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An online questionnaire investigating the attitudes of Bhutanese school leaders towards inclusive education was conducted in 2016. The respondents were 20 school leaders, 16 males and 4 females, with an average age of 41 years, and teaching experience ranging from 8 to 32 years. Responses revealed that this group of school leaders had generally positive attitudes towards inclusive education; however, they were uncertain about including children with high support needs resulting from socio-emotional, cognitive and behavioural difficulties. Results confirmed that the school leaders' religious beliefs did not negatively influence their perceptions of disability and inclusive education. The findings from this exploratory study highlight the need for a legal and educational framework to underpin inclusive education in Bhutan. Such a framework will guide the provision of adequate professional learning for school leaders, appropriate resourcing, and the implementation of further systemic support.

Students preferentially absorb and process information in diverse ways. Pedagogy should vary accordingly. The knowledge of teachers on the learners' preferred learning styles plays a pivotal role in better teaching and learning processes, contributing to a better-quality education. Still, little is known about the preferred learning style of learners. In the present study, the VARK (visual, aural, read or write, kinaesthetic) model version 8.01 survey questionnaire was adapted and given to 215 middle and higher secondary students. Using descriptive analysis of correlation, frequency and percentage, the study revealed that the preferred learning styles of students are aural (A) and kinaesthetic (K) with the smallest preference given to visual (V). The findings showed that male and female participants' preferences were the same, and that high-achiever learners prefer K. Recommendations from the findings apply to both the classroom and teacher training opportunities.

The study explored the use of Flipped Classroom (FC) approach in learning Economics by grade X students at Gaselo Higher Secondary School, Wangduephodrang, Bhutan employing a quasi-experimental design. The study found a significant mean difference between control (M = 9.5200, SD = 2.21491) and experiment group (M = 14.2273, SD = 3.48252) and the independent sample t-test indicated that this mean difference was significantly greater than zero [t(78) = 1.994, p = 0.000 < 0.05]. Further, the Wilcoxon Signed Rank Test (Z = - 3.933, p < 0.001) and the one-way ANOVA (p < 0.05 [F(1, 78) = 38.447, p = 0.000]) revealed that there was a statistical significant difference in mean scores of the experiment and control groups. Thus, FC approach was effective in learning economic subjects and was also more effective than traditional face-to-face teacher centered learning. It is recommended that FC approach should be used as one of the most effective approaches to teach and learn economics. However, the present study focused on only grade X students, so a study may be carried out across the school to have a broader understanding of the subject.

Inclusive education is a relatively new educational concept in Bhutan. Teachers play a critical role in the successful implementation of educational change. Investigating teachers' attitudes towards inclusion was conducted through an online survey. Respondents included 145 teachers (70 male and 75 female) from eight schools from across eight different districts in Bhutan, representing a return rate of 57%. Data were analysed using Rasch latent trait scaling techniques ("Proquest") to determine the face validity of the survey. Case estimates from Rasch were incorporated into further analysis adopting the R statistical environment. Significant differences of attitude were detected based on gender (Pr(Chi) = 0.031); teacher qualifications (Pr(Chi) = 0.005); and experience of teaching children with special education needs (SEN) (Pr(Chi) = 0.018). The slightly positive attitude towards inclusion, measured by a 38-item questionnaire on a six-point scale, showed a mean average score of 3.965. Teachers' satisfaction of teaching children with SEN was positive (73%). The study also revealed the need for safer playgrounds, accessible toilets, less crowded classrooms, and greater education for teachers and support staff. These findings inform future policies and advancement of inclusive education in Bhutanese schools.

This paper reports a study of students' and teachers' perceptions of their classroom learning environment in Bhutanese eighth-grade mathematics classes. Research suggests that positive perceptions of the learning environment can have a positive influence on students' learning outcomes, interest and engagement in classroom activities. The study was conducted in 2013, using the survey samples of 608 students and 98 teachers from 22 lower- and middle-secondary schools in western Bhutan. Students' and teachers' perceptions of the classroom environment were measured using the Mathematics Classroom Learning Environment Survey (MCLES). Students and teachers mostly perceived their classroom environments favourably on the MCLES scales irrespective of gender, school level and school location. The study is significant for understanding and evaluating the implementation of new mathematics curriculum in Bhutanese schools because it could guide the development of strategies for more-productive mathematics classroom learning. It is also significant from the perspective of Bhutan's national goal of Gross National Happiness because perceptions and happiness always go hand-in-hand.

This study explored pre-service secondary science teachers' perceptions of classroom emotional climate in the context of the Bhutanese macro-social policy of Gross National Happiness. Drawing upon sociological perspectives of human emotions and using Interaction Ritual Theory this study investigated how pre-service science teachers may be supported in their professional development. It was a multi-method study involving video and audio recordings of teaching episodes supported by interviews and the researcher's diary. Students also registered their perceptions of the emotional climate of their classroom at 3-minute intervals using audience response technology. In this way, emotional events were identified for video analysis. The findings of this study highlighted that the activities pre-service teachers engaged in matter to them. Positive emotional climate was identified in activities involving students' presentations using video clips and models, co-teaching, and interactive whole class discussions. Decreases in emotional climate were identified during formal lectures and when unprepared presenters led presentations. Emotions such as frustration and disappointment characterized classes with negative emotional climate. The enabling conditions to sustain a positive emotional climate are identified. Implications for sustaining macro-social policy about Gross National Happiness are considered in light of the climate that develops in science teacher education classes.

The purpose of this paper is to trace the evolution of school assessment in Bhutan, briefly, as a background to considering the present and future school assessment issues especially as they relate to quality concerns and educational improvement in Bhutan. A benchmark for Bhutan, the National Educational Assessment (NEA) programme in Bhutan was inspired by a 2002 initiative in South Asia funded by the World Bank. In this paper, we address how the 2003 NEA was developed. Emerging issues are discussed including methods of reporting and the concept of "benchmarking" in three senses of that term. Technical issues are also addressed in the context of the desire to administer another comparative NEA in 2010. Out of these developments, the Bhutan Board of Examinations has developed ideas about expanding access to system-wide assessment data to different levels of stakeholders in order to achieve improvements. A 2x2 matrix is provided identifying four key questions around judgments of educational achievement at two key levels (system and school) within and between these levels. This matrix represents a model of the evolution of assessment in Bhutan. This paper should be of interest to education systems in developing countries that have undertaken or intend to undertake national educational assessment programmes. (Contains 3 tables and 5 notes.)

The purpose of the study is to explore the demand and extent of religious rituals performed by patients and families during illness and hospitalization in Bhutan. The study has used a convenience sample with quantitative method. The survey questionnaire was administered to a total of 106 patients and families who were admitted to the hospital at least for three days. Simple frequency count and percentages were used to interpret the findings of the study. The study reveals significant religious rituals performed during the illness and hospitalizations. 105 (99.1%) of the sample performed religious rituals/prayers when someone in the family is sick. Of 105, 43 (41.3%) performed ritual/prayers to gods, evil spirits, local deities, and simply as ritual. Of 88 respondents, 31 (35.2%) who performed the rituals/prayers before they came to hospital did for the cure or recovery from the disease. The extent of religious practice during illness and hospitalization were assessed. In addition, information about the benefits of religious rituals/prayers and the religious facilities needed in the hospitals were explored. The results of the study suggest that religious care is considered important for Bhutanese people and integration of the religious care in the health care system would enhance the quality of health care services. [ABSTRACT FROM AUTHOR]

This paper explores the general nurses' attitudes towards mental illness in Bhutan. A non-probability convenience sample with quantitative descriptive method was used. The sample represents the known population of nurses from National Referral Hospital (JDWNR Hospital), Thimphu. Responses were analyzed using descriptive statistics including means; standard deviations, and frequency. Cronbach's alpha and Spearman's correlation were used to analyze the internal consistency reliability of each factors and the correlational variation caused by each variables. Overall, the findings indicated that the nurses surveyed have a positive attitude towards mental illness (mean - 134.39, SD - 17.35). Findings from this study shows that the nurses with psychiatric experience of 3-4 weeks and 4 weeks respectively were found to have more positive attitude towards mental illness indicating that the clinical placement of nurses in psychiatric unit improves attitudes towards mental illness. [ABSTRACT FROM AUTHOR]

Village health workers (VHWs) serve as an integral health resource for many resource limited nations, including the Kingdom of Bhutan. As such, we aimed to identify community perceptions as well as utilization rates and types with relation to VHWs based on the urban-rural divide. Our team conducted a randomized survey of 429 community members in 14 villages within the Western region of Bhutan. Our findings indicate VHWs in rural communities are requested for their services twice as much as their urban counterparts. More specifically, urban VHWs are utilized 2.5 times more for general community services, while rural VHWs are utilized more for accessing medications. Additionally, our research indicates a need to increase training of VHWs as well as overall program promotion relating to the specific services that VHWs can provide. These investigations indicate the importance of differentially allocating resources, programming, and training based on the urban-rural divide.

Background: Village health workers (VHWs) in Bhutan play an all-encompassing role in supporting the health of their communities. Recent reports from the Bhutan Ministry of Health have indicated a sharp reduction in the number of working VHWs. As such, our work attempts to estimate the cost saved and the number of averted hospital admissions onto the Bhutanese healthcare system and the individuals who are served by these health workers., Methods: We utilized a dataset from the Bhutan Ministry of Health which encompassed over 95% of all reported disease cases within the nation. We examined the impact that VHWs have on hospital admission rates for eight diseases of interest by using multiple multivariate logistic regression models. Our model allowed us to estimate the potential disease cases averted when the average number of VHWs per health center is increased by one unit. Lastly, we utilized the 2011 "A Costing of Healthcare Services in Bhutan" to estimate the cost saved attributed to VHWs., Results: An average one unit increase of VHWs per health center is associated with a decrease in hospital and clinic admission for diarrhea, dysentery, wound care, depression/anxiety, dental caries, and skin infection, while a non-significant increase was observed for scabies and conjunctivitis. These findings translate to 4604 outpatient visits averted, with $28,637 saved, and 78 inpatient visits averted, with $10,711 saved. These values sum to a total of 4682 yearly averted admissions at health centers, with a total cost savings of $39,348 yearly. Additionally, we estimated a yearly savings of $13,348 in transportation costs and a total of $20,960 saved in wages to the community members that VHWs serve., Conclusions: VHWs serve as a source of cost-savings for the Kingdom of Bhutan and also act as an economic buffer for more vulnerable communities. The cost-savings associated with these health workers is likely to become more pertinent as the nation begins to develop and healthcare costs increase. It is imperative that proper action be taken to retain these health workers as every VHW who leaves the program increases healthcare costs onto the Bhutanese government.