student learning. However, little is known about how doctoral students use RJs to improve academic engagement. Through a mixed-method study, this paper explored how six international students from a Chinese normal university utilized RJs in their engagement in an advanced learning sciences course. This study used reflective journals, surveys, and interviews to examine doctoral students' perceptions of the effectiveness of reflective journals in their learning process in a 12-week 'Frontiers of the Learning Sciences' course. The quantitative results revealed that all items received a positive rating and were appropriate for exploring how reflective journals enhanced the participants' critical thinking, writing skills and engagement. Overall, the findings confirmed that reflective journals facilitate critical thinking, metacognition, and self-engagement. The findings of the study likewise provide information for course instructors to adjust their lesson plans in response to students' comments and suggestions. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education is seen as a key intervention to address the high HIV-incidence rate and low knowledge among young people in South Africa, yet this lacks inclusion of learners with disabilities. At the same time, educators of learners with disabilities experience cultural barriers and lack skills and knowledge on how to deliver sexuality education in accessible formats. In response, the Breaking the Silence approach, a curriculum implementation and disability-accommodating approach, was developed and tested. This paper presents findings from a formative evaluation using in-depth interviews with educators from eight “schools for learners with special educational needs”. The paper focuses on their experience with implementing the approach. The analysis used conventional content analysis and NVIVO software. Educators conceptualized sexuality education within a risk-protection discourse. They revealed that the training and tools enabled them to provide sexuality education in accessible formats, tackle difficult topics such as sexual orientation and masturbation, and improved awareness and assertiveness within their learners. Educators identified the need for further development including a whole school approach, adjustments to differentiating developmental stages and addressing gender-specific topics. Through its application within the South African mainstream Life Orientation curriculum, this approach lends itself for further development and testing through implementing the approach within a whole school setting and ongoing support that will not only drive change in educators’ skills and knowledge but also drive the needed shift in cultural norms and values. [ABSTRACT FROM AUTHOR]

Aim: To assess the perception of the nursing profession in Armenia from the perspective of multiple stakeholders, including nurses and the general public. Background: Nurses' role perception is a complex phenomenon defined by multiple stakeholders. Methods: The assessment used a convergent parallel mixed‐methods design, with a dominant qualitative status. We conducted the qualitative phase through focus group discussions and in‐depth interviews with 235 people and collected quantitative data in a cross‐sectional telephone survey with 389 participants. Results: The nursing profession has been influenced by medical hierarchy and subordination, and none of the participants recognized nursing as an autonomous health care profession. The quantitative survey findings were largely consistent with the qualitative results. Our findings highlighted empathy and compassion as inherent qualities of nurses in Armenia. Conclusion: To change opinions about the nursing profession and highlight nurses' meaningful contribution to the provision of health care services, it is important to develop a national definition of nursing and introduce higher educational opportunities for nurses in Armenia. Implications for nursing management: The paper highlights the importance of quality education for preparing highly competent nurse managers who can become role models in promoting nurses' roles in health care systems and improving the professional and public image of nursing. [ABSTRACT FROM AUTHOR]

Learning letters is an important area of language learning, conducive to the beginning of reading and writing. Indeed, today's generation prefers to learn through digital games rather than through formal teaching processes. Inspired by this need, the researcher designed this study (a) to test the effectiveness of an instructional digital game, "Kes Sesi," designed to teach letter recognition skills and (b) to briefly present its instructional development process, which was based on the ADDIE model. This was a quasi‐experimental study with two treatment groups and a control group involving 87 kindergarteners. Treatment groups played the game for 12–6 weeks for learning, 6 weeks for practice. The control group continued with its regular class activities. One treatment group played the game based on predefined sound categorization, the other without any categorization. A test on children's sound recognition abilities was administered three times as a pretest, a midtest, and a posttest. The treatment groups performed significantly better than the control group. The game enhanced the kindergarteners' ability to practice uncategorized content while it enhanced their ability to learn categorized content. The results are promising in that Kes Sesi can be useful in self‐supported learning contexts with little adult input and with minimum outside interference. Lay Description: What is already known about this topic: Learning letters is an important area of language learning, conducive to the beginning of reading and writing.There is a variety of research studies on digital games for learning in the literature.It is a challenge to teach preschool children letters. What this paper adds: There seems to be a gap when it comes to experiments on kindergarteners' early reading skills.Although there are many relevant games in the market, there are no studies investigating kindergarteners' sound recognition skills through game playing on mobile technology.This study has its unique feature in terms of providing a sample article on "Design, development and application of learning tools and systems," which is a topic within the Journal's scope. Implications for practice and/or policy: Digital educational games such as "Kes Sesi" can be useful in self‐supported learning circumstances with little adult input or intervention.Similar educational games can be designed by taking the current research study as an example, and it is believed that it will encourage production of many similar games.Students' performances reach an optimal level when educational games are used after the teacher helps them construct their learning and guide them in this endeavor. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aims of this project were to (a) determine barriers to current handover and transport process, (b) develop a new protocol and process for team‐to‐team handover, and (c) evaluate staff satisfaction with the new process. Background: The handover and transport of critically ill patients from the paediatric emergency department to the paediatric intensive care unit is a period of vulnerability associated with adverse events. Design: A mixed‐methods study using a quasi‐experimental design and qualitative approach. Methods: Focus groups were conducted to determine the barriers and facilitators of the current handover and transport process. Using these themes, a multidisciplinary team developed and implemented a new process including establishment of eight patient criteria for specialised transport and a standardised, interdisciplinary handover tool for team‐to‐team handover. Staff satisfaction was examined pre‐ and postintervention. Results: Content analysis of focus groups revealed five categories: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardisation and ambiguity between providers regarding acuity. Staff members reported improvements in their perceptions of satisfaction, safety, communication and role understanding associated with the new process. Conclusions: Standardisation through the establishment of severity of illness criteria and communication tools creates shared mental models and decreases risks to safety. A paradigm shift of team‐to‐team handover and transport is recommended. Relevance to clinical practice: This paper suggests the importance of improving communication during the handover and transport process through establishing standardised patient severity of illness criteria, use of standardised tools and team‐to‐team handover processes. [ABSTRACT FROM AUTHOR]

Aims and objectives: To develop a communication app to support nursing staff during the provision of standard care of patients from non‐English‐speaking backgrounds (NESBs), when an interpreter is not available. This paper reports on the user needs analysis phase that informed the development, content and functionality of the app. Background: In 2014 we developed CALD Assist, a communication app to support patient interactions with allied health clinicians when interpreters are not present. It includes 95 commonly used phrases professionally interpreted into 10 languages and grouped by discipline. This work expands upon our previous app to meet the needs of the nursing workforce. Design: Qualitative through focus groups, observations and interviews, with a quantitative component from observational data and staff surveys. Methods: Four focus groups with hospital staff, ten interviews with patients from NESBs and 85 observation sessions of everyday patient–staff interactions followed by staff surveys (n = 85) were held between January and June 2017. Results: Baseline data prior to app development revealed that staff confidence of the patients’ level of understanding and the success of the interaction were significantly greater for English‐speaking (ES) patients, than for non‐English‐speaking patients. A total of 143 phrases were identified and subdivided into 16 categories for inclusion in the new app. Conclusion: Staff participants highlighted that patients from NESBs are a challenging patient group to interact with. Patient and staff participants identified a range of areas where the nursing app could benefit, including pain management, mobility, hygiene and nutrition. Relevance to clinical practice: The proposed app can be used to reduce variances in practice and provide a timely and positive patient experience for patients from NESBs who are unable to communicate in English during hospital admissions. [ABSTRACT FROM AUTHOR]

In this paper, we describe the process of construction and validation of a health-related quality of life (HRQOL) measure for patients with endometriosis. The items in the measure were initially constructed, edited and reduced using a consultative process with endometriosis experts. We then determined the test reliability, validity and factor structure of the measure by administering the measure and several other measures to 203 patients with endometriosis. The 35-item measure produced an eight-dimension factor structure. The measure and its subscales demonstrated excellent internal consistency reliability and promising validity. [ABSTRACT FROM AUTHOR]

This paper investigates the definitions and onset of an old person in South-Western Nigeria. Conventionally, anyone who has reached the age of 60 or 65 years is regarded as the onset of an old person. But on contrary, this recent study is strongly emphasizing that 50 years and above is the onset of an old person in South-Western Nigeria. Obviously, the definitions and onset of an old person are controversial, yet, revealing in this paper. The study captured 13 Local Government Areas in Lagos state while 11 Local Government Areas were covered in Oyo state. The study employed focus group discussions (FGDs) and in-depth interviews (IDIs). However, 938 old persons were interviewed through questionnaire administration in Lagos and Oyo states of South-Western Nigeria. The univariate, FGDs, and IDIs were employed in the analyses of this research. The major findings of this study are the following: firstly, that there are different dimensions of the definitions of an old person that include frailty, inactivity, loss of strength, respect, blessedness, sickness, growing old, and inability to do hard work. Secondly, that someone who has reached the age of 50 years and above can be regarded as an old person, which is the onset of an old person in South-Western Nigeria society. On the basis of earlier findings, the study hereby recommends that anyone who has attained the age of 50 years and above should be recognized, regarded, and honored as an Elder by the State Government of South-Western Nigeria society where they are presently residing. [ABSTRACT FROM AUTHOR]

Background: Practice based research networks (PBRNs) are increasingly used as a tool for evidence based practice. We developed and tested the feasibility of using software to enable online collection of patient data within a chiropractic PBRN to support clinical decision making and research in participating clinics. Purpose: To assess the feasibility of using online software to collect quality patient information. Methods: The study consisted of two phases: 1) Assessment of the quality of information provided, using a standardized form; and 2) Exploration of patients' perspectives and experiences regarding online information provision through semi-structured interviews. Data analysis was descriptive. Results: Forty-five new patients were recruited. Thirty-six completed online forms, which were submitted by an appropriate person 100% of the time, with an error rate of less than 1%, and submitted in a timely manner 83% of the time. Twenty-one participants were interviewed. Overall, online forms were preferred given perceived security, ease of use, and enabling provision of more accurate information. Conclusions: Use of online software is feasible, provides high quality information, and is preferred by most participants. A pen-and-paper format should be available for patients with this preference and in case of technical difficulties. [ABSTRACT FROM AUTHOR]

Many studies have examined clinical and institutional moral problems in the practice of nurses that have led to the experience of moral distress. The causes and implications of moral distress in nurses, however, have not been understood in terms of their implications from the perspective of virtue ethics. This paper analyzes how nurses reach for the telos of their practice, within a context of moral distress. A qualitative case study was carried out in a private hospital in Brazil. Observation and semi‐semistructured interviews were conducted with 13 nurse participants. With the aid of ATLAS.ti software, the data were analyzed by using thematic content analysis using virtue ethics to theorize the findings. These nurses experienced a loss of their nursing identity as they encountered an ambiguous telos and the domination of institutional values. In their reach for the telos of their practice, nurses found an environment permeated by ethical challenges, which not only created moral distress but also created professional invisibility, a phenomenon referred to as 'invisibility of the self'. [ABSTRACT FROM AUTHOR]