Search

A successful digital conversion for classrooms, districts, and states is not determined by the technology, but by how technology enables teaching and learning. The purpose of our multisite case study was to document digital instructional strategies teachers use to enhance and transform student learning, and align that use with learning research. We conducted focus groups and interviews, and observed classrooms in seven exemplary schools across the United States. We surveyed teachers' familiarity, use, and comfort with technology as well. We document six common strategies used across the seven sites and identify five roles that technology plays in enhancing teaching and learning, and discuss how these strategies benefit teachers and learners.

English language learners (ELLs) are the fastest growing subgroup in American schools. These students, by a provision in the reauthorization of the Elementary and Secondary Education Act, are to be supported in their quest for language proficiency through the creation of systems that more effectively measure ELLs' progress across years. In the past, ELLs' progress has been based on students' prior scores measuring the same construct. To disentangle effectiveness from achievement, the reporting has generally targeted mean-group activity. In contrast, student growth percentiles (SGPs) provide a comparison of students' growth with others who have the same achievement score history. By examining the construct measured by an English language proficiency test as manifested in student scores in Speaking, Listening, Reading and Writing, this article outlines the use of SGPs in providing information on "how much" each student needs to grow, which will allow educators to more effectively apply differential formative instructional strategies.

The authors compared the performance of third-grade students testing on answer sheets with those testing on machine-scored test booklets. The 1,832 students in the nationally representative sample were assigned at the campus level to complete the Stanford Achievement Test Series, Tenth Edition in 1 of 4 conditions: (a) Form A answer sheet, (b) Form A booklet, (c) Form B answer sheet, and (d) Form B booklet. After controlling for scholastic ability, no significant differences in performance on total reading, total mathematics, and total language strands were found between students using booklets and those using answer sheets. The results of this study provide no evidence to support the need to use separate test booklets with general education third-grade students. States may consider using separate answer sheets with these students to realize potential cost and schedule efficiencies.

This study investigated the efficacy of a package of accommodations for poor readers in Grade 7. Students with and without word reading disabilities were randomly assigned to take an experimental version of a high-stakes reading comprehension test in 1 of 3 formats: (a) standard administration, (b) read aloud accommodations with 1-day administration, or (c) read aloud accommodations with 2-day administration. The significant condition effect and nonsignificant group by condition interaction suggested that accommodations helped both poor and average readers. However, the accommodation effect in average readers stemmed from low performance in the nonaccommodated experimental condition that was not apparent when the same students previously took the state-administered test. The 2-day administration was more effective than the 1-day administration. (Contains 3 tables and 2 figures.)

Purpose: Our objectives are to present a conceptual model of the pain assessment process in persons with dementia and discuss methods for validating our model within this population. Design and Methods: This conceptual work is based on an integrative review and current pain theory, pain assessment research in demented and nondemented populations, and research on the science of self-report. Results: We present a multidimensional model of pain assessment that emphasizes the role of the external rater. Our model posits that a nociceptive stimulus leads to pain sensation, followed by pain perception, followed by the exhibition of external signs of pain by the patient, followed by an external rater's observation and interpretation of those external signs. Further, the model specifies the effects of nociceptive stimulus factors on pain sensation; patient-specific factors on pain perception; method-specific factors on external sign observation; and rater-specific factors on external sign interpretation. Implications: Pain assessment in persons with dementia must go beyond a unidimensional model of pain assessment. This multidimensional model also directly addresses the challenges of using external ratings to assess pain in persons with dementia. Finally, we present clinical recommendations for applying the model to pain assessment endeavors and research recommendations for evaluating models of pain in this population.

Objective: To compare the effects of active and didactic teaching strategies on learning- and process-oriented outcomes. Design: Controlled trial. Setting: After-hours residents' teaching session. Participants: Family and Community Medicine, Internal Medicine, and Pediatrics residents at two academic medical institutions. Interventions: We randomly assigned residents to two groups. One group received a didactic lecture on effective use of diagnostic tests; during this session, the teacher spent a full hour delivering content. The other group received the same content in a session structured to foster resident-to-resident interactions. In the latter session, the teacher spent only 30 minutes directly delivering content to residents. Measures and Main Results: We measured residents' knowledge about and attitudes toward the session content before, immediately after, and one month after each session. We measured residents' perceptions of engagement and session value immediately after each session. We employed blinded observers who used a structured instrument to observe residents' activities during each session. Both teaching methods led to improvements in residents' scores on both knowledge and attitude assessments. The amount of improvement was not statistically different between groups. Residents in the active learning session perceived themselves, and were observed to be, more engaged with the session content and each other than residents in the didactic session. Residents in the didactic session perceived greater educational value from the session compared to residents in the active session. Conclusions: We reduced the amount of time spent in teacher-driven content delivery by 50 percent and covered the same amount of content with no detrimental effects on knowledge acquisition or attitude enhancement. Teaching strategies that foster learner-to-learner interactions will lead to more active engagement among learners, however, these learners may value the session less. Further research is needed to explore learner perceptions of the teaching process and other outcomes of active learning in medical education.

Poor readers who met low achievement and IQ-discrepancy definitions of reading disability (n=54) were compared with non-impaired readers (n=325) on development of eight precursor and reading-related skills. Results indicate no evidence for differences between the two groups of poor readers in the development on the eight skills, with three exceptions. (Contains references.) (CR)

Background. Determining whether a particular medical intervention is cost-effective requires that a threshold of cost per benefit gained be established. As debate continues over the appropriate threshold, we present measures [...]

Arthroscopic surgery is not beneficial for treating osteoarthritis in the knee, according to a study of 180 patients. Arthroscopic surgery involves inserting a device into the knee to scrape away dead tissue or wash the joint.

Objective. Recurrent abdominal pain (RAP) is a common problem in children and adolescents. Evaluation and treatment of children with RAP continue to challenge physicians because of the lack of a psychometrically sound measure for RAP. A major obstacle to progress in research on RAP has been the lack of a biological marker for RAP and the lack of a reliable and valid clinical measure for RAP. The objectives of this study were (1) to develop and test a multidimensional measure for RAP (MM-RAP) in children to serve as a primary outcome measure for clinical trials, (2) to evaluate the reliability of the measure and compare its responses across different populations, and (3) to examine the reliabilities of the measure scales in relation to the demographic variables of the studied population. Methods. We conducted 3 cross-sectional studies. Two studies were clinic-based studies that enrolled children with RAP from 1 pediatric gastroenterology clinic and 6 primary care clinics. The third study was a community-based study in which children from I elementary and 2 middle schools were screened for frequent episodes of abdominal pain. The 3 studies were conducted in Houston, Texas. Inclusion criteria for the clinic-based studies were (1) age of 4 to 18 years; (2) abdominal pain that had persisted for 3 or more months; (3) abdominal pain that was moderate to severe and interfered with some or all regular activities; (4) abdominal pain that may or may not be accompanied by upper-gastrointestinal symptoms; and (5) children were accompanied by a parent or guardian who was capable of giving informed consent, and children over the age of 10 years were capable of giving informed assent. The community-based study used standardized questionnaires that were offered to 1080 children/parents from the 3 participating schools; 700 completed and returned the questionnaires (65% response rate). The questionnaire was designed to elicit data concerning the history of abdominal pain or discomfort. A total of 160 children met Apley's criteria and were classified as having RAP. Inclusion criteria were identical to those criteria for the clinic-based studies. Participating children in the 3 studies received a standardized questionnaire that asked about socioeconomic variables, abdominal pain (intensity; frequency; duration; nature of abdominal pain, if present, and possible relationships with school activities; and other upper gastrointestinal symptoms). We used 4 scales for the MM-RAP: pain intensity scale (3 items), nonpain symptoms scale (12 items), disability scale (3 items), and satisfaction scale (2 items). Age 7 was used as a cutoff point for the analysis as the 7-year-olds have been shown to exhibit more sophisticated knowledge of illness than younger children. Results. A total of 295 children who were aged 4 to 18 years participated in the study: 155 children from the pediatric gastroenterology clinics, 82 from the primary care clinics, and 58 from the schools. The interitem consistency (Cronbach's coefficient [alpha]) for the pain intensity items, nonpain symptoms items, disability items, and satisfaction items were 0.75, 0.81, 0.80, and 0.78, respectively, demonstrating good reliability of the measure. The internal consistencies of the 4 scales did not significantly differ between younger ([less than or equal to] 7 years) and older (>7 years) children. There was also no significant variation in the coefficient [alpha] of each of the 4 scales in relation to gender or the level of the parent's education. Reliability was identical for the pain-intensity items (0.74) among children who sought medical attention from primary care or pediatric gastroenterology clinics. The intercorrelations of factor scores among the 4 scales showed a strong relationship among the factors but not high enough that correlations would be expected to be measuring the same items. The results of the factor analysis identified 5 components instead of 4 components representing the 4 scales. The 12 items of the nonpain symptoms scale were classified into 2 components; 1 component included heartburn, burping, passing gas, bloating, problem with ingestion of milk, bad breath, and sour taste (nonpain symptoms I), and the other included nausea/vomiting, diarrhea, and constipation (nonpain symptoms II). The program ordered the 5 components on the basis of the percentage of the total variance explained by each component and consequently by the strength of each components in the following order: nonpain symptoms I, pain intensity, pain disability, satisfaction, and nonpain symptoms II. Of the 20 items that composed the MMRAP, 17 met the inclusion criteria of having a correlation of [greater than or equal to] 0.40 on the primary factor analyses. The 3 items that assessed pain intensity met the inclusion criteria as well as the 2 items that assessed satisfaction. Two of the 3 items that assessed disability met the inclusion criteria; however, the missed school item did not. The sleep problem and the loss of appetite items in the nonpain items also did not meet the inclusion criteria in both components of the nonpain symptoms scale. However, the loss of appetite item met the inclusion criteria in the disability scale with a correlation of 0.6. The 2 items that did not meet the inclusion criteria (missed school days and sour taste) will be eliminated in the revised measure for RAP. Conclusion. The MM-RAP demonstrated good reliability evidence in population samples. Children who have RAP and are seen at pediatric gastroenterology or primary care pediatric clinics have similar responses, showing that the measure performed well across several populations. Age did not affect the reliability of responses. The MM-RAP included 4 dimensions, each with several items that may identify disease-specific dimensions. In addition, dividing the nonpain symptoms scale into 2 components instead of I component could assist in creating a disease-specific measure. The present study focused exclusively on developing the multidimensional measure for RAP in children that could assist physicians in evaluating the efficacy of RAP treatment independent of psychological evaluations. In addition, the measure was designed for use in clinical trials that evaluate the efficacy of RAP treatment and to allow comparison between intervention studies. In conclusion, we were able to identify 4 dimensions of RAP in children (pain intensity, nonpain symptoms, pain disability, and satisfaction with health). We demonstrated that these dimensions can be measured in a reliable manner that is applicable to children who experience RAP in various settings. URL: www.pediatrics.org/cgi/ doi/10.1542/peds.2004-1412; recurrent abdominal pain, children, scale, outcome measure.

Objectives: This study was conducted to evaluate the relationship among patient outcome expectancies, perceived shoulder function changes, and perceptions of expectancy fulfillment. Methods: Patients (n = 199) treated for shoulder problems at one orthopedic surgeon's office completed a baseline survey comprised of measures of outcome expectancies, shoulder function, health status, and demographics. At 1 month, 2 months, and 3 months, patients completed a mailed follow-up survey comprised of all baseline measures except demographic variables. At 3 months, a measure of expectancy fulfillment was added. A general linear modeling approach was used to assess the significance and effect size of 1) outcome expectancies on changes in shoulder function; and (2) outcome expectancies, shoulder function changes, and their interaction on perceptions of expectancy fulfillment. Results: Outcome expectancies significantly predicted changes in shoulder function and accounted for 10% of the variance in functional improvement. The improvement difference between patients with high expectancies compared with those with low expectancies was clinically relevant (4.57 points), as it was greater than the minimal clinically important difference (3.02 points). Outcome expectancies and shoulder function changes significantly predicted patients' perceptions of fulfilled expectancies, but their interaction was not statistically significant. Conclusions: Results highlight the importance of patient expectancy in medical encounters. The findings suggest the need for interventions targeting patient expectancies such as including discussions about expectancy in patient-physician negotiations of therapeutic plans. Results also underscore the need for the development of better measures of outcome expectancies and expectancy fulfillment. [ABSTRACT FROM AUTHOR]

Documenting student engagement has received increased emphasis in medical schools, as teaching strategies are changing to include more student-to-student interactions. The purpose of this study was to develop and evaluate a measure of student engagement completed by independent observers that would not interfere with student learning time. Data from 3,182 observations completed by nine observers in 32 educational classroom settings with 23 different instructors were used to evaluate the interobserver reliability and gather validity evidence for our observational instrument, named the STROBE. Results indicated that interobserver agreement was good to excellent when observations were conducted simultaneously on randomly selected students in the same classroom (84% average agreement and 0.79 average kappa coefficient) and when observations were conducted on different randomly selected students (79% average agreement). Results also provided strong evidence for validity. Overall, findings indicate that the STROBE demonstrates promise for educational research and evaluation by documenting student engagement in medical education settings. [ABSTRACT FROM AUTHOR]

Poor readers who met low achievement and IQ-discrepancy definitions of reading disability were compared with nonimpaired readers on their development of eight precursor and reading-related skills to evaluate developmental differences prior to students’ identification as reading disabled. Results indicated no evidence for differences between the two groups of poor readers in the development of the eight skills, with three exceptions. Students in the IQ-discrepant group demonstrated greater growth in letter sound knowledge, greater mean performance in visual-motor integration at the beginning of first grade, and greater deceleration in rapid naming of letters. When compared to the nonimpaired group, low-achieving readers demonstrated poorer performance and development in all skills, while the IQ-discrepant readers demonstrated poorer performance and development in phonemic awareness, rapid naming of letters and objects, spelling, and word reading. The largely null results for comparisons between the two groups of poor readers challenges the validity of the two-group classification of reading disabilities based on IQ-discrepancy. [ABSTRACT FROM AUTHOR]