Service Learning in Undergraduate Nursing Education: Strategies to Facilitate Meaningful Reflection.

PubMed

Schmidt, Nola A; Brown, Janet M

2016-01-01

Service learning is recognized as a valuable pedagogy involving experiential learning, reflection, and reciprocal learning. Students develop critical thinking and social awareness by using the crucial activity of reflecting upon their experiential learning with community partners. The purpose of this paper is to demystify the process of reflection by identifying best practices to enhance reflection and offering suggestions for grading. By understanding "the what" and "the how" of reflection, educators can implement service learning experiences designed to include the essential component of reflection. Strategies for facilitating meaningful reflection are described including descriptions of what students should reflect upon and how to initiate reflection through writing, reading, doing, and telling. Grading rubrics are suggested to facilitate evaluation of student reflection. When properly implemented, service learning encourages students to be good citizens of the world. By using best practices associated with reflection, students can be challenged to think critically about the world and how their service can achieve community goals. Copyright © 2016. Published by Elsevier Inc.

A Written, Reflective and Dialogic Strategy for Assessment Feedback That Can Enhance Student/Teacher Relationships

ERIC Educational Resources Information Center

Crimmins, Gail; Nash, Gregory; Oprescu, Florin; Liebergreen, Marama; Turley, Janet; Bond, Richard; Dayton, Jeanne

2016-01-01

In response to the shortcomings of current assessment feedback practice, this paper presents the results of a study designed to examine students' and teachers' experience of engaging in a written, reflective and dialogic feedback (WRDF) strategy. The strategy was designed to enhance the learning experience of students undertaking a large…

Challenging Narcissus, or Reflecting on Reflecting.

ERIC Educational Resources Information Center

Achilles, C. M.

The concept of reflective practice and teaching people to be reflective practitioners is examined. The document begins with a look at professional knowledge according to three prominent professionals in the educational administration field: Schon, Schein, and Achilles. "Reflective" strategies that could be incorporated into courses and…

Reflections on Teaching Referencing: What Four Case Studies Can Tell Us about Developing Effective Teaching Strategies

ERIC Educational Resources Information Center

Hyland, Theresa

2010-01-01

Two contradictions are inherent in our research into referencing practices and the subsequent development of teaching strategies to remedy inappropriate practices. First, aggregate studies and teaching strategies that tend toward a one-size-fits-all formula for researching and teaching referencing do not consider individual differences in…

Intentional Mathematics Teaching in Early Childhood Classrooms

ERIC Educational Resources Information Center

Jung, Myoungwhon; Conderman, Gregory

2013-01-01

Studies and discussions around "good teaching practices" have often identified intentionality as the chief characteristic of outstanding teachers. Intentional teachers are identified as maintaining the habit of informed reflection as they plan, teach, reflect on, and revise the effectiveness of their practices. Intentional teaching strategies are…

Reflection: an educational strategy to develop emotionally-competent nurse leaders.

PubMed

Horton-Deutsch, Sara; Sherwood, Gwen

2008-11-01

This paper explores educational strategies for nurses that focus on reflectivity and promote the development of self-awareness, relationship and communication skills and ability to lead with presence and compassion in the midst of change. Today nurses move rapidly from carefully-controlled educational experiences to a fast-paced clinical world of increasing patient complexity amid calls for improved quality of care. Making the transition to clinical competence and leadership in practice requires a strong sense of self and emotional intelligence. Pedagogies that integrate theoretical and data-based textbook learning with experiential learning and reflection are a foundation for the development of emotionally- and intellectually-competent leaders and requires new ways of assessing learner outcomes. Reflection is a key instructional strategy for preparing transformational nurse leaders for interdisciplinary settings where they lead patient care management. The remarkable global spread of reflection in nursing education, practice and research follows an emphasis on developing self-awareness as a leadership strategy for improving individual and organizational performance. Empirical, experiential and anecdotal evidence suggests that reflection has the potential to prepare emotionally-capable nurse leaders. As educators create more reflective and nurturing learning environments, they will promote the development of emotionally-competent nurse leaders who will, in turn, inspire individual and organizational growth and positive change in society.

The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum.

PubMed

Tsingos-Lucas, Cherie; Bosnic-Anticevich, Sinthia; Schneider, Carl R; Smith, Lorraine

2016-05-25

Objective. To determine the effectiveness of integrating reflective practice activities into a second-year undergraduate pharmacy curriculum and their impact on reflective thinking ability. Design. A cross-over design with repeated measures was employed. Newly developed reflective modules based on real hospital and community pharmacy cases were integrated into the second-year pharmacy practice curriculum. A novel strategy, the Reflective Ability Clinical Assessment (RACA), was introduced to enhance self- and peer reflection. Assessment. Student responses (n=214) to the adapted Kember et al(1) Reflective Thinking Questionnaire (RTQ) were compared before and after reflective activities were undertaken. Significant improvement in three indicators of reflective thinking was shown after students engaged in reflective activities. Conclusion. Integration of reflective activities into a pharmacy curriculum increased the reflective thinking capacity of students. Enhancing reflective thinking ability may help students make better informed decisions and clinical judgments, thus improving future practice.

The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum

PubMed Central

Bosnic-Anticevich, Sinthia; Schneider, Carl R.; Smith, Lorraine

2016-01-01

Objective. To determine the effectiveness of integrating reflective practice activities into a second-year undergraduate pharmacy curriculum and their impact on reflective thinking ability. Design. A cross-over design with repeated measures was employed. Newly developed reflective modules based on real hospital and community pharmacy cases were integrated into the second-year pharmacy practice curriculum. A novel strategy, the Reflective Ability Clinical Assessment (RACA), was introduced to enhance self- and peer reflection. Assessment. Student responses (n=214) to the adapted Kember et al1 Reflective Thinking Questionnaire (RTQ) were compared before and after reflective activities were undertaken. Significant improvement in three indicators of reflective thinking was shown after students engaged in reflective activities. Conclusion. Integration of reflective activities into a pharmacy curriculum increased the reflective thinking capacity of students. Enhancing reflective thinking ability may help students make better informed decisions and clinical judgments, thus improving future practice. PMID:27293232

Tell Me Your Story: A Reflection Strategy for Preservice Teachers

ERIC Educational Resources Information Center

Binks, Emily; Smith, Dennie L.; Smith, Lana J.; Joshi, R. Malatesha

2009-01-01

"Tell me your story" is a phrase popularly being promoted in the business setting during recent years. The power of storytelling can be utilized in student teacher reflection as a strategy for making connections between theory and practice in authentic classroom environments and enabling preservice teachers to actively develop plans for growth. A…

Using visual thinking strategies with nursing students to enhance nursing assessment skills: A qualitative design.

PubMed

Nanavaty, Joanne

2018-03-01

This qualitative design study addressed the enhancement of nursing assessment skills through the use of Visual Thinking Strategies and reflection. This study advances understanding of the use of Visual Thinking Strategies and reflection as ways to explore new methods of thinking and observing patient situations relating to health care. Sixty nursing students in a licensed practical nursing program made up the sample of participants who attended an art gallery as part of a class assignment. Participants replied to a survey of interest for participation at the art gallery. Participants reviewed artwork at the gallery and shared observations with the larger group during a post-conference session in a gathering area of the museum at the end of the visit. A reflective exercise on the art gallery experience exhibited further thoughts about the art gallery experience and demonstrated the connections made to clinical practice by the student. The findings of this study support the use of Visual Thinking Strategies and reflection as effective teaching and learning tools for enhancing nursing skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

Divesting strategies for medical practices.

PubMed

Sullivan, John D

2006-01-01

The decision to sell a medical practice is never easy. There is often a personal attachment to a medical practice started from scratch that has grown into a full-fledged operation. Selling has advantages as well as drawbacks. Much like selling a home, most of the price can be reflected in the preparation and market research. This article will examine the advantages, disadvantages, and strategies associated with the process of selling a medical practice.

Cultivating Reflective Practitioners in Technology Preparation: Constructing TPACK through Reflection

ERIC Educational Resources Information Center

Lu, Liangyue

2014-01-01

Teaching is a complex profession, which is further complicated by the integration of technology into classrooms. Reflection can help teachers unpack the complexity in their practice. Reflection can be an effective instructional strategy in helping preservice teachers develop technological pedagogical content knowledge (TPACK), the complex and…

Reflective education for professional practice: discovering knowledge from experience.

PubMed

Lyons, J

1999-01-01

To continually develop as a discipline, a profession needs to generate a knowledge base that can evolve from education and practice. Midwifery reflective practitioners have the potential to develop clinical expertise directed towards achieving desirable, safe and effective practice. Midwives are 'with woman', providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice. Midwife educators and practitioners can assist students and enhance their learning by expanding the scope of practice, encouraging self-assessment and the development of reflective and professional skills. This paper explores journal writing as a learning strategy for the development of reflective skills within midwifery and explores its value for midwifery education. It also examines, through the use of critical social theory and adult learning principles, how midwives can assist and thus enhance students learning through the development of professional and reflective skills for midwifery practice.

Building health promotion capacity in a primary health care workforce in the Northern Territory: some lessons from practice.

PubMed

Judd, Jenni; Keleher, Helen

2013-12-01

Reorientation of the workforce in primary health care is a complex process and requires specific strategies and interventions. Primary health care providers are a key health care workforce that is expected to deliver tangible outcomes from disease prevention and health promotion strategies. This paper describes a training intervention that occurred as part of a broader participatory action research process for building health promotion capacity in the primary health care workforce. Participatory action research (PAR) was conducted over six action and reflection cycles in a two-year period (2001-02) in an urban community health setting in the Northern Territory. One of the PAR cycles was a training intervention that was identified as a need from a survey in the first action and reflection cycle. This training was facilitated by a health promotion specialist, face-to-face and comprised five 3.5-h sessions over a 5-month period. A pre-post questionnaire was used to measure the knowledge and skills components of the training intervention. The results reinforced the importance of using a participatory approach that involved the primary health care providers themselves. Multiple strategies such as workforce development within capacity building frameworks assisted in shifting work practice more upstream. Additionally, these strategies encouraged more reflective practice and built social capital within the primary health care workforce. Lessons from practice reinforce that workforce development influenced work practice change and is an important element in building the health promotion capacity of primary health care centres. SO WHAT?: Workforce development is critical for reorienting health services. Health promotion specialists play an important role in reorienting practice, which is only effective when combined with other strategies, and driven and led by the primary health care workforce.

Troubling Muddy Waters: Problematizing Reflective Practice in Global Medical Education.

PubMed

Naidu, Thirusha; Kumagai, Arno K

2016-03-01

The idea of exporting the concept of reflective practice for a global medical education audience is growing. However, the uncritical export and adoption of Western concepts of reflection may be inappropriate in non-Western societies. The emphasis in Western medical education on the use of reflection for a specific end--that is, the improvement of individual clinical practice--tends to ignore the range of reflective practice, concentrating on reflection alone while overlooking critical reflection and reflexivity. This Perspective places the concept of reflective practice under a critical lens to explore a broader view for its application in medical education outside the West. The authors suggest that ideas about reflection in medicine and medical education may not be as easily transferable from Western to non-Western contexts as concepts from biomedical science are. The authors pose the question, When "exporting" Western medical education strategies and principles, how often do Western-trained educators authentically open up to the possibility that there are alternative ways of seeing and knowing that may be valuable in educating Western physicians? One answer lies in the assertion that educators should aspire to turn exportation of educational theory into a truly bidirectional, collaborative exchange in which culturally conscious views of reflective practice contribute to humanistic, equitable patient care. This discussion engages in troubling the already-muddy waters of reflective practice by exploring the global applicability of reflective practice as it is currently applied in medical education. The globalization of medical education demands critical reflection on reflection itself.

Doing Feminist Difference Differently: Intersectional Pedagogical Practices in the Context of the Neoliberal Diversity Regime

ERIC Educational Resources Information Center

Smele, Sandra; Siew-Sarju, Rehanna; Chou, Elena; Breton, Patricia; Bernhardt, Nicole

2017-01-01

At present there is a small, albeit growing, body of literature on pedagogical strategies and reflections which addresses the ways educators attempt to challenge the effects of neoliberalism on higher education. In this article, we reflect upon our pedagogical practices in higher education in this moment of neoliberal transformation wherein, as…

Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice.

PubMed

Wald, Hedy S; Anthony, David; Hutchinson, Tom A; Liben, Stephen; Smilovitch, Mark; Donato, Anthony A

2015-06-01

Recent calls for an expanded perspective on medical education and training include focusing on complexities of professional identity formation (PIF). Medical educators are challenged to facilitate the active constructive, integrative developmental process of PIF within standardized and personalized and/or formal and informal curricular approaches. How can we best support the complex iterative PIF process for a humanistic, resilient health care professional? How can we effectively scaffold the necessary critical reflective learning and practice skill set for our learners to support the shaping of a professional identity?The authors present three pedagogic innovations contributing to the PIF process within undergraduate and graduate medical education (GME) at their institutions. These are (1) interactive reflective writing fostering reflective capacity, emotional awareness, and resiliency (as complexities within physician-patient interactions are explored) for personal and professional development; (2) synergistic teaching modules about mindful clinical practice and resilient responses to difficult interactions, to foster clinician resilience and enhanced well-being for effective professional functioning; and (3) strategies for effective use of a professional development e-portfolio and faculty development of reflective coaching skills in GME.These strategies as "bridges from theory to practice" embody and integrate key elements of promoting and enriching PIF, including guided reflection, the significant role of relationships (faculty and peers), mindfulness, adequate feedback, and creating collaborative learning environments. Ideally, such pedagogic innovations can make a significant contribution toward enhancing quality of care and caring with resilience for the being, relating, and doing of a humanistic health care professional.

Scaffolding reflective journal writing - negotiating power, play and position.

PubMed

Harris, M

2008-04-01

A three-year qualitative study based on an action-research design, framed within the critical genre and using a multi-method approach, was used to establish how a model of critical reflective practice [Van Aswegen, E.J., Brink, H.I., Steyn, P.J., 2000. A model for facilitation of critical reflective practice: Part I- Introductory discussion and explanation of the phases followed to construct the model. Part ll - Conceptual analysis within the context of constructing the model. Part III - Description of the model. Curationis 23 (4), 117-135.] could be implemented. Reflective journals were introduced as one of the educational strategies within the model to support and sustain 'deep' transformatory learning. A component of this larger study focused on how scaffolding deep learning through reflective writing is enhanced by supportive structures. These include critiquing (feedback), a mutually developed self-evaluation strategy, as well as an awareness of and sensitivity to the need for student/writer-responder negotiation. Three student groups of part-time post-basic, practicing South African nurses engaged in reflective writing over the period of an academic year. This article is based on their perceptions, mid-way through their writing, of these strategies. It reflects the story of assumptions made by educators, and challenges for change. Students find reflective writing difficult, and although they are willing to accept its value and engage in the process, they require a regular, specific and sensitive critical response from their writer-responder and follow-up supportive contact. Self-evaluation for the purposes of 'owning' their own ideas is difficult, and requires constant support and validation. Transformatory learning comes at a cost, and a revisiting of the balance of power between student and educator is in order.

Implementing reflection: insights from pre-registration mental health students.

PubMed

Donovan, Moira O

2007-08-01

Reflection and reflective practice continues to be contentious issues in nursing. The focus of this article is the use of reflection by pre-registration mental health students. The broad aim of this preliminary study was to discover student mental health nurses' perceptions of reflection as a learning strategy during clinical placement. Using a constructivist grounded theory methodology [Charmaz, K., 2000. Grounded theory: Objectivist and Constructivist Methods. In: Denzin, N., Lincoln, Y. (Eds.), Handbook of Qualitative Research, second ed. Sage, Thousand Oaks, California], five students were interviewed individually in their clinical placements. Data analysis revealed three major categories: understanding the process of reflection, using reflection in clinical practice, and needing support and guidance. Findings indicated that students were primarily using reflection-on-action, but to varying extents. Overall, students felt that reflection facilitated their learning. Factors were discovered that both helped and hindered students' use of reflection. These included level of preparation to reflect, a limited culture of reflection and the level of support from preceptors, clinical staff, clinical placement co-ordinators, and lecturers. In conclusion, it appears that a collaborative approach between students, Health Service Providers and institutes of nursing is vital for the successful development and implementation of reflective learning strategies in clinical placement. Suggestions are made as to how a collaborative approach may be developed to enhance this process.

Identity, Values, and Reflection: Shaping (and Being Shaped) through Assessment

ERIC Educational Resources Information Center

Isabella, Marcy; McGovern, Heather

2018-01-01

Outlining one program's history of outcomes-based assessment, the authors examine the relationships among assessment practices, program identity, and program values. Understanding the ways in which past processes of identifying learning outcomes reflected, and failed to reflect, shared values points us toward a new set of strategies for developing…

The MBA Capstone Course: Building Theoretical, Practical, Applied, and Reflective Skills

ERIC Educational Resources Information Center

Inamdar, Syeda Noorein; Roldan, Malu

2013-01-01

The capstone strategy course is used in many management education programs to provide practical business relevance as a means for students to transition to the business world. We conducted an empirical study to determine to what extent capstone strategy courses are teaching the following four skills that prepare students to meet business job…

The legacy of care as reflexive learning

PubMed Central

García, Marta Rodríguez; Moya, Jose Luis Medina

2016-01-01

Abstract Objective: to analyze whether the tutor's use of reflexive strategies encourages the students to reflect. The goal is to discover what type of strategies can help to achieve this and how tutors and students behave in the practical context. Method: a qualitative and ethnographic focus was adopted. Twenty-seven students and 15 tutors from three health centers participated. The latter had received specific training on reflexive clinical tutoring. The analysis was developed through constant comparisons of the categories. Results: the results demonstrate that the tutors' use of reflexive strategies such as didactic questioning, didactic empathy and pedagogical silence contributes to encourage the students' reflection and significant learning. Conclusions: reflexive practice is key to tutors' training and students' learning. PMID:27305180

Enhancing medical-surgical nursing practice: using practice tests and clinical examples to promote active learning and program evaluation.

PubMed

DuHamel, Martha B; Hirnle, Constance; Karvonen, Colleen; Sayre, Cindy; Wyant, Sheryl; Colobong Smith, Nancy; Keener, Sheila; Barrett, Shannon; Whitney, Joanne D

2011-10-01

In a 14-week medical-surgical nursing review course, two teaching strategies are used to promote active learning and assess the transfer of knowledge to nursing practice. Practice tests and clinical examples provide opportunities for participants to engage in self-assessment and reflective learning and enhance their nursing knowledge, skills, and practice. These strategies also contribute to program evaluation and are adaptable to a variety of course formats, including traditional classroom, web conference, and online self-study. Copyright 2011, SLACK Incorporated.

Reflections on clinical practice whilst developing a portfolio of evidence: Perceptions of undergraduate nursing students in the Western Cape, South Africa.

PubMed

Ticha, Victoire; Fakude, Lorraine P

2015-12-09

In order to develop clinical judgement, nurses should be encouraged to become analytical and critical thinkers. Development of a portfolio of evidence (PoE) of reflection on clinical experiences is one of the strategies that can be used to enhance analytical and critical thinking amongst nursing students. Students' perceptions of the process are important in order to encourage their reflective practice. PoE compilation at a school of nursing at a university in the Western Cape includes evidence of students' clinical learning which they present in a portfolio. The students are expected to reflect on their clinical learning experiences and include these reflections in their portfolios. To describe the perceptions of fourth-year nursing students regarding reflective practice whilst compiling their PoEs. A qualitative design was used to explore the perceptions of registered fourth-year nursing students with regard to their reflective practice whilst compiling their PoEs. Purposive sampling was used for selection of participants. Three focus group discussions were held, each consisting of six to eight participants. Data saturation was reached during the third meeting. Tesch's method of data analysis was used. Findings revealed that reflection enabled the learners to gain experience and identify challenges related to the expected events and tasks carried out at the hospitals and in the classroom whilst developing their PoE. The compilation of a PoE was a good teaching and learning strategy, and the skills, experience and knowledge that the participants in this study acquired boosted their self-esteem, confidence and critical thinking. Reflection also assisted in self-directed learning.

Mirrors, Reflections and Refractions: The Contribution of Microteaching to Reflective Practice.

ERIC Educational Resources Information Center

L'Anson, John; Rodrigues, Susan; Wilson, Gary

2003-01-01

Examines the range of strategies that can be used to promote reflection, focusing on microteaching as a vehicle for enabling students to become aware of their values, attitudes, and assumptions about learning as these are enacted within microteaching. The subsequent feedback becomes a dialogue between student, peer, teacher fellow, and tutor that…

Developing skilled doctor-patient communication in the workplace: a qualitative study of the experiences of trainees and clinical supervisors.

PubMed

Giroldi, Esther; Veldhuijzen, Wemke; Geelen, Kristel; Muris, Jean; Bareman, Frits; Bueving, Herman; van der Weijden, Trudy; van der Vleuten, Cees

2017-12-01

To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the workplace. We conducted a qualitative study in a general practice training setting, triangulating various sources of data to obtain a rich understanding of trainees and supervisors' experiences: three focus group discussions, five discussions during training sessions and five individual interviews. Thematic network analysis was performed during an iterative process of data collection and analysis. We identified a communication learning cycle consisting of six phases: impactful experience, change in frame of reference, identification of communication strategies, experimentation with strategies, evaluation of strategies and incorporation into personal repertoire. Supervisors supported trainees throughout this process by creating challenges, confronting trainees with their behaviour and helping them reflect on its underlying mechanisms, exploring and demonstrating communication strategies, giving concrete practice assignments, creating safety, exploring the effect of strategies and facilitating repeated practice and reflection. Based on the experiences of trainees and supervisors, we conclude that skilled communication involves the development of a personal communication repertoire from which learners are able to apply strategies that fit the context and their personal style. After further validation of our findings, it may be recommended to give learners concrete examples, opportunities for repeated practise and reflection on personal frames of reference and the effect of strategies, as well as space for authenticity and flexibility. In the workplace, the clinical supervisor is able to facilitate all these essential conditions to support his/her trainee in becoming a skilled communicator.

Teaching and evaluating point of care learning with an Internet-based clinical-question portfolio.

PubMed

Green, Michael L; Reddy, Siddharta G; Holmboe, Eric

2009-01-01

Diplomates in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program satisfy the self-evaluation of medical knowledge requirement by completing open-book multiple-choice exams. However, this method remains unlikely to affect practice change and often covers content areas not relevant to diplomates' practices. We developed and evaluated an Internet-based point of care (POC) learning portfolio to serve as an alternative. Participants enter information about their clinical questions, including characteristics, information pursuit, application, and practice change. After documenting 20 questions, they reflect upon a summary report and write commitment-to-change statements about their learning strategies. They can link to help screens and medical information resources. We report on the beta test evaluation of the module, completed by 23 internists and 4 internal medicine residents. Participants found the instructions clear and navigated the module without difficulty. The majority preferred the POC portfolio to multiple-choice examinations, citing greater relevance to their practice, guidance in expanding their palette of information resources, opportunity to reflect on their learning needs, and "credit" for self-directed learning related to their patients. Participants entered a total of 543 clinical questions, of which 250 (46%) resulted in a planned practice change. After completing the module, 14 of 27 (52%) participants committed to at least 1 change in their POC learning strategies. Internists found the portfolio valuable, preferred it to multiple-choice examinations, often changed their practice after pursuing clinical questions, and productively reflected on their learning strategies. The ABIM will offer this portfolio as an elective option in MOC.

Gathering Requirements for Teacher Tools: Strategies for Empowering Teachers Through Co-Design

NASA Astrophysics Data System (ADS)

Matuk, Camillia; Gerard, Libby; Lim-Breitbart, Jonathan; Linn, Marcia

2016-02-01

Technology can enhance teachers' practice in multiple ways. It can help them better understand patterns in their students' thinking, manage class progress at individual and group levels, and obtain evidence to inform modifications to curriculum and instruction. Such technology is most effective when it is aligned with teachers' goals and expectations. Participatory methods, which involve teachers closely in the design process, are widely recommended for establishing accurate design requirements that address users' needs. By collaborating with researchers, teachers can contribute their professional expertise to shape the tools of their practice, and ultimately ensure their sustained use. However, there is little guidance available for maintaining effective teacher-researcher design partnerships. We describe four strategies for engaging teachers in designing tools intended to support and enhance their practice within a web-based science learning environment: discussing physical artifacts, reacting to scenarios, customizing prototypes, and writing user stories. Using design artifacts and documents of teachers' reflections, we illustrate how we applied these techniques over 5 years of annual professional development workshops, and examine their affordances for eliciting teachers' ideas. We reflect on how these approaches have helped inform technology refinements and innovations. We moreover discuss the further benefits these strategies have had in encouraging teachers to reflect on their own practice and on the roles of technology in supporting it; and in allowing researchers to gain a deeper understanding of the relationship between technology, teaching, and design.

Executive Coaching Practices in the Adult Workplace

ERIC Educational Resources Information Center

Campone, Francine

2015-01-01

This chapter provides an overview of key principles and practices in executive coaching. Coaching is discussed as a reflective learning opportunity and offers the theoretical grounding, strategies, and case studies for each of four key elements of a coaching engagement.

Graders' Mathematics Achievement

ERIC Educational Resources Information Center

Bond, John B.; Ellis, Arthur K.

2013-01-01

The purpose of this experimental study was to investigate the effects of metacognitive reflective assessment instruction on student achievement in mathematics. The study compared the performance of 141 students who practiced reflective assessment strategies with students who did not. A posttest-only control group design was employed, and results…

76 FR 30193 - National Fish, Wildlife, and Plants Climate Adaptation Strategy; Notice of Intent: Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... principles and science-based practices--for reducing the negative impacts of climate change on fish, wildlife... develop a draft Strategy. The adverse impacts of climate change transcend political and administrative... climate change. This Strategy will provide a unified approach--reflecting shared principles and science...

Teaching HR Professionals: The Classroom as a Community of Practice

ERIC Educational Resources Information Center

Rowlands, Kate; Avramenko, Alex

2013-01-01

This paper introduces an innovative course design incorporating both communities of practice and reflective practice as a learning strategy for part-time learners in higher education. The new design has been applied to teaching HR practitioners in a UK-based business school. Findings indicate that the suggested way of organizing teaching and…

Reflections on Classroom Thinking Strategies: Practical Strategies to Encourage Thinking in Your Classroom. Sixth Edition

ERIC Educational Resources Information Center

Frangenheim, Eric

2005-01-01

The major purpose of this book is to introduce teachers (and by that the author means all types of teachers-classroom teachers, administrators, teacher aids, parents and coaches) to various individual and group thinking strategies related to specific questions and activities. This guide is a personal interpretation and critique of those strategies…

Group Coaching on Pre-School Teachers' Implementation of Pyramid Model Strategies: A Program Description

ERIC Educational Resources Information Center

Fettig, Angel; Artman-Meeker, Kathleen

2016-01-01

The purpose of this article was to describe a group coaching model and present preliminary evidence of its impact on teachers' implementation of Pyramid Model practices. In particular, we described coaching strategies used to support teachers in reflecting and problem solving on the implementation of the evidence-based strategies. Preliminary…

Une lecture, mille et une reflexions: Cahier de reflexion sur le processus de lecture. (One Reading, 1001 Reflections: Notebook of Reflection on the Reading Process.)

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton.

This activity notebook is intended to help French-speaking students in Alberta, Canada, develop reflective reading practices. Following an introduction and information (with graphics) on the notebook's organization, the notebook is divided into three sections of reading strategies: the first section contains three activities, the second section…

A four-phase strategy for the implementation of reflectance confocal microscopy in dermatology.

PubMed

Hoogedoorn, L; Gerritsen, M J P; Wolberink, E A W; Peppelman, M; van de Kerkhof, P C M; van Erp, P E J

2016-08-01

Reflectance confocal microscopy (RCM) is gradually implemented in dermatology. Strategies for further implementation and practical 'hands on' guidelines are lacking. The primary outcome was to conduct a general strategy for further implementation of RCM. The secondary outcome was the diagnosis of psoriasis and differentiation of stable from unstable psoriatic plaques by means of the 'hands on' protocol, derived from the strategy. We used a four-phased model; an exploring phase, a systematic literature search, a clinical approach and, finally, an integration phase to develop a clinical guideline for RCM in psoriasis. Receiver operating characteristic curve statistics was applied to define the accuracy for the diagnosis of unstable psoriasis. A general strategy for further implementation of RCM and practical approach was developed to examine psoriasis by RCM and to distinguish stable from unstable psoriasis. Unstable psoriasis was diagnosed by epidermal inflammatory cell counts with a sensitivity and specificity of 91.7% and 98.3%, respectively, and with an accuracy of 0.92 (area under the curve). In addition, a monitoring model was proposed. This is the first study that shows a method for implementation of RCM in dermatology. The strategy and hands on protocol for psoriasis may serve as a model for other dermatological entities and additionally may lead to specialized ready-to-use RCM protocols for clinical dermatological practice. © 2016 European Academy of Dermatology and Venereology.

A typology and analysis of drug resistance strategies of rural Native Hawaiian youth.

PubMed

Okamoto, Scott K; Helm, Susana; Giroux, Danielle; Kaliades, Alexis; Kawano, Kaycee Nahe; Kulis, Stephen

2010-12-01

This study examines the drug resistance strategies described by Native Hawaiian youth residing in rural communities. Sixty-four youth from 7 middle and intermediate schools on the Island of Hawai'i participated in a series of gender-specific focus groups. Youth responded to 15 drug-related problem situations developed and validated from prior research. A total of 509 responses reflecting primary or secondary drug resistance strategies were identified by the youth, which were qualitatively collapsed into 16 different categories. Primary drug resistance strategies were those that participants listed as a single response, or the first part of a two-part response, while secondary drug resistance strategies were those that were used in tandem with primary drug resistance strategies. Over half of the responses reflecting primary drug resistance strategies fell into three different categories ("refuse," "explain," or "angry refusal"), whereas over half of the responses reflecting secondary drug resistance strategies represented one category ("explain"). Significant gender differences were found in the frequency of using different strategies as well as variations in the frequency of using different strategies based on the type of drug offerer (family versus friends/peers). Implications for prevention practice are discussed.

Supporting Adolescent Literacy Achievement. Issue Brief

ERIC Educational Resources Information Center

Berman, Ilene

2009-01-01

This brief enhances recommendations and policy strategies from the National Governors Association Center for Best Practices (NGA Center) publication "Reading to Achieve: A Governor's Guide to Adolescent Literacy". It reflects lessons from recent research and best practices from states selected to receive NGA Center support to develop statewide…

Moral dilemmas in medical school admission.

PubMed

Self, D J

1990-03-01

The wide range of complex moral and ethical issues of medical school admission committees are seldom publicly acknowledged, reflected upon, analyzed, or discussed, although they are faced regularly. Three cases are presented that illustrate some of the common and unusual moral dilemmas in the admission process. These issues and several practical strategies for ethical decision making are discussed, along with their limitations and weaknesses. These practical strategies are applied to the three cases to see what solutions might be offered.

Innovation, Research and Professional Development in Higher Education: Learning from Our Own Experience

ERIC Educational Resources Information Center

Garcia, Leonor Margalef; Roblin, Natalie Pareja

2008-01-01

This paper describes and analyses an innovative experience carried out by a group of lecturers from the Psychopedagogy Faculty of the University of Alcala, involved in an action research process with the purpose of reflecting about our own practice and constructing alternative teaching strategies to facilitate students' reflective, autonomous and…

Male Student Perceptions of Reflective Practice in Online College English Reading Courses

ERIC Educational Resources Information Center

Schumacher, Alexa J.

2013-01-01

Researchers have confirmed that male students at all academic levels often struggle while engaging in self-reflection, reading, and writing activities for reasons such as incompatible pedagogical strategy, poor choice of reading materials, and lack of belief in success for students. In conjunction with the growing popularity of online learning, an…

Enhancing Critical Reflection and Writing Skills in the HBSE Classroom and beyond

ERIC Educational Resources Information Center

Wiener, Diane R.

2012-01-01

Human Behavior in the Social Environment (HBSE) is an ideal location in which graduate social work students can enhance their critical reflection and writing skills while integrating social work theories with practice, research, and policy. A writing-intensive, learner-centered model using specific strategies is described via a framework of…

The Effect of Teaching with Stories on Associate Degree Nursing Students' Approach to Learning and Reflective Practice

ERIC Educational Resources Information Center

Bradshaw, Vicki

2012-01-01

This action research study is the culmination of several action cycles investigating cognitive information processing and learning strategies based on students approach to learning theory and assessing students' meta-cognitive learning, motivation, and reflective development suggestive of deep learning. The study introduces a reading…

“A memorable consultation”: Writing reflective accounts articulates students’ learning in general practice

PubMed Central

Svenberg, Kristian; Wahlqvist, Mats; Mattsson, Bengt

2007-01-01

Objectives To explore and analyse students’ learning experiences of a memorable consultation during a final-year attachment in general practice. Setting After a two-week primary care attachment in the undergraduate curriculum, students were invited to write a reflective account of a memorable consultation. Design A total of 52 reflective accounts were read and processed according to qualitative content analysis. Credibility of the analysis was validated by two co-authors reading the descriptions separately and trustworthiness was tested at local seminars. Results Three main themes emerged. In “The person beyond symptoms” the students recognize the individual properties of a consultation. “Facing complexity” mirrors awareness of changing tracks in problem-solving and strategies of handling unclear conditions. “In search of a professional role” reflects the interest in role modelling and the relation to the supervisor. Conclusion Involving students in writing reflective accounts appears to stimulate them to articulate practice experiences of the consultation. PMID:17497483

Effectiveness of past and current critical incident analysis on reflective learning and practice change.

PubMed

Vachon, Brigitte; LeBlanc, Jeannette

2011-09-01

Critical incident analysis (CIA) is one of the strategies frequently used to facilitate reflective learning. It involves the thorough description and analysis of an authentic and experienced event within its specific context. However, CIA has also been described as having the potential to expose vulnerabilities, threaten learners' coping mechanisms and increase rather than reduce their anxiety levels. The aim of this study was to compare the analysis of current critical incidents with that of past critical incidents, and to further explore why and how the former is more conducive to reflective learning and practice change than the latter. A collaborative research study was conducted. Eight occupational therapists were recruited to participate in a reflective learning group that convened for 12 meetings held over a 15-month period. The group facilitator planned and adapted the learning strategies to be used to promote reflective learning and guided the group process. Critical incident analysis represented the main activity carried out in the group discussions. The data collected were analysed using the grounded theory method. Three phenomena were found to differentiate between the learning contexts created by the analysis of, respectively, past and current critical incidents: attitudinal disposition; legitimacy of purpose, and the availability of opportunities for experimentation. Analysis of current clinical events was found to improve participants' motivation to self-evaluate, to increase their self-efficacy, and to help them transfer learning into action and to progressively self-regulate. The results of this collaborative research study suggest that the analysis of current clinical events in order to promote reflection offers a safer and more constructive learning environment than does the analysis of incidents that have occurred in the past. This learning strategy is directly grounded in health professional practice. The remaining challenge for continuing education providers is that of creating conditions conducive to its use. © Blackwell Publishing Ltd 2011.

Teaching Strategy: Reflections on Professional Practice

ERIC Educational Resources Information Center

Ruth, Damian

2014-01-01

This paper explores how strategic management concepts, especially the notion of 'wicked problems', can be useful in analysing the professional practice of teachers in higher education. The keeping of a dialogical journal with a colleague helped illuminate that strategic management and education have much in common. Both are situated in…

Drama, Media Advertising, and Inner-City Youth.

ERIC Educational Resources Information Center

Conrad, Diane

2002-01-01

Describes a reflective practice case study which involved creating and delivering a unit integrating drama, media literacy, and media production with a focus on advertising for a group of students at an alternative inner-city high school. Proposes this strategy may assist others in studies and teaching practice. (PM)

A Cultural Communities Approach to Understanding Head Start Teachers' Beliefs about Language Use with Dual Language Learners: Implications for Practice

ERIC Educational Resources Information Center

Garrity, Sarah; Guerra, Alison Wishard

2015-01-01

The school-readiness gap for Latino dual language learners in the United States has been well documented, despite a strong research base highlighting effective strategies and practices for supporting their academic success. However, current educational practices reflect the hegemonic discourse that, because the United States is an English-speaking…

Promoting self-reflection in clinical practice among Chinese nursing undergraduates in Hong Kong.

PubMed

Ip, Wan Yim; Lui, May H; Chien, Wai Tong; Lee, Iris F; Lam, Lai Wah; Lee, Diana T

2012-06-01

This study evaluated the effect of a structured education programme on improving the self-reflection skills of Chinese nursing undergraduates in managing clinical situations. Johns' Structured Reflection Model was used as a framework for the development of the education programme. Thirty-eight nursing undergraduates attended a 3-hour interactive workshop on reflective skills and were encouraged to practise the skills learned under the guidance of a nurse instructor during their 4-week clinical practicum. The findings indicated that the programme was helpful in improving the undergraduates' reflective skills though only a few of them reached the highest level as critical reflectors. Some undergraduates identified time constraints and the lack of a trusting relationship with their nurse instructor as barriers to their reflective learning. The findings may help nurse educators develop education programmes with structured learning strategies to promote nursing undergraduates' self-refection in clinical practice.

Brokering the Evidence-Practice Gap: A Strategy for Moving Evidence Into Clinical Practice.

PubMed

Segre, Lisa S; Trusty, Stephanie; Gullickson, Renee; Chuffo Davila, Rebecca; O'Hara, Michael W

2018-05-08

Moving novel, evidence-based interventions into broad community use is challenging. This column describes how a midlevel public health administrator acted in the role of broker to link university-based researchers with maternal health clinical staff to successfully implement an innovative, evidence-based maternal depression treatment. Program evaluation assessed adoption, implementation, reach, and effectiveness. In reflecting on this partnership, the broker provided critical elements of access, credibility, and accountability. A partnership between service providers and research teams provides one strategy to disseminate evidence-based practices among those served by public-health programs.

Greening EPA

EPA Pesticide Factsheets

EPA ensures its buildings and practices reflect our mission by implementing strategies to reduce the environmental impact of its facilities and operations by building sustainable structures and improving the energy efficiency of older buildings.

Primary Teachers' Reflections on Inquiry- and Context-Based Science Education

NASA Astrophysics Data System (ADS)

Walan, Susanne; Mc Ewen, Birgitta

2017-04-01

Inquiry- and context-based teaching strategies have been proven to stimulate and motivate students' interests in learning science. In this study, 12 teachers reflected on these strategies after using them in primary schools. The teachers participated in a continuous professional development (CPD) programme. During the programme, they were also introduced to a teaching model from a European project, where inquiry- and context-based education (IC-BaSE) strategies were fused. The research question related to teachers' reflections on these teaching strategies, and whether they found the model to be useful in primary schools after testing it with their students. Data collection was performed during the CPD programme and consisted of audio-recorded group discussions, individual portfolios and field notes collected by researchers. Results showed that compared with using only one instructional strategy, teachers found the new teaching model to be a useful complement. However, their discussions also showed that they did not reflect on choices of strategies or purposes and aims relating to students' understanding, or the content to be taught. Before the CPD programme, teachers discussed the use of inquiry mainly from the aspect that students enjoy practical work. After the programme, they identified additional reasons for using inquiry and discussed the importance of knowing why inquiry is performed. However, to develop teachers' knowledge of instructional strategies as well as purposes for using certain strategies, there is need for further investigations among primary school teachers.

Mapping new theoretical and methodological terrain for knowledge translation: contributions from critical realism and the arts

PubMed Central

Kontos, Pia C; Poland, Blake D

2009-01-01

Background Clinical practice guidelines have been a popular tool for the improvement of health care through the implementation of evidence from systematic research. Yet, it is increasingly clear that knowledge alone is insufficient to change practice. The social, cultural, and material contexts within which practice occurs may invite or reject innovation, complement or inhibit the activities required for success, and sustain or alter adherence to entrenched practices. However, knowledge translation (KT) models are limited in providing insight about how and why contextual contingencies interact, the causal mechanisms linking structural aspects of context and individual agency, and how these mechanisms influence KT. Another limitation of KT models is the neglect of methods to engage potential adopters of the innovation in critical reflection about aspects of context that influence practice, the relevance and meaning of innovation in the context of practice, and the identification of strategies for bringing about meaningful change. Discussion This paper presents a KT model, the Critical Realism and the Arts Research Utilization Model (CRARUM), that combines critical realism and arts-based methodologies. Critical realism facilitates understanding of clinical settings by providing insight into the interrelationship between its structures and potentials, and individual action. The arts nurture empathy, and can foster reflection on the ways in which contextual factors influence and shape clinical practice, and how they may facilitate or impede change. The combination of critical realism and the arts within the CRARUM model promotes the successful embedding of interventions, and greater impact and sustainability. Conclusion CRARUM has the potential to strengthen the science of implementation research by addressing the complexities of practice settings, and engaging potential adopters to critically reflect on existing and proposed practices and strategies for sustaining change. PMID:19123945

A Service-Learning Project Using Crowdfunding Strategy: Students' Experience and Reflection

ERIC Educational Resources Information Center

Mat-jizat, Jessnor Elmy; Khalid, Khalizul

2016-01-01

The aim of this study was to explore students' experience and reflection in doing a Service Learning project as part of their course work. The Service Learning project allows the students to practice their knowledge of raising capital through crowdfunding, and at the same time situates them in an environment where they could learn from the…

Students' reflections in a portfolio pilot: highlighting professional issues.

PubMed

Haffling, Ann-Christin; Beckman, Anders; Pahlmblad, Annika; Edgren, Gudrun

2010-01-01

Portfolios are highlighted as potential assessment tools for professional competence. Although students' self-reflections are considered to be central in the portfolio, the content of reflections in practice-based portfolios is seldom analysed. To investigate whether students' reflections include sufficient dimensions of professional competence, notwithstanding a standardized portfolio format, and to evaluate students' satisfaction with the portfolio. Thirty-five voluntary final-year medical students piloted a standardized portfolio in a general practice (GP) attachment at Lund University, Sweden. Students' portfolio reflections were based upon documentary evidence from practice, and aimed to demonstrate students' learning. The reflections were qualitatively analysed, using a framework approach. Students' evaluations of the portfolio were subjected to quantitative and qualitative analysis. Among professional issues, an integration of cognitive, affective and practical dimensions in clinical practice was provided by students' reflections. The findings suggested an emphasis on affective issues, particularly on self-awareness of feelings, attitudes and concerns. In addition, ethical problems, clinical reasoning strategies and future communication skills training were subjects of several reflective commentaries. Students' reflections on their consultation skills demonstrated their endeavour to achieve structure in the medical interview by negotiation of an agenda for the consultation, keeping the interview on track, and using internal summarizing. The importance of active listening and exploration of patient's perspective was also emphasized. In students' case summaries, illustrating characteristic attributes of GP, the dominating theme was 'patient-centred care', including the patient-doctor relationship, holistic modelling and longitudinal continuity. Students were satisfied with the portfolio, but improved instructions were needed. A standardized portfolio in a defined course with a limited timeframe provided ample opportunities for reflections on professional issues. Support by mentors and a final examiner interview contributed to the success of the portfolio with students. The interview also allowed students to deepen their reflections and to receive feedback.

A Program Evaluation of the Effects of PLCs on Direct Interactive Instruction

ERIC Educational Resources Information Center

Reyes, Deirdre

2014-01-01

Increased student achievement is the goal of all educators, and to that end, teachers must engage in professional development so that they are introduced to new strategies. Moreover, these professional development offerings must be sustained with a follow-up plan that allows teachers to practice strategies and reflect and collaborate with…

Teachers' Memories of Disciplinary Control Strategies from Their Own School Days

ERIC Educational Resources Information Center

DePalma, Renee; Membiela, Pedro; Pazos, Mercedes Suarez

2011-01-01

This article provides a vision of school disciplinary strategies as provided by childhood school memories of practicing or unemployed teachers. This narrative approach allows us to understand the school and its daily routines and rituals from an insiders' point of view, drawing upon the double perspective teachers employ when reflecting on their…

Developing a Framework for Evaluating Ethical Outcomes of Good Participatory Practices in TB Clinical Drug Trials.

PubMed

MacQueen, Kathleen M; Eley, Natalie T; Frick, Mike; Mingote, Laia Ruiz; Chou, Alicia; Seidel, Stephanie S; Hannah, Stacey; Hamilton, Carol

2016-07-01

Good Participatory Practice Guidelines for TB Drug Trials (GPP-TB) were issued in 2012, based on similar guidelines for HIV prevention and reflecting growing acceptance of the importance of community engagement and participatory strategies in clinical research. Though the need for such strategies is clear, evaluation of the benefits and burdens are needed. Working with a diverse group of global TB stakeholders including advocates, scientists, and ethicists, we used a Theory of Change approach to develop an evaluation framework for GPP-TB that includes a clearly defined ethical goal, a set of powerful strategies derived from GPP-TB practices for achieving the goal, and outcomes connecting strategies to goal. The framework is a first step in systematically evaluating participatory research in clinical trials. © The Author(s) 2016.

An innovative peer assessment approach to enhance guideline adherence in physical therapy: single-masked, cluster-randomized controlled trial.

PubMed

Maas, Marjo J M; van der Wees, Philip J; Braam, Carla; Koetsenruijter, Jan; Heerkens, Yvonne F; van der Vleuten, Cees P M; Nijhuis-van der Sanden, Maria W G

2015-04-01

Clinical practice guidelines (CPGs) are not readily implemented in clinical practice. One of the impeding factors is that physical therapists do not hold realistic perceptions of their adherence to CPGs. Peer assessment (PA) is an implementation strategy that aims at improving guideline adherence by enhancing reflective practice, awareness of professional performance, and attainment of personal goals. The purpose of this study was to compare the effectiveness of PA with the usual case discussion (CD) strategy on adherence to CPGs for physical therapist management of upper extremity complaints. A single-masked, cluster-randomized controlled trial with pretest-posttest design was conducted. Twenty communities of practice (n=149 physical therapists) were randomly assigned to groups receiving PA or CD, with both interventions consisting of 4 sessions over 6 months. Both PA and CD groups worked on identical clinical cases relevant to the guidelines. Peer assessment focused on individual performance observed and evaluated by peers; CD focused on discussion. Guideline adherence was measured with clinical vignettes, reflective practice was measured with the Self-Reflection and Insight Scale (SRIS), awareness of performance was measured via the correlation between perceived and assessed improvement, and attainment of personal goals was measured with written commitments to change. The PA groups improved more on guideline adherence compared with the CD groups (effect=22.52; 95% confidence interval [95% CI]=2.38, 42.66; P=.03). The SRIS scores did not differ between PA and CD groups. Awareness of performance was greater for the PA groups (r=.36) than for the CD groups (r=.08) (effect=14.73; 95% CI=2.78, 26.68; P=.01). The PA strategy was more effective than the CD strategy in attaining personal goals (effect=0.50; 95% CI=0.04, 0.96; P=.03). Limited validity of clinical vignettes as a proxy measure of clinical practice was a limitation of the study. Peer assessment was more effective than CD in improving adherence to CPGs. Personal feedback may have contributed to its effectiveness. Future research should address the role of the group coach. © 2015 American Physical Therapy Association.

Peer Assisted Learning and Blogging: A Strategy to Promote Reflective Practice during Clinical Fieldwork

ERIC Educational Resources Information Center

Ladyshewsky, Richard K.; Gardner, Peter

2008-01-01

The use of peer assisted learning in clinical education is explored in this case study. Groups of undergraduate physiotherapy students were structured into communities of practice during the second half of their clinical fieldwork program. They collaborated online in an asynchronous manner, using information communications technology (blogs) and…

Does Our Diversity Talk Match Our Walk? Aligning Institutional Goals and Practice

ERIC Educational Resources Information Center

Horn, Catherine L.; Marin, Patricia

2017-01-01

To help admissions professionals achieve their diversity objectives, a strategy should be adopted that encourages universities to be more broadly self-reflective across a range of interrelated admissions policies and practices. Educational scrutiny is a data-analytic framework for campus-based understanding of the extent to which internal policies…

Electronic Clinic Journaling: The Use of Weblogs to Support Evidence-Based Practice in Doctor of Audiology Students

ERIC Educational Resources Information Center

Neldon, Gayle B.

2009-01-01

Evidence-based practice (EBP) is a strategy for the provision of high quality health care. The use of journals to document clinical experiences and reflection has been used in speech-language pathology as well as nursing and psychology. This study uses qualitative analysis to study what AuD students learn about evidence-based practice from writing…

Using So-Called Mind-Body Practices to Promote Youths' Well-Being: Reflections on Therapeutic Outcomes, Strategies, and Processes

ERIC Educational Resources Information Center

Renshaw, Tyler L.

2016-01-01

The present article provides commentary on this pioneering special issue covering the usefulness of so-called mind-body practices with youth and in schools. I begin by addressing the way we talk about this approach to practice, describing a few undesirable consequences that can follow from using the mind-body moniker adopted from the world of…

Using a Metacognitive Approach with Case-Based Instruction to Enhance Teacher Reflection and Promote Effective Educational Practices for Diverse Learners

ERIC Educational Resources Information Center

Whittaker, Catharine; van Garderen, Delinda

2009-01-01

Many teacher educators have enthusiastically embraced case-based instruction in teacher education programs. However, the research base is equivocal on whether preservice and in-service teacher educators' case-based reflections on educational issues are comprehensive and critical. This study explores the use of a metacognitive strategy--the case…

Exploring arts-based knowledge translation: sharing research findings through performing the patterns, rehearsing the results, staging the synthesis.

PubMed

Rieger, Kendra; Schultz, Annette S H

2014-04-01

Cultivation of knowledge translation (KT) strategies that actively engage health professionals in critical reflection of their practice and research-based evidence are imperative to address the research-practice gap. While research-based evidence is exponentially growing, our ability to facilitate uptake by nurses and other health professionals has not kept pace. Innovative approaches that extend epistemological bias beyond a singular standpoint of postpositivism, such as the utilization of arts-based methods, expand the possibility to address the complexities of context, engage audience members, promote dissemination within communities of practice, and foster new audiences interested in research findings. In this paper, we address the importance of adopting a social constructivist epistemological stance to facilitate knowledge translation to diverse audiences, explore various arts-based knowledge translation (ABKT) strategies, and open a dialogue concerning evaluative tenets of ABKT. ABKT utilizes various art forms to disseminate research knowledge to diverse audiences and promote evidence-informed practice. ABKT initiatives translate knowledge not based upon a linear model, which views knowledge as an objective entity, but rather operate from the premise that knowledge is socially situated, which demands acknowledging and engaging the learner within their context. Theatre, dance, photography, and poetry are art forms that are commonly used to communicate research findings to diverse audiences. Given the emerging interest and importance of utilizing this KT strategy situated within a social constructivist epistemology, potential challenges and plausible evaluative criteria specific to ABKT are presented. ABKT is an emerging KT strategy that is grounded in social constructivist epistemological tenets, and holds potential for meaningfully sharing new research knowledge with diverse audiences. ABKT is an innovative and synergistic approach to traditional dissemination strategies. This creative KT approach is emerging as potent transformational learning tools that are congruent with the relational nature of nursing practice. ABKT facilitates learning about new research findings in an engaging and critical reflective manner that promotes learning within communities of practice. © 2014 Sigma Theta Tau International.

Chain of Influence from Policy to Practice in the New Zealand Literacy Strategy

ERIC Educational Resources Information Center

Timperley, Helen S.; Parr, Judy M.

2009-01-01

New Zealand's literacy strategy seeks to translate into reality the broad policy goals of equipping all New Zealanders with the knowledge, skills and values to be successful citizens of the twenty-first century. The central policy concern is reflected in international surveys showing that although the country's student achievement is above the…

Visual Thinking Strategies: Teachers' Reflections on Closely Reading Complex Visual Texts within the Disciplines

ERIC Educational Resources Information Center

Cappello, Marva; Walker, Nancy T.

2016-01-01

The authors offer a new perspective on close reading that uses a range of multimodal texts to capitalize on the visual nature of contemporary society and to support literacy within the academic disciplines. Specifically, a qualitative study explored teachers' perspectives on the use of Visual Thinking Strategies (VTS), a practice borrowed from…

How the dual process model of human cognition can inform efforts to de‐implement ineffective and harmful clinical practices: A preliminary model of unlearning and substitution

PubMed Central

Rose, Adam J.; Hartmann, Christine W.; van Bodegom‐Vos, Leti; Graham, Ian D.; Wood, Suzanne J.; Majerczyk, Barbara R.; Good, Chester B.; Pogach, Leonard M.; Ball, Sherry L.; Au, David H.; Aron, David C.

2018-01-01

Abstract Rationale and objectives One way to understand medical overuse at the clinician level is in terms of clinical decision‐making processes that are normally adaptive but become maladaptive. In psychology, dual process models of cognition propose 2 decision‐making processes. Reflective cognition is a conscious process of evaluating options based on some combination of utility, risk, capabilities, and/or social influences. Automatic cognition is a largely unconscious process occurring in response to environmental or emotive cues based on previously learned, ingrained heuristics. De‐implementation strategies directed at clinicians may be conceptualized as corresponding to cognition: (1) a process of unlearning based on reflective cognition and (2) a process of substitution based on automatic cognition. Results We define unlearning as a process in which clinicians consciously change their knowledge, beliefs, and intentions about an ineffective practice and alter their behaviour accordingly. Unlearning has been described as “the questioning of established knowledge, habits, beliefs and assumptions as a prerequisite to identifying inappropriate or obsolete knowledge underpinning and/or embedded in existing practices and routines.” We hypothesize that as an unintended consequence of unlearning strategies clinicians may experience “reactance,” ie, feel their professional prerogative is being violated and, consequently, increase their commitment to the ineffective practice. We define substitution as replacing the ineffective practice with one or more alternatives. A substitute is a specific alternative action or decision that either precludes the ineffective practice or makes it less likely to occur. Both approaches may work independently, eg, a substitute could displace an ineffective practice without changing clinicians' knowledge, and unlearning could occur even if no alternative exists. For some clinical practice, unlearning and substitution strategies may be most effectively used together. Conclusions By taking into account the dual process model of cognition, we may be able to design de‐implementation strategies matched to clinicians' decision‐making processes and avoid unintended consequence. PMID:29314508

Pondering practice: Enhancing the art of reflection.

PubMed

Hayes, Carolyn; Jackson, Debra; Davidson, Patricia M; Daly, John; Power, Tamara

2018-01-01

The aim of this study was to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications. Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted. This study used role-play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students' understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second-year undergraduate nursing students enrolled in a medical-surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis. Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes. Following a role-play simulation experience, student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realistic settings adds to current strategies that aim to reduce medication errors by allowing students to reflect on and in practice and develop strategies to ensure patient safety. Experiencing clinical scenarios within the safety of simulated environments, offers undergraduate student nurses an opportunity to reflect on practice to provide safer, more empathetic and compassionate care for patients in the future. © 2017 John Wiley & Sons Ltd.

Power and promise of narrative for advancing physical therapist education and practice.

PubMed

Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

2015-06-01

This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.

Teaching about Love and Practicing Feminist Pedagogy in a College Classroom

ERIC Educational Resources Information Center

Mei-Hui, You

2014-01-01

Being a feminist teacher, working on gender equity education, including teaching, reading, writing, and doing research on this topic, has become a commitment for me. I have frequently reflected my teaching practices and occasionally found new teaching strategies in the classroom. I always try to bring new topics or issues into the classroom in…

Personalized instructor responses to guided student reflections: Analysis of two instructors' perspectives and practices

NASA Astrophysics Data System (ADS)

Reinholz, Daniel L.; Dounas-Frazer, Dimitri R.

2017-11-01

One way to foster a supportive culture in physics departments is for instructors to provide students with personal attention regarding their academic difficulties. To this end, we have developed the Guided Reflection Form (GRF), an online tool that facilitates student reflections and personalized instructor responses. In the present work, we report on the experiences and practices of two instructors who used the GRF in an introductory physics lab course. Our analysis draws on two sources of data: (i) post-semester interviews with both instructors and (ii) the instructors' written responses to 134 student reflections. Interviews focused on the instructors' perceptions about the goals and framing of the GRF activity, and characteristics of good or bad feedback. Their GRF responses were analyzed for the presence of up to six types of statement: encouraging statements, normalizing statements, empathizing statements, strategy suggestions, resource suggestions, and feedback to the student on the structure of students' reflections. We find that both instructors used all six response types, in alignment with their perceptions of what counts as good feedback. In addition, although each instructor had their own unique feedback style, both instructors' feedback practices were compatible with two principles for effective feedback: praise should focus on effort, express confidence in students' abilities, and be sincere; and process-level feedback should be specific and strategy-oriented. This exploratory qualitative investigation demonstrates that the GRF can serve as a mechanism for instructors to pay personal attention to their students. In addition, it opens the door to future work about the impact of the GRF on student-teacher interactions.

Transformative learning and research utilization in nursing practice: a missing link?

PubMed

Matthew-Maich, Nancy; Ploeg, Jenny; Jack, Susan; Dobbins, Maureen

2010-03-01

Poor or inconsistent research utilization into clinical practice is a recurrent theme across study contexts, rendering leaders disillusioned with how best to foster the uptake of research into nursing practice. This makes it imperative to look to new approaches. Research utilization involves a learning process engaging attitudes, beliefs, and behaviors; yet, this is often overlooked in approaches and models used to facilitate research use. This oversight may offer some explanation to the limited progress in research utilization to date. Transformation Theory offers an explanatory theory and specific strategies (critical reflection and critical discourse) to explore attitudes, beliefs, and behaviors so that they are understood, validated, and can better guide actions. The purpose of this article was to explore what Transformation Theory can contribute to research utilization initiatives in nursing practice. Transformation Theory and transformative learning strategies are discussed and critically analyzed in consideration of their potential roles in fostering research utilization in clinical nursing practice. (1) Research utilization is a learning process that involves knowledge, skills, feelings, attitudes, and beliefs. (2) Transformative learning strategies of critical reflection and discourse can facilitate insight into experiences, finding shared meanings among groups of people, and understanding/validating beliefs, attitudes, and feelings so they can more consciously guide future actions. This dimension is frequently neglected in research utilization efforts. (3) In combination with research utilization theories, Transformation Theory may be a missing link to make research utilization initiatives more effective in rendering and sustaining nursing practice change, thus enhancing client care and well-being. (4) Research and further consideration are both warranted and needed.

Translating research into practice in nursing homes: can we close the gap?

PubMed

Rahman, Anna N; Applebaum, Robert A; Schnelle, John F; Simmons, Sandra F

2012-10-01

A gap between research and practice in many nursing home (NH) care areas persists despite efforts by researchers, policy makers, advocacy groups, and NHs themselves to close it. The reasons are many, but two factors that have received scant attention are the dissemination process itself and the work of the disseminators or change agents. This review article examines these two elements through the conceptual lens of Roger's innovation dissemination model. The application of general principles of innovation dissemination suggests that NHs are characteristically slow to innovate and thus may need more time as well as more contact with outside change agents to adopt improved practices. A review of the translation strategies used by NH change agents to promote adoption of evidence-based practice in NHs suggests that their strategies inconsistently reflect lessons learned from the broader dissemination literature. NH-related research, policy, and practice recommendations for improving dissemination strategies are presented. If we can make better use of the resources currently devoted to disseminating best practices to NHs, we may be able to speed NHs' adoption of these practices.

Reorienting health services in the Northern Territory of Australia: a conceptual model for building health promotion capacity in the workforce.

PubMed

Judd, Jenni; Keleher, Helen

2013-06-01

Reorienting work practices to include health promotion and prevention is complex and requires specific strategies and interventions. This paper presents original research that used 'real-world' practice to demonstrate that knowledge gathered from practice is relevant for the development of practice-based evidence. The paper shows how practitioners can inform and influence improvements in health promotion practice. Practitioner-informed evidence necessarily incorporates qualitative research to capture the richness of their reflective experiences. Using a participatory action research (PAR) approach, the research question asked 'what are the core dimensions of building health promotion capacity in a primary health care workforce in a real-world setting?' PAR is a method in which the researcher operates in full collaboration with members of the organisation being studied for the purposes of achieving some kind of change, in this case to increase the amount of health promotion and prevention practice within this community health setting. The PAR process involved six reflection and action cycles over two years. Data collection processes included: survey; in-depth interviews; a training intervention; observations of practice; workplace diaries; and two nominal groups. The listen/reflect/act process enabled lessons from practice to inform future capacity-building processes. This research strengthened and supported the development of health promotion to inform 'better health' practices through respectful change processes based on research, practitioner-informed evidence, and capacity-building strategies. A conceptual model for building health promotion capacity in the primary health care workforce was informed by the PAR processes and recognised the importance of the determinants approach. Practitioner-informed evidence is the missing link in the evidence debate and provides the links between evidence and its translation to practice. New models of health promotion service delivery can be developed in community settings recognising the importance of involving practitioners themselves in these processes.

Scaffolding knowledge building in a Web-based communication and cultural competence program for international medical graduates.

PubMed

Lax, Leila R; Russell, M Lynn; Nelles, Laura J; Smith, Cathy M

2009-10-01

Professional behaviors, tacitly understood by Canadian-trained physicians, are difficult to teach and often create practice barriers for IMGs. The purpose of this design research study was to develop a Web-based program simulating Canadian medical literacy and culture, and to evaluate strategies of scaffolding individual knowledge building. Study 1 (N = 20) examined usability and pedagogic design. Studies 2 (N = 39) and 3 (N = 33) examined case participation patterns. Model design was validated in Study 1. Studies 2 and 3 demonstrated high levels of participation, on unprompted third tries, on knowledge tests. Recursive patterns were strongest on Reflective Exercises. Five strategies scaffolded knowledge building: (1) video simulations, (2) contextualized resources, (3) concurrent feedback, (4) Reflective Exercises, and (5) commentaries prompting "reflection on reflection." Scaffolded design supports complex knowledge building. These findings are concurrent with educational research on the importance of recursion and revision of knowledge for improvable and relational understanding.

Reflections in the clinical practice.

PubMed

Borrell-Carrió, F; Hernández-Clemente, J C

2014-03-01

The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria). We have added the importance of emotions in decision making within highly complex situations, such as those occurring within the clinical practice. The quality of the reflective act depends, among other factors, on the ability of metacognition (thinking about what we think). Finally, we propose an educational strategy based on having a task supervisor and rectification scenarios to improve the quality of medical decision making. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Walking the bridge: Nursing students' learning in clinical skill laboratories.

PubMed

Ewertsson, Mona; Allvin, Renée; Holmström, Inger K; Blomberg, Karin

2015-07-01

Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified - walking the bridge - in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring the attributes of critical thinking: a conceptual basis.

PubMed

Forneris, Susan G

2004-01-01

Many teaching methods used in nursing education to enhance critical thinking focus on teaching students how to directly apply knowledge; a technically rational approach. While seemingly effective at enhancing students' critical thinking abilities in structured learning situations, these methods don't prepare students to operationalize critical thinking to manage the complexities that actually exist in practice. The work of contemporary educational theorists Paulo Freire, Donald Schon, Chris Argyris, Jack Mezirow, Stephen Brookfield, and Robert Tennyson all share similar perspectives on thinking in practice and the use of reflection to achieve a coherence of understanding. Their perspectives provide insight on how educators can shift from a means-end approach to operationalizing thinking in practice. The author identifies four attributes of critical thinking in practice evidenced in these views, followed by a discussion of specific educational strategies that reflect these attributes, and operationalize a critical thinking process in nursing practice to achieve a coherence of understanding.

How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: A preliminary model of unlearning and substitution.

PubMed

Helfrich, Christian D; Rose, Adam J; Hartmann, Christine W; van Bodegom-Vos, Leti; Graham, Ian D; Wood, Suzanne J; Majerczyk, Barbara R; Good, Chester B; Pogach, Leonard M; Ball, Sherry L; Au, David H; Aron, David C

2018-02-01

One way to understand medical overuse at the clinician level is in terms of clinical decision-making processes that are normally adaptive but become maladaptive. In psychology, dual process models of cognition propose 2 decision-making processes. Reflective cognition is a conscious process of evaluating options based on some combination of utility, risk, capabilities, and/or social influences. Automatic cognition is a largely unconscious process occurring in response to environmental or emotive cues based on previously learned, ingrained heuristics. De-implementation strategies directed at clinicians may be conceptualized as corresponding to cognition: (1) a process of unlearning based on reflective cognition and (2) a process of substitution based on automatic cognition. We define unlearning as a process in which clinicians consciously change their knowledge, beliefs, and intentions about an ineffective practice and alter their behaviour accordingly. Unlearning has been described as "the questioning of established knowledge, habits, beliefs and assumptions as a prerequisite to identifying inappropriate or obsolete knowledge underpinning and/or embedded in existing practices and routines." We hypothesize that as an unintended consequence of unlearning strategies clinicians may experience "reactance," ie, feel their professional prerogative is being violated and, consequently, increase their commitment to the ineffective practice. We define substitution as replacing the ineffective practice with one or more alternatives. A substitute is a specific alternative action or decision that either precludes the ineffective practice or makes it less likely to occur. Both approaches may work independently, eg, a substitute could displace an ineffective practice without changing clinicians' knowledge, and unlearning could occur even if no alternative exists. For some clinical practice, unlearning and substitution strategies may be most effectively used together. By taking into account the dual process model of cognition, we may be able to design de-implementation strategies matched to clinicians' decision-making processes and avoid unintended consequence. © 2018 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Using a teaching OSCE to prompt learners to engage with patients who talk about religion and/or spirituality.

PubMed

Ledford, Christy J W; Seehusen, Dean A; Canzona, Mollie Rose; Cafferty, Lauren A

2014-01-01

The objective structured clinical examination (OSCE) has only occasionally been used as a teaching tool. The authors describe the initial use of an educational innovation consisting of a teaching OSCE used as "sensitizing practice," followed by personal, guided, and group reflection. Staff and resident physicians and one medical student (N = 28) at a community hospital's family medicine residency participated in the innovation during August 2012. The initial use of the educational innovation allowed learners to engage in a potentially challenging conversation with a standardized patient about religion and/or spirituality (R/S). The aim of the innovation was not to equip learners with a particular tactic to introduce or discuss R/S but, rather, to prompt learners to engage in mindful practice with patients who identify R/S as part of their biopsychosocial contexts. Written, dyadic, and group reflection added value to the OSCE by allowing participants to reflect on a difficult learning objective over time. Participants moved along the stages-of-change continuum when engaging in guided reflection compared with personal reflection. Additionally, all participants provided evidence of at least the preparation stage at the time of guided reflection. By following the OSCE's sensitizing practice with three periods of reflection, learners were enabled first, to recognize the need for readiness to address challenging communication topics (in this case, R/S) and, second, to reflect on practiced strategies for those conversations. The educational innovation can help learners become more aware of and skillful in dealing with difficult physician-patient communication topics.

Beyond Comprehension Strategy Instruction: What's Next?

PubMed

Elleman, Amy M; Compton, Donald L

2017-04-20

In this article, we respond to Catts and Kamhi's (2017) argument that reading comprehension is not a single ability. We provide a brief review of the impact of strategy instruction, the importance of knowledge in reading comprehension, and possible avenues for future research and practice. We agree with Catts and Kamhi's argument that reading comprehension is a complex endeavor and that current recommended practices do not reflect the complexity of the construct. Knowledge building, despite its important role in comprehension, has been relegated to a back seat in reading comprehension instruction. In the final section of the article, we outline possible avenues for research and practice (e.g., generative language instruction, dialogic approaches to knowledge building, analogical reasoning and disciplinary literacy, the use of graphics and media, inference instruction) for improving reading-comprehension outcomes. Reading comprehension is a complex ability, and comprehension instruction should reflect this complexity. If we want to have an impact on long-term growth in reading comprehension, we will need to expand our current repertoire of instructional methods to include approaches that support the acquisition and integration of knowledge across a variety of texts and topics.

Building the Foundation the WRITE WAY: Mini-Lessons with Practical Strategies for Teaching the Personal Narrative, Feature Article, "How-to..." Article, and Persuasive Letter.

ERIC Educational Resources Information Center

Miller, Susan A.; Vincent, Donna

This book presents strategies for teaching the personal narrative, feature article, how-to article, and persuasive letter, and for teaching fiction and reflective thinking and writing. It includes definitions, lesson plans, originals for transparencies and photocopies, and sample student writing. The first four sections are: Teaching the Personal…

IMPLEMENTATION AND SUSTAINABILITY OF CHILD-PARENT PSYCHOTHERAPY: THE ROLE OF REFLECTIVE CONSULTATION IN THE LEARNING COLLABORATIVE MODEL.

PubMed

Noroña, Carmen Rosa; Acker, Michelle L

2016-11-01

Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers. This article describes the authors' experiences in facilitating Child-Parent Psychotherapy (CPP) training and explores the role of reflective clinical consultation as an active process that supports the implementation of a rich, but complex, model that requires sophisticated knowledge and skills from practitioners. It examines the intricate range of the CPP consultant's functions, which ultimately support clinicians' reflective practice as they learn and adopt this EBT. Reflective consultation is proposed as an essential component for the integration of knowledge, experience, and emotions in practitioners and as a catalyst for organizational change. Using their voices as trainers-consultants and those of their trainees, the authors discuss the implications of reflective consultation for the effective implementation and sustainability of CPP. Reflections are offered on lessons learned. © 2016 Michigan Association for Infant Mental Health.

Current Understandings of the Research-Practice Gap From the Viewpoint of Complementary Medicine Academics: A Mixed-Method Investigation.

PubMed

Leach, Matthew J; Tucker, Basil

Research plays an important role in advancing health and healthcare. However, much research evidence is not reflected in contemporary complementary and alternative medicine (CAM) practice. Understanding and addressing the reasons for this research-practice gap may have positive implications for quality of care. To shed light on the gap between research and CAM practice. Descriptive cross-sectional, mixed-method study. A total of 126 senior CAM academics across Australasia, Europe, UK, and North America. Participants completed a 30-item online survey and a semi-structured interview; both of which explored the research-practice gap in CAM. A total of 43 (34%) academics completed the survey, with 29 (67%) respondents undergoing an interview. There was general agreement among respondents that CAM research should be informed by practice, and practice informed by research; however, most agreed that this did not reflect the current situation. Translational issues were perceived to be the primary reason for the research-practice gap in CAM. Suggested strategies for closing the gap focussed mostly around improving CAM student/practitioner education and training, and researcher-practitioner engagement and collaboration. Study findings point toward the presence of a research-practice gap in CAM, with several factors likely to be instrumental in sustaining this gap. Attention now needs to focus on understanding the views of CAM clinicians on this issue. Insights gained from this research will help inform the development of a multi-modal strategy that will effectively target the barriers to change in order to bring CAM research and practice closer together. Copyright © 2017 Elsevier Inc. All rights reserved.

Translating Knowledge Into Practice Through an Academic-Practice Partnership for Exploring Barriers That Impact Management of Homebound Patients With Heart Failure.

PubMed

Echevarria, Mercedes

A knowledge translation project involving an academic-practice partnership and guided by action-oriented research was used for exploring barriers that impact management of homebound heart failure patients. The intervention process followed an action research model of interaction, self-reflection, response, and change in direction. External facilitators (academia) and internal facilitators (practice) worked with clinicians to identify a topic for improvement, explore barriers, locate the evidence compare current practice against evidence-based practice recommendations, introduce strategies to "close the gap" between actual practice and the desired practice, develop audit criteria, and reevaluate the impact.

The Plagiarism Polyconundrum

ERIC Educational Resources Information Center

Bethany, Reine D.

2016-01-01

Plagiarism hinders student success because it shortcuts genuine writing practice and incurs penalties when discovered. Although students are aware of its potential consequences, plagiarism continues. This article reflects on the polyconundrum of empathizing with the many hindrances to student writing while deploying strategies to reduce plagiarism…

What do we do? Practices and learning strategies of medical education leaders.

PubMed

Lieff, Susan; Albert, Mathieu

2012-01-01

Continuous changes in undergraduate and postgraduate medical education require faculty to assume a variety of new leadership roles. While numerous faculty development programmes have been developed, there is little evidence about the specific practices of medical education leaders or their learning strategies to help inform their design. This study aimed to explore what medical education leaders' actually do, their learning strategies and recommendations for faculty development. A total of 16 medical education leaders from a variety of contexts within the faculty of medicine of a large North American medical school participated in semi-structured interviews to explore the nature of their work and the learning strategies they employ. Using thematic analysis, interview transcripts were coded inductively and then clustered into emergent themes. Findings clustered into four key themes of practice: (1) intrapersonal (e.g., self-awareness), (2) interpersonal (e.g., fostering informal networks), (3) organizational (e.g., creating a shared vision) and (4) systemic (e.g. strategic navigation). Learning strategies employed included learning from experience and example, reflective practice, strategic mentoring or advanced training. Our findings illuminate a four-domain framework for understanding medical education leader practices and their learning preferences. While some of these findings are not unknown in the general leadership literature, our understanding of their application in medical education is unique. These practices and preferences have a potential utility for conceptualizing a coherent and relevant approach to the design of faculty development strategies for medical education leadership.

Strategies for Achieving Whole-Practice Engagement and Buy-in to the Patient-Centered Medical Home

PubMed Central

Bleser, William K.; Miller-Day, Michelle; Naughton, Dana; Bricker, Patricia L.; Cronholm, Peter F.; Gabbay, Robert A.

2014-01-01

PURPOSE The current model of primary care in the United States limits physicians’ ability to offer high-quality care. The patient-centered medical home (PCMH) shows promise in addressing provision of high-quality care, but achieving a PCMH practice model often requires comprehensive organizational change. Guided by Solberg’s conceptual framework for practice improvement, which argues for shared prioritization of improvement and change, we describe strategies for obtaining organizational buy-in to and whole-staff engagement of PCMH transformation and practice improvement. METHODS Semistructured interviews with 136 individuals and 7 focus groups involving 48 individuals were conducted in 20 small- to mid-sized medical practices in Pennsylvania during the first regional rollout of a statewide PCMH initiative. For this study, we analyzed interview transcripts, monthly narrative reports, and observer notes from site visits to identify discourse pertaining to organizational buy-in and strategies for securing buy-in from personnel. Using a consensual qualitative research approach, data were reduced, synthesized, and managed using qualitative data management and analysis software. RESULTS We identified 13 distinct strategies used to obtain practice buy-in, reflecting 3 overarching lessons that facilitate practice buy-in: (1) effective communication and internal PCMH campaigns, (2) effective resource utilization, and (3) creation of a team environment. CONCLUSION Our study provides a list of strategies useful for facilitating PCMH transformation in primary care. These strategies can be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers. Our study findings also extend Solberg’s conceptual framework for practice improvement to include buy-in as a necessary condition across all elements of the change process. PMID:24445102

Occupation emerges in the process of therapy.

PubMed

Price, Pollie; Miner, Stephanie

2007-01-01

The current literature offers no cohesive definition of occupation-based practice. Current definitions emphasize intervention forms and contexts, which do not reflect the complexity of practice. This article demonstrates that the therapeutic relationship and the meanings that are created in the therapy process are central aspects of occupation-based practice. Occupation, as an idea that emerges in the therapeutic process, has aspects of both doing and becoming. The authors conducted observation sessions and interviews with an occupational therapist, Nancy, who used multiple therapeutic strategies with one child, Hannah, as they worked toward Hannah's goals of going to preschool and becoming a friend. Strategies include changing therapeutic conditions, using cognitive strategies, bridging the person-task-social context, pushing participation, and engaging in narrative micronegotiations. Occupation emerged in the therapeutic processes as the occupational therapist and client co-created meaning about the client moving toward or away from who she wanted to become.

Reflective Practice in the Clinical Setting: A Multi-Institutional Qualitative Study of Pediatric Faculty and Residents.

PubMed

Plant, Jennifer; Li, Su-Ting T; Blankenburg, Rebecca; Bogetz, Alyssa L; Long, Michele; Butani, Lavjay

2017-11-01

To explore when and in what form pediatric faculty and residents practice reflection. From February to June 2015, the authors conducted focus groups of pediatric faculty and residents at the University of California, Davis; Stanford University; and the University of California, San Francisco, until thematic saturation occurred. Transcripts were analyzed based on Mezirow's and Schon's models of reflection, using the constant comparative method associated with grounded theory. Two investigators independently coded transcripts and reconciled codes to develop themes. All investigators reviewed the codes and developed a final list of themes through consensus. Through iterative discussions, investigators developed a conceptual model of reflection in the clinical setting. Seventeen faculty and 20 residents from three institutions participated in six focus groups. Five themes emerged: triggers of reflection, intrinsic factors, extrinsic factors, timing, and outcome of reflection. Various triggers led to reflection; whether a specific trigger led to reflection depended on intrinsic and extrinsic factors. When reflection occurred, it happened in action or on action. Under optimal conditions, this reflection was goal and action directed and became critical reflection. In other instances, this process resulted in unproductive rumination or acted as an emotional release or supportive therapy. Participants reflected in clinical settings, but did not always explicitly identify it as reflection or reflect in growth-promoting ways. Strategies to enhance critical reflection include developing knowledge and skills in reflection, providing performance data to inform reflection, creating time and space for safe reflection, and providing mentorship to guide the process.

Connecting Classroom, Clinic, and Context: Clinical Reasoning Strategies for Clinical Instructors and Academic Faculty.

PubMed

Furze, Jennifer; Kenyon, Lisa K; Jensen, Gail M

2015-01-01

Clinical reasoning is an essential skill in pediatric physical therapist (PT) practice. As such, explicit instruction in clinical reasoning should be emphasized in PT education. This article provides academic faculty and clinical instructors with an overview of strategies to develop and expand the clinical reasoning capacity of PT students within the scope of pediatric PT practice. Achieving a balance between deductive reasoning strategies that provide a framework for thinking and inductive reasoning strategies that emphasize patient factors and the context of the clinical situation is an important variable in educational pedagogy. Consideration should be given to implementing various teaching and learning approaches across the curriculum that reflect the developmental level of the student(s). Deductive strategies may be helpful early in the curriculum, whereas inductive strategies are often advantageous after patient interactions; however, exposure to both is necessary to fully develop the learner's clinical reasoning abilities. For more insights from the authors, see Supplemental Digital Content 1, available at http://links.lww.com/PPT/A87.

Professional Development for Career Educators. ERIC Digest.

ERIC Educational Resources Information Center

Brown, Bettina Lankard

New approaches to career and technical education (CTE) create new roles for career educators, including providing career awareness, counseling, guidance, and self-education. Career educators must understand and reflect upon career development theories; teaching and learning strategies; school-to-work practices; school/business linkages; and…

Narrative reflective practice in medical education for residents: composing shifting identities

PubMed Central

Clandinin, Jean; Cave, Marie Thérèse; Cave, Andrew

2011-01-01

As researchers note, medical educators need to create situations to work with physicians in training to help them attend to the development of their professional identities. While there is a call for such changes to be included in medical education, educational approaches that facilitate attention to the development of medical students’ professional identities, that is, who they are and who they are becoming as physicians, are still under development. One pedagogical strategy involves narrative reflective practice as a way to develop physician identity. Using this approach, medical residents first write narrative accounts of their experiences with patients in what are called “parallel charts”. They then engage in a collaborative narrative inquiry within a sustained inquiry group of other residents and two researcher/facilitators (one physician, one narrative researcher). Preliminary studies of this approach are underway. Drawing on the experiences of one medical resident in one such inquiry group, we show how this pedagogical strategy enables attending to physician identity making. PMID:23745070

Narrative reflective practice in medical education for residents: composing shifting identities.

PubMed

Clandinin, Jean; Cave, Marie Thérèse; Cave, Andrew

2011-01-01

As researchers note, medical educators need to create situations to work with physicians in training to help them attend to the development of their professional identities. While there is a call for such changes to be included in medical education, educational approaches that facilitate attention to the development of medical students' professional identities, that is, who they are and who they are becoming as physicians, are still under development. One pedagogical strategy involves narrative reflective practice as a way to develop physician identity. Using this approach, medical residents first write narrative accounts of their experiences with patients in what are called "parallel charts". They then engage in a collaborative narrative inquiry within a sustained inquiry group of other residents and two researcher/facilitators (one physician, one narrative researcher). Preliminary studies of this approach are underway. Drawing on the experiences of one medical resident in one such inquiry group, we show how this pedagogical strategy enables attending to physician identity making.

Rural nursing education: a photovoice perspective.

PubMed

Leipert, Beverly; Anderson, Emma

2012-01-01

For many rural Canadians nursing care is the primary and often the sole access point to health care. As such, rural nurses are an invaluable resource to the health and wellbeing of rural populations. However, due to a nursing workforce that is aging and retiring, limited resources and support, healthcare reform issues, and other factors, these rural professionals are in short supply. Because of limited opportunities to learn about rural practice settings, nursing students may be reluctant to select rural practice locations. Relevant and effective educational initiatives are needed to attract nursing students to underserved rural and remote communities so that rural people receive the health care they require. The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. Fostering of interest in rural may help to address nursing workforce shortages in rural settings. Thirty-eight third and fourth year nursing and health sciences students enrolled in an elective 'Rural Nursing' course used the qualitative research method photovoice to take photographs that represented challenges and facilitators of rural nursing practice. They then engaged in written reflection about their photos. Photos were to be taken in rural settings of their choice, thus fostering both urban and rural student exposure to diverse rural communities. One hundred forty-four photos and reflections were submitted, representing students' appreciation of diverse facilitators and challenges to rural nursing practice. Facilitators included technology, a generalist role, strong sense of community, and slower pace of life. Challenges included inadequate rural education in undergraduate nursing programs, professional isolation, safety issues, few opportunities for professional development, lack of anonymity, and insider/outsider status. Exemplar photos and reflections are provided. The photovoice research approach used in this rural education endeavour proved to be very useful in fostering students' exposure to, interest in, and understanding of rural settings and their influence on rural nursing practice. Photovoice is also recommended for use in rural courses other than nursing. Suggested strategies include group photovoice experience and the expansion of reflection to enhance rural health research.

Students' experiences of learning in relation to didactic strategies during the first year of a nursing programme: a qualitative study.

PubMed

Westin, Lars; Sundler, Annelie J; Berglund, Mia

2015-03-17

In university undergraduate nursing programmes, didactic strategies that enable students to learn nursing skills, solve problems and develop reflective and critical thinking and practice are needed. The aim of this study was to explore how different didactic strategies support nursing students' experiences of learning during the first year of a reconstructed nursing curriculum. This study employed a qualitative approach. The data were gathered through written narratives that were analysed using qualitative content analysis. Nursing students' experiences of learning through different didactic strategies, were evident in the text. These perspectives were organised into the following themes: To focus on the patient perspective and paying more attention to others, Learning from discussions and reflections on one's own learning, Training for the professional role and becoming more courage, and Gaining insights into nursing and increasing one's self-awareness. The education increased the students' self-awareness, which helped them to pay greater attention to patients and their relative. During the learning process, the students became more courageous, reflected and discovered their shortcomings. Stated didactic strategies supported a broad base of knowledge on nursing and the professional role of nurses. Educators are challenged to strengthen meaningful learning in nursing and to facilitate the progression of nursing programmes.

Trying to find the quickest way: employed mothers' constructions of time for food.

PubMed

Jabs, Jennifer; Devine, Carol M; Bisogni, Carole A; Farrell, Tracy J; Jastran, Margaret; Wethington, Elaine

2007-01-01

The study sought to develop an understanding of how employed mothers constructed time for food provisioning for themselves and their families. A grounded theory approach and semistructured, in-depth interviews. A metropolitan area of approximately 1 million people in the northeastern United States. Thirty-five low-wage employed mothers were purposively recruited to vary in occupation, race/ethnicity, education, household composition, and age using workplace, community, convenience, and snowball sampling. Low-wage employed mothers' constructions of time for food. Interview transcripts were analyzed using the constant comparative method. Most mothers expressed feelings of time scarcity. Mothers described 3 timestyles that reflected how they constructed time. Timestyles reflected mothers' experiences of strain and time scarcity, usual time management strategies, and sense of control over time. Mothers prioritized feeding their children but wanted to complete meals quickly in order to move on to other tasks. Recognizing issues of time scarcity and individual differences of timestyles and time management strategies can help researchers better understand food choice practices and assist practitioners in identifying practical food provisioning strategies for low-wage employed mothers. Food policies and recommendations should be evaluated for their relevance to the time scarcity and work strain issues that these mothers faced.

Critical thinking evaluation in reflective writing: Development and testing of Carter Assessment of Critical Thinking in Midwifery (Reflection).

PubMed

Carter, Amanda G; Creedy, Debra K; Sidebotham, Mary

2017-11-01

develop and test a tool designed for use by academics to evaluate pre-registration midwifery students' critical thinking skills in reflective writing. a descriptive cohort design was used. a random sample (n = 100) of archived student reflective writings based on a clinical event or experience during 2014 and 2015. a staged model for tool development was used to develop a fifteen item scale involving item generation; mapping of draft items to critical thinking concepts and expert review to test content validity; inter-rater reliability testing; pilot testing of the tool on 100 reflective writings; and psychometric testing. Item scores were analysed for mean, range and standard deviation. Internal reliability, content and construct validity were assessed. expert review of the tool revealed a high content validity index score of 0.98. Using two independent raters to establish inter-rater reliability, good absolute agreement of 72% was achieved with a Kappa coefficient K = 0.43 (p<0.0001). Construct validity via exploratory factor analysis revealed three factors: analyses context, reasoned inquiry, and self-evaluation. The mean total score for the tool was 50.48 (SD = 12.86). Total and subscale scores correlated significantly. The scale achieved good internal reliability with a Cronbach's alpha coefficient of .93. this study establishedthe reliability and validity of the CACTiM (reflection) for use by academics to evaluate midwifery students' critical thinking in reflective writing. Validation with large diverse samples is warranted. reflective practice is a key learning and teaching strategy in undergraduate Bachelor of Midwifery programmes and essential for safe, competent practice. There is the potential to enhance critical thinking development by assessingreflective writing with the CACTiM (reflection) tool to provide formative and summative feedback to students and inform teaching strategies. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Virtual science instructional strategies: A set of actual practices as perceived by secondary science educators

NASA Astrophysics Data System (ADS)

Gillette, Tammy J.

2009-12-01

The purpose of this proposed research study was to identify actual teaching practices/instructional strategies for online science courses. The identification of these teaching practices/instructional strategies could be used to compile a set of teaching practices/instructional strategies for virtual high school and online academy science instructors. This study could assist online science instructors by determining which teaching practices/instructional strategies were preferred for the online teaching environment. The literature reviewed the role of online and face-to-face instructional strategies, then discussed and elaborated on the science instructional strategies used by teachers, specifically at the secondary level. The current literature did not reflect an integration of these areas of study. Therefore, the connectedness of these two types of instructional strategies and the creation of a set of preferred instructional practices for online science instruction was deemed necessary. For the purpose of this study, the researcher designed a survey for face-to-face and online teachers to identify preferred teaching practices, instructional strategies, and types of technology used when teaching high school science students. The survey also requested demographic data information from the faculty members, including years of experience, subject(s) taught, and whether the teacher taught in a traditional classroom or online, to determine if any of those elements affect differences in faculty perceptions with regard to the questions under investigation. The findings from the current study added to the literature by demonstrating the differences and the similarities that exist between online and face-to-face instruction. Both forms of instruction tend to rely on student-centered approaches to teaching. There were many skills that were similar in that both types of instructors tend to focus on implementing the scientific method. The primary difference is the use of technology tools that were used by online instructors. Online instructors tend to rely on more technological tools such as virtual labs. A list of preferred instructional practices was generated from the qualitative responses to the open-ended questions. Research concerned with this line of inquiry should continue in order to enhance both theory and practice in regard to online instruction.

Look before You Leap: Reconsidering Contemplative Pedagogy

ERIC Educational Resources Information Center

Fisher, Kathleen M.

2017-01-01

This paper presents a critique of a set of teaching strategies known as "contemplative pedagogy." Using practices such as meditation, attentive listening, and reflective reading, contemplative inquiry focuses on direct first-person experience as an essential means of knowing that has historically been overshadowed and dismissed by an…

The Learning Leader: Reflecting, Modeling, and Sharing

ERIC Educational Resources Information Center

Jacobs, Jacqueline E.; O'Gorman, Kevin L.

2012-01-01

With this book, principals, principals-in-training, and other school leaders get practical, easy-to-implement strategies for professional growth, strengthening relationships with faculty and staff, and making the necessary changes to improve K-12 learning environments. Grounded in specific, real-world examples and personal experiences, "The…

Instructional and behavior management practices implemented by elementary general education teachers.

PubMed

Reddy, Linda A; Fabiano, Gregory A; Dudek, Christopher M; Hsu, Louis

2013-12-01

This investigation examined 317 general education kindergarten through fifth-grade teachers' use of instructional and behavioral management strategies as measured by the Classroom Strategy Scale (CSS)-Observer Form, a multidimensional tool for assessing classroom practices. The CSS generates frequency of strategy use and discrepancy scores reflecting the difference between recommended and actual frequencies of strategy use. Hierarchical linear models (HLMs) suggested that teachers' grade-level assignment was related to their frequency of using instructional and behavioral management strategies: Lower grade teachers utilized more clear 1 to 2 step commands, praise statements, and behavioral corrective feedback strategies than upper grade teachers, whereas upper grade teachers utilized more academic monitoring and feedback strategies, content/concept summaries, student focused learning and engagement, and student thinking strategies than lower grade teachers. Except for the use of praise statements, teachers' usage of instructional and behavioral management strategies was not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. HLMs suggested that teachers' grade level was related to their discrepancy scores of some instructional and behavioral management strategies: Upper grade teachers had higher discrepancy scores in academic performance feedback, behavioral feedback, and praise than lower grade teachers. Teachers' discrepancy scores of instructional and behavioral management strategies were not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. Implications of results for school psychology practice are outlined. © 2013.

The Transformation Process in Nurses Caring for Dying Patients.

PubMed

Huang, Ching-Chi; Chen, Jih-Yuan; Chiang, Hsien-Hsien

2016-06-01

Despite the recent increase in attention to end-of-life hospice care, little empirical evidence regarding the process of emotional or mental transformation in caregivers is available. This study explores the transformative process that occurs in nurses because of the spiritual suffering and conflict associated with after caring for dying patients. A phenomenological approach was used to investigate eight nurses (27-40 years old) working in the hospice ward of a medical center in Taipei. Data were collected through open-ended questions using semistructured interviews and were analyzed reflectively. A three-stage transformation in the emotional processes of participants was observed. In the first stage, the participants experienced acute emotional suffering because of facing the death of their patients, potentially exacerbated by their own memories of losing family members. In the second stage, the participants adopted coping strategies to improve self-care. These strategies included attempting to soothe patients, helping patients face or deal with unfulfilled business, and participating in funeral or memorial services. In the third stage, the participants learned to provide better care through emancipatory reflection and a reassertion of responsibilities toward the self, patients, and patient families. After the third stage, the initial emotional impact morphed into a medium for self-strengthening, and participants became more adept at detecting patient needs and at providing care to complete the transformational process fully. Emotional suffering was the primary factor that induced participants to transform their personal and professional selves. Adequate emotional self-management, dialogue with other nurses, and personal reflection are crucial actions that nurses may use to cultivate personal growth, implement ethical practice, interact with other nurses, and engage in personal reflection. Strategies such as caring for patients, implementing reflective nursing practices, focusing on patient needs, and utilizing past experiences enable nurses to develop a heightened sense of responsibility and awareness, thus empowering them to take better care of themselves and their patients.

MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

PubMed

Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

2018-05-04

In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

Interpersonal issues between pain physician and patient: strategies to reduce conflict.

PubMed

Diesfeld, Kate

2008-11-01

This article analyzes scholarship on the interpersonal challenges that pain physicians face, with an emphasis on strategies to reduce conflicts within therapeutic relationships. Scholarship on the dilemmas pain physicians face suggests that 1) there are unique and perhaps unrecognized features of pain medicine that generate stress; 2) interpersonal conflict may contribute to stress; and 3) clinicians' biases may interfere with the doctor-patient relationship and with the best practice of pain medicine. Application of a framework based on clinicians' beliefs and Papadimos' reflections on justice and temperance may reduce such conflicts. The challenges of pain medicine may be complicated by the clinician's undisclosed attitudes regarding their roles and their perceptions of pain sufferers. A strategy for physicians to examine their beliefs within a supportive environment may aid physicians caring for people with chronic pain. Papadimos' reflections upon the virtues of justice and tolerance guide this analysis.

The Monets, Van Goghs, and Renoirs of Science Education: Writing Impressionist Tales as a Strategy for Facilitating Prospective Teachers' Reflections on Science Experiences

NASA Astrophysics Data System (ADS)

Bryan, Lynn A.; Tippins, Deborah J.

2005-08-01

A particularly useful pedagogical strategy for beginning a dialogue with prospective teachers about the ways in which their experiences and beliefs shape their development of professional knowledge is writing impressionist tales. Impressionist tales are a form of autobiography that portrays one highly personal perspective on a significant moment in time. In this pedagogical practice article, we describe our use of impressionist tales, summarize the assumptions underpinning our use of impressionist tales in science methods courses, provide several examples of our students’ tales, and discuss the pedagogical advantages and the teacher educator’s role in using impressionist tales to promote reflective thinking among prospective elementary science teachers.

Inventing the Future: Options and Strategies for Educators.

ERIC Educational Resources Information Center

Burdin, Joel L.; Nutter, Norma

A brief overview of Alvin Toffler's "waves" explanation of history (agricultural, industrial, and post-industrial) introduces reflections on future educational practices. While the limitations of the typical American home once made it imperative that education occur in centralized places, societal changes, as well as the development of individual…

Instructional Qualities of a Successful Mathematical Problem-Solving Class.

ERIC Educational Resources Information Center

Santos-Trigo, Manuel

1998-01-01

Describes activities that have been successfully implemented by an expert during a mathematical problem-solving course. Focuses on the identification of the qualities of these problems used to promote the development of student strategies and values that reflect mathematical practice in the classroom. Contains 17 references. (ASK)

Reflective Dialogue: A Path to Enhanced Teacher Efficacy and Classroom Practice

ERIC Educational Resources Information Center

Isai, Shelley

2010-01-01

Literature abounds on professional development. However, teacher change is not so much the result of professional development, but rather successful implementation of strategies learned into the classroom: a mastery experience. Mastery experience, after all, is the most influential predicator of teacher efficacy, which is equated to student…

Supporting Source Integration in Student Writing

ERIC Educational Resources Information Center

Refaei, Brenda; Kumar, Rita; Wahman, M. Lauren; Peplow, Amber Burkett

2017-01-01

A cross-disciplinary team of composition, communication, and library faculty used lesson study to investigate interdisciplinary instructional strategies to improve students' use of quoting in their writing. The team developed a three-class lesson plan to introduce the concept of quoting, practice the concept, and allow students to reflect on their…

The Mathematics and Mathematical Thinking of Seamstresses.

ERIC Educational Resources Information Center

Hancock, Sabrina J. C.

This study documents the mathematics practiced by four women in the context of sewing. The study describes the mathematics recognized in the skills, thinking and strategies used by the seamstresses. Through their work, the seamstresses exhibited an understanding of the concepts of angles, direction, parallel, reflection, symmetry, proportion,…

Nursing department orientation: are we missing the mark?

PubMed

Kennedy, Julie Marie; Nichols, Amy A; Halamek, Louis P; Arafeh, Julie M R

2012-01-01

Hospitals routinely provide orientation for the new nurses they hire. The evolution of nursing practice is not reflected in the current teaching methods of nursing orientation. The authors examine the past 60 years of nursing department orientation and assert the need to move toward more effective and innovative teaching strategies.

Teaching Strategic Processes in Reading. Second Edition

ERIC Educational Resources Information Center

Almasi, Janice F.; Fullerton, Susan King

2012-01-01

This accessible teacher resource and course text shows how to incorporate strategy instruction into the K-8 classroom every day. Cutting-edge theory and research are integrated with practical guidance and reflections from experienced teachers of novice and struggling readers. The book describes the nuts and bolts of creating classroom contexts…

The Design and Evaluation of a Cryptography Teaching Strategy for Software Engineering Students

ERIC Educational Resources Information Center

Dowling, T.

2006-01-01

The present paper describes the design, implementation and evaluation of a cryptography module for final-year software engineering students. The emphasis is on implementation architectures and practical cryptanalysis rather than a standard mathematical approach. The competitive continuous assessment process reflects this approach and rewards…

Strategy to Promote Active Learning of an Advanced Research Method

ERIC Educational Resources Information Center

McDermott, Hilary J.; Dovey, Terence M.

2013-01-01

Research methods courses aim to equip students with the knowledge and skills required for research yet seldom include practical aspects of assessment. This reflective practitioner report describes and evaluates an innovative approach to teaching and assessing advanced qualitative research methods to final-year psychology undergraduate students. An…

Empowering Leadership: Developing Behaviors for Success

ERIC Educational Resources Information Center

Martin, Ann M.

2013-01-01

This book takes the mystery out of leadership by illustrating the visible and invisible components of leadership. Essential questions, reflective strategies, and practical tips within each chapter will bring school librarians to their next level in leadership while they recognize the hidden leadership opportunities in daily tasks that are already…

Creating Professional Learning Communities in a Traditional Educational Leadership Preparation Program

ERIC Educational Resources Information Center

Doolittle, Gini; Stanwood, H. Mark; Simmerman, Herb

2006-01-01

In this article, the authors examine the prerequisites for leadership preparation programs with regard to implementing and institutionalizing professional learning communities as an instructional strategy. First, the authors posit that as faculty they must examine and reflect on their own teaching practices and how they influence their reciprocal…

Understanding Relationship: Maximizing the Effects of Science Coaching

ERIC Educational Resources Information Center

Anderson, Ruth; Feldman, Sue; Minstrell, Jim

2014-01-01

There is growing empirical evidence that instructional coaching can help teachers transfer their learning from professional trainings (e.g., new strategies) to classroom practice and that coaching promotes greater collaboration and reflection among teachers. At the same time, however, research on the effectiveness of particular coaching models and…

Meta-Teaching: Meaning and Strategy

ERIC Educational Resources Information Center

Chen, Xiaoduan

2013-01-01

Meta-teaching is the knowledge and reflection on teaching based on meta-ideas. It is the teaching about teaching, a teaching process with practice consciously guided by thinking, inspiring teachers to teach more effectively. Meta-teaching is related to the knowledge, inspection and amendment of teaching activities in terms of their design,…

Early Childhood Teachers' Understanding of Inclusive Education and Associated Practices: Reflections from Greece

ERIC Educational Resources Information Center

Fyssa, Aristea; Vlachou, Anastasia; Avramidis, Elias

2014-01-01

This paper focuses on Greek regular and special preschool teachers' understanding of inclusion; their views about the engagement of children with disabilities in typical day routines/activities; and their preferred strategies for facilitating children's engagement in classroom activities. Data were gathered through semi-structured interviews with…

Applying the CREAM Strategy for Coaching Teaching Practices

ERIC Educational Resources Information Center

Milad, Marine

2017-01-01

Monitoring and evaluating staff tutors necessitates constant follow-up to ensure that they are in line with the University's mission and vision. This has raised a fundamental educational question: how to coach rather than monitor the tutors. To answer this question, Cottrell's (2008) CREAM (Creative, Reflective, Effective, Active, Motivated)…

Leadership and Strategy.

ERIC Educational Resources Information Center

Cheng, Yin Cheong

This document is a chapter in "The Principles and Practice of Educational Management," which aims to provide a systematic and analytical introduction to the study of educational management. The structure of the book reflects the main substantive areas of educational leadership and management, and most of the major themes are covered in the…

Cautions about Inferences from International Assessments: The Case of PISA 2009

ERIC Educational Resources Information Center

Ercikan, Kadriye; Roth, Wolff-Michael; Asil, Mustafa

2015-01-01

Background/Context: Two key uses of international assessments of achievement have been (a) comparing country performances for identifying the countries with the best education systems and (2) generating insights about effective policy and practice strategies that are associated with higher learning outcomes. Do country rankings really reflect the…

Academic Maturation and Metacognitive Strategies in Academic Research and Production

ERIC Educational Resources Information Center

Filipovic, Jelena; Jovanovic, Ana

2016-01-01

This qualitative research aims at linking recent findings related to cognition and self-regulated learning with complexity-driven educational framework that promotes Teacher-Learner communities of practice, in which knowledge is generated and constructed through a complex process of reflection and negotiation. Building on the data that was…

Primary Care Practice Transformation Is Hard Work

PubMed Central

Crabtree, Benjamin F.; Nutting, Paul A.; Miller, William L.; McDaniel, Reuben R.; Stange, Kurt C.; Jaén, Carlos Roberto; Stewart, Elizabeth

2010-01-01

Background Serious shortcomings remain in clinical care in the United States despite widespread use of improvement strategies for enhancing clinical performance based on knowledge transfer approaches. Recent calls to transform primary care practice to a patient-centered medical home present even greater challenges and require more effective approaches. Methods Our research team conducted a series of National Institutes of Health funded descriptive and intervention projects to understand organizational change in primary care practice settings, emphasizing a complexity science perspective. The result was a developmental research effort that enabled the identification of critical lessons relevant to enabling practice change. Results A summary of findings from a 15-year program of research highlights the limitations of viewing primary care practices in the mechanistic terms that underlie current or traditional approaches to quality improvement. A theoretical perspective that views primary care practices as dynamic complex adaptive systems with “agents” who have the capacity to learn, and the freedom to act in unpredictable ways provides a better framework for grounding quality improvement strategies. This framework strongly emphasizes that quality improvement interventions should not only use a complexity systems perspective, but also there is a need for continual reflection, careful tailoring of interventions, and ongoing attention to the quality of interactions among agents in the practice. Conclusions It is unlikely that current strategies for quality improvement will be successful in transforming current primary care practice to a patient-centered medical home without a stronger guiding theoretical foundation. Our work suggests that a theoretical framework guided by complexity science can help in the development of quality improvement strategies that will more effectively facilitate practice change. PMID:20856145

Reflections on Post-16 Strategies in European Countries. Interim Report of the Leonardo da Vinci/Multiplier Effect Project III.3.a. Priority 2: Forging Links between Educational Establishments and Enterprises (1997-2000) ID 27009. Working Papers, No. 9.

ERIC Educational Resources Information Center

Stenstrom, Marja-Leena, Ed.

This four-part publication contains 19 papers on educational practices and promises for post-16 education in European countries. Part I, the introduction, contains these three papers: "Sharpening Post-16 Education Strategies: Building on the Results of the Previous Projects" (Johanna Lasonen); "'Parity of Esteem' and 'Integrated…

Assessment and management of burn pain at the Komfo Anokye Teaching Hospital: a best practice implementation project.

PubMed

Bayuo, Jonathan; Munn, Zachary; Campbell, Jared

2017-09-01

Pain management is a significant issue in health facilities in Ghana. For burn patients, this is even more challenging as burn pain has varied facets. Despite the existence of pharmacological agents for pain management, complaints of pain still persist. The aim of this project was to identify pain management practices in the burns units of Komfo Anokye Teaching Hospital, compare these approaches to best practice, and implement strategies to enhance compliance to standards. Ten evidence-based audit criteria were developed from evidence summaries. Using the Joanna Briggs Institute Practical Application of Clinical Evidence Software (PACES), a baseline audit was undertaken on a convenience sample of ten patients from the day of admission to the seventh day. Thereafter, the Getting Research into Practice (GRiP) component of PACES was used to identify barriers, strategies, resources and outcomes. After implementation of the strategies, a follow-up audit was undertaken using the same sample size and audit criteria. The baseline results showed poor adherence to best practice. However, following implementation of strategies, including ongoing professional education and provision of assessment tools and protocols, compliance rates improved significantly. Atlhough the success of this project was almost disrupted by an industrial action, collaboration with external bodies enabled the successful completion of the project. Pain management practices in the burns unit improved at the end of the project which reflects the importance of an audit process, education, providing feedback, group efforts and effective collaboration.

Using a critical reflection process to create an effective learning community in the workplace.

PubMed

Walker, Rachel; Cooke, Marie; Henderson, Amanda; Creedy, Debra K

2013-05-01

Learning circles are an enabling process to critically examine and reflect on practices with the purpose of promoting individual and organizational growth and change. The authors adapted and developed a learning circle strategy to facilitate open discourse between registered nurses, clinical leaders, clinical facilitators and students, to critically reflect on practice experiences to promote a positive learning environment. This paper reports on an analysis of field notes taken during a critical reflection process used to create an effective learning community in the workplace. A total of 19 learning circles were conducted during in-service periods (that is, the time allocated for professional education between morning and afternoon shifts) over a 3 month period with 56 nurses, 33 students and 1 university-employed clinical supervisor. Participation rates ranged from 3 to 12 individuals per discussion. Ten themes emerged from content analysis of the clinical learning issues identified through the four-step model of critical reflection used in learning circle discussions. The four-step model of critical reflection allowed participants to reflect on clinical learning issues, and raise them in a safe environment that enabled topics to be challenged and explored in a shared and cooperative manner. Copyright © 2012 Elsevier Ltd. All rights reserved.

Promoting resilience among nursing students in clinical education.

PubMed

Thomas, Lisa Jean; Asselin, Marilyn

2018-01-01

Resilience is the ability to overcome adversity and grow stronger from the experience. Increased resilience has been shown to positively impact nurses in practice. With this knowledge, recommendations to incorporate resilience training into nursing education have been made. Research, integrative reviews and a theoretical model of resilience in nursing students are explored in this paper. The authors posit that facilitating resilience is important in the setting of clinical education. Through incorporating resilience training in the clinical setting, educators can better prepare students for challenges in their educational environment and ultimately for nursing practice. Specific strategies for clinical educators to incorporate resilience training are suggested. Strategies are organized into three categories, support, education and reflection. The position of facilitating resilience in clinical education may open a discussion for future educational practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice.

PubMed

Tomlinson, Patricia S; Thomlinson, Elizabeth; Peden-McAlpine, Cynthia; Kirschbaum, Mark

2002-04-01

To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.

Changing practice to support self-management and recovery in mental illness: application of an implementation model.

PubMed

Harris, Melanie; Jones, Phil; Heartfield, Marie; Allstrom, Mary; Hancock, Janette; Lawn, Sharon; Battersby, Malcolm

2015-01-01

Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

Teaching Design in Middle-School: Instructors' Concerns and Scaffolding Strategies

NASA Astrophysics Data System (ADS)

Bamberger, Yael M.; Cahill, Clara S.

2013-04-01

This study deals with engineering education in the middle-school level. Its focus is instructors' concerns in teaching design, as well as scaffolding strategies that can help teachers deal with these concerns. Through participatory action research, nine instructors engaged in a process of development and instruction of a curriculum about energy along with engineering design. A 50-h curriculum was piloted during a summer camp for 38 middle-school students. Data was collected through instructors' materials: observation field notes, daily reflections and post-camp discussions. In addition, students' artifacts and planning graphical models were collected in order to explore how instructors' concerns were aligned with students' learning. Findings indicate three main tensions that reflect instructors' main concerns: how to provide sufficient scaffolding yet encourage creativity, how to scaffold hands-on experiences that promote mindful planning, and how to scaffold students' modeling practices. Pedagogical strategies for teaching design that developed through this work are described, as well as the ways they address the National Research Council (A framework for K-12 science education: practices, crosscutting concepts, and core ideas. National Academies Press, Washington, DC, 2011) core ideas of engineering education and the International Technological Literacy standards (ITEA in Standards for technological literacy, 3rd edn. International Technology education Association, Reston, VA, 2007).

Supporting pre-service elementary teachers in their understanding of inquiry teaching through the construction of a third discursive space

NASA Astrophysics Data System (ADS)

Greca, Ileana M.

2016-03-01

Several international reports promote the use of the inquiry teaching methodology for improvements in science education at elementary school. Nevertheless, research indicates that pre-service elementary teachers have insufficient experience with this methodology and when they try to implement it, the theory they learnt in their university education clashes with the classroom practice they observe, a problem that has also been noted with other innovative methodologies. So, it appears essential for pre-service teachers to conduct supportive reflective practice during their education to integrate theory and practice, which various studies suggest is not usually done. Our study shows how opening up a third discursive space can assist this supportive reflective practice. The third discursive space appears when pre-service teachers are involved in specific activities that allow them to contrast the discourses of theoretical knowledge taught at university with practical knowledge arising from their ideas on science and science teaching and their observations during classroom practice. The case study of three pre-service teachers shows that this strategy was fundamental in helping them to integrate theory and practice, resulting in a better understanding of the inquiry methodology and its application in the classroom.

Assessing reflective thinking and approaches to learning.

PubMed

Dunn, Louise; Musolino, Gina M

2011-01-01

Facilitation of reflective practice is critical for the ongoing demands of health care practitioners. Reflective thinking concepts, grounded in the work of Dewey and Schön, emphasize critical reflection to promote transformation in beliefs and learning necessary for reflective practice. The Reflective Thinking Questionnaire (QRT) and Revised Study Process Questionnaire (RSPQ-2F) assess skill aspects of professional reasoning, with promise for measuring changes over time. The purpose of this study was to examine the reliability and responsiveness and the model validity of reflective thinking and approaches to learning measures for U.S. health professions students enrolled in entry-level occupational (MOT) and physical therapy (DPT) programs. This measurement study addressed reliability and responsiveness of two measures, the QRT and RSPQ-2F, for graduate health professionals. A convenience sample of 125 MOT and DPT students participated in the two-measure, test-retest investigation, with electronic data collection. Outcomes support the stability of the four-scale QRT (ICC 0.63 to 0.82) and the two-scale RSPQ-2F (ICC 0.91 and 0.87). Descriptive data supporting responsiveness are presented. With noted limitations, the results support the use of the QRT and RSPQ-2F measures to assess changes in reflective thinking and approaches to learning. Measurement of these learning outcomes furthers our understanding and knowledge about instructional strategies, development of professional reasoning, and fostering of self-directed learning within MOT and DPT programs.

Teaching with a Technological Twist: Exit Tickets via Twitter in Literacy Classrooms

ERIC Educational Resources Information Center

Amaro-Jiménez, Carla; Hungerford-Kresser, Holly; Pole, Kathryn

2016-01-01

In this article, the authors describe, reflect, and analyze the implementation of a commonly used teaching strategy with a technological twist: exit tickets via Twitter. Longitudinal data collected over the course of three years demonstrated that using Twitter to reinvent a nondigital teaching practice ultimately demonstrated a better…

Self-Citation and Self-Reference: Credibility and Promotion in Academic Publication.

ERIC Educational Resources Information Center

Hyland, Ken

2003-01-01

Explores the use of self-citation and authorial mention in a corpus of 240 research articles and 800 abstracts in eight disciplines. Shows how self-mention is used and the ways these uses reflect both the promotional strategies of individuals and the epistemological practices of their disciplines. (Author/LRW)

Inclusive Education: Identifying Teachers' Strategies for Coping with Perceived Stressors in Inclusive Classrooms

ERIC Educational Resources Information Center

Brackenreed, Darlene

2011-01-01

This research replicates the study conducted by Forlin (2001) in Churchlands, Western Australia. Forlin's Inclusive Education "Teacher Stress and Coping Questionnaire" was adapted from the original questionnaire to more accurately reflect the language and practice of inclusion in Ontario. The purpose of this portion of the study was to…

Socratic Circles in World History: Reflections on a Year in Dialogue

ERIC Educational Resources Information Center

Thomas, Corey; Goering, Christian Z.

2018-01-01

This article examines and offers insights to a year of Socratic circles in the context of a world history classroom. Grounding this practice in relevant research before offering examples from the classroom and providing advice to practitioners, this discussion strategy offers an antidote to the often divisive and destructive examples of…

Exploring Postcolonial and Feminist Issues: "Rabbit-Proof Fence" in a Teaching Context

ERIC Educational Resources Information Center

Beyer, Charlotte

2010-01-01

The discussion in this article focuses on representations in Doris Pilkington's "Rabbit-Proof Fence" of trauma and reparation, and reflects on processes and strategies involved in teaching undergraduate students about these issues within literary contexts. The article discusses the practice of introducing students to new texts and areas…

Practical Pedagogy for Embedding ESD in Science, Technology, Engineering and Mathematics Curricula

ERIC Educational Resources Information Center

Hopkinson, Peter; James, Peter

2010-01-01

Purpose--The purpose of this paper is to review and highlight some recent examples of embedding education for sustainable development (ESD), within science and related curricula in ways that are meaningful and relevant to staff and students and reflect on different embedding strategies and discourses. Design/methodology/approach--A review of…

Unifying Different Theories of Learning: Theoretical Framework and Empirical Evidence

ERIC Educational Resources Information Center

Phan, Huy Phuong

2008-01-01

The main aim of this research study was to test out a conceptual model encompassing the theoretical frameworks of achievement goals, study processing strategies, effort, and reflective thinking practice. In particular, it was postulated that the causal influences of achievement goals on academic performance are direct and indirect through study…

COIN Goes GLOCAL: Traditional COIN With a Global Perspective: Does the Current US Strategy Reflect COIN Theory, Doctrine and Principles

DTIC Science & Technology

2007-05-17

Fighting a Global Insurgency” in Parameters Summer 2006. Beckett , Ian F. W., [ed.]. The Roots of Counter-Insurgency : Armies and Guerrilla Warfare...Scranton, Phil (ed.). Beyond September 11: An Anthology of Dissent. London: Pluto Press, 2002. Sepp, Kalev I., “Best Practices in

Impacts of a Redesigned Virtual Internship Program on Preservice Teachers' Skills and Attitudes

ERIC Educational Resources Information Center

Faucette, Nell; Nugent, Peg

2015-01-01

An important issue in teacher education is how to design and implement effective virtual internships for future educators. Today, these experiences should reflect best practices (as found in more traditional programs) by infusing constructivist values and strategies into the process. Interns can develop needed content knowledge and delivery skills…

Student Perceptions of Learning Strategies in a Secondary Video Production Classroom

ERIC Educational Resources Information Center

Doles, Jeffrey M.

2016-01-01

This qualitative case study asked the participants to reflect on their own learning experiences as a result of the instructional practices employed by the instructor to create an improved learning environment for students. The research investigated student perceptions of their learning via classmates' produced tutorials and how viewing the…

The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies.

PubMed

Dhaliwal, Rupinder; Cahill, Naomi; Lemieux, Margot; Heyland, Daren K

2014-02-01

Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners and patient decisions about appropriate healthcare for specific clinical circumstances, and are designed to minimize practice variation, improve costs, and improve clinical outcomes. The Canadian Critical Care Practice Guidelines (CCPGs) were first published in 2003 and most recently updated in 2013. A total of 68 new randomized controlled trials were identified since the last version in 2009, 50 of them published between 2009 and 2013. The remaining articles were trials published before 2009 but were not identified in previous iterations of the CCPGs. For clinical practice guidelines to be useful to practitioners, they need to be up-to-date and be reflective of the current body of evidence. Herein we describe the process by which the CCPGs were updated. This process resulted in 10 new sections or clinical topics. Of the old clinical topics, 3 recommendations were upgraded, 4 were downgraded, and 27 remained the same. To influence decision making at the bedside, these updated guidelines need to be accompanied by active guideline implementation strategies. Optimal implementation strategies should be guided by local contextual factors including barriers and facilitators to best practice recommendations. Moreover, evaluating and monitoring performance, such as participating in the International Nutrition Survey of practice, should be part of any intensive care unit's performance improvement strategy. The active implementation of the updated CCPGs may lead to better nutrition care and improved patient outcomes in the critical care setting.

The implementation of problem-based learning: changing pedagogy in nurse education.

PubMed

Creedy, D; Hand, B

1994-10-01

Problem-based learning (PBL) employs approaches to teaching and learning in nurse education that develop meaningful links between theory and practice. The adoption of such approaches, however, may require changes in pedagogical beliefs and practices which reflect a student-centred approach to teaching and learning. This paper focuses on a group of volunteer nurse educators (n = 14) who attended a 7-month professional development programme centred on introducing pedagogical changes when adopting PBL. From this group, three nurse educators participated in an in-depth study which aimed to examine the processes of conceptual change associated with adopting PBL as part of alternative teaching strategies. These three participants held common concerns about the changes required to their current teaching practices when moving to a new pedagogical approach. On completion of the programme, varying degrees of change in existing instructional practices were evident. This change was found to result from engaging educators in reflection about practice, providing opportunities to implement the new approaches on a trial basis, and providing feedback and support throughout the change process.

Medical students' reflective writing about a task-based learning experience on public health communication.

PubMed

Koh, Yang Huang; Wong, Mee Lian; Lee, Jeanette Jen-Mai

2014-02-01

Medical educators constantly face the challenge of preparing students for public health practice. This study aimed to analyze students' reflections to gain insight into their task-based experiences in the public health communication selective. We have also examined their self-reported learning outcomes and benefits with regard to application of public health communication. Each student wrote a semi-structured reflective journal about his or her experiences leading to the delivery of a public health talk by the group. Records from 41 students were content-analyzed for recurring themes and sub-themes. Students reported a wide range of personal and professional issues. Their writings were characterized by a deep sense of self-awareness and social relatedness such as increased self-worth, communications skills, and collaborative learning. The learning encounter challenged assumptions, and enhanced awareness of the complexity of behaviour change Students also wrote about learning being more enjoyable and how the selective had forced them to adopt a more thoughtful stance towards knowledge acquisition and assimilation. Task-based learning combined with a process for reflection holds promise as an educational strategy for teaching public health communication, and cultivating the habits of reflective practice.

Commentary on Becoming a Daughter: Trauma is a powerful teacher.

PubMed

Veach, Patricia McCarthy

2006-06-01

Personal life crises profoundly impact genetic counselor practice. In this commentary, themes from Matloff's (in press) article, Becoming a Daughter are highlighted and expanded upon. These themes include: personal impact of a life crisis, and professional impact vis a vis empathy countertransference, self-disclosure, nondirectiveness, and self-confidence. Strategies that help genetic counselors manage personal life crises within their clinical practice and also promote their professional development are emphasized, including normalization of life crises, self-reflection, boundary-setting, and use of peer supervision and consultation.

[Twenty-five years of screening eugenics in Spain].

PubMed

Mérida Donoso, Salvador

2012-01-01

Over the past 25 years, the incidence of newborns with congenital defects in Spain has fallen by 56.7% primarily due to the practice of "fetal risk" abortion, after prenatal diagnosis. In some cases, such as people with Down syndrome, the strategy involves the removal of 80-90% of those affected in pregnancy. After presenting the techniques used today and statistical data, we will make a reflection about the ethical justification for prenatal diagnosis programs and practice of "eugenic" abortion.

Aggressive behaviour by people with dementia in residential care settings: a review.

PubMed

Pulsford, D; Duxbury, J

2006-10-01

This paper considers the phenomenon of aggressive behaviour perpetrated by people with dementia in residential care settings. Aggressive behaviour is defined in the context of people with dementia, and the problem of ascertaining the incidence of aggression among people with dementia is discussed. The emotional impact of assaults on nurses and other professionals is highlighted, and differing perspectives on the causation of aggressive behaviour are considered. Management strategies derived from the physical/pharmacological; environment management; behaviour modification and person-centred approaches are reviewed. Our conclusion is that while certain strategies appear to reflect good and common sense practice, in particular those deriving from the person-centred approach, there is no clear research evidence for the general effectiveness of any one management approach, and each has drawbacks of a practical or ethical nature. There is also little empirical information about how professional carers actually manage aggressive behaviour in practice.

Celebrating Jhumki Basu's contributions to science education as a scholar and an activist: voices from the field

NASA Astrophysics Data System (ADS)

Milne, Catherine; Rubel, Laurie; Rodriguez, Alberto J.; Emdin, Christopher; Maulucci, Maria Rivera; Locke, Donyagay; Tan, Edna; Clairmont, Neil; Upadhyay, Bhaskar

2009-06-01

This metalogue addresses the ways Sreyashi Jhumki Basu mediated our practices in science education and life. We focus on Basu's uses of critical science agency, democratic science classrooms, and critical feminist ethnography to transform the possibilities for all participants in her research and educational practices. We also examine her use of cases and pedagogical strategies to support youth set practice goals based on conceptions of self and preferred learning trajectories. These strategies allow youth to develop power through the use of disciplinary knowledge and modes of inquiry to support their understanding of themselves as powerful, able to change their position in the world, and make the world more socially just. This (Key Contributors) article acknowledges a life cut short through disease, reflects our personal loss of a friend and colleague, and expresses determination to ensure that her contributions to science education are sustained and continued.

The pedagogy of argumentation in science education: science teachers' instructional practices

NASA Astrophysics Data System (ADS)

Özdem Yilmaz, Yasemin; Cakiroglu, Jale; Ertepinar, Hamide; Erduran, Sibel

2017-07-01

Argumentation has been a prominent concern in science education research and a common goal in science curriculum in many countries over the past decade. With reference to this goal, policy documents burden responsibilities on science teachers, such as involving students in dialogues and being guides in students' spoken or written argumentation. Consequently, teachers' pedagogical practices regarding argumentation gain importance due to their impact on how they incorporate this practice into their classrooms. In this study, therefore, we investigated the instructional strategies adopted by science teachers for their argumentation-based science teaching. Participants were one elementary science teacher, two chemistry teachers, and four graduate students, who have a background in science education. The study took place during a graduate course, which was aimed at developing science teachers' theory and pedagogy of argumentation. Data sources included the participants' video-recorded classroom practices, audio-recorded reflections, post-interviews, and participants' written materials. The findings revealed three typologies of instructional strategies towards argumentation. They are named as Basic Instructional Strategies for Argumentation, Meta-level Instructional ‌St‌‌rategies for ‌Argumentation, and Meta-strategic Instructional ‌St‌‌rategies for ‌Argumentation. In conclusion, the study provided a detailed coding framework for the exploration of science teachers' instructional practices while they are implementing argumentation-based lessons.

Overcoming early barriers to PCMH practice improvement in family medicine residencies.

PubMed

Fernald, Douglas H; Deaner, Nicole; O'Neill, Caitlin; Jortberg, Bonnie T; degruy, Frank Verloin; Dickinson, W Perry

2011-01-01

Residency programs face inevitable challenges as they redesign their practices for higher quality care and resident training. Identifying and addressing early barriers can help align priorities and thereby augment the capacity to change. Evaluation of the Colorado Family Medicine Residency PCMH Project included iterative qualitative analysis of field notes, interviews, and documents to identify early barriers to change and strategies to overcome them. Nine common but not universal barriers were identified: (1) a practice's history reflected some negative past experiences with quality improvement or routines incompatible with transformative change, (2) leadership gaps were evident in unprepared practice leaders or hierarchical leadership, (3) resistance and skepticism about change were expressed through cynicism aimed at change or ability to change, (4) unproductive team processes were reflected in patterns of canceled meetings, absentee leaders, or lack of accountability, (5) knowledge gaps about the Patient-centered Medical Home (PCMH) were apparent from incomplete dissemination about the project or planned changes, (6) EHR implementation distracted focus or stalled improvement activity, (7) sponsoring organizations' constraints emerged from staffing rules and differing priorities, (8) insufficient staff participation resulted from traditional role expectations and structures, and (9) communication was hampered by ineffective methods and part-time faculty and residents. Early barriers responded to varying degrees to specific interventions by practice coaches. Some barriers that interfere with practices getting started with cultural and structural transformation can be addressed with persistent attention and reflection from on-site coaches and by realigning the talents, leaders, and priorities already in these residency programs.

Acquiring and refining CBT skills and competencies: which training methods are perceived to be most effective?

PubMed

Bennett-Levy, James; McManus, Freda; Westling, Bengt E; Fennell, Melanie

2009-10-01

A theoretical and empirical base for CBT training and supervision has started to emerge. Increasingly sophisticated maps of CBT therapist competencies have recently been developed, and there is evidence that CBT training and supervision can produce enhancement of CBT skills. However, the evidence base suggesting which specific training techniques are most effective for the development of CBT competencies is lacking. This paper addresses the question: What training or supervision methods are perceived by experienced therapists to be most effective for training CBT competencies? 120 experienced CBT therapists rated which training or supervision methods in their experience had been most effective in enhancing different types of therapy-relevant knowledge or skills. In line with the main prediction, it was found that different training methods were perceived to be differentially effective. For instance, reading, lectures/talks and modelling were perceived to be most useful for the acquisition of declarative knowledge, while enactive learning strategies (role-play, self-experiential work), together with modelling and reflective practice, were perceived to be most effective in enhancing procedural skills. Self-experiential work and reflective practice were seen as particularly helpful in improving reflective capability and interpersonal skills. The study provides a framework for thinking about the acquisition and refinement of therapist skills that may help trainers, supervisors and clinicians target their learning objectives with the most effective training strategies.

Relational Strategies to Engage Boys: The Need for Reflective Practice

ERIC Educational Resources Information Center

Reichert, Michael C.

2015-01-01

Some boys thrive in school; many do not. There is a growing consensus that many boys' scholastic performance is failing to keep up with the new knowledge economy. As troubling as this trend in boys' scholastic performance may be generally, school troubles are neither universal nor normative. The intriguing fact is that some boys in most schools…

Designing Pedagogic Strategies for Dialogic Learning in Higher Education

ERIC Educational Resources Information Center

Simpson, Alyson

2016-01-01

This article focuses on the pedagogic value of dialogue to strengthen pre-service teachers' reflective practices and improve their knowledge about the power of talk for learning. Dialogic learning was introduced to a unit of study taken by a final-year cohort of students in an initial teacher education degree at an urban university in Australia.…

Policies and Practices of School Leaderships in Japan: A Case of Leadership Development Strategies in Akita

ERIC Educational Resources Information Center

Yamamoto, Yukiko; Enomoto, Naoko; Yamaguchi, Shinobu

2016-01-01

Reflecting the social and economic change, Japanese education has shifted to decentralization since the 1980s. With an increased autonomy and responsibility, the local government plays an important role to develop competent school leaders. This descriptive study employs case study approach to illustrate current status of leadership development at…

Concept Maps: Practice Applications in Adult Education and Human Resource Development

ERIC Educational Resources Information Center

Daley, Barbara J.

2010-01-01

Concept maps can be used as both a cognitive and constructivist learning strategy in teaching and learning in adult education and human resource development. The maps can be used to understand course readings, analyze case studies, develop reflective thinking and enhance research skills. The creation of concept maps can also be supported by the…

Mindfulness-Based Parent Training: Strategies to Lessen the Grip of Automaticity in Families with Disruptive Children

ERIC Educational Resources Information Center

Dumas, Jean E.

2005-01-01

Disagreements and conflicts in families with disruptive children often reflect rigid patterns of behavior that have become overlearned and automatized with repeated practice. These patterns are mindless: They are performed with little or no awareness and are highly resistant to change. This article introduces a new, mindfulness-based model of…

Practices and Prospects of Learner Autonomy: Teachers' Perceptions

ERIC Educational Resources Information Center

Al Asmari, AbdulRahman

2013-01-01

Language learning process works through the learners' own reflection on how they learn and it makes learners active in the sense that they learn to analyze their learning strategies. So they start making decisions, e.g., whether to improve them or not, and in which way. Generally, this trait is missing in traditional language teaching process and…

Strategies for Using Pop Culture in Sport Psychology and Coaching Education

ERIC Educational Resources Information Center

Collins, Karen

2012-01-01

The use of pop culture as a tool for learning and instruction is paramount. Therefore, it is imperative for teachers to be aware of, and incorporate, trends that are popular and reflect the student experience. This article addresses the pop culture trends that can positively affect teaching, coaching education, and sport psychology practice.…

An Investigation of Traditional Professional Development versus Reform Professional Development and the Implementation of Strategies, Curriculum and Classroom Environment by Prekindergarten Teachers

ERIC Educational Resources Information Center

Oliver-Brooks, Helen

2013-01-01

The purpose of this study is to investigate differences between traditional conventional professional development and high quality reflective professional development and curriculum implementation of classroom practices. This study examined the extent to which professional development activities were associated with increased levels of curriculum…

Refining Family Literacy Practice: A New Zealand Case Study

ERIC Educational Resources Information Center

Benseman, John

2006-01-01

Following the results of the International Adult Literacy Survey (IALS) in 1996, there has been an upsurge of interest in adult literacy in New Zealand. This interest is reflected in a national adult literacy strategy with foundation learning as one of the government's six priorities for the postschool sector. One result of this policy change has…

Experiential learning in practice: An ethnographic study among nursing students and preceptors.

PubMed

Rodríguez-García, Marta; Medina-Moya, José Luis; González-Pascual, Juan Luis; Cardenete-Reyes, César

2018-03-01

This study aimed to explore the reflective dialogues and processes that take place between preceptors and their nursing students and to examine how preceptors make use of their expert knowledge in order to enhance students' experiential learning during clinical placements. Two 30-h courses on reflective teaching were conducted. The study sample included 15 preceptors and 27 undergraduate nursing students. Data were collected during the course and during clinical placements at two X hospitals. Data collection included non-participatory observation and informal conversations with preceptors, in-depth interviews and focus groups. Preceptors used a series of strategies to promote experiential learning; these included creating links with practice, the use of examples, allowing students to adopt professional roles and enhancing autonomy. The value of preceptors is their wealth of professional experience, which is key during the learning process of nursing students. Preceptors must learn to master the art of questioning and stimulating reflective dialogues, in order to stimulate students' critical thinking and encourage them to resolve common problems that arise during practice. Students demand a more active role in their own learning processes. Copyright © 2017. Published by Elsevier Ltd.

Concept mapping to promote meaningful learning, help relate theory to practice and improve learning self-efficacy in Asian mental health nursing students: A mixed-methods pilot study.

PubMed

Bressington, Daniel T; Wong, Wai-Kit; Lam, Kar Kei Claire; Chien, Wai Tong

2018-01-01

Student nurses are provided with a great deal of knowledge within university, but they can find it difficult to relate theory to nursing practice. This study aimed to test the appropriateness and feasibility of assessing Novak's concept mapping as an educational strategy to strengthen the theory-practice link, encourage meaningful learning and enhance learning self-efficacy in nursing students. This pilot study utilised a mixed-methods quasi-experimental design. The study was conducted in a University school of Nursing in Hong Kong. A total of 40 third-year pre-registration Asian mental health nursing students completed the study; 12 in the concept mapping (CM) group and 28 in the usual teaching methods (UTM) group. The impact of concept mapping was evaluated thorough analysis of quantitative changes in students' learning self-efficacy, analysis of the structure and contents of the concept maps (CM group), a quantitative measure of students' opinions about their reflective learning activities and content analysis of qualitative data from reflective written accounts (CM group). There were no significant differences in self-reported learning self-efficacy between the two groups (p=0.38). The concept mapping helped students identify their current level of understanding, but the increased awareness may cause an initial drop in learning self-efficacy. The results highlight that most CM students were able to demonstrate meaningful learning and perceived that concept mapping was a useful reflective learning strategy to help them to link theory and practice. The results provide preliminary evidence that the concept mapping approach can be useful to help mental health nursing students visualise their learning progress and encourage the integration of theoretical knowledge with clinical knowledge. Combining concept mapping data with quantitative measures and qualitative reflective journal data appears to be a useful way of assessing and understanding the effectiveness of concept mapping. Future studies should utilise a larger sample size and consider using the approach as a targeted intervention immediately before and during clinical learning placements. Copyright © 2017 Elsevier Ltd. All rights reserved.

Factors that influence the professional resilience of occupational therapists in mental health practice.

PubMed

Ashby, Samantha E; Ryan, Susan; Gray, Mel; James, Carole

2013-04-01

Mental health practice can create challenging environments for occupational therapists. This study explores the dynamic processes involved in the development and maintenance of professional resilience of experienced mental health occupational therapy practitioners. It presents the PRIOrity model that summarises the dynamic relationship between professional resilience, professional identity and occupation-based practice. A narrative inquiry methodology with two phases of interviews was used to collect the data from nine experienced mental health practitioners. Narrative thematic analysis was used to interpret the data. Professional resilience was linked to: (i) professional identity which tended to be negatively influenced in contexts dominated by biomedical models and psychological theories; (ii) expectations on occupational therapists to work outside their professional domains and use generic knowledge; and (iii) lack of validation of occupation-focussed practice. Professional resilience was sustained by strategies that maintained participants' professional identity. These strategies included seeking 'good' supervision, establishing support networks and finding a job that allowed a match between valued knowledge and opportunities to use it in practice. For occupational therapists professional resilience is sustained and enhanced by a strong professional identity and valuing an occupational perspective of health. Strategies that encourage reflection on the theoretical knowledge underpinning practice can sustain resilience. These include supervision, in-service meetings and informal socialisation. Further research is required into the role discipline-specific theories play in sustaining professional values and identity. The development of strategies to enhance occupational therapists' professional resilience may assist in the retention of occupational therapists in the mental health workforce. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

Body-Mind Healing Strategies in Patients with Cancer: a Qualitative Content Analysis

PubMed

Khoshnood, Zohreh; Iranmanesh, Sedigheh; Rayyani, Masoud; Dehghan, Mahlegha

2018-06-25

Background: Cancer is a major health problem around the world. The use of coping strategies among patients with cancer depends on several issues. This study was conducted to determine coping strategies used by patients with cancer in south-east Iran. Methods: This study is a conventional, qualitative content analysis with a descriptive explorative approach. Data saturation achieved after interviewing 13 participants in 15 interviews. Using an in-depth individual semi-structured approach the participants were asked to narrate their experiences of strategies that they used to cope with cancer. The following were considered: unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: Data analysis led to extraction of two main categories of body-mind healing strategies: being connected to the body and mindfully reconnected to the self. The first category was explained with reference to two sub-categories, being aware of intelligence and body nurturing. The second category was explained with the three sub-categories of using embodying knowledge, living for the moment, and being connected to nature. Conclusion: According to the results of this qualitative study, it is possible to form discussion groups with peers or to have self-reflective practice learning groups to reflect patients’ questions and strategies that they use for body-mind healing. Creative Commons Attribution License

Strategies to Mitigate Obsolescence in Defense Systems Using Commercial Components (Strategies visant a attenuer l’obsolescence des systemes par l’emploi de composants du commerce)

DTIC Science & Technology

2001-06-01

reflection of the composition of the audience which contained a high proportion of Defence Industry Contractors, who were interested in the practicalities of...to future project cost containment. In proportion to the potential costs, insufficient debate on software obsolescence was presented at this event. T...devoted to it should be proportionate to the risk. The risk is all the greater, as the ASIC is frequently, by its very nature, in the critical path of the

Low authority-threshold control for large flexible structures

NASA Technical Reports Server (NTRS)

Zimmerman, D. C.; Inman, D. J.; Juang, J.-N.

1988-01-01

An improved active control strategy for the vibration control of large flexible structures is presented. A minimum force, low authority-threshold controller is developed to bring a system with or without known external disturbances back into an 'allowable' state manifold over a finite time interval. The concept of a constrained, or allowable feedback form of the controller is introduced that reflects practical hardware implementation concerns. The robustness properties of the control strategy are then assessed. Finally, examples are presented which highlight the key points made within the paper.

Changing the attitudes and practices of professional developers through a constructivist model: The Technical Assistance Academy for Mathematics and Science Services

NASA Astrophysics Data System (ADS)

Charles, Karen Jungblut

For much of this century, mathematics and science have been taught in a didactic manner that is characterized by a passive student and a lecturing teacher. Since the late eighties national standards have encouraged professional developers specializing in mathematics and science education to deliver the messages of inquiry-based learning, active student engagement, and learner-constructed knowledge to the teachers they support. Follow-up studies of professional development programs, however, found that telling teachers was no more effective than telling students. Information transmitted in a passive setting was not transferring into effective classroom practices. This phenomenological case study was conducted to determine the effects of a constructivist-oriented professional development experience, the Technical Assistance Academy, in changing the practices and attitudes of mathematics and science professional developers regarding the use of constructivist strategies in workshop design. This study focused on 45 professional developers who participated in the Technical Assistance Academy. Data from a 2 1/2 year period were collected from session evaluations, journal reflections, a follow-up interview, and site visits that included observations and collaborative planning. Content analysis procedures were used to find common themes among the data. Use of new skills developed as a result of participation in the Technical Assistance Academy was determined using the Concerns-Based Adoption Model Levels of Use framework (Hall & Hord, 1987). Changes in attitude were determined by examining participants' journal reflections related to common constructivist themes such as those discussed by Fosnot (1996c): learning is developmental, disequilibrium and reflection facilitate learning, and the construction of "big ideas" results from the opportunity to struggle with new information. Results verified that all 45 participants demonstrated some level of use, and that most were in the 3 highest of 5 levels of use: mechanical (11%), routine (16%), refinement (27%), integration (24%), and renewal (22%). Participants reported valuing (a) active engagement necessary for the developmental progression of learning to occur, (b) their own disequilibrium, (c) opportunity to reflect, and they acknowledged a clearer understanding and appreciation of the big ideas in workshop design such as networking, collaboration, content and staff development standards, equity, and community building. Results support the conclusion that learning about constructivist instructional strategies in a long-term program that models them positively affects participants' attitudes and enhances their use of similar strategies in the design of professional development experiences for others. Knowledge developed in a constructivist setting transferred into effective facilitator practices.

Reflective Teaching

ERIC Educational Resources Information Center

Farrell, Thomas S. C.

2013-01-01

Thomas Farrell's "Reflective Teaching" outlines four principles that take teachers from just doing reflection to making it a way of being. Using the four principles, Reflective Practice Is Evidence Based, Reflective Practice Involves Dialogue, Reflective Practice Links Beliefs and Practices, and Reflective Practice Is a Way of Life,…

Reflective practice in speech-language pathology: a scoping review.

PubMed

Caty, Marie-Ève; Kinsella, Elizabeth Anne; Doyle, Philip C

2015-01-01

Within the profession of speech-language pathology, there is limited information related to both conceptual and empirical perspectives of reflective practice. This review considers the key concepts and approaches to reflection and reflective practice that have been published in the speech-language pathology literature in order to identify potential research gaps. A scoping review was conducted using Arksey and O'Malley's (2005) framework. A total of 42 relevant publications were selected for review. The resulting literature mapping revealed that scholarship on reflection and reflective practice in speech-language pathology is limited. Our conceptual mapping pointed to the use of both multiple and generic terms and a lack of conceptual clarity about reflection and reflective practice in speech-language pathology. Two predominant approaches to reflection and reflective practice were identified: written reflection and reflective discussion. Both educational and clinical practice contexts were associated with reflection and reflective practice. Publications reviewed were primarily concerned with reflection and reflective practice by novices and expert practitioners. Based on this review, we posit that there is considerable need for conceptual and empirical work with a goal to support university- and work-based educational initiatives involving reflection and reflective practice in speech-language pathology.

Racism in nursing education: a reflective journey.

PubMed

Markey, Kathleen; Tilki, Mary

This article discusses the personal and professional journey of discovery experienced by a nurse lecturer as a result of engagement in a project exploring the impact of racism in the nursing classroom. The findings of the study demonstrated the existence and complexity of racism, the impact of racism on student learning, the limitations of lecturers in recognizing and addressing racism and organizational factors which perpetuate institutional racism. The authors describe the insight gained from the research process and how this has influenced the practice of the first author and how reflection and mentorship by the second author have challenged personal ethnocentricity, encouraged new ways of thinking, enhanced confidence and encouraged experiential teaching strategies. The article highlights the ways in which nurse lecturers might become culturally competent and in particular addressing issues of racism in the classroom and enabling learning which is applicable in practice.

Putting conflict management into practice: a nursing case study.

PubMed

Vivar, Cristina García

2006-04-01

This paper is intended to put knowledge in conflict management into practice through reflecting on a nursing case study. Nursing organizations are particularly vulnerable to conflict as the context of nurses' work may be difficult and stressful. Power conflict is argued to be an important source of tension within nursing units. Learning to manage conflict at an early stage is therefore crucial to the effective functioning of nursing organizations. A nursing case study that illustrates power conflict in an oncology nursing unit is displayed and reflection on conflict management from the case is provided. There is no appropriate or inappropriate strategy to deal with conflict. However, detecting initial symptoms of conflict and adopting the most effective behaviour to conflict resolution is essential in nursing units. Further nursing education in conflict management for staff nurses and nurse managers is greatly needed.

Using flash cards to engage Indonesian nursing students in reflection on their practice.

PubMed

Wanda, Dessie; Fowler, Cathrine; Wilson, Valerie

2016-03-01

Reflective practice is now widely used as a critical learning tool in undergraduate and postgraduate nursing programs in most developed countries. However in developing countries, reflective practice is in its infancy. To introduce reflective practice to postgraduate students in an Indonesian nursing education institution. This paper presents the positive meanings of reflection and reflective practice experienced by the students and the way they used reflection within their practice. A descriptive qualitative study was conducted to explore the meaning of reflection or reflective practice using flashcards. A clinical reflective practice model taking into consideration Indonesian culture was developed and applied during students' clinical placement. A few weeks post clinical placement, 21 students participated in an evaluation session. The meaning of reflection or reflective practice was explored using flash cards containing images of people and environment with different situations and events. Students were asked to choose a card that represented their viewpoints about reflective practice and share it with the group. Data were digitally captured and analyzed using thematic analysis. Reflection provided a positive experience for the students. In their own words, they discussed their journey of using reflection during the clinical placement period. The use of reflection was identified as expanding their view of nursing practice, providing a safe place to explore their experiences and clarity when they encountered challenging situations during their clinical practice. Reflecting on practice experiences resulted in increased self-awareness, and enhanced their learning. The findings indicate that reflective practice can be implemented successfully in Indonesia and may have value for other Eastern countries that share similar cultural characteristics. The use of flash cards assisted the students describe through stories their experiences of participating in this reflective practice program. Copyright © 2015 Elsevier Ltd. All rights reserved.

Accelerating Educational Innovation in the MPH Degree Program: What Is the Role of Peer Review of Teaching?

ERIC Educational Resources Information Center

Vian, Taryn; Ashigbie, Paul G.

2015-01-01

Purpose: The environment of public health practice is rapidly changing, creating the need to adapt graduate education and accelerate educational innovation. Formative peer review is a strategy designed to promote critical reflection on teaching and to develop faculty as teachers. Through case study methods, we explore how peer review of teaching…

Changing Practice: An Evaluation of the Impact of a Nature of Science Inquiry-Based Professional Development Programme on Primary Teachers

ERIC Educational Resources Information Center

Murphy, Clíona; Smith, Greg; Varley, Janet; Razi, Özge

2015-01-01

This study investigates how a two-year continuing professional development (CPD) programme, with an emphasis on teaching about science through inquiry, impacted the experiences of, approaches to and attitudes towards teaching science of 17 primary teachers in Dublin. Data sources included interview, questionnaire and reflective journal strategies.…

Putting Research into Practice in the Elementary Grades: Readings from Journals of the National Council of Teachers of Mathematics.

ERIC Educational Resources Information Center

Chambers, Donald L., Ed.

This book describes children's mathematical thinking to guide and support teachers in their reflection upon student thinking and teaching and learning. It is organized into five parts: (1) reasoning, student thinking, and invented strategies independent of the mathematics content domain which addresses the role of discourse in helping students…

New graduate transition to practice: how can the literature inform support strategies?

PubMed

Moores, Alis; Fitzgerald, Cate

2017-07-01

Objective The transition to practice for new graduate health professionals has been identified as challenging, with health services typically adopting a range of support and management strategies to assist safe professional practice. Queensland's state-wide Occupational Therapy Clinical Education Program supporting new graduates within public sector health facilities conducted a narrative literature review to identify evidence-based recommended actions that would assist new graduate occupational therapists' to transition from student to practitioner. Method Searches of Medline, CINAHL and PubMed databases were used to locate articles describing or evaluating occupational therapy new graduate support actions. Results The themes of supervision, support and education emerged from the literature. Additionally, four interactions were identified as factors potentially influencing and being influenced by the processes and outcomes of supervision, support and education actions. The interactions identified were professional reasoning, professional identity, an active approach to learning and reflective practice. Conclusions The interactions emerging from the literature will serve to inform the delivery and focus of supervision, support and education for new graduate occupational therapists as they transition to practice. The results may have application for other health professions. What is known about the topic? The transition to practice for new graduate occupational therapists has been reported as challenging with health services implementing various actions to support and assist this transition. A previous literature review of recommended support strategies could not be found providing an impetus for this enquiry. What does this paper add? This narrative literature review identified three themes of actions supporting the transition of new graduates from student to practitioner. In addition to these themes of supervision, support and education, also emerging from the literature were factors identified as important to facilitating the transition of new graduates to the workplace. These factors, or interactions, are identified in this paper as professional reasoning, professional identity, an active approach to learning, and reflective practice. It is proposed that these interactions have an effect on and can be effected by supervision, support and education actions. The articulation between the interactions and the themes was a notable outcome emerging from this literature review. What are the implications for practitioners? This literature review will assist those planning actions to guide new graduates' transition into practice. It is proposed that the methods of implementing supervision, support and education actions are optimised by the identified interactions.

Measuring critical thinking in pre-registration midwifery students: A multi-method approach.

PubMed

Carter, Amanda G; Creedy, Debra K; Sidebotham, Mary

2018-02-01

Test the concurrent validity of three newly developed tools (student self-rating, preceptor rating, and reflective writing) that aim to measure critical thinking in midwifery practice. A descriptive matched cohort design was used. Australian research intensive university offering a three year Bachelor of Midwifery programme. Fifty-five undergraduate midwifery students. Students assessed their ability to apply critical thinking in midwifery practice using a 25-item tool and a 5-item subscale in Motivated Strategies for Learning Questionnaire. Clinical preceptors completed a 24-item tool assessing the students' application of critical thinking in practice. Reflective writing by students was assessed by midwifery academics using a 15-item tool. Internal reliability, and concurrent validity were assessed. Correlations, t-tests, multiple regression and confidence levels were calculated for the three scales and associations with student characteristics. The three scales achieved good internal reliability with a Cronbach's alpha coefficient between 0.93 and 0.97. Matched total scores for the three critical thinking scales were moderately correlated; student/preceptor (r=0.36, p<0.01); student/reflective writing (r=0.38, p<0.01); preceptor/reflective writing (r=0.30, p<0.05). All critical thinking mean scores were higher for students with a previous degree, but only significant for reflective writing (t (53)=-2.35, p=0.023). Preceptor ratings were predictive of GPA (beta=0.50, p<0.001, CI=0.10 to 0.30). Students' self-rating scores were predictive of year level (beta=0.32, p<0.05, CI=0.00 to 0.03). The student, preceptor, and reflective writing tools were found to be reliable and valid measures of critical thinking. The three tools can be used individually or in combination to provide students with various sources of feedback to improve their practice. The tools allow formative measurement of critical thinking over time. Further testing of the tools with larger, diverse samples is recommended. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Reflective blogs in clinical education to promote critical thinking in dental hygiene students.

PubMed

Wetmore, Ann O'Kelley; Boyd, Linda D; Bowen, Denise M; Pattillo, Robin E

2010-12-01

One challenge facing dental hygiene, as well as dental, education is to identify clinical teaching strategies promoting critical thinking and clinical reasoning. These skills are crucial elements in the practice of dental hygiene. A two-group design (intervention, n=28, and control, n=30) assessed first-year dental hygiene students using pre-and post-Health Science Reasoning Test (HSRT) scores to evaluate the effect of reflective blogging on critical thinking skills. A reflective blog rubric, based on Mezirow's levels of reflection, determined if reflective blogging increased the level of reflection for dental hygiene students. The results suggest within this nonprobability sample that reflective blogging did not produce a significant change in students' HSRT scores (p>0.05). However, analyses of reflective blog rubric scores demonstrated statistically significant improvements (p<0.05) in students' levels of reflection. Furthermore, data analysis revealed a correlation (p<0.05) between HSRT subscale scores and the element of reflection scores for the intervention group. This study addressed needs of the dental and dental hygiene education community by examining the use of blogs, an emerging technology, as a tool for reflecting on clinical experiences and, in turn, for promoting critical thinking.

Biology Reflective Assessment Curriculum

NASA Astrophysics Data System (ADS)

Bayley, Cheryl Ann

Often students and educators view assessments as an obligation and finality for a unit. In the current climate of high-stakes testing and accountability, the balance of time, resources and emphasis on students' scores related to assessment have been slanted considerably toward the summative side. This tension between assessment for accountability and assessment to inform teaching strains instruction and educators' ability to use that information to design learning opportunities that help students develop deeper conceptual understanding. A substantive body of research indicates that formative and reflective assessment can significantly improve student learning. Biology Reflective Assessment Curriculum (BRAC) examines support provided for high school science students through assessment practices. This investigation incorporates the usage of reflective assessments as a guiding practice for differentiated instruction and student choice. Reflective assessment is a metacognitive strategy that promotes self-monitoring and evaluation. The goals of the curriculum are to promote self-efficacy and conceptual understanding in students learning biology through developing their metacognitive awareness. BRAC was implemented in a high school biology classroom. Data from assessments, metacognitive surveys, self-efficacy surveys, reflective journals, student work, a culminating task and field notes were used to evaluate the effectiveness of the curriculum. The results suggest that students who develop their metacognitive skills developed a deeper conceptual understanding and improved feelings of self-efficacy when they were engaged in a reflective assessment unit embedded with student choice. BRAC is a tool for teachers to use assessments to assist students in becoming metacognitive and to guide student choice in learning opportunities.

Effect of reflective practice education on self-reflection, insight, and reflective thinking among experienced nurses: a pilot study.

PubMed

Asselin, Marilyn E; Fain, James A

2013-01-01

A mixed-method study was conducted to determine whether nurses' participation in a reflective practice continuing education program using a structured reflection model makes a difference in nurses' self-reflection, insight, and reflective thinking about clinical practice situations. Findings suggested that use of structured reflection using question cues, written narratives, and peer-facilitated reflection increased nurses' engagement in self-reflection and enhanced reflective thinking in practice. Including reflective practice education in novice orientation and preceptor training may be beneficial.

How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

PubMed

Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J

2008-07-01

In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new structures. The group's learning supported a view of change that sees the organisation as a living system in which information flow, participation and the development of resilience are key aspects. These themes fit well into an understanding of change based on complexity theory. If managers of the health system wish to enhance organisational change, then their goal may need to shift from optimising health care delivery in a mechanistic model to optimising health care workers in a living system.

Left behind in the return-to-work journey: consumer insights for policy change and practice strategies.

PubMed

Korzycki, Monica; Korzycki, Martha; Shaw, Lynn

2008-01-01

This study examined system barriers that precluded injured workers from accessing services and supports in the return-to-work (RTW) process. A grounded theory approach was used to investigate injured worker experiences. Methods included in-depth telephone interviews and the constant comparative method to analyze the data. Findings revealed that consumers experienced tensions or a tug-of-war between the RTW system, the health care system, and in accessing and using knowledge. Over time consumers reflected upon these tensions and initiated strategies to enhance return to function and RTW. Insights from consumer-driven strategies that might inform future policy change and promote positive service delivery for injured workers are examined.

A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care.

PubMed

Comino, Elizabeth Jean; Davies, Gawaine Powell; Krastev, Yordanka; Haas, Marion; Christl, Bettina; Furler, John; Raymont, Anthony; Harris, Mark F

2012-11-21

Although primary health care (PHC) is a key component of all health care systems, services are not always readily available, accessible or affordable. This systematic review examines effective strategies to enhance access to best practice processes of PHC in three domains: chronic disease management, prevention and episodic care. An extensive search of bibliographic data bases to identify peer and non-peer reviewed literature was undertaken. Identified papers were screened to identify and classify intervention studies that measured the impact of strategies (singly or in combination) on change in use or the reach of services in defined population groups (evaluated interventions). The search identified 3,148 citations of which 121 were intervention studies and 75 were evaluated interventions. Evaluated interventions were found in all three domains: prevention (n = 45), episodic care (n = 19), and chronic disease management (n = 11). They were undertaken in a number of countries including Australia (n = 25), USA (n = 25), and UK (n = 15). Study quality was ranked as high (31% of studies), medium (61%) and low (8%). The 75 evaluated interventions tested a range of strategies either singly (n = 46 studies) or as a combination of two (n = 20) or more strategies (n = 9). Strategies targeted both health providers and patients and were categorised to five groups: practice re-organisation (n = 43 studies), patient support (n = 29), provision of new services (n = 19), workforce development (n = 11), and financial incentives (n = 9). Strategies varied by domain, reflecting the complexity of care needs and processes. Of the 75 evaluated interventions, 55 reported positive findings with interventions using a combination of strategies more likely to report positive results. This review suggests that multiple, linked strategies targeting different levels of the health care system are most likely to improve access to best practice PHC. The proposed changes in the structure of PHC in Australia may provide opportunities to investigate the factors that influence access to best practice PHC and to develop and implement effective, evidence based strategies to address these.

Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

PubMed

Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

2018-04-17

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest clinical need were crucial beginning for this hospital's growing program.

The impact of professional development on classroom teaching for science educators participating in a long term community of practice

NASA Astrophysics Data System (ADS)

Jensen, Aaron C.

Efforts to modify and improve science education in the United States have seen minimal success (Crawford, 2000; Borko & Putman, 1996; Puntambekar, Stylianou & Goldstein, 2007; Lustick, 2011). One important reason for this is the professional development that teachers go through in order to learn about and apply these new ideas is generally of poor quality and structured incorrectly for long-term changes in the classroom (Little, 1993; Fullen, 1996; Porter, 2000; Jeanpierre, Oberhauser, & Freeman, 2005). This grounded theory study explores a science community of practice and how the professional development achieved through participation in that community has effected the instruction of the teachers involved, specifically the incorporation of researched based effective science teaching instructional strategies. This study uses personal reflection papers written by the participants, interviews, and classroom observations to understand the influence that the science community of practice has had on the participants. Results indicate that participation in this science community of practice has significant impact on the teachers involved. Participants gained greater understanding of science content knowledge, incorporated effective science instructional strategies into their classroom, and were able to practice both content knowledge and strategies in a non-threatening environment thus gaining a greater understanding of how to apply them in the classrooms. These findings motivate continued research in the role that communities of practice may play in teacher professional develop and the effectiveness of quality professional development in attaining long-term, sustained improvement in science education.

Strategies for preventing group B streptococcal infections in newborns: a nation-wide survey of Italian policies.

PubMed

Tzialla, Chryssoula; Berardi, Alberto; Farina, Claudio; Clerici, Pierangelo; Borghesi, Alessandro; Viora, Elsa; Scollo, Paolo; Stronati, Mauro

2017-11-02

There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Facilitating Dental Student Reflections: Using Mentor Groups to Discuss Clinical Experiences and Personal Development.

PubMed

Koole, Sebastiaan; Christiaens, Veronique; Cosyn, Jan; De Bruyn, Hugo

2016-10-01

Despite the consensus on the importance of reflection for dental professionals, a lack of understanding remains about how students and clinicians should develop their ability to reflect. The aim of this study was to investigate dental students' and mentors' perceptions of mentor groups as an instructional method to facilitate students' reflection in terms of the strategy's learning potential, role of the mentor, group dynamics, and feasibility. At Ghent University in Belgium, third- and fourth-year dental students were encouraged to reflect on their clinical experiences and personal development in three reflective mentor sessions. No preparation or reports afterwards were required; students needed only to participate in the sessions. Sessions were guided by trained mentors to establish a safe environment, frame clinical discussions, and stimulate reflection. Students' and mentors' perceptions of the experience were assessed with a 17-statement questionnaire with response options on a five-point Likert scale (1=totally disagree to 5=totally agree). A total of 50 students and eight mentors completed the questionnaire (response rates 81% and 89%, respectively). Both students and mentors had neutral to positive perceptions concerning the learning potential, role of the mentor, group dynamics, and feasibility. The mean ideal total time for sessions in a year was 99 minutes (third-year students), 111 minutes (fourth-year students), and 147 minutes (mentors). Reported reflective topics related to patient management, frustrations, and practice of dentistry. Overall mean appreciation for the experience ranged from 14.50 to 15.14 on the 20-point scale. These findings about students' and mentors' positive perceptions of the experience suggest that mentor groups may be a potentially valuable strategy to promote dental students' reflection.

Insights from SMPY's Greatest Former Child Prodigies: Drs. Terence ("Terry") Tao and Lenhard ("Lenny") Ng Reflect on Their Talent Development

ERIC Educational Resources Information Center

Muratori, Michelle C.; Stanley, Julian C.; Ng, Lenhard; Ng, Jack; Gross, Miraca U. M.; Tao, Terence; Tao, Billy

2006-01-01

If the academic needs of the most profoundly gifted students can be met through the use of existing educational practices, specialists in gifted education can assume that the educational needs of less able, but still academically talented, students can also be met by using some combination of these strategies as well. This paper illustrates the…

Long-term practice effects on a new skilled motor learning: an electrophysiological study.

PubMed

Fattapposta, F; Amabile, G; Cordischi, M V; Di Venanzio, D; Foti, A; Pierelli, F; D'Alessio, C; Pigozzi, F; Parisi, A; Morrocutti, C

1996-12-01

Cortical functions concerned with the execution of skilled movements can be studied through complex interactive tasks. Skilled performance task (SPT) offers the greatest deal of information about the electrophysiological components reflecting pre-programming, execution of the movement and control of the results. Overall, these components are indicated as "movement-related brain macropotentials' (MRBMs). Among them, Bereitschaftspotential (BP) reflects cerebral processes related to the preparation of movement and skilled performance positivity (SPP) reflects control processes on the result of performance. There is some evidence supporting a training effect on MRBMs, but less clear is whether long-term practice of a skilled activity could modify learning strategies of a new skilled task. We recorded MRBMs in subjects trained for a long time to perform a highly skillful athletic activity, i.e. gun shooting, and in a group of control subjects without any former experience in skilled motor activities. Our findings demonstrated the existence of a relationship between pre-programming and performance control, as suggested by decrease of BP amplitude and increase of SPP amplitude in presence of high levels of performance. Long-term practice seems to develop better control models on performance, that reduce the need of a high mental effort in pre-programming a skilled action.

Nurses' perceptions of the impact of Team-Based Learning participation on learning style, team behaviours and clinical performance: An exploration of written reflections.

PubMed

Oldland, Elizabeth; Currey, Judy; Considine, Julie; Allen, Josh

2017-05-01

Team-Based Learning (TBL) is a teaching strategy designed to promote problem solving, critical thinking and effective teamwork and communication skills; attributes essential for safe healthcare. The aim was to explore postgraduate student perceptions of the role of TBL in shaping learning style, team skills, and professional and clinical behaviours. An exploratory descriptive approach was selected. Critical care students were invited to provide consent for the use for research purposes of written reflections submitted for course work requirements. Reflections of whether and how TBL influenced their learning style, teamwork skills and professional behaviours during classroom learning and clinical practice were analysed for content and themes. Of 174 students, 159 participated. Analysis revealed three themes: Deep Learning, the adaptations students made to their learning that resulted in mastery of specialist knowledge; Confidence, in knowledge, problem solving and rationales for practice decisions; and Professional and Clinical Behaviours, including positive changes in their interactions with colleagues and patients described as patient advocacy, multidisciplinary communication skills and peer mentorship. TBL facilitated a virtuous cycle of feedback encouraging deep learning that increased confidence. Increased confidence improved deep learning that, in turn, led to the development of professional and clinical behaviours characteristic of high quality practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Narrating practice: reflective accounts and the textual construction of reality.

PubMed

Taylor, Carolyn

2003-05-01

Two approaches dominate current thinking in health and welfare: evidence-based practice and reflective practice. Whilst there is debate about the merits of evidence-based practice, reflective practice is generally accepted with critical debate as an important educational tool. Where critique does exist it tends to adopt a Foucauldian approach, focusing on the surveillance and self-regulatory aspects of reflective practice. This article acknowledges the critical purchase on the concept of reflective practice offered by Foucauldian approaches but argues that microsociological and discourse analytic approaches can further illuminate the subject and thus serve as a complement to them. The claims of proponents of reflective practice are explored, in opposition to the technical-rational approach of evidence-based practice. Reflective practice tends to adopt a naive or romantic realist position and fails to acknowledge the ways in which reflective accounts construct the world of practice. Microsociological approaches can help us to understand reflective accounts as examples of case-talk, constructed in a narrative form in the same way as case records and presentations.

Self-reflection, gender and science achievement

NASA Astrophysics Data System (ADS)

Shoop, Kathleen A.

Drawing on socio-cognitive learning theory, this study compared achievement scores of 134 male and female high school biology students randomly assigned to groups which either used self-reflection, used self-reflection and received feedback, or did not self-reflect. Following a pretest, the teacher provided self-reflection strategy instruction to students in the two intervention groups and then subsequently provided in-class self-reflection time for these groups. The posttest concluded the unit; the retention measure was five weeks later. A quasi-experimental 3 x 3 x 2 (time x intervention x gender) factorial repeated-measures control group design was used for this study; a repeated measures ANOVA and several one-way ANOVA's were used to answer the research questions. Results from the repeated-measures ANOVA revealed significant results for Time and Time x Intervention, with the reflection group demonstrating significantly lower gains from pretest to posttest than the other two groups. The ANOVA examining differences between those who reflected and those who reflected and received feedback provided significant results with similar results for the difference between the control group and the reflection group. For teachers and students this study provides several areas of practical significance. Primarily, teachers may find lower student achievement if students regularly self-reflect but do not receive feedback for their reflection.

Practical Qualitative Research Strategies: Training Interviewers and Coders.

PubMed

Goodell, L Suzanne; Stage, Virginia C; Cooke, Natalie K

2016-09-01

The increased emphasis on incorporating qualitative methodologies into nutrition education development and evaluation underscores the importance of using rigorous protocols to enhance the trustworthiness of the findings. A 5-phase protocol for training qualitative research assistants (data collectors and coders) was developed as an approach to increase the consistency of the data produced. This training provides exposure to the core principles of qualitative research and then asks the research assistant to apply those principles through practice in a setting structured on critical reflection. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Clinical Growth: An Evolutionary Concept Analysis.

PubMed

Barkimer, Jessica

2016-01-01

Clinical growth is an essential component of nursing education, although challenging to evaluate. Considering the paradigm shift toward constructivism and student-centered learning, clinical growth requires an examination within contemporary practices. A concept analysis of clinical growth in nursing education produced defining attributes, antecedents, and consequences. Attributes included higher-level thinking, socialization, skill development, self-reflection, self-investment, interpersonal communication, and linking theory to practice. Identification of critical attributes allows educators to adapt to student-centered learning in the clinical environment. These findings allow educators to determine significant research questions, develop situation-specific theories, and identify strategies to enhance student learning in the clinical environment.

Teaching strategies for coping with stress--the perceptions of medical students.

PubMed

Pereira, Maria Amelia Dias; Barbosa, Maria Alves

2013-04-08

The undergraduate medical course is a period full of stressors, which may contribute to the high prevalence of mental disorders among students and a decrease in life's quality. Research shows that interventions during an undergraduate course can reduce stress levels. The aim of this paper is to evaluate the Strategies for Coping with Professional Stress class offered to medical students of the Federal University of Goiás, at Goiânia, Goiás, in Brazil. Qualitative research, developed with medical students in an elective class addressing strategies for coping with stress after a focal group (composed of nine of the 33 students taking this course) identified stress factors in the medical course and the coping strategies that these students use. Analysis of the results of the class evaluation questionnaire filled out by the students on the last day of class. Stress factors identified by students in the focus group: lack of time, excessive class content, tests, demanding too much of themselves, overload of extracurricular activities, competitiveness among students and family problems. Coping strategies mentioned in the focus group: respecting one's limits, setting priorities, avoiding comparisons, leisure activities (movies, literature, sports, meeting with friends and family). Results of the questionnaires: class content that was considered most important: quality of life, strategies for coping with stress, stress factors, assertiveness, community therapy, relaxation, cognitive restructuring, career choice, breathing, social networking, taking care of the caregiver, music therapy and narcissism. Most popular methodologies: relaxation practice, drawing words and discussion them in a group, community therapy, music therapy, simulated jury, short texts and discussion. Meaning of the class: asking questions and reinforcing already known strategies (22.6%), moment of reflection and self-assessment (19.4%), new interest and a worthwhile experience (19.4%), improvement in quality of life (16.1%), expression's opportunity (9.7%), other (6.4%). The stressors perceived by the medical students are intense and diverse, and the coping strategies used by them are wide-ranging. Most students felt that the class was a worthwhile learning experience, incorporated new practices for improving quality of life and recognized the importance of sharing and reflecting on one's stressors and life choices.

On the limits of Kagan's impulsive reflective distinction.

PubMed

Jones, B; McIntyre, L

1976-05-01

A logical analysis is made of the Matching Familiar Figures (MFF) Test on the basis of which children have been classified as "impulsive" or "reflective." The reflective strategy is implicitly preferred to the impulsive because the reflective child makes fewer errors though generally taking longer to make his first response. We show that the test allows the choice of a number of "game plans" and speed-accuracy tradeoffs which in practice may not be very different. Error rates may not indicate perceptual sensitivity, in any case, since sensitivity and response factors may be confounded in the error rate. Using a visual running-memory-span task to avoid the inherent difficulties of the MFF test, we found that children previously classified on the basis of that test as impulsive or reflective did not differ in recognition accuracy but did differ in response bias and response latency. Accuracy and bias are estimated by way of Luce's choice theory (Luce, 1963), and the results are discussed in those terms.

Supporting new graduate professional development: a clinical learning framework.

PubMed

Fitzgerald, Cate; Moores, Alis; Coleman, Allison; Fleming, Jennifer

2015-02-01

New graduate occupational therapists are required to competently deliver health-care practices within complex care environments. An occupational therapy clinical education programme within a large public sector health service sought to investigate methods to support new graduates in their clinical learning and professional development. Three cycles of an insider action research approach each using the steps of planning, action, critical observation and reflection were undertaken to investigate new graduate learning strategies, develop a learning framework and pilot its utility. Qualitative research methods were used to analyse data gathered during the action research cycles. Action research identified variations in current practices to support new graduate learning and to the development of the Occupational Therapy Clinical Learning Framework (OTCLF). Investigation into the utility of the OTCLF revealed two themes associated with its implementation namely (i) contribution to learning goal development and (ii) compatibility with existing learning supports. The action research cycles aimed to review current practices to support new graduate learning. The learning framework developed encourages reflection to identify learning needs and the review, discussion of, and engagement in, goal setting and learning strategies. Preliminary evidence indicates that the OTCLF has potential as an approach to guide new graduate goal development supported by supervision. Future opportunity to implement a similar learning framework in other allied health professions was identified, enabling a continuation of the cyclical nature of enquiry, integral to this research approach within the workplace. © 2014 Occupational Therapy Australia.

Self-Tracking: Reflections from the BodyTrack Project.

PubMed

Wright, Anne

2016-07-06

Based on the author's experiences the practice of self-tracking can empower individuals to explore and address issues in their lives. This work is inspired by examples of people who have reclaimed their wellness through an iterative process of noticing patterns of ups and downs, trying out new ideas and strategies, and observing the results. In some cases, individuals have realized that certain foods, environmental exposures, or practices have unexpected effects for them, and that adopting custom strategies can greatly improve quality of life, overcoming chronic problems. Importantly, adopting the role of investigator of their own situation appears to be transformative: people who embarked on this path changed their relationship to their health situation even before making discoveries that helped lead to symptom improvement. The author co-founded the BodyTrack project in 2010 with the goal of empowering a broader set of people to embrace this investigator role in their own lives and better address their health and wellness concerns, particularly those with complex environmental or behavioral components. The core of the BodyTrack system is an open source web service called Fluxtream ( https://fluxtream.org ) that allows users to aggregate, visualize, and reflect on data from myriad sources on a common timeline. The project is also working to develop and spread peer coaching practices to help transfer the culture and skills of self-tracking while mentoring individuals in how to self-assess their own situation and guide the process for themselves.

Managing clinical education through understanding key principles.

PubMed

Cunningham, Joanne; Wright, Caroline; Baird, Marilyn

2015-01-01

Traditionally, a practicum facilitated the integration of on-campus learning and practical workplace training. Over the past 3 decades, an educative practicum has evolved that promotes clinical reasoning, including analytical and evaluative abilities, through reflective practice. Anecdotal evidence indicates that the delivery of clinical education within medical radiation science entry-level programs continues to vacillate between traditional practicums and the new reflective practicums. To review the literature about clinical education within the medical radiation sciences and identify key principles for practitioners seeking to reflect upon and improve their approach to teaching and supporting students in the clinical environment. A search of 3 major journal databases, Internet searches, and hand searches of reference lists were conducted to identify literature about clinical education in the medical radiation sciences from January 1, 2000, to December 31, 2012. Twenty-two studies were included in this review. The 5 key elements associated with clinical education include the clinical support model and quality, overcoming the theory-practice gap, learning outcomes and reliable and valid assessment, preparing and supporting students, and accommodating differing teaching and learning needs. Many factors influence the quality of clinical education, including the culture of the clinical environment and clinical leadership roles. Several approaches can help students bridge the theory-practice gap, including simulators, role-playing activities, and reflective journals. In addition, clinical educators should use assessment strategies that objectively measure student progress, and they should be positive role models for their students. The successful clinical education of students in the medical radiation sciences depends upon the systems, structures, and people in the clinical environment. Clinical education is accomplished through the collaborative efforts of the clinical practitioner, the academic, and the student. Universities should include introductory material on clinical learning and teaching in their radiologic science curriculum.

Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations.

PubMed

Polaschek, Linda; Polaschek, Nick

2007-07-01

This paper is a report of a study to explore well child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. Well child nurses (health visitors) in some services provide a separate telephone consultation service for parents who need immediate advice or are unable to visit the clinic. As well as purely physical issues suggesting infant pathology, these consultations address a range of other concerns relating to parenting and child behaviour. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of well child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognize the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of well child telenurses. Solution-focused conversation is a suitable approach for the single, relatively short, interactions involved in telephone nursing. Other communication strategies could be appropriate for nurses in different clinical situations.

What roles do middle managers play in implementation of innovative practices?

PubMed Central

Engle, Ryann L.; Lopez, Emily R.; Gormley, Katelyn E.; Chan, Jeffrey A.; Charns, Martin P.; Lukas, Carol VanDeusen

2017-01-01

Background: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. Purpose: The aim of this study was to expand the understanding of middle managers’ influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. Methodology/Approach: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices. We analyzed 98 interviews with staff ranging from senior leaders to frontline staff to identify themes within an a priori framework reflecting middle manager activities. Findings: Analyses yielded 14 emergent themes that allowed us to classify specific expressions of middle manager commitment to implementation of innovative practices (e.g., facilitate improvement innovation, garner staff buy-in). In comparing middle manager behaviors in high and low change potential sites, we found that most emergent themes were present in both groups. However, the activities and interactions described differed between the groups. Practice Implications: Middle managers can use the promising strategies identified by our analyses to guide and improve their effectiveness in implementing new practices. These strategies can also inform senior leaders striving to guide middle managers in those efforts. PMID:26488239

Being reasonable: supporting disabled nursing students in practice.

PubMed

Tee, Steve R; Owens, Kathy; Plowright, Sharon; Ramnath, Paro; Rourke, Sue; James, Claire; Bayliss, Jane

2010-07-01

To analyse recurring adjustments made in practice settings and the support strategies put in place to enable disabled students to achieve the levels of proficiency required on pre-registration nursing programmes. Legislative and regulatory changes in the UK require higher education institutions to make reasonable adjustments for disabled students whose needs must be considered and adjustments made before their programmes of study begin. The student practice learning advisor's (SPLA) primary role is to support disabled students and to operationalise recommended adjustments in practice. An evaluative case study design was employed to analyse the work of the SPLA over 12 months using progression data, individual interviews and reflective accounts. The evaluation illustrates the need for support throughout the student's programme which appears to reach a peak in the final year. Disabled students required 20% more contact time than their non-disabled peers. Operationalising adjustments requires attention to inter-disciplinary, practical and communication considerations. Implementing adjustments in practice requires a multi-disciplinary approach in order to support disabled students, and their mentors and to enable the development and application of coping strategies to overcome potential restrictions. The SPLA provides an essential role in ensuring opportunities for the disabled student to succeed are maximised. Copyright 2009 Elsevier Ltd. All rights reserved.

Online interviewing with interpreters in humanitarian contexts

PubMed Central

Chiumento, Anna; Rahman, Atif; Frith, Lucy

2018-01-01

ABSTRACT Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. Results: A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Conclusions: Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing. PMID:29532739

Online interviewing with interpreters in humanitarian contexts.

PubMed

Chiumento, Anna; Machin, Laura; Rahman, Atif; Frith, Lucy

2018-12-01

Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing.

It pays to compare: an experimental study on computational estimation.

PubMed

Star, Jon R; Rittle-Johnson, Bethany

2009-04-01

Comparing and contrasting examples is a core cognitive process that supports learning in children and adults across a variety of topics. In this experimental study, we evaluated the benefits of supporting comparison in a classroom context for children learning about computational estimation. Fifth- and sixth-grade students (N=157) learned about estimation either by comparing alternative solution strategies or by reflecting on the strategies one at a time. At posttest and retention test, students who compared were more flexible problem solvers on a variety of measures. Comparison also supported greater conceptual knowledge, but only for students who already knew some estimation strategies. These findings indicate that comparison is an effective learning and instructional practice in a domain with multiple acceptable answers.

Twenty-five years of breast-feeding research in Midwifery.

PubMed

Dykes, Fiona

2011-02-01

This paper explores some of the significant changes that have taken place with regard to the protection, promotion and support of breast feeding during the past three decades. The period covered since the first issue of Midwifery in 1985, has been marked by some dramatic reversals of harmful discourses and detrimental practices with regard to infant and young child feeding and more specifically breast feeding. Midwifery has spanned this period with the publication of 80 papers on breast feeding. This collection of papers has both influenced and reflected upon changes in international and national breast-feeding strategies and practices. Six papers have been selected for a special virtual edition of Midwifery to reflect the diversity of breast-feeding research in terms of issues explored, methodology and country of origin (www.midwiferyjournal.com). Considerable progress is reflected in these papers. However, there are still enormous challenges ahead in working towards the optimisation of infant and young child feeding. In addition to continuing to conduct and collate robust scientific and epidemiological research we need further studies that explore the political, economic, socio-cultural and psychological factors influencing women's infant feeding practices. Our professional practice needs to continue to improve in order to provide women and families with appropriate support, encouragement and resources to enable them to breastfeed effectively. Finally, we need to continue to challenge the systems and approaches at organisational and community levels that impede women in their endeavours to feed their infants in optimum ways. Copyright © 2010 Elsevier Ltd. All rights reserved.

I See, I Think I Wonder: An Evaluation of Journaling as a Critical Reflective Practice Tool for Aiding Teachers in Challenging or Confronting Contexts

ERIC Educational Resources Information Center

Lowe, Geoffrey M.; Prout, Peter; Murcia, Karen

2013-01-01

In October 2011, five selected Western Australian teachers took part in a teacher mentoring project in Tanzania. The teachers spent a month embedded in local primary and secondary schools, working collaboratively with their Tanzanian counterparts. As a strategy for making sense of their experiences, each teacher was asked to maintain a reflective…

Developing biology teachers' pedagogical content knowledge through learning study: the case of teaching human evolution

NASA Astrophysics Data System (ADS)

Bravo, Paulina; Cofré, Hernán

2016-11-01

This work explores how pedagogical content knowledge (PCK) on evolution was modified by two biology teachers who participated in a professional development programme (PDP) that included a subsequent follow-up in the classroom. The PDP spanned a semester and included activities such as content updates, collaborative lesson planning, and the presentation of planned lessons. In the follow-up part, the lessons were videotaped and analysed, identifying strategies, activities, and conditions based on student learning about the theory of evolution. Data were collected in the first round with an interview before the training process, identifying these teachers' initial content representation (CoRe) for evolution. Then, a group interview was conducted after the lessons, and, finally, an interview of stimulated recall with each teacher was conducted regarding the subject taught to allow teachers to reflect on their practice (final CoRe). This information was analysed by the teachers and the researchers, reflecting on the components of the PCK, possible changes, and the rationale behind their actions. The results show that teachers changed their beliefs and knowledge about the best methods and strategies to teach evolution, and about students' learning obstacles and misconceptions on evolution. They realised how a review of their own practices promotes this transformation.

Meeting report: ‘How do I incorporate research into my family practice?’: Reflections on experiences of and solutions for young family doctors

PubMed Central

2018-01-01

Background Family doctors (FDs) focus on biopsychosocial components of health during consultations. However, much of the evidence employed by these doctors is produced by researchers who are not routinely involved in family practice. Family doctors competent in both clinical practice and research are essential to addressing this gap. With the growing recognition of family medicine as the specialty of choice for many young doctors, there is a scarcity of literature that describes their experiences in combining research and daily family practice. Aim Members from Young Doctor Movements (YDMs) under the auspices of the World Organisation of Family Doctors (WONCA) sought to address this knowledge gap by reflecting on their experiences towards becoming researchers. With the assistance of senior doctors, they explored solutions that can help young FDs incorporate research into their family practice. Methods Following an online YDM meeting, a summary of the experiences of young FDs as well as strategies useful for incorporating research into their everyday practice as FDs was prepared. Result Nine thematic areas were derived, including experiences and motivation towards regular research, culture and environment of practice, relevance and gains of research, teamwork and mentorship. Conclusion Family practices can incorporate research by promoting a personal and organisational research culture, highlighting gains and relevance of making it part of the profession and fostering teamwork, supportive networks and mentorship while making it enjoyable. PMID:29781695

Virtual Knowledge Brokering: Describing the Roles and Strategies Used by Knowledge Brokers in a Pediatric Physiotherapy Virtual Community of Practice.

PubMed

Hurtubise, Karen; Rivard, Lisa; Héguy, Léa; Berbari, Jade; Camden, Chantal

2016-01-01

Knowledge transfer in pediatric rehabilitation is challenging and requires active, multifaceted strategies. The use of knowledge brokers (KBs) is one such strategy noted to promote clinician behavior change. The success of using KBs to transfer knowledge relies on their ability to adapt to ever-changing clinical contexts. In addition, with the rapid growth of online platforms as knowledge transfer forums, KBs must become effective in virtual environments. Although the role of KBs has been studied in various clinical contexts, their emerging role in specific online environments designed to support evidence-based behavior change has not yet been described. Our objective is to describe the roles of, and strategies used by, four KBs involved in a virtual community of practice to guide and inform future online KB interventions. A descriptive design guided this study and a thematic content analysis process was used to analyze online KB postings. The Promoting Action on Research in Health Sciences knowledge transfer framework and online andragogical learning theories assisted in the coding. A thematic map was created illustrating the links between KBs' strategies and emerging roles in the virtual environment. We analyzed 95 posts and identified three roles: 1) context architect: promoting a respectful learning environment, 2) knowledge sharing promoter: building capacity, and 3) linkage creator: connecting research-to-practice. Strategies used by KBs reflected invitational, constructivism, and connectivism approaches, with roles and strategies changing over time. This study increases our understanding of the actions of KBs in virtual contexts to foster uptake of research evidence in pediatric physiotherapy. Our results provide valuable information about the knowledge and skills required by individuals to fulfill this role in virtual environments.

Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study.

PubMed

Waltz, Thomas J; Powell, Byron J; Matthieu, Monica M; Damschroder, Laura J; Chinman, Matthew J; Smith, Jeffrey L; Proctor, Enola K; Kirchner, JoAnn E

2015-08-07

Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase. Purposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy's relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible. This study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting.

Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives.

PubMed

Naccarella, Lucio; Biuso, Catuscia; Jennings, Amanda; Patsamanis, Harry

2018-05-29

Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, <30% of people participate in a program. Significant patient, hospital and health system challenges exist to improve recovery through increased heart health literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels. What is known about the topic? Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals. What does this paper add? This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. What are the implications for practitioners? Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and their carers, as well as support from hospital management.

Fixing our focus: Training attention to regulate emotion

PubMed Central

Wadlinger, Heather A.; Isaacowitz, Derek M.

2010-01-01

Empirical studies have frequently linked negative attentional biases with attentional dysfunction and negative moods; however, far less research has focused on how attentional deployment can be an adaptive strategy that regulates emotional experience. We argue that attention may be an invaluable tool for promoting emotion regulation. Accordingly, we present evidence that selective attention to positive information reflects emotion regulation, and that regulating attention is a critical component of the emotion regulatory process. Furthermore, attentional regulation can be successfully trained through repeated practice. We ultimately propose a model of attention training methodologies integrating attention-dependent emotion regulation strategies with attention networks. While additional interdisciplinary research is needed to bolster these nascent findings, meditative practices appear to be among the most effective training methodologies in enhancing emotional well-being. Further exploration of the positive and therapeutic qualities of attention warrants the empirical attention of social and personality psychologists. PMID:20435804

Nursing students' perceptions of learning after high fidelity simulation: Effects of a Three-step Post-simulation Reflection Model.

PubMed

Lestander, Örjan; Lehto, Niklas; Engström, Åsa

2016-05-01

High-fidelity simulation (HFS) has become a bridge between theoretical knowledge and practical skills. A safe and realistic environment is commonly used in nursing education to improve cognitive, affective and psychomotor abilities. Debriefing following a simulation experience provides opportunities for students to analyze and begin to reflect upon their decisions, actions and results. The nursing literature highlights the need to promote the concept of reflective practice and to assist students in reflection, and research indicates the need to refine and develop debriefing strategies, which is the focus of the current paper. To explore the value of reflections after HFS by investigating nursing students' perceptions of their learning when a Three-step Post-simulation Reflection Model is used. A qualitative descriptive research approach was applied. A Three-step Post-simulation Reflection Model that combined written and verbal reflections was used after an HFS experience in a second-year course in the Bachelor Program in Nursing at Luleå University of Technology, Sweden. Reflective texts written before and after a verbal group reflection were subjected to qualitative content analysis. The main theme in the first written reflections was identified as "Starting to act as a nurse", with the following categories: feeling stressed, inadequate and inexperienced; developing an awareness of the importance of never compromising patient safety; planning the work and prioritizing; and beginning to understand and implement nursing knowledge. The main theme in the second written reflections was identified to be "Maturing in the profession", with the following categories: appreciating colleagues, good communication and thoughtfulness; gaining increased self-awareness and confidence; and beginning to understand the profession. The Three-step Post-simulation Reflection Model fostered an appreciation of clear and effective communication. Having time for thoughtfulness and reflection promotes self-awareness and a better understanding of both the nursing profession and patient safety. The progress demonstrated in the depth of the themes in the written reflections indicates that repeated reflections stimulate and enhance student learning. The findings point towards the potential effectiveness of alternate methods of reflections. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reflecting Reflective Practice

ERIC Educational Resources Information Center

Galea, Simone

2012-01-01

This paper demystifies reflective practice on teaching by focusing on the idea of reflection itself and how it has been conceived by two philosophers, Plato and Irigaray. It argues that reflective practice has become a standardized method of defining the teacher in teacher education and teacher accreditation systems. It explores how practices of…

Principles underlying rational design of live attenuated influenza vaccines

PubMed Central

Jang, Yo Han

2012-01-01

Despite recent innovative advances in molecular virology and the developments of vaccines, influenza virus remains a serious burden for human health. Vaccination has been considered a primary countermeasure for prevention of influenza infection. Live attenuated influenza vaccines (LAIVs) are particularly attracting attention as an effective strategy due to several advantages over inactivated vaccines. Cold-adaptation, as a classical means for attenuating viral virulence, has been successfully used for generating safe and effective donor strains of LAIVs against seasonal epidemics and occasional pandemics. Recently, the advent of reverse genetics technique expedited a variety of rational strategies to broaden the pool of LAIVs. Considering the breadth of antigenic diversity of influenza virus, the pool of LAIVs is likely to equip us with better options for controlling influenza pandemics. With a brief reflection on classical attenuating strategies used at the initial stage of development of LAIVs, especially on the principles underlying the development of cold-adapted LAIVs, we further discuss and outline other attenuation strategies especially with respect to the rationales for attenuation, and their practicality for mass production. Finally, we propose important considerations for a rational vaccine design, which will provide us with practical guidelines for improving the safety and effectiveness of LAIVs. PMID:23596576

Journey to the Patient-Centered Medical Home: A Qualitative Analysis of the Experiences of Practices in the National Demonstration Project

PubMed Central

Nutting, Paul A.; Crabtree, Benjamin F.; Miller, William L.; Stewart, Elizabeth E.; Stange, Kurt C.; Jaén, Carlos Roberto

2010-01-01

PURPOSE We describe the experience of practices in transitioning toward patient-centered medical homes (PCMHs) in the National Demonstration Project (NDP). METHODS The NDP was launched in June 2006 as the first national test of a model of the PCMH in a diverse sample of 36 family practices, randomized to facilitated and self-directed intervention groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical records, and patient and practice surveys. The evaluation team reviewed data from all practices as they became available and produced interim summaries. Four 2- to 3-day evaluation team retreats were held during which case summaries of all practices were discussed and patterns were described. RESULTS The 6 themes that emerged from the data reflect major shifts in individual and practice roles and identities, as well as changes in practices’ management strategies. The themes are (1) practice adaptive reserve is critical to managing change, (2) developmental pathways to success vary considerably by practice, (3) motivation of key practice members is critical, (4) the larger system can help or hinder, (5) practice transformation is more than a series of changes and requires shifts in roles and mental models, and (6) practice change is enabled by the multiple roles that facilitators play. CONCLUSIONS Transformation to a PCMH requires more than a sequence of discrete changes. The practice transformation process may be fostered by promoting adaptive reserve and local control of the developmental pathway. PMID:20530394

Dual practice in the health sector: review of the evidence

PubMed Central

Ferrinho, Paulo; Van Lerberghe, Wim; Fronteira, Inês; Hipólito, Fátima; Biscaia, André

2004-01-01

This paper reports on income generation practices among civil servants in the health sector, with a particular emphasis on dual practice. It first approaches the subject of public–private overlap. Thereafter it focuses on coping strategies in general and then on dual practice in particular. To compensate for unrealistically low salaries, health workers rely on individual coping strategies. Many clinicians combine salaried, public-sector clinical work with a fee-for-service private clientele. This dual practice is often a means by which health workers try to meet their survival needs, reflecting the inability of health ministries to ensure adequate salaries and working conditions. Dual practice may be considered present in most countries, if not all. Nevertheless, there is surprisingly little hard evidence about the extent to which health workers resort to dual practice, about the balance of economic and other motives for doing so, or about the consequences for the proper use of the scarce public resources dedicated to health. In this paper dual practice is approached from six different perspectives: (1) conceptual, regarding what is meant by dual practice; (2) descriptive, trying to develop a typology of dual practices; (3) quantitative, trying to determine its prevalence; (4) impact on personal income, the health care system and health status; (5) qualitative, looking at the reasons why practitioners so frequently remain in public practice while also working in the private sector and at contextual, personal life, institutional and professional factors that make it easier or more difficult to have dual practices; and (6) possible interventions to deal with dual practice. PMID:15509305

"Unscrambling what's in your head": A mixed method evaluation of clinical supervision for midwives.

PubMed

Love, Bev; Sidebotham, Mary; Fenwick, Jennifer; Harvey, Susan; Fairbrother, Greg

2017-08-01

As a strategy to promote workforce sustainability a number of midwives working in one health district in New South Wales, Australia were trained to offer a reflective model of clinical supervision. The expectation was that these midwives would then be equipped to facilitate clinical supervision for their colleagues with the organisational aim of supporting professional development and promoting emotional well-being. To identify understanding, uptake, perceptions of impact, and the experiences of midwives accessing clinical supervision. Mixed Methods. In phase one 225 midwives were invited to complete a self-administered survey. Descriptive and inferential statistics were used to analyse the data. In phase two 12 midwives were interviewed. Thematic analysis was used to deepen understanding of midwives' experiences of receiving clinical supervision. Sixty percent of midwives responding in phase one had some experience of clinical supervision. Findings from both phases were complementary with midwives reporting a positive impact on their work, interpersonal skills, situational responses and career goals. Midwives described clinical supervision as a formal, structured and confidential space for 'safe reflection' that was valued as an opportunity for self-care. Barriers included misconceptions, perceived work related pressures and a sense that taking time out was unjustifiable. Education, awareness raising and further research into reflective clinical supervision, to support emotional well-being and professional midwifery practice is needed. In addition, health organisations need to design, implement and evaluate strategies that support the embedding of clinical supervision within midwives' clinical practice. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

EUVL Mask Blank Repair

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barty, A; Mirkarimi, P; Stearns, D G

2002-05-22

EUV mask blanks are fabricated by depositing a reflective Mo/Si multilayer film onto super-polished substrates. Small defects in this thin film coating can significantly alter the reflected field and introduce defects in the printed image. Ideally one would want to produce defect-free mask blanks; however, this may be very difficult to achieve in practice. One practical way to increase the yield of mask blanks is to effectively repair multilayer defects, and to this effect they present two complementary defect repair strategies for use on multilayer-coated EUVL mask blanks. A defect is any area on the mask which causes unwanted variationsmore » in EUV dose in the aerial image obtained in a printing tool, and defect repair is correspondingly defined as any strategy that renders a defect unprintable during exposure. The term defect mitigation can be adopted to describe any strategy which renders a critical defect non-critical when printed, and in this regard a non-critical defect is one that does not adversely affect device function. Defects in the patterned absorber layer consist of regions where metal, typically chrome, is unintentionally added or removed from the pattern leading to errors in the reflected field. There currently exists a mature technology based on ion beam milling and ion beam assisted deposition for repairing defects in the absorber layer of transmission lithography masks, and it is reasonable to expect that this technology will be extended to the repair of absorber defects in EUVL masks. However, techniques designed for the repair of absorber layers can not be directly applied to the repair of defects in the mask blank, and in particular the multilayer film. In this paper they present for the first time a new technique for the repair of amplitude defects as well as recent results on the repair of phase defects.« less

Rehabilitation goal setting with community dwelling adults with acquired brain injury: a theoretical framework derived from clinicians' reflections on practice.

PubMed

Prescott, Sarah; Fleming, Jennifer; Doig, Emmah

2017-06-11

The aim of this study was to explore clinicians' experiences of implementing goal setting with community dwelling clients with acquired brain injury, to develop a goal setting practice framework. Grounded theory methodology was employed. Clinicians, representing six disciplines across seven services, were recruited and interviewed until theoretical saturation was achieved. A total of 22 clinicians were interviewed. A theoretical framework was developed to explain how clinicians support clients to actively engage in goal setting in routine practice. The framework incorporates three phases: a needs identification phase, a goal operationalisation phase, and an intervention phase. Contextual factors, including personal and environmental influences, also affect how clinicians and clients engage in this process. Clinicians use additional strategies to support clients with impaired self-awareness. These include structured communication and metacognitive strategies to operationalise goals. For clients with emotional distress, clinicians provide additional time and intervention directed at new identity development. The goal setting practice framework may guide clinician's understanding of how to engage in client-centred goal setting in brain injury rehabilitation. There is a predilection towards a client-centred goal setting approach in the community setting, however, contextual factors can inhibit implementation of this approach. Implications for Rehabilitation The theoretical framework describes processes used to develop achievable client-centred goals with people with brain injury. Building rapport is a core strategy to engage clients with brain injury in goal setting. Clients with self-awareness impairment benefit from additional metacognitive strategies to participate in goal setting. Clients with emotional distress may need additional time for new identity development.

Developing mathematical practices through reflection cycles

NASA Astrophysics Data System (ADS)

Reinholz, Daniel L.

2016-09-01

This paper focuses on reflection in learning mathematical practices. While there is a long history of research on reflection in mathematics, it has focused primarily on the development of conceptual understanding. Building on notion of learning as participation in social practices, this paper broadens the theory of reflection in mathematics learning. To do so, it introduces the concept of reflection cycles. Each cycle begins with prospective reflection, which guides one's actions during an experience, and ends with retrospective reflection, which consolidates the experience and informs the next reflection cycle. Using reflection cycles as an organizing framework, this paper synthesizes the literature on reflective practices at a variety of levels: (1) metacognition, (2) self-assessment, (3) noticing, and (4) lifelong learning. These practices represent a spectrum of reflection, ranging from the micro level (1) to macro level (4).

Professional Learning in Human Resource Management: Problematising the Teaching of Reflective Practice

ERIC Educational Resources Information Center

Griggs, V.; Holden, R.; Rae, J.; Lawless, A.

2015-01-01

Reflection and reflective practice are much discussed aspects of professional education. This paper conveys our efforts to problematise teaching reflective practice in human resources (HR) education. The research, on which the paper is based, engages with stakeholders involved in the professional learning and education of reflective practice in…

How do medical specialists value their own intercultural communication behaviour? A reflective practice study.

PubMed

Paternotte, E; Scheele, F; van Rossum, T R; Seeleman, M C; Scherpbier, A J J A; van Dulmen, A M

2016-08-24

Intercultural communication behaviour of doctors with patients requires specific intercultural communication skills, which do not seem structurally implemented in medical education. It is unclear what motivates doctors to apply intercultural communication skills. We investigated how purposefully medical specialists think they practise intercultural communication and how they reflect on their own communication behaviour. Using reflective practice, 17 medical specialists independently watched two fragments of videotapes of their own outpatient consultations: one with a native patient and one with a non-native patient. They were asked to reflect on their own communication and on challenges they experience in intercultural communication. The interviews were open coded and analysed using thematic network analysis. The participants experienced only little differences in their communication with native and non-native patients. They mainly mentioned generic communication skills, such as listening and checking if the patient understood. Many participants experienced their communication with non-native patients positively. The participants mentioned critical incidences of intercultural communication: language barriers, cultural differences, the presence of an interpreter, the role of the family and the atmosphere. Despite extensive experience in intercultural communication, the participants of this study noticed hardly any differences between their own communication behaviour with native and non-native patients. This could mean that they are unaware that consultations with non-native patients might cause them to communicate differently than with native patients. The reason for this could be that medical specialists lack the skills to reflect on the process of the communication. The participants focused on their generic communication skills rather than on specific intercultural communication skills, which could either indicate their lack of awareness, or demonstrate that practicing generic communication is more important than applying specific intercultural communication. They mentioned well-known critical incidences of ICC: language barriers, cultural differences, the presence of an interpreter, the role of the family and the atmosphere. Nevertheless, they showed a remarkably enthusiastic attitude overall was noteworthy. A strategy to make doctors more aware of their intercultural communication behaviour could be a combination of experiential learning and ICC training, for example a module with reflective practice.

Feedback in action within bedside teaching encounters: a video ethnographic study.

PubMed

Rizan, Chantelle; Elsey, Christopher; Lemon, Thomas; Grant, Andrew; Monrouxe, Lynn V

2014-09-01

Feedback associated with teaching activities is often synonymous with reflection on action, which comprises the evaluative assessment of performance out of its original context. Feedback in action (as correction during clinical encounters) is an underexplored, complementary resource facilitating students' understanding and learning. The purpose of this study was to explore the interactional patterns and correction modalities utilised in feedback sequences between doctors and students within general practice-based bedside teaching encounters (BTEs). A qualitative video ethnographic approach was used. Participants were recorded in their natural settings to allow interactional practices to be contextually explored. We examined 12 BTEs recorded across four general practices and involving 12 patients, four general practitioners and four medical students (209 minutes and 20 seconds of data) taken from a larger corpus. Data analysis was facilitated by Transana video analysis software and informed by previous conversation analysis research in ordinary conversation, classrooms and health care settings. A range of correction strategies across a spectrum of underlying explicitness were identified. Correction strategies classified at extreme poles of this scale (high or low explicitness) were believed to be less interactionally effective. For example, those using abrupt closing of topics (high explicitness) or interactional ambiguity (low explicitness) were thought to be less effective than embedded correction strategies that enabled the student to reach the correct answer with support. We believe that educators who are explicitly taught linguistic strategies for how to manage feedback in BTEs might manage learning more effectively. For example, clinicians might maximise learning moments during BTEs by avoiding abrupt or ambiguous feedback practices. Embedded correction strategies can enhance student participation by guiding students towards the correct answer. Clinician corrections can sensitively manage student face-saving by minimising the exposure of student error to patients. Furthermore, we believe that the effective practices highlighted by our analysis might facilitate successful transformation of feedback in action into feedback for action. © 2014 John Wiley & Sons Ltd.

Dynamic equilibrium strategy for drought emergency temporary water transfer and allocation management

NASA Astrophysics Data System (ADS)

Xu, Jiuping; Ma, Ning; Lv, Chengwei

2016-08-01

Efficient water transfer and allocation are critical for disaster mitigation in drought emergencies. This is especially important when the different interests of the multiple decision makers and the fluctuating water resource supply and demand simultaneously cause space and time conflicts. To achieve more effective and efficient water transfers and allocations, this paper proposes a novel optimization method with an integrated bi-level structure and a dynamic strategy, in which the bi-level structure works to deal with space dimension conflicts in drought emergencies, and the dynamic strategy is used to deal with time dimension conflicts. Combining these two optimization methods, however, makes calculation complex, so an integrated interactive fuzzy program and a PSO-POA are combined to develop a hybrid-heuristic algorithm. The successful application of the proposed model in a real world case region demonstrates its practicality and efficiency. Dynamic cooperation between multiple reservoirs under the coordination of a global regulator reflects the model's efficiency and effectiveness in drought emergency water transfer and allocation, especially in a fluctuating environment. On this basis, some corresponding management recommendations are proposed to improve practical operations.

Still Going Strong: A Tracer Study of the Community Mothers Programme, Dublin, Ireland. Early Childhood Development: Practice and Reflections. Following Footsteps.

ERIC Educational Resources Information Center

Molloy, Brenda

Home visiting is the strategy used by the Community Mothers Programme to enhance parenting skills of first-time mothers from economically disadvantaged areas in Dublin, Ireland. The home visitors are all women from the community who volunteer to visit parents in their homes once a month for 1 hour over a 12-month period. In a 1989 evaluation, 232…

Nutrition and lead: Strategies for public health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahaffey, K.R.

Over the past two decades, blood lead levels among U.S. children have been reduced by approximately 80%. This decline reflects both primary interventions (removal of lead solder form food beverage cans and virtual elimination of lead additives form gasoline) and secondary prevention strategies (public health programs and nutritional intervention). Nonetheless, pediatric lead poisoning (i.e., blood lead concentrations {ge} 10 {mu}g/dl) continues to occur in 8.9% of 1- to 5-year-old children. Currently, blood lead concentrations exceed the U.S. Centers for Disease Control`s targeted value (10 {mu}g/dl), most often among minority and low-income populations. These same subpopulations are at greatest risk ofmore » marginal nutrition status (especially for iron and calcium), which increases their susceptibility to lead toxicity. Adverse child feeding practices (e.g., irregular temporal patterns of food intake) are also of concern among the subpopulations at highest risk to excessive lead from external or environmental dose to internal dose as reflected by blood lead concentration. 60 refs.« less

How improving practice relationships among clinicians and nonclinicians can improve quality in primary care.

PubMed

Lanham, Holly J; McDaniel, Reuben R; Crabtree, Benjamin F; Miller, William L; Stange, Kurt C; Tallia, Alfred F; Nutting, Paula

2009-09-01

Understanding the role of relationships health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Data were drawn from four large National Institutes of Health (NIH)-funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties.

Clinical-academic partnerships research: converting the rhetoric into reality.

PubMed

Happell, Brenda

2005-09-01

An increasing recognition of the importance of research-based practice to the nursing profession has led to a number of strategies designed to increase the utilization and conduct of nursing research. The transfer of nursing education from hospitals to universities occurred partly in response to the identified theory-practice gap. Subsequently, a significant investment in joint clinical-academic positions and clinical professorial positions has been made with the intention of bridging the gap between the tertiary sector and the clinical field. Anecdotal evidence suggests that neither strategy has achieved the desired degree of success. The available literature suggests that nurses do not tend to become involved in the conduct of research, nor do they readily utilise research findings in their practice. It is hypothesized in this paper that this reflects the strong cultural differences between the clinical and academic worlds in nursing. The aim of this paper is to discuss the impact of these cultural differences and describe specific principals that could contribute to significant cultural change and the bridging of the academic-clinician divide.

Designing Reflective Practice in the Context of OER-Based E-Learning

ERIC Educational Resources Information Center

Karunanayaka, Shironica P.; Naidu, Som; Rajendra, J. C. N.; Ratnayake, H. U. W.

2017-01-01

Much is said about the importance of reflective practice especially in the professions. Yet much of what happens as part of reflective practice in the professions such as teaching is most of the time left to chance. Reflective practice allows practitioners to see the link between theory and practice by thoughtfully considering their own…

Teaching Reflective Practice in Practice Settings: Students' Perceptions of Their Clinical Educators

ERIC Educational Resources Information Center

Trede, Franziska; Smith, Megan

2012-01-01

Reflective practice in practice settings can enhance practice knowledge, self-assessment and lifelong learning, develop future practice capability and professional identity, and critically appraise practice traditions rather than reproduce them. The inherent power imbalance between student and educator runs the risk for the reflective practice…

Fostering nature of science teaching in elementary pre-service teachers through developing reflection on teaching and learning

NASA Astrophysics Data System (ADS)

Pongsanon, Khemmawadee

Although teacher educators have successfully helped K-12 teachers' develop adequate views of NOS, their views have not been transferred to their students. It is evident that K-12 students' understanding of NOS still does not align with the recommendation of the reforms document, indicating that holding an adequate view of NOS is insufficient for teaching NOS effectively. Instead, to teach NOS, teachers must develop the knowledge for translating their understanding of NOS into the forms accessible to students. The current study investigated the influence of four contexts of reflective practice on prospective elementary teachers' learning of how and intention to teach NOS. The participants were 18 pre-service teachers enrolled in a science methods course that was tied to a field experience course. To understand the development of the participants' intentions, knowledge of instructional strategies, and knowledge of assessment for teaching NOS, multiple data were collected throughout the science methods course and the field experience. Data sources included different versions of participants' lesson plans, video recordings of their teaching and teaching debriefings, online weekly teaching reflections, final semester reflection and other artifacts from the methods course. Content analysis was conducted with all data. The data revealed that the participants' knowledge of how and intentions to teach NOS were developed throughout the science methods course. Toward the conclusion of the semester, the participants showed intention to include NOS in their science instruction. With regard to strategies, participants planned to apply explicit reflective NOS instruction in the context of inquiry-based activities and stories from children's literature. They also planned to use age-appropriate language to refer to the targeted NOS aspects. In terms of assessment, by the conclusion of the semester the participants tended to use more formal assessment strategies. They reported reflections on experiences from modeled lessons and their own teaching as most influential on such development. Implications of the study include applying the four contexts of reflection to help future elementary teachers develop the components of PCK for teaching NOS.

Implementing evidence in an onco-haematology nursing unit: a process of change using participatory action research.

PubMed

Abad-Corpa, Eva; Delgado-Hito, Pilar; Cabrero-García, Julio; Meseguer-Liza, Cristobal; Zárate-Riscal, Carmen Lourdes; Carrillo-Alcaraz, Andrés; Martínez-Corbalán, José Tomás; Caravaca-Hernández, Amor

2013-03-01

To implement evidence in a nursing unit and to gain a better understanding of the experience of change within a participatory action research. Study design of a participatory action research type was use from the constructivist paradigm. The analytical-methodological decisions were inspired by Checkland Flexible Systems for evidence implementation in the nursing unit. The study was carried out between March and November 2007 in the isolation unit section for onco-haematological patients in a tertiary level general university hospital in Spain. Accidental sampling was carried out with the participation of six nurses. Data were collected using five group meetings and individual reflections in participants' dairies. The participant observation technique was also carried out by researchers. Data analysis was carried out by content analysis. The rigorous criteria were used: credibility, confirmability, dependence, transferability and reflexivity. A lack of use of evidence in clinical practice is the main problem. The factors involved were identified (training, values, beliefs, resources and professional autonomy). Their daily practice (complexity in taking decisions, variability, lack of professional autonomy and safety) was compared with an ideal situation (using evidence it will be possible to normalise practice and to work more effectively in teams by increasing safety and professional recognition). It was decided to create five working areas about several clinical topics (mucositis, pain, anxiety, satisfaction, nutritional assessment, nauseas and vomiting, pressure ulcers and catheter-related problems) and seven changes in clinical practice were agreed upon together with 11 implementation strategies. Some reflections were made about the features of the study: the changes produced; the strategies used and how to improve them; the nursing 'subculture'; attitudes towards innovation; and the commitment as participants in the study and as healthcare professionals. The findings throw light on the process of change in the healthcare sector. The results are useful to modify nursing practice based on evidence. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

Orientations to Reflective Practice.

ERIC Educational Resources Information Center

Wellington, Bud; Austin, Patricia

1996-01-01

Delineates five orientations to reflective practice: immediate, technical, deliberative, dialectic, and transpersonal, each reflecting different social science bases and beliefs and values about education. Views them as interactive, interdependent, noncompeting, aspects of reflective practice. (SK)

A Consensus Approach to Investigate Undergraduate Pharmacy Students’ Experience of Interprofessional Education

PubMed Central

Obara, Ilona; Paterson, Alastair; Nazar, Zachariah; Portlock, Jane; Husband, Andrew

2017-01-01

Objective. To assess the development of knowledge, attitudes, and behaviors for collaborative practice among first-year pharmacy students following completion of interprofessional education. Methods. A mixed-methods strategy was employed to detect student self-reported change in knowledge, attitudes, and behaviors. Validated survey tools were used to assess student perception and attitudes. The Nominal Group Technique (NGT) was used to capture student reflections and provide peer discussion on the individual IPE sessions. Results. The validated survey tools did not detect any change in students’ attitudes and perceptions. The NGT succeeded in providing a milieu for participating students to reflect on their IPE experiences. The peer review process allowed students to compare their initial perceptions and reactions and renew their reflections on the learning experience. Conclusion. The NGT process has provided the opportunity to assess the student experience through the reflective process that was enriched via peer discussion. Students have demonstrated more positive attitudes and behaviors toward interprofessional working through IPE. PMID:28381886

Students' Involvement in Authentic Modelling Practices as Contexts in Chemistry Education

NASA Astrophysics Data System (ADS)

Prins, Gjalt T.; Bulte, Astrid M. W.; van Driel, Jan H.; Pilot, Albert

2009-11-01

In science education students should come to understand the nature and significance of models. A promising strategy to achieve this goal is using authentic modelling practices as contexts for meaningful learning of models and modelling. An authentic practice is defined as professionals working with common motives and purposes, pertaining to a similar type of procedure and applying relevant knowledge on the modelling issue they work on. In this study we evaluate whether the use of authentic practices initiates adequate students’ involvement. This was done by investigating students’ interests, ownership, familiarity and complexity. In addition, we evaluated students’ expressed modelling procedures in response to the modelling issues. We designed learning tasks which were enacted by a focus group of students. Three primary data sources were used to collect data. Firstly, a group discussion was organised in which students’ reflected on both authentic practices. Secondly, students filled in written questionnaires containing items on affective and cognitive aspects. Thirdly, the realised modelling procedures by students were analysed. The results show that students’ involvement was successfully initiated, evidenced by motivated students, willingness to continue and the completeness and quality of the realised modelling procedures. The design of the learning tasks proved to be successful in realising this involvement. The results obtained in this study support the strategy of using authentic modelling practices as contexts for meaningful learning of models and modelling.

Image of God: effect on coping and psychospiritual outcomes in early breast cancer survivors.

PubMed

Schreiber, Judith A

2011-05-01

To examine the effect of breast cancer survivors' views of God on religious coping strategies, depression, anxiety, stress, concerns about recurrence, and psychological well-being. Exploratory, cross-sectional, comparative survey. Outpatients from community and university oncology practices in the southeastern United States. 130 early breast cancer survivors (6-30 months postdiagnosis). Self-report written survey packets were mailed to practice-identified survivors. Image of God, religious coping strategies, depression, anxiety, stress, concerns about recurrence, and psychological well-being. Women who viewed God as highly engaged used more coping strategies to promote spiritual conservation in proportion to coping strategies that reflect spiritual struggle. Women who viewed God as highly engaged maintained psychological well-being when either spiritual conservation or spiritual struggle coping styles were used. No differences in variables were noted for women who viewed God as more or less angry. The belief in an engaged God is significantly related to increased psychological well-being, decreased psychological distress, and decreased concern about recurrence. Addressing survivors' issues related to psychological adjustment and concern about recurrence within their world view would allow for more personalized and effective interventions. Future research should be conducted to establish how the view that God is engaged affects coping and psychological adjustment across diverse groups of cancer survivors and groups with monotheistic, polytheistic, and naturalistic world views. This could lead to a practical method for examining the influence of these world views on individuals' responses to cancer diagnosis, treatment, and survivorship.

Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses.

PubMed

Lam, Stanley Kk; Kwong, Enid Wy; Hung, Maria Sy; Pang, Samantha Mc

2016-10-01

To explore the difficulties and strategies regarding guideline implementation among emergency nurses. Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps. A qualitative descriptive design was used. Semi-structured, face-to-face, individual interviews were conducted between November 2013-May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach. Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established. The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines. It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important component for effective guideline implementation. © 2016 John Wiley & Sons Ltd.

Reflective practice and its implications for pharmacy education.

PubMed

Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-02-12

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

Reflective Practice and Its Implications for Pharmacy Education

PubMed Central

Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-01-01

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286

A qualitative exploration of the factors underlying seniors' receptiveness to entomophagy.

PubMed

Myers, Gael; Pettigrew, Simone

2018-01-01

Entomophagy presents a novel approach to securing a nutritive and environmentally sustainable food source to meet the needs of a growing and ageing population. To date, research exploring the receptiveness of Western consumers towards entomophagy has focused on younger age groups and there has been little examination of the views of older adults. The aims of this study were to (i) explore the factors associated with older people's attitudes towards entomophagy and (ii) identify strategies to encourage seniors to adopt the practice. Interviews were conducted with 77 Western Australian seniors aged 60years and over. The average age of the interviewees was 73years and most were female (n=67). Reflecting the lack of promotion of entomophagy as a desirable eating behaviour, there were very low levels of awareness of the environmental and nutritional advantages of this practice. Most of the interviewed seniors saw entomophagy as a disgusting practice that was incompatible with their cultural beliefs and values, however a small group viewed it as a novel and potentially enjoyable experience. The findings suggest that strategies to target the former group could focus on overcoming the disgust reaction, such as by disguising insects in food and providing guarantees of food safety. Consumption in the latter group could be facilitated by improving knowledge and skills relating to the preparation of insect-based foods. Strategies to increase entomophagy in the Western world need to consider the unique views of different consumer groups towards the practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Minimization of power consumption during charging of superconducting accelerating cavities

NASA Astrophysics Data System (ADS)

Bhattacharyya, Anirban Krishna; Ziemann, Volker; Ruber, Roger; Goryashko, Vitaliy

2015-11-01

The radio frequency cavities, used to accelerate charged particle beams, need to be charged to their nominal voltage after which the beam can be injected into them. The standard procedure for such cavity filling is to use a step charging profile. However, during initial stages of such a filling process a substantial amount of the total energy is wasted in reflection for superconducting cavities because of their extremely narrow bandwidth. The paper presents a novel strategy to charge cavities, which reduces total energy reflection. We use variational calculus to obtain analytical expression for the optimal charging profile. Energies, reflected and required, and generator peak power are also compared between the charging schemes and practical aspects (saturation, efficiency and gain characteristics) of power sources (tetrodes, IOTs and solid state power amplifiers) are also considered and analysed. The paper presents a methodology to successfully identify the optimal charging scheme for different power sources to minimize total energy requirement.

Knowledge, attitudes and practices of food handlers in food safety: An integrative review.

PubMed

Zanin, Laís Mariano; da Cunha, Diogo Thimoteo; de Rosso, Veridiana Vera; Capriles, Vanessa Dias; Stedefeldt, Elke

2017-10-01

This study presents an overview of the relationship between knowledge, attitudes and practices (KAP) of food handlers with training in food safety, in addition to proposing reflections on the training of food handlers, considering its responsibility for food safety and health of consumers. The review was based on the integrative method. The descriptors used were: (food handler), (knowledge, attitudes and practice) and (training). Six databases were searched, 253 articles were consulted and 36 original articles were included. Fifty per cent of the articles pointed that there was no proper translation of knowledge into attitudes/practices or attitudes into practices after training. Knowledge, attitudes and practices of food handlers are important for identifying how efficient training in food safety is allowing prioritize actions in planning training. The evaluation of KAP is the first step to understand the food handler's point of view. After this evaluation other diagnostic strategies become necessary to enhance this understanding. Copyright © 2017. Published by Elsevier Ltd.

Thinking strategies of baccalaureate nursing students prompted by self-regulated learning strategies.

PubMed

Kuiper, RuthAnne; Murdock, Nancy; Grant, Nancy

2010-08-01

The standard in nursing education today is to prepare nurses for future practice through generic programs with a culminating practicum experience. The clinical faculty in this program was interested in evaluating differences in student thinking strategies that occurred as a result of an increase from 60 to 120 clinical hours, coupled with reflective journaling. The Self-Regulated Learning model was used as a conceptual support for the journaling prompts, as well as a structure for narrative analysis. the 120-hour practicum group revealed a greater use of metacognitive self-evaluation strategies versus greater use of behavioral self-monitoring strategies by the 60-hour practicum group. This finding suggests that although self-observation and self-monitoring are important and desired thinking habits to develop in nursing students, an increase to 120 hours is beneficial. It promotes a greater use of self-evaluation of thinking and greater levels of self-efficacy in making decisions to solve clinical problems.

Illuminating exemplary professionalism using appreciative inquiry dialogues between students and mentors.

PubMed

Butani, Lavjay; Bogetz, Alyssa; Plant, Jennifer

2018-05-25

To explore the types of exemplary professional behaviors and the facilitators and barriers to professional behavior discussed by student-mentor dyads during appreciative inquiry (AI) dialogs. We conducted a qualitative analysis of AI narratives discussing exemplary professional practice written by third-year medical students following a dialog with mentors. Narratives were thematically analyzed using directed content analysis to explore the types of exemplary professional behaviors discussed and the facilitators and barriers to professional practice. Narratives were coded independently by two investigators; codes were finalized, themes were derived, and a model on how exemplary professional behaviors are nurtured and reinforced was developed. Themes addressed humanism toward others and excellence, with altruism being an underlying implicit guiding principle behind professional behavior. Humanism toward self was infrequently discussed as an aspect of professionalism, but when discussed, was perceived to foster resilience. Principle-based attitudes and emotional intelligence facilitated professional behaviors. Programmatic scaffolds facilitated professional behavior and included curricula on reflective practice, mentorship, promoting learner autonomy and connectedness, and a safe environment. AI is an effective strategy that can be used to stimulate learner reflection on professionalism, humanism, and wellness and promote learner acknowledgement of positive aspects of the learning environment.

Making the Most of Five Minutes: The Clinical Teaching Moment.

PubMed

Smith, Jo R; Lane, India F

2015-01-01

Clinical educators face the challenge of simultaneously caring for patients and teaching learners, often with an unpredictable caseload and learners of varied abilities. They also often have little control over the organization of their time. Effective clinical teaching must encourage student participation, problem solving, integration of basic and clinical knowledge, and deliberate practice. Close supervision and timely feedback are also essential. Just as one develops an effective lecture through training and practice, clinical teaching effectiveness may also be improved by using specific skills to teach in small increments. The purpose of this paper is to identify potential teachable moments and to describe efficient instructional methods to use in the clinical setting under time constraints. These techniques include asking better questions, performing focused observations, thinking aloud, and modeling reflection. Different frameworks for teaching encounters during case presentations can be selected according to learner ability and available time. These methods include modeling and deconstructing the concrete experience; guiding the thinking and reflecting process; and providing the setting and opportunity for active practice. Use of these educational strategies encourages the learner to acquire knowledge, clinical reasoning, and technical skills, and also values, attitudes, and professional judgment.

[The teaching of social sciences in health: between practice and theory].

PubMed

Barros, Nelson Filice de

2014-04-01

The models of teaching social sciences and clinical practice are insufficient for the needs of practical-reflective teaching of social sciences applied to health. The scope of this article is to reflect on the challenges and perspectives of social science education for health professionals. In the 1950s the important movement bringing together social sciences and the field of health began, however weak credentials still prevail. This is due to the low professional status of social scientists in health and the ill-defined position of the social sciences professionals in the health field. It is also due to the scant importance attributed by students to the social sciences, the small number of professionals and the colonization of the social sciences by the biomedical culture in the health field. Thus, the professionals of social sciences applied to health are also faced with the need to build an identity, even after six decades of their presence in the field of health. This is because their ambivalent status has established them as a partial, incomplete and virtual presence, requiring a complex survival strategy in the nebulous area between social sciences and health.

An introduction to medical simulation.

PubMed

Brindley, Peter G; Arabi, Yaseen M

2009-08-01

While medical simulation is no panacea, it offers numerous potential strategies for comprehensive and practical training, safer patient care, and for those keen to attract and retain staff. It is a technique, rather than just a technology that promotes experiential and reflective learning. It is also a key strategy to teach Crisis Resource Management skills. Simulation can benefit the individual learner, the multidisciplinary team, and the hospital as a whole. It has been described as a key driver of patient safety, and even as the patient safety laboratory of the future. As such is endorsed by many professional societies in many nations. While challenges remain (and are outlined) there are great opportunities for clinicians, administrators, and educators alike.

Shifting and Sharing: Academic Physicians' Strategies for Navigating Underperformance and Failure.

PubMed

LaDonna, Kori A; Ginsburg, Shiphra; Watling, Christopher

2018-05-22

Medical practice is uncertain and complex. Consequently, even outstanding performers will inevitably experience moments of underperformance and failure. Coping relies on insight and resilience. However, how physicians develop and use these skills to navigate struggle remains underexplored. A better understanding may reveal strategies to support both struggling learners and stressed practitioners. In 2015, 28 academic physicians were interviewed about their experiences with underperformance or failure. Constructivist grounded theory informed data collection and analysis. Participants' experiences with struggle ranged from patient errors and academic failures to frequent, smaller moments of interpersonal conflict and work-life imbalance. To buffer impact, participants sometimes shifted their focus to an aspect of their identity where they felt successful. Additionally, while participants perceived that insight develops by acknowledging and reflecting on error, they sometimes deflected blame for performance gaps. More often, participants seemed to accept personal responsibility while simultaneously sharing accountability for underperformance or failure with external forces. Paradoxically, participants perceived learners who used these strategies as lacking in insight. Participants demonstrated the protective and functional value of distributing responsibility for underperformance and failure. Shifting and sharing may be an element of reflection and resilience; recognizing external factors may provide a way to gain perspective and to preserve the self. However, this strategy challenges educators' assumptions that learners who deflect are avoiding personal responsibility. The authors' findings raise questions about what it means to be resilient, and how assumptions about learners' responses to failure may affect strategies to support underperforming learners.

Combining administrative data feedback, reflection and action planning to engage primary care professionals in quality improvement: qualitative assessment of short term program outcomes.

PubMed

Vachon, Brigitte; Désorcy, Bruno; Gaboury, Isabelle; Camirand, Michel; Rodrigue, Jean; Quesnel, Louise; Guimond, Claude; Labelle, Martin; Huynh, Ai-Thuy; Grimshaw, Jeremy

2015-09-18

Improving primary care for chronic disease management requires a coherent, integrated approach to quality improvement. Evidence in the continuing professional development (CPD) field suggests the importance of using strategies such as feedback delivery, reflective practice and action planning to facilitate recognition of gaps and service improvement needs. Our study explored the outcomes of a CPD intervention, named the COMPAS Project, which consists of a three-hour workshop composed of three main activities: feedback, critical reflection and action planning. The feedback intervention is delivered face-to-face and presents performance indicators extracted from clinical-administrative databases. This aim of this study was to assess the short term outcomes of this intervention to engage primary care professional in continuous quality improvement (QI). In order to develop an understanding of our intervention and of its short term outcomes, a program evaluation approach was used. Ten COMPAS workshops on diabetes management were directly observed and qualitative data was collected to assess the intervention short term outcomes. Data from both sources were combined to describe the characteristics of action plans developed by professionals. Two independent coders analysed the content of these plans to assess if they promoted engagement in QI and interprofessional collaboration. During the ten workshops held, 26 interprofessional work teams were formed. Twenty-two of them developed a QI project they could implement themselves and that targeted aspects of their own practice they perceived in need of change. Most frequently prioritized strategies for change were improvement of systematic clientele follow-up, medication compliance, care pathway and support to improve adoption of healthier life habits. Twenty-one out of 22 action plans were found to target some level of improvement of interprofessional collaboration in primary care. Our study results demonstrate that the COMPAS intervention enabled professionals to target priorities for practice improvements and to develop action plans that promote interprofessional collaboration. The COMPAS intervention aims to increase capability for continuous QI, readiness to implement process of care changes and team shared goals but available resources, climate and culture for change and leadership, are also important required conditions to successfully implement these practice changes. We think that the proposed approach can be very useful to support and engage primary care professionals in the planning stage of quality improvement projects since it combines key successful ingredients: feedback, reflection and planning of action.

Trust and Reflection in Primary Care Practice Redesign.

PubMed

Lanham, Holly Jordan; Palmer, Raymond F; Leykum, Luci K; McDaniel, Reuben R; Nutting, Paul A; Stange, Kurt C; Crabtree, Benjamin F; Miller, William L; Jaén, Carlos Roberto

2016-08-01

To test a conceptual model of relationships, reflection, sensemaking, and learning in primary care practices transitioning to patient-centered medical homes (PCMH). Primary data were collected as part of the American Academy of Family Physicians' National Demonstration Project of the PCMH. We conducted a cross-sectional survey of clinicians and staff from 36 family medicine practices across the United States. Surveys measured seven characteristics of practice relationships (trust, diversity, mindfulness, heedful interrelation, respectful interaction, social/task relatedness, and rich and lean communication) and three organizational attributes (reflection, sensemaking, and learning) of practices. We surveyed 396 clinicians and practice staff. We performed a multigroup path analysis of the data. Parameter estimates were calculated using a Bayesian estimation method. Trust and reflection were important in explaining the characteristics of practice relationships and their associations with sensemaking and learning. The strongest associations between relationships, sensemaking, and learning were found under conditions of high trust and reflection. The weakest associations were found under conditions of low trust and reflection. Trust and reflection appear to play a key role in moderating relationships, sensemaking, and learning in practices undergoing practice redesign. © Health Research and Educational Trust.

Using Reflective Practice to Support Management Student Learning: Three Brief Assignments

ERIC Educational Resources Information Center

Reilly, Anne H.

2018-01-01

Reflective practice supports critical thinking and assessment skills through analyzing one's own life experiences, and the role of reflection in learning has been long recognized. However, drawbacks of many reflective practice assignments are their broad scope and lengthy written requirements. I propose that the reflection process is robust enough…

What can we learn from corporate sustainability reporting? Deriving propositions for research and practice from over 9,500 corporate sustainability reports published between 1999 and 2015 using topic modelling technique

PubMed Central

vom Brocke, Jan

2017-01-01

Organizations are increasingly using sustainability reports to inform their stakeholders and the public about their sustainability practices. We apply topic modelling to 9,514 sustainability reports published between 1999 and 2015 in order to identify common topics and, thus, the most common practices described in these reports. In particular, we identify forty-two topics that reflect sustainability and focus on the coverage and trends of economic, environmental, and social sustainability topics. Among the first to analyse such a large amount of data on organizations’ sustainability reporting, the paper serves as an example of how to apply natural language processing as a strategy of inquiry in sustainability research. The paper also derives from the data analysis ten propositions for future research and practice that are of immediate value for organizations and researchers. PMID:28403158

What can we learn from corporate sustainability reporting? Deriving propositions for research and practice from over 9,500 corporate sustainability reports published between 1999 and 2015 using topic modelling technique.

PubMed

Székely, Nadine; Vom Brocke, Jan

2017-01-01

Organizations are increasingly using sustainability reports to inform their stakeholders and the public about their sustainability practices. We apply topic modelling to 9,514 sustainability reports published between 1999 and 2015 in order to identify common topics and, thus, the most common practices described in these reports. In particular, we identify forty-two topics that reflect sustainability and focus on the coverage and trends of economic, environmental, and social sustainability topics. Among the first to analyse such a large amount of data on organizations' sustainability reporting, the paper serves as an example of how to apply natural language processing as a strategy of inquiry in sustainability research. The paper also derives from the data analysis ten propositions for future research and practice that are of immediate value for organizations and researchers.

Today's challenge, tomorrow's excellence: the practice of evidence-based education.

PubMed

Emerson, Roberta J; Records, Kathie

2008-08-01

Nurse educators are being challenged to maintain quality in light of increasing numbers of students, declining numbers of experienced faculty, societal mandates, and rapid changes in health care. The scholarship underlying the practice of nursing education, or evidence-based education, must continue to be explored through the design, testing, and refinement of education strategies from nursing and other disciplines. The involvement of every educator in this process will help create institutional valuing that serves to retain inquisitive and reflective educators in academic settings, while expanding evidence-based education in nursing. This article describes a literature review of the scholarship of nursing education practice and suggests approaches to generate a dynamic explosion of growth in nursing education to inform our students, promote optimal client health outcomes, and challenge each of us to reach higher levels of excellence in the practice of nursing education.

Practice-based Learning and Improvement (PBLI) in Postgraduate Medical Training: Milestones, Instructional and Assessment strategies.

PubMed

Mahajan, Rajiv; Anshu, -; Gupta, Piyush; Singh, Tejinder

2017-04-15

Patient-safety and quality-improvement are high-priority issues. One of the ways by which this can be implemented is by training residents to gather and appraise scientific evidence, as well as to evaluate their own patient-care practices. This competency is called Practice-based Learning and Improvement (PBLI). Training in PBLI provides residents with skills and knowledge necessary to reflect on their own strengths and deficiencies, identify their own learning needs, and engage in learning for improvement. PBLI also involves teaching residents to access and integrate literature by using scientific evidence and practice experience to make better clinical decisions. Training in PBLI has been found to lead to better health outcomes. We recommend explicitly incorporating elements of PBLI training and assessment in the present residency training curriculum in India. Implementing PBLI training and assessment will also require capacity-building through targeted faculty development programs.

Developing the skills required for evidence-based practice.

PubMed

French, B

1998-01-01

The current health care environment requires practitioners with the skills to find and apply the best currently available evidence for effective health care, to contribute to the development of evidence-based practice protocols, and to evaluate the impact of utilizing validated research findings in practice. Current approaches to teaching research are based mainly on gaining skills by participation in the research process. Emphasis on the requirement for rigour in the process of creating new knowledge is assumed to lead to skill in the process of using research information created by others. This article reflects upon the requirements for evidence-based practice, and the degree to which current approaches to teaching research prepare practitioners who are able to find, evaluate and best use currently available research information. The potential for using the principles of systematic review as a teaching and learning strategy for research is explored, and some of the possible strengths and weakness of this approach are highlighted.

A summary of the new GINA strategy: a roadmap to asthma control

PubMed Central

Bateman, Eric D.; Becker, Allan; Boulet, Louis-Philippe; Cruz, Alvaro A.; Drazen, Jeffrey M.; Haahtela, Tari; Hurd, Suzanne S.; Inoue, Hiromasa; de Jongste, Johan C.; Lemanske, Robert F.; Levy, Mark L.; O'Byrne, Paul M.; Paggiaro, Pierluigi; Pedersen, Soren E.; Pizzichini, Emilio; Soto-Quiroz, Manuel; Szefler, Stanley J.; Wong, Gary W.K.; FitzGerald, J. Mark

2015-01-01

Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA report was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence. This article provides a summary of key changes in the GINA report, and their rationale. The changes include a revised asthma definition; tools for assessing symptom control and risk factors for adverse outcomes; expanded indications for inhaled corticosteroid therapy; a framework for targeted treatment based on phenotype, modifiable risk factors, patient preference, and practical issues; optimisation of medication effectiveness by addressing inhaler technique and adherence; revised recommendations about written asthma action plans; diagnosis and initial treatment of the asthma−chronic obstructive pulmonary disease overlap syndrome; diagnosis in wheezing pre-school children; and updated strategies for adaptation and implementation of GINA recommendations. PMID:26206872

Self-Assessment: A Review of the Literature and Pedagogical Strategies for Its Promotion in Dental Education.

PubMed

Gadbury-Amyot, Cynthia C; Woldt, Janet L; Siruta-Austin, Kylie J

2015-12-01

In response to several publications drawing attention to self-assessment and revised Commission on Dental Accreditation standards that state graduates should possess and demonstrate the ability to self-assess, dental hygiene and pre-doctoral dental programs find themselves searching for ways in which to incorporate self-assessment practices into the curriculum. Research indicates that students are often not familiar with self-assessment strategies nor are they effective at self-assessment upon entering professional programs. Therefore, students must be taught strategies to self-assess and be given opportunities to practice and refine these skills. Opportunities to develop and demonstrate self-assessment skills can be incorporated across the curriculum at the classroom level and at the global level. Both the A.T. Still University Arizona School of Dentistry and Oral Health and the University of Missouri-Kansas City School of Dentistry utilize a capstone portfolio project to incorporate self-assessment throughout the curriculum. By combining artifacts from their dental and dental hygiene school experience with reflective writing essays, students can demonstrate attainment of program competencies. As more faculty members and students become involved and engaged in assessment strategies such as portfolios, they are also gaining a greater appreciation for the value of self-assessment. Copyright © 2015 The American Dental Hygienists’ Association.

An appraisal of students' awareness of "self-reflection" in a first-year pathology course of undergraduate medical/dental education.

PubMed

Kanthan, Rani; Senger, Jenna-Lynn B

2011-09-23

Self-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21st century. The aim of this study was to determine the extent of students' awareness and understanding of the reflective process and the meaning of 'self-reflection' within the contextual framework of their learning environment in the first-year of their medical/dental education. We endorse that the introduction of such explicit educational tasks at this early stage enhances and promotes students' awareness, understanding, and proficiency of this skill in their continuing life-long health professional learning. Over two years, students registered in first-year pathology at the University of Saskatchewan were introduced to a self-reflection assignment which comprised in the submission of a one-page reflective document to a template of reflective questions provided in the given context of their learning environment. This was a mandatory but ungraded component at the midterm and final examinations. These documents were individually analyzed and thematically categorized to a "5 levels-of-reflection-awareness" scale using a specially-designed rubric based on the accepted major theories of reflection that included students' identification of: 1) personal abilities, 2) personal learning styles 3) relationships between course material and student history 4) emotional responses and 5) future applications. 410 self-reflection documents were analyzed. The student self-awareness on personal learning style (72.7% level 3+) and course content (55.2% level 3+) were well-reflected. Reflections at a level 1 awareness included identification of a) specific teaching strategies utilized to enhance learning (58.4%), b) personal strengths/weaknesses (53%), and c) emotional responses, values, and beliefs (71.5%). Students' abilities to connect information to life experiences and to future events with understanding were more evenly distributed across all 5 levels of reflection-awareness. Exposure to self-reflection assignments in the early years of undergraduate medical education increases student awareness and promotes the creation of personal meaning of one's reactions, values, and premises in the context of student learning environments. Early introduction with repetition to such cognitive processes as practice tools increases engagement in reflection that may facilitate proficiency in mastering this competency leading to the creation of future reflective health professionals.

An appraisal of students' awareness of "self-reflection" in a first-year pathology course of undergraduate medical/dental education

PubMed Central

2011-01-01

Background Self-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21st century. The aim of this study was to determine the extent of students' awareness and understanding of the reflective process and the meaning of 'self-reflection' within the contextual framework of their learning environment in the first-year of their medical/dental education. We endorse that the introduction of such explicit educational tasks at this early stage enhances and promotes students' awareness, understanding, and proficiency of this skill in their continuing life-long health professional learning. Methods Over two years, students registered in first-year pathology at the University of Saskatchewan were introduced to a self-reflection assignment which comprised in the submission of a one-page reflective document to a template of reflective questions provided in the given context of their learning environment. This was a mandatory but ungraded component at the midterm and final examinations. These documents were individually analyzed and thematically categorized to a "5 levels-of-reflection-awareness" scale using a specially-designed rubric based on the accepted major theories of reflection that included students' identification of: 1) personal abilities, 2) personal learning styles 3) relationships between course material and student history 4) emotional responses and 5) future applications. Results 410 self-reflection documents were analyzed. The student self-awareness on personal learning style (72.7% level 3+) and course content (55.2% level 3+) were well-reflected. Reflections at a level 1 awareness included identification of a) specific teaching strategies utilized to enhance learning (58.4%), b) personal strengths/weaknesses (53%), and c) emotional responses, values, and beliefs (71.5%). Students' abilities to connect information to life experiences and to future events with understanding were more evenly distributed across all 5 levels of reflection-awareness. Conclusions Exposure to self-reflection assignments in the early years of undergraduate medical education increases student awareness and promotes the creation of personal meaning of one's reactions, values, and premises in the context of student learning environments. Early introduction with repetition to such cognitive processes as practice tools increases engagement in reflection that may facilitate proficiency in mastering this competency leading to the creation of future reflective health professionals. PMID:21943239

Examining occupational therapy education through faculty engagement in curriculum mapping and pedagogical reflection.

PubMed

MacNeil, Cheryl; Hand, Theresa

2014-01-01

This article discusses a 1-yr evaluation study of a master of science in occupational therapy program to examine curriculum content and pedagogical practices as a way to gauge program preparedness to move to a clinical doctorate. Faculty members participated in a multitiered qualitative study that included curriculum mapping, semistructured individual interviewing, and iterative group analysis. Findings indicate that curriculum mapping and authentic dialogue helped the program formulate a more streamlined and integrated curriculum with increased faculty collaboration. Curriculum mapping and collaborative pedagogical reflection are valuable evaluation strategies for examining preparedness to offer a clinical doctorate, enhancing a self-study process, and providing information for ongoing formative curriculum review. Copyright © 2014 by the American Occupational Therapy Association, Inc.

The extent to which the public health 'war on obesity' reflects the ethical values and principles of critical health promotion: a multimedia critical discourse analysis.

PubMed

O'Hara, Lily; Taylor, Jane; Barnes, Margaret

2015-12-01

The discipline of health promotion is responsible for implementing strategies within weight-related public health initiatives (WR-PHI). It is imperative that such initiatives be subjected to critical analysis through a health promotion ethics lens to help ensure ethical health promotion practice. Multimedia critical discourse analysis was used to examine the claims, values, assumptions, power relationships and ideologies within Australian WR-PHI. The Health Promotion Values and Principles Continuum was used as a heuristic to evaluate the extent to which the WR-PHI reflected the ethical values of critical health promotion: active participation of people in the initiative; respect for personal autonomy; beneficence; non-maleficence; and strong evidential and theoretical basis for practice. Ten initiatives were analysed. There was some discourse about the need for participation of people in the WR-PHI, but people were routinely labelled as 'target groups' requiring 'intervention'. Strong evidence of a coercive and paternalistic discourse about choice was identified, with minimal attention to respect for personal autonomy. There was significant emphasis on the beneficiaries of the WR-PHI but minimal attention to the health benefits, and nothing about the potential for harm. Discourse about the evidence of need was objectivist, and there was no discussion about the theoretical foundations of the WR-PHI. The WR-PHI were not reflective of the ethical values and principles of critical health promotion. So what? Health promotion researchers and practitioners engaged in WR-PHI should critically reflect on the extent to which they are consistent with the ethical aspects of critical health promotion practice.

How Improving Practice Relationships Among Clinicians and Nonclinicians Can Improve Quality in Primary Care

PubMed Central

Lanham, Holly J.; McDaniel, Reuben R.; Crabtree, Benjamin F.; Miller, William L.; Stange, Kurt C.; Tallia, Alfred F.; Nutting, Paul A.

2010-01-01

Background Understanding the role of relationships in health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Methods Data were drawn from four large National Institutes of Health (NIH)–funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Findings Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Discussion Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties. PMID:19769206

A missing ethical competency? A review of critical reflection in health promotion.

PubMed

Tretheway, Rebecca; Taylor, Jane; O'Hara, Lily; Percival, Nikki

2015-12-01

There is increasing emphasis in the health promotion literature on the ethical imperative for the profession to move towards critical practice. A key challenge for health promotion is that critical practice appears both under-developed and under-practiced. This is evident in the omission of critical reflection from Australian and international competencies for health promotion practitioners. A narrative literature review was undertaken to explore the current use of critical reflection in health promotion. Critical reflection models relevant to health promotion were identified and critiqued. There was a dearth of literature on critical reflection within health promotion, despite recognition of its potential to support critical practice. The discipline of critical social work provided literature on the use, effect and outcome of critical reflection in practice. The interdisciplinary critical reflection model was identified as the model most applicable to health promotion. Underpinned by critical theory, this model emphasises both critical and ethical practice. Critical reflection is a core competency for health promotion practitioners to address the ethical imperative to move towards critical practice. There is a need to explore the application of a critical reflection model in health promotion to determine how it may support critical and ethical practice. So what? If health promotion is to meet its ethical responsibilities, then critical reflection needs to be articulated as a core health promotion competency and a model for its application in health promotion developed.

Professional knowledge and the epistemology of reflective practice.

PubMed

Kinsella, Elizabeth Anne

2010-01-01

Reflective practice is one of the most popular theories of professional knowledge in the last 20 years and has been widely adopted by nursing, health, and social care professions. The term was coined by Donald Schön in his influential books The Reflective Practitioner, and Educating the Reflective Practitioner, and has garnered the unprecedented attention of theorists and practitioners of professional education and practice. Reflective practice has been integrated into professional preparatory programmes, continuing education programmes, and by the regulatory bodies of a wide range of health and social care professions. Yet, despite its popularity and widespread adoption, a problem frequently raised in the literature concerns the lack of conceptual clarity surrounding the term reflective practice. This paper seeks to respond to this problem by offering an analysis of the epistemology of reflective practice as revealed through a critical examination of philosophical influences within the theory. The aim is to discern philosophical underpinnings of reflective practice in order to advance increasingly coherent interpretations, and to consider the implications for conceptions of professional knowledge in professional life. The paper briefly examines major philosophical underpinnings in reflective practice to explicate central themes that inform the epistemological assumptions of the theory. The study draws on the work of Donald Schön, and on texts from four philosophers: John Dewey, Nelson Goodman, Michael Polanyi, and Gilbert Ryle. Five central epistemological themes in reflective practice are illuminated: (1) a broad critique of technical rationality; (2) professional practice knowledge as artistry; (3) constructivist assumptions in the theory; (4) the significance of tacit knowledge for professional practice knowledge; and (5) overcoming mind body dualism to recognize the knowledge revealed in intelligent action. The paper reveals that the theory of reflective practice is concerned with deep epistemological questions of significance to conceptions of knowledge in health and social care professions.

Enhancing communication in oncology outpatient consultations: critical reflections from doctors

PubMed Central

Murphy, Roger; Cox, Karen; Steward, William

2011-01-01

Objectives The experiences of patients diagnosed with advanced incurable cancer and the doctors who conducted their medical consultations were studied in order to improve the understanding of what happens in consultations, when bad news is disclosed. The major objective of the study was to critically reflect upon doctor-patient communication, in such situations, with a view to considering future strategies for doctors’ continuing professional development. Methods Sixteen patients and sixteen Oncologists, from a cancer centre in the UK were recruited into this ethnographic study. One hundred and fifteen episodes of data were collected from audio recorded consultations; interviews with doctors and patients and their relatives and observations of consultations. These data were analysed using a constant comparison method. Results Interactions between doctors and patients are complex and consultations can be challenging for both of them. Some doctors spoke openly about their need for additional support to enhance their communication related competencies within Oncology consultations. These doctors wanted to observe their peers conducting consultations. They also wanted to receive feedback about their own clinical practices. These doctors stated that they wanted an open culture whereby they could talk freely about difficult and emotionally challenging consultations without fear of being considered incompetent by their Consultants, who act in a clinical supervisory role. Conclusions To help practitioners consolidate their practice in such settings it is necessary to develop better collaborations among practitioners within clinical practice. Providing individual supervisory sessions or group workshops can facilitate reflective learning and provide an open and supportive learning culture.

Evaluating the Use of Reflective Practice in a Nonprofessional, Undergraduate Clinical Communication Skills Course

ERIC Educational Resources Information Center

Beveridge, Tyler S.; Fruchter, Lauren L.; Sanmartin, Cleo V.; deLottinville, Carl B.

2014-01-01

Recent studies suggest that the quality of reflective practice being achieved in educational settings is inadequate. Our study aims to determine the level of reflection present in written student reflections in a nonprofessional undergraduate course. We also seek to explore student and instructor perspectives on the value of reflective practices.…

Does self-reflection and peer-assessment improve Saudi pharmacy students' academic performance and metacognitive skills?

PubMed

Yusuff, Kazeem B

2015-07-01

The patient-centered focus of clinical pharmacy practice which demands nuanced application of specialized knowledge and skills targeted to meeting patient-specific therapeutic needs warrant that the training strategy used for PharmD graduates must empower with the ability to use the higher level cognitive processes and critical thinking effectively in service delivery. However, the historical disposition to learning in the Middle East and among Saudi students appeared heavily focused on rote memorization and recall of memorized facts. To assess the impact of active pedagogic strategies such as self-reflection and peer assessment on pharmacy students' academic performance and metacognitive skills, and evaluate students' feedback on the impact of these active pedagogic strategies on their overall learning experience. An exploratory prospective cohort study was conducted among 4th year students at the College of Clinical Pharmacy, King Faisal University, Saudi Arabia to assess the impact of self-reflection and peer-assessment in a semester-wide assessment tasks in two compulsory first semester 4th year courses (Therapeutics-3 and Pharmacoeconomics). An end-of-course evaluation survey with a pre-tested 5-item open-ended questionnaire was also conducted to evaluate students' feedback on the impact of active pedagogic strategies on their overall learning experience. Male students (study group) constituted 40.7% of the cohort while 59.3% were females (control group) with mean ± SD age of 23.2 ± 5.6 and 22.1 ± 4.9 years respectively. The mean ± SD scores for quizzes, mid-term and final exams, and the overall percentage pass were significantly higher in the study group for both courses (P < 0.001). The majority of the students in the study group opined that the exposure to active pedagogic strategies enabled them to improve their use of critical thinking, facilitated deeper engagement with their learning and improved their clinical decision-making and discussion skills. The use of active pedagogic strategies such as self-reflection and peer-assessment appeared to significantly improve examination performance, facilitate deep and constructive engagement with learning and fostered students' confidence in the use of critical thinking and clinical decision-making.

Does self-reflection and peer-assessment improve Saudi pharmacy students’ academic performance and metacognitive skills?

PubMed Central

Yusuff, Kazeem B.

2014-01-01

Background: The patient-centered focus of clinical pharmacy practice which demands nuanced application of specialized knowledge and skills targeted to meeting patient-specific therapeutic needs warrant that the training strategy used for PharmD graduates must empower with the ability to use the higher level cognitive processes and critical thinking effectively in service delivery. However, the historical disposition to learning in the Middle East and among Saudi students appeared heavily focused on rote memorization and recall of memorized facts. Objectives: To assess the impact of active pedagogic strategies such as self-reflection and peer assessment on pharmacy students’ academic performance and metacognitive skills, and evaluate students’ feedback on the impact of these active pedagogic strategies on their overall learning experience. Method: An exploratory prospective cohort study was conducted among 4th year students at the College of Clinical Pharmacy, King Faisal University, Saudi Arabia to assess the impact of self-reflection and peer-assessment in a semester-wide assessment tasks in two compulsory first semester 4th year courses (Therapeutics-3 and Pharmacoeconomics). An end-of-course evaluation survey with a pre-tested 5-item open-ended questionnaire was also conducted to evaluate students’ feedback on the impact of active pedagogic strategies on their overall learning experience. Result: Male students (study group) constituted 40.7% of the cohort while 59.3% were females (control group) with mean ± SD age of 23.2 ± 5.6 and 22.1 ± 4.9 years respectively. The mean ± SD scores for quizzes, mid-term and final exams, and the overall percentage pass were significantly higher in the study group for both courses (P < 0.001). The majority of the students in the study group opined that the exposure to active pedagogic strategies enabled them to improve their use of critical thinking, facilitated deeper engagement with their learning and improved their clinical decision-making and discussion skills. Conclusion: The use of active pedagogic strategies such as self-reflection and peer-assessment appeared to significantly improve examination performance, facilitate deep and constructive engagement with learning and fostered students’ confidence in the use of critical thinking and clinical decision-making. PMID:26106275

Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

PubMed

Elhoseeny, Taghareed A; Mourad, Juidan K

2014-08-01

The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to patients and providers include inadequate injection safety training and incomplete hepatitis B vaccination of healthcare providers. Indicators that may reflect risk to providers include nonadherence to safety precautions related to injection practices, such as inadequate access to heavy gloves by staff handling healthcare waste.

Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice.

PubMed

Mathews, Rahel; Zachariah, Rachel

2008-07-01

Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.

Teaching the abyss: living the art-science of nursing.

PubMed

Ramey, Sandra L; Bunkers, Sandra Schmidt

2006-10-01

This column addresses how nurse educators can provide the teaching-learning experiences for novice nurses to develop the leadership competence to effectively practice nursing in an extremely demanding healthcare environment. The authors delve into Mitchell and Bunkers' use of the metaphor of an abyss to explore the lived experience of risking being with others in extremely intense interpersonal situations. Using reflection, students' journal narratives affirm connections made among past experiences and the new knowledge gleaned from exploring and naming the phenomenon of the abyss. Several teaching-learning strategies are offered as ways for addressing the leadership issues related to dealing with intense relational experiences in nursing practice, including exploring nurse theorist Rosemarie Rizzo Parse's essentials of leadership.

Cognitive bias in clinical practice - nurturing healthy skepticism among medical students.

PubMed

Bhatti, Alysha

2018-01-01

Errors in clinical reasoning, known as cognitive biases, are implicated in a significant proportion of diagnostic errors. Despite this knowledge, little emphasis is currently placed on teaching cognitive psychology in the undergraduate medical curriculum. Understanding the origin of these biases and their impact on clinical decision making helps stimulate reflective practice. This article outlines some of the common types of cognitive biases encountered in the clinical setting as well as cognitive debiasing strategies. Medical educators should nurture healthy skepticism among medical students by raising awareness of cognitive biases and equipping them with robust tools to circumvent such biases. This will enable tomorrow's doctors to improve the quality of care delivered, thus optimizing patient outcomes.

Guidelines for reporting methodological challenges and evaluating potential bias in dementia research

PubMed Central

Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C.; Gross, Alden L.; Hofer, Scott M.; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M. Maria; Dufouil, Carole

2015-01-01

Clinical and population research on dementia and related neurologic conditions, including Alzheimer’s disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on “best practices.” We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. PMID:26397878

Implementation of behavioral health interventions in real world scenarios: Managing complex change.

PubMed

Clark, Khaya D; Miller, Benjamin F; Green, Larry A; de Gruy, Frank V; Davis, Melinda; Cohen, Deborah J

2017-03-01

A practice embarks on a radical reformulation of how care is designed and delivered when it decides to integrate medical and behavioral health care for its patients and success depends on managing complex change in a complex system. We examined the ways change is managed when integrating behavioral health and medical care. Observational cross-case comparative study of 19 primary care and community mental health practices. We collected mixed methods data through practice surveys, observation, and semistructured interviews. We analyzed data using a data-driven, emergent approach. The change management strategies that leadership employed to manage the changes of integrating behavioral health and medical care included: (a) advocating for a mission and vision focused on integrated care; (b) fostering collaboration, with a focus on population care and a team-based approaches; (c) attending to learning, which includes viewing the change process as continuous, and creating a culture that promoted reflection and continual improvement; (d) using data to manage change, and (e) developing approaches to finance integration. This paper reports the change management strategies employed by practice leaders making changes to integrate care, as observed by independent investigators. We offer an empirically based set of actionable recommendations that are relevant to a range of leaders (policymakers, medical directors) and practice members who wish to effectively manage the complex changes associated with integrated primary care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Reflective Practice in Group Co-Leadership

ERIC Educational Resources Information Center

Okech, Jane E. Atieno

2008-01-01

Group literature on co-leaders' experiences and perceptions while leading groups illuminate reflective practice as highly influential to co-leader relationships and performances. Using practical examples grounded by interdisciplinary literature on reflective practice, this article explores and expands dialogue on the complex interplay between…

Developing Musical Creativity through Reflective and Collaborative Practices

ERIC Educational Resources Information Center

Gruenhagen, Lisa M.

2017-01-01

This article focuses on developing musical creativity through reflective and collaborative practices in elementary music. Studies on reflective practices reveal that students of any age are able to reflect knowingly. Researchers who have examined thinking, creativity, and musical understanding have discussed the importance of teaching practices…

Making Sense of Clinical Practice: Order Set Design Strategies in CPOE

PubMed Central

Novak, Laurie L.

2007-01-01

A case study was conducted during the customization phase of a commercial CPOE system at a multi-hospital, academic health system. The study focused on the development of order sets. Three distinct approaches to order set development were observed: Empirical, Local Consensus and Departmental. The three approaches are first described and then examined using the framework of sensemaking. Different approaches to sensemaking in the context of order set development reflect variations in sources of knowledge related to the standardization of care. PMID:18693900

Information literacy of U.S. and Indian engineering undergraduates.

PubMed

Taraban, Roman; Suar, Damodar; Oliver, Kristin

2013-12-01

To be competitive, contemporary engineers must be capable of both processing and communicating information effectively. Available research suggests that Indian students would be disadvantaged in information literacy in their language of instruction (English) compared to U.S. students because English is not Indian students' native language. Compared to U.S. students, Indian students (a) were predicted to apply practical text processing strategies to a greater extent than analytic strategies and (b) endorse the direct transmission of information over critical, interpretive analysis of information. Two validated scales measuring self-reported use of reading strategies and beliefs about interpreting and critiquing written information were administered to engineering students at an Indian Institute of Technology in their freshman to senior years. Neither prediction was supported: Indian students reported applying analytic strategies over pragmatic strategies and were more disposed to critically analyze information rather than accept it passively. Further, Indian students reported being more analytic and more reflective in their reading behaviors than U.S. engineering students. Additional data indicated that U.S. and Indian students' text-processing strategies and beliefs are associated with the texts that they read and their academic behaviors.

Reflective Practice in Physical Education and Physical Education Teacher Education: A Review of the Literature since 1995

ERIC Educational Resources Information Center

Standal, Oyvind F.; Moe, Vegard F.

2013-01-01

Reflection and reflective practice are key concepts in the educational literature as well as in research on physical education (PE) and physical education teacher education (PETE). The purpose of this article is to review the current empirical knowledge base for reflection and reflective practice in PE and PETE from 1995 to 2011. The review…

Readiness for self-directed change in professional behaviours: factorial validation of the Self-Reflection and Insight Scale.

PubMed

Roberts, Chris; Stark, Patsy

2008-11-01

Self-reflection, the practice of inspecting and evaluating one's own thoughts, feelings and behaviour, and insight, the ability to understand one's own thoughts, feelings and behaviour, are central to the self-regulation of behaviours. The Self-Reflection and Insight Scale (SRIS) measures three factors in the self-regulation cycle: need for reflection; engagement in reflection, and insight. We used structural equation modelling to undertake a confirmatory factor analysis of the SRIS. We re-specified our model to analyse all of the data to explain relationships between the SRIS, medical student characteristics, and responses to issues of teaching and learning in professionalism. The factorial validity of a modified SRIS showed all items loading significantly on their expected factors, with a good fit to the data. Each subscale had good internal reliability (> 0.8). There was a strong relationship between the need for reflection and engagement in reflection (r = 0.77). Insight was related to need for reflection (0.22) and age (0.21), but not to the process of engaging in reflection (0.06). Validation of the SRIS provides researchers with a new instrument with which to measure and investigate the processes of self-reflection and insight in the context of students' self-regulation of their professionalism. Insight is related to the motive or need for reflection, but the process of reflection does not lead to insight. Attending to feelings is an important and integral aspect of self-reflection and insight. Effective strategies are needed to develop students' insight as they reflect on their professionalism.

Building an ethical organizational culture.

PubMed

Nelson, William A; Taylor, Emily; Walsh, Thom

2014-01-01

The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

Reflective Practice in Physiotherapy Education: A Critical Conversation.

ERIC Educational Resources Information Center

Clouder, Lynn

2000-01-01

Describes how reflective practice is conceptualized and interpreted by practicing physiotherapists and undergraduate physiotherapy students. Analysis of qualitative interviews and workshops highlights both contextual and practical differences in modes of reflection by practitioners. Discussion notes the context of the task-oriented culture of the…

Connecting Reflective Practice, Dialogic Protocols, and Professional Learning

ERIC Educational Resources Information Center

Nehring, James; Laboy, Wilfredo T.; Catarius, Lynn

2010-01-01

In recent years, elements of reflective practice have been popularized in state school professional development. As reflective practice has moved into the mainstream, dialogic protocols have been developed by numerous organizations to structure discourse for deep understanding, enhance professional practice and advance organizational learning.…

Does Provider Self-Reporting of Etiquette Behaviors Improve Patient Experience? A Randomized Controlled Trial.

PubMed

Siddiqui, Zishan; Qayyum, Rehan; Bertram, Amanda; Durkin, Nowella; Kebede, Sosena; Ponor, Lucia; Oduyebo, Ibironke; Allen, Lisa; Brotman, Daniel J

2017-06-01

There is a glaring lack of published evidence-based strategies to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience scores on the physician domain. Strategies that have been used are resource intensive and difficult to sustain. We hypothesized that prompting providers to assess their own etiquette-based practices every 2 weeks over the course of 1 year would improve patient experience on the physician domain. Randomized controlled trial. 4 acute care hospitals. Hospitalists. Hospitalists were randomized to the study or the control arm. The study arm was prompted every 2 weeks for 12 months to report how frequently they engaged in 7 best-practice bedside etiquette behaviors. Control arm participants received similarly worded questions on quality improvement behaviors. Provider experience scores were calculated from the physician HCAHPS and Press Ganey survey provider items. Physicians reported high rates of etiquette-based behavior at baseline, and this changed modestly over the study period. Self-reported etiquette behaviors were not associated with experience scores. The difference in difference analysis of the baseline and postintervention physician experience scores between the intervention arm and the control arm was not statistically significant (P = 0.71). In this 12-month study, biweekly reflection and reporting of best-practice bedside etiquette behaviors did not result in significant improvement on physician domain experience scores. It is likely that hospitalists' self-assessment of their bedside etiquette may not reflect patient perception of these behaviors. Furthermore, hospitalists may be resistant to improvement in this area since they rate themselves highly at baseline. Journal of Hospital Medicine 2017;12:402-406. © 2017 Society of Hospital Medicine

Reflections from the interface between seismological research and earthquake risk reduction

NASA Astrophysics Data System (ADS)

Sargeant, S.

2012-04-01

Scientific understanding of earthquakes and their attendant hazards is vital for the development of effective earthquake risk reduction strategies. Within the global disaster reduction policy framework (the Hyogo Framework for Action, overseen by the UN International Strategy for Disaster Reduction), the anticipated role of science and scientists is clear, with respect to risk assessment, loss estimation, space-based observation, early warning and forecasting. The importance of information sharing and cooperation, cross-disciplinary networks and developing technical and institutional capacity for effective disaster management is also highlighted. In practice, the degree to which seismological information is successfully delivered to and applied by individuals, groups or organisations working to manage or reduce the risk from earthquakes is variable. The challenge for scientists is to provide fit-for-purpose information that can be integrated simply into decision-making and risk reduction activities at all levels of governance and at different geographic scales, often by a non-technical audience (i.e. people without any seismological/earthquake engineering training). The interface between seismological research and earthquake risk reduction (defined here in terms of both the relationship between the science and its application, and the scientist and other risk stakeholders) is complex. This complexity is a function of a range issues that arise relating to communication, multidisciplinary working, politics, organisational practices, inter-organisational collaboration, working practices, sectoral cultures, individual and organisational values, worldviews and expectations. These factors can present significant obstacles to scientific information being incorporated into the decision-making process. The purpose of this paper is to present some personal reflections on the nature of the interface between the worlds of seismological research and risk reduction, and the implications for scientists and information delivery.

The Nature of Reflective Practice and Emotional Intelligence in Tutorial Settings

ERIC Educational Resources Information Center

Gill, Gobinder Singh

2014-01-01

The purpose of this paper was to assess the nature of reflective practice and emotional intelligence in tutorial settings. Following the completion of a self-report measure of emotional intelligence, practitioners incorporated a model of reflective practice into their tutorial sessions. Practitioners were instructed to utilise reflective practice…

Diffracting Reflection: A Move beyond Reflective Practice

ERIC Educational Resources Information Center

Mitchell, Veronica Ann

2017-01-01

Reflective practice has become a core component in higher education studies. In the health sciences, reflective tasks are required throughout the undergraduate programmes, yet many students struggle to find value in these tasks for their present and future professional practice. Benefits that can be derived from the process are undermined by this…

Uses of Technology to Support Reflective Teaching Practices

ERIC Educational Resources Information Center

Brent, Wayne

2010-01-01

This dissertation researched and reported on how technology was used to facilitate and inform reflective teaching practices. It also identified the characteristics of benefits and barriers in using technology for teaching and reflection. The study, descriptive in nature, was designed to determine the reflective practices of instructors and how…

Developing Mathematical Practices through Reflection Cycles

ERIC Educational Resources Information Center

Reinholz, Daniel L.

2016-01-01

This paper focuses on reflection in learning mathematical practices. While there is a long history of research on reflection in mathematics, it has focused primarily on the development of conceptual understanding. Building on notion of learning as participation in social practices, this paper broadens the theory of reflection in mathematics…

Reflection and Reflective Practice Discourses in Coaching: A Critical Analysis

ERIC Educational Resources Information Center

Cushion, Christopher J.

2018-01-01

Reflection and reflective practice is seen as an established part of coaching and coach education practice. It has become a "taken-for-granted" part of coaching that is accepted enthusiastically and unquestioningly, and is assumed to be "good" for coaching and coaches. Drawing on sociological concepts, a primarily Foucauldian…

How Educators Conceptualize and Teach Reflective Practice: A Survey of North American Pediatric Medical Educators.

PubMed

Butani, Lavjay; Bannister, Susan L; Rubin, Allison; Forbes, Karen L

2017-04-01

The objectives of this study were to explore pediatric undergraduate medical educators' understanding of reflective practice, the barriers they face in teaching this, the curricular activities they use, and the value they assign to reflective practice. Nine survey questions were sent to members of the Council on Medical Student Education in Pediatrics, an international pediatric undergraduate medical educator group. Quantitative data were analyzed using descriptive statistics. Open-ended responses were analyzed qualitatively through an iterative process to establish themes representing understanding of reflective practice and barriers in teaching this. Respondents representing 56% of all North American schools answered at least 1 survey question. Qualitative analysis of understanding of reflection revealed 11 themes spanning all components of reflective practice, albeit with a narrow view on triggers for reflection and a lower emphasis on understanding the why of things and on perspective-taking. The most frequent barriers in teaching this were the lack of skilled educators and limited time. Most respondents valued reflective skills but few reported confidence in their ability to teach reflection. Several curricular activities were used to teach reflection, the most common being narrative writing. Pediatric undergraduate medical educators value reflection and endorse its teaching. However, many do not have a complete understanding of the construct and few report confidence in teaching this. Implementing longitudinal curricula in reflective practice may require a culture change; opportunities exist for faculty development about the meaning and value of reflective practice and how best to teach this. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Reflective Practice and Inquiry: Let's Talk More about Inquiry

ERIC Educational Resources Information Center

Earl, Kerry; Ussher, Bill

2016-01-01

Reflective practice and inquiry are aspects of teacher professional practice that characterise teachers as learners. Reflective practice in some form is considered in contemporary education as an essential activity for teachers and teacher educators. "Inquiry as professional development" and "inquiry as research", on the other…

Lessons learned in using realist evaluation to assess maternal and newborn health programming in rural Bangladesh.

PubMed

Adams, Alayne; Sedalia, Saroj; McNab, Shanon; Sarker, Malabika

2016-03-01

Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the three MNH programmes under consideration employed different implementation models to deliver similar services and meet similar MNH goals. Programme targets included adoption of recommended antenatal, post-natal and essential newborn care practices; health systems strengthening through improved referral, accountability and administrative systems, and increased community knowledge. Drawing on focused examples from this research, seven steps for operationalizing the realist evaluation approach are offered, while emphasizing the need to iterate and innovate in terms of methods and analysis strategies. The paper concludes by reflecting on lessons learned in applying realist evaluation, and the unique insights it yields regarding implementation strategies for successful MNH programming. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Implementation science: a role for parallel dual processing models of reasoning?

PubMed Central

Sladek, Ruth M; Phillips, Paddy A; Bond, Malcolm J

2006-01-01

Background A better theoretical base for understanding professional behaviour change is needed to support evidence-based changes in medical practice. Traditionally strategies to encourage changes in clinical practices have been guided empirically, without explicit consideration of underlying theoretical rationales for such strategies. This paper considers a theoretical framework for reasoning from within psychology for identifying individual differences in cognitive processing between doctors that could moderate the decision to incorporate new evidence into their clinical decision-making. Discussion Parallel dual processing models of reasoning posit two cognitive modes of information processing that are in constant operation as humans reason. One mode has been described as experiential, fast and heuristic; the other as rational, conscious and rule based. Within such models, the uptake of new research evidence can be represented by the latter mode; it is reflective, explicit and intentional. On the other hand, well practiced clinical judgments can be positioned in the experiential mode, being automatic, reflexive and swift. Research suggests that individual differences between people in both cognitive capacity (e.g., intelligence) and cognitive processing (e.g., thinking styles) influence how both reasoning modes interact. This being so, it is proposed that these same differences between doctors may moderate the uptake of new research evidence. Such dispositional characteristics have largely been ignored in research investigating effective strategies in implementing research evidence. Whilst medical decision-making occurs in a complex social environment with multiple influences and decision makers, it remains true that an individual doctor's judgment still retains a key position in terms of diagnostic and treatment decisions for individual patients. This paper argues therefore, that individual differences between doctors in terms of reasoning are important considerations in any discussion relating to changing clinical practice. Summary It is imperative that change strategies in healthcare consider relevant theoretical frameworks from other disciplines such as psychology. Generic dual processing models of reasoning are proposed as potentially useful in identifying factors within doctors that may moderate their individual uptake of evidence into clinical decision-making. Such factors can then inform strategies to change practice. PMID:16725023

Implementation science: a role for parallel dual processing models of reasoning?

PubMed

Sladek, Ruth M; Phillips, Paddy A; Bond, Malcolm J

2006-05-25

A better theoretical base for understanding professional behaviour change is needed to support evidence-based changes in medical practice. Traditionally strategies to encourage changes in clinical practices have been guided empirically, without explicit consideration of underlying theoretical rationales for such strategies. This paper considers a theoretical framework for reasoning from within psychology for identifying individual differences in cognitive processing between doctors that could moderate the decision to incorporate new evidence into their clinical decision-making. Parallel dual processing models of reasoning posit two cognitive modes of information processing that are in constant operation as humans reason. One mode has been described as experiential, fast and heuristic; the other as rational, conscious and rule based. Within such models, the uptake of new research evidence can be represented by the latter mode; it is reflective, explicit and intentional. On the other hand, well practiced clinical judgments can be positioned in the experiential mode, being automatic, reflexive and swift. Research suggests that individual differences between people in both cognitive capacity (e.g., intelligence) and cognitive processing (e.g., thinking styles) influence how both reasoning modes interact. This being so, it is proposed that these same differences between doctors may moderate the uptake of new research evidence. Such dispositional characteristics have largely been ignored in research investigating effective strategies in implementing research evidence. Whilst medical decision-making occurs in a complex social environment with multiple influences and decision makers, it remains true that an individual doctor's judgment still retains a key position in terms of diagnostic and treatment decisions for individual patients. This paper argues therefore, that individual differences between doctors in terms of reasoning are important considerations in any discussion relating to changing clinical practice. It is imperative that change strategies in healthcare consider relevant theoretical frameworks from other disciplines such as psychology. Generic dual processing models of reasoning are proposed as potentially useful in identifying factors within doctors that may moderate their individual uptake of evidence into clinical decision-making. Such factors can then inform strategies to change practice.

Effectiveness of vaginal breech birth training strategies: An integrative review of the literature.

PubMed

Walker, Shawn; Breslin, Eamonn; Scamell, Mandie; Parker, Pam

2017-06-01

The safety of vaginal breech birth depends on the skill of the attendant. The objective of this review was to identify, synthesize, and report the findings of evaluated breech birth training strategies. A systematic search of the following on-line databases: Medline, CINAHL Plus, PsychINFO, EBM Reviews/Cochrane Library, EMBASE, Maternity and Infant Care, and Pubmed, using a structured search strategy. Studies were included in the review if they evaluated the efficacy of a breech birth training program or particular strategies, including obstetric emergency training evaluations that reported differentiated outcomes for breech. Out of 1040 original citings, 303 full-text articles were assessed for eligibility, and 17 methodologically diverse studies met the inclusion criteria. A data collection form was used to extract relevant information. Data were synthesized, using an evaluation levels framework, including reaction, learning (subjective and objective assessment), and behavioral change. No evaluations included clinical outcome data. Improvements in self-assessed skill and confidence were not associated with improvements in objective assessments or behavioral change. Inclusion of breech birth as part of an obstetric emergencies training package without support in practice was negatively associated with subsequent attendance at vaginal breech births. As a result of the heterogeneity of the studies available, and the lack of evidence concerning neonatal or maternal outcomes, no conclusive practice recommendations can be made. However, the studies reviewed suggest that vaginal breech birth training may be enhanced by reflection, repetition, and experienced clinical support in practice. Further evaluation studies should prioritize clinical outcome data. © 2017 Wiley Periodicals, Inc.

Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.

PubMed

Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J

2017-08-01

In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017 American Physical Therapy Association

A Multidimensional Model of Mothers’ Perceptions of Parent Alcohol Socialization and Adolescent Alcohol Misuse

PubMed Central

Ennett, Susan T.; Jackson, Christine; Cole, Veronica T.; Haws, Susan; Foshee, Vangie A.; Reyes, Heathe Luz McNaughton; Burns, Alison Reimuller; Cox, Melissa J.; Cai, Li

2015-01-01

We assessed a multidimensional model of parent alcohol socialization in which key socialization factors were considered simultaneously to identify combinations of factors that increase or decrease risk for development of adolescent alcohol misuse. Of interest was the interplay between putative risk and protective factors, such as whether the typically detrimental effects on youth drinking of parenting practices tolerant of some adolescent alcohol use are mitigated by an effective overall approach to parenting and parental modeling of modest alcohol use. The sample included 1,530 adolescents and their mothers; adolescents’ mean age was 13.0 (SD = .99) at the initial assessment. Latent profile analysis was conducted of mothers’ reports of their attitude toward teen drinking, alcohol-specific parenting practices, parental alcohol use and problem use, and overall approach to parenting. The profiles were used to predict trajectories of adolescent alcohol misuse from early to middle adolescence. Four profiles were identified: two profiles reflected conservative alcohol-specific parenting practices and two reflected alcohol-tolerant practices, all in the context of other attributes. Alcohol misuse accelerated more rapidly from grade 6 through 10 in the two alcohol-tolerant compared with conservative profiles. Results suggest that maternal tolerance of some youth alcohol use, even in the presence of dimensions of an effective parenting style and low parental alcohol use and problem use, is not an effective strategy for reducing risky adolescent alcohol use. PMID:26415053

Effects of Matching Teaching Strategy to Thinking Style on Learner's Quality of Reflection in an Online Learning Environment

ERIC Educational Resources Information Center

Chen, Nian-Shing; Kinshuk; Wei, Chun-Wang; Liu, Chia-Chi

2011-01-01

Reflection plays an important role in improving learning performance. This study, therefore, attempted to explore whether learners' reflection levels can be improved if teaching strategies are adapted to fit with learners' thinking styles in an online learning environment. Three teaching strategies, namely constructive, guiding, and inductive,…

Understanding the processes of writing papers reflectively.

PubMed

Regmi, Krishna; Naidoo, Jennie

2013-07-01

This paper explores the writing of research papers using reflective frameworks. Reflective practice is integral to professional education and development. However, healthcare students, academics and practitioners have given limited attention to how to write reflectively. In addition, there are limited resources on the practical aspects of writing papers reflectively. The following major databases were searched: PubMed, Medline, King's Library, Excerpta Medica Database, Department of Health database, Cumulative Index to Nursing and Allied Health Literature. The searches were conducted using 'free text' and 'index' terms. Only relevant papers published in English were reviewed and scrutinised. Unpublished reports, internal publications, snowballing from the reference lists and personal contacts were also included in the search. This is a review paper that critiques the frameworks used for reflective practice. Writing papers reflectively is a complex task. Healthcare professionals and researchers need to understand the meaning of reflection and make appropriate use of reflective frameworks. Demystifying the process of reflectively writing papers will help professionals develop skills and competencies. IMPLICATION FOR RESEARCH/PRACTICE: This article provides a practical guide to reflection and how nursing and allied healthcare students, academics and practitioners can practise it. The paper identifies four generic stages in frameworks: description, assessment, evaluation and action, which are illustrated by annotated 'skeletal' examples. It is hoped that this will assist the process of reflective practice, writing and learning.

The concept of animal welfare at the interface between producers and scientists: the example of organic pig farming.

PubMed

Leeb, Christine

2011-06-01

In organic farming animal welfare is one important aspect included in the internationally agreed organic principles of health, ecology, fairness and care (IFOAM 2006), reflecting expectation of consumers and farmers. The definition of organic animal welfare includes-besides traditional terms of animal welfare-'regeneration' and 'naturalness'. Organic animal welfare assessment needs to reflect this and use complex parameters, include natural behaviour and a systemic view. Furthermore, various parties with seemingly conflicting interests are involved, causing ethical dilemmas, such as the use of nose rings for outdoor sows (impaired animal welfare vs. destruction of humus). Solutions can only be found when foundational concepts are translated and applied to practical situations. On-farm animal welfare assessment and implementation of improvement strategies are increasingly relevant scientific areas. They combine on-farm welfare assessment, identification of key problem areas and connected risk factors. Constant communication between all parties is crucial for success. Animal health and welfare planning is one application of this approach, which was carried out on Austrian organic pig farms as well as organic dairy farms in seven European countries. The projects included welfare assessment, feedback and benchmarking as a tool for communication between farmers, advisors and scientists. Finally goals were set by the farmer and improvement strategies applicable to organic farming were implemented. This included prevention of disease by management strategies instead of routine treatment with pharmaceutical products. It appeared that next to problem structuring, multidisciplinary problem solving demands good communications skills to relate animal welfare science to value reflections.

Self-employed nurses as change agents in healthcare: strategies, consequences, and possibilities.

PubMed

Wall, Sarah

2014-01-01

The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare. Focussed ethnography was used to explore self-employed nurses' work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system. These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice. Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing's professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.

Lights, Camera, Action: Facilitating PETE Students' Reflection through Film

ERIC Educational Resources Information Center

Lee, Okseon; Ravizza, Dean; Lee, Myung-Ah

2009-01-01

Preparing teacher candidates to be reflective professionals is a critical component of physical education teacher education programs. Although many specific strategies have been developed to facilitate post-lesson reflection, strategies for reflecting on future work and professional life have not been widely explored. As a way to facilitate…

Pedagogical Practices of Reflection in Tertiary Dance Education

ERIC Educational Resources Information Center

Leijen, Ali; Lam, Ineke; Simons, P. Robert-Jan; Wildschut, Liesbeth

2008-01-01

The three different perspectives on reflection in education are embedded in the philosophical traditions of pragmatism, critical social theory and Kant. We aimed to describe the pedagogical practices of reflection, and to develop a descriptive model of the practices of reflection in tertiary dance education which can be used by dance educators to…

Towards a Theory of the Ecology of Reflection: Reflective Practice for Experiential Learning in Higher Education

ERIC Educational Resources Information Center

Harvey, Marina; ; Coulson, Debra; McMaugh, Anne

2016-01-01

Reflective practice is widely adopted across the field of experience-based learning subjects in higher education, including practicums, work-integrated learning, internships, service learning and community participation. This adoption of reflective practice implies that it supports student learning through experience. When reviewing the evidence…

Eliciting and Assessing Reflective Practice: A Case Study in Web 2.0 Technologies

ERIC Educational Resources Information Center

Parkes, Kelly A.; Kajder, Sara

2010-01-01

This paper focuses on the role of multimodal technologies in facilitating reflective processes and the subsequent assessment of reflectivity for students in pre-professional programs. Reflective practice has been established as a critical tool for developing identity in and on practice. This paper will focus firstly on reviewing salient literature…

Life Story Reflection in Social Work Education: A Practical Model

ERIC Educational Resources Information Center

Spector-Mersel, Gabriela

2017-01-01

Drawing from the practice-oriented conception of reflection in social work, its applications in social work education typically focus on students' encounters with the field. Recognizing the value of practice-oriented reflection yet aware of its limitations, complementing it with life story reflection (LSR) is urged. The importance of LSR in social…

Using a Collaborative Course Reflection Process to Enhance Faculty and Curriculum Development

ERIC Educational Resources Information Center

Sellheim, Debra; Weddle, Mary

2015-01-01

Reflective practice is a vital skill of effective teachers and a precondition for professional growth. Lack of time, poorly developed reflective skills, or academic cultures that are not supportive of reflection may curtail reflective practice. This article describes a peer-led course reflection process designed to increase the reflection and…

Reflection: moving from a mandatory ritual to meaningful professional development.

PubMed

Murdoch-Eaton, Deborah; Sandars, John

2014-03-01

Reflection has become established as a key principle underpinning maintenance of standards within professional education and practice. A requirement to evidence reflection within performance review is intended to develop a transformative approach to practice, identify developmental goals, and ultimately, improve healthcare. However, some applications have taken an excessively instrumental approach to the evidencing of reflection, and while they have provided useful templates or framing devices for recording individualistic reflective practice, they potentially have distorted the original intentions. This article revisits the educational theory underpinning the importance of reflection for enhancing performance and considers how to enhance its value within current paediatric practice.

[Pedagogical reflective practice of nursing undergraduates: the portfolio as an instrument].

PubMed

Vaz, Débora Rodrigues; Prado, Cláudia

2014-12-01

Analyzing the narratives related to the pedagogical practice experienced during the Supervised Curricular Internship reported in the portfolios of Nursing undergraduate students, regarding the levels of reflection. This is a documentary descriptive exploratory study that examined two of the activities proposed for the portfolio preparation. Among the 28 analyzed portfolios, all showed the three levels of reflection (technical, critical and metacritical). The students had the opportunity to experience the pedagogical practice and presented reflections at metacritical level, reflecting on their performance, the construction of their teaching identity, and about the importance of reflecting on the practice with the objective of transforming it and transforming themselves.

(Mis)Understanding Strategy as a "Spectacular Intervention": A Phenomenological Reflection on the Strategy Orientations Underpinning School Improvement in England

ERIC Educational Resources Information Center

Bates, Agnieszka

2014-01-01

The introduction of the "National Strategies" for primary education in 1998, positioned "strategy" as a powerful instrument for mobilising the school "workforce" in England in the cause of continuous improvement. Government approaches to strategy formulation and enactment appear to reflect an instrumentalist…

A review of teaching-learning strategies to be used with film for prelicensure students.

PubMed

Oh, Jina; De Gagné, Jennie Chang; Kang, Jeongae

2013-03-01

The use of film in nursing and medical education has been supported as an effective instructional method. The purpose of this article is to identify and synthesize the available studies on teaching-learning strategies to be used with film for prelicensure students. Electronic databases were searched to identify studies published in the English language between January 1990 and March 2012. Twenty-seven articles met the selection criteria for this review and were analyzed. After in-depth discussion about and investigation of the relevant literature, we narrowed down three teaching-learning strategies: reflective activities, practical activities, and evaluative activities. The synthesis of the identified teaching-learning strategies provides a data point for the development of more effective evidence-based learning activities for prelicensure students. Future studies should focus on the examination of teaching effectiveness and learning outcomes, as well as the evaluation of using film, to achieve nursing competencies appropriate to role preparation. Copyright 2013, SLACK Incorporated.

H2/H∞ control for grid-feeding converter considering system uncertainty

NASA Astrophysics Data System (ADS)

Li, Zhongwen; Zang, Chuanzhi; Zeng, Peng; Yu, Haibin; Li, Shuhui; Fu, Xingang

2017-05-01

Three-phase grid-feeding converters are key components to integrate distributed generation and renewable power sources to the power utility. Conventionally, proportional integral and proportional resonant-based control strategies are applied to control the output power or current of a GFC. But, those control strategies have poor transient performance and are not robust against uncertainties and volatilities in the system. This paper proposes a H2/H∞-based control strategy, which can mitigate the above restrictions. The uncertainty and disturbance are included to formulate the GFC system state-space model, making it more accurate to reflect the practical system conditions. The paper uses a convex optimisation method to design the H2/H∞-based optimal controller. Instead of using a guess-and-check method, the paper uses particle swarm optimisation to search a H2/H∞ optimal controller. Several case studies implemented by both simulation and experiment can verify the superiority of the proposed control strategy than the traditional PI control methods especially under dynamic and variable system conditions.

Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy.

PubMed

Rowe, Michael; Frantz, Jose; Bozalek, Vivienne

2013-04-10

While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond "having" knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches. This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed. Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology. There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills.

Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy

PubMed Central

2013-01-01

Background While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond “having” knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches. Methods This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed. Results Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology. Conclusions There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills. PMID:23574731

Client-centered home care: balancing between competing responsibilities.

PubMed

Schoot, Tineke; Proot, Ireen; Legius, Marja; ter Meulen, Ruud; de Witte, Luc

2006-11-01

This study explores and describes the perceptions of nurses with respect to everyday client-centered care. A grounded theory study was conducted with 10 Dutch nurses and auxiliary nurses giving home care to chronically ill clients. Participatory observations and semistructured interviews were held. Nurses perceived roles and responsibilities competing with the role as a responsive professional to the client demand: a critical professional, developer of client competencies, individual, and employee. Strategies in balancing between competing responsibilities were distinguished: pleasing, dialoguing, directing, and detaching. Directing (related to impaired client competencies) and detaching (related to organizational barriers) were also used as second choice strategies. Effectively balancing between competing responsibilities was seen in dialoguing and directing as second choice. Conditions identified related to these strategies are awareness of, and responsibility taking for competing responsibilities. Recommendations for practice concern a care relationship and a dialogue with the client, critical ethical reflection, professional autonomy, self-assertiveness and organizational support.

Use of video-feedback, reflection, and interactive analysis to improve nurse leadership practices.

PubMed

Crenshaw, Jeannette T

2012-01-01

The chronic shortage of registered nurses (RNs) affects patient safety and health care quality. Many factors affect the RN shortage in the workforce, including negative work environments, exacerbated by ineffective leadership approaches. Improvements in the use of relationship-based leadership approaches lead to healthier work environments that foster RN satisfaction and reduce RN turnover and vacancy rates in acute care settings. In this article, an innovative approach to reduce nurse turnover and decrease vacancy rates in acute care settings is described. Video feedback with reflection and interactive analysis is an untapped resource for nurse leaders and aspiring nurse leaders in their development of effective leadership skills. This unique method may be an effective leadership strategy for addressing recruitment and retention issues in a diverse workforce.

Teachers Talking about Teaching and School: Collaboration and Reflective Practice via Critical Friends Groups

ERIC Educational Resources Information Center

Kuh, Lisa P.

2016-01-01

Reflective practice has potentially positive effects on an organization's capacity to focus on student learning and teaching practices. In an effort to comply with policy and provide teachers with opportunities to reflect on their practice, districts, schools, and teachers have turned to various models that feature collaborative experiences. One…

From Reflective Practice to Practical Wisdom: Toward a Post-Foundational Teacher Education

ERIC Educational Resources Information Center

Eryaman, Mustafa Yunus

2007-01-01

The author situates this paper within ongoing debates in related areas such as reflective practice, critical pedagogy, practical wisdom and critical theory. First, the author identifies some of the problems in the present notions of reflective teaching and progressive teacher education. The analyzes and compares the traditional-technical and…

"Keeping SCORE": Reflective Practice through Classroom Observations

ERIC Educational Resources Information Center

Farrell, Thomas S. C.

2011-01-01

Reflective practice means that teachers must subject their own teaching beliefs and practices to critical examination. One way of facilitating reflective practice in ESL teachers is to encourage them to engage in classroom observations as part of their professional development. This paper reports on a case study of a short series of classroom…

Beginning Science Teachers' Use of a Digital Video Annotation Tool to Promote Reflective Practices

NASA Astrophysics Data System (ADS)

McFadden, Justin; Ellis, Joshua; Anwar, Tasneem; Roehrig, Gillian

2014-06-01

The development of teachers as reflective practitioners is a central concept in national guidelines for teacher preparation and induction (National Council for Accreditation of Teacher Education 2008). The Teacher Induction Network (TIN) supports the development of reflective practice for beginning secondary science teachers through the creation of online "communities of practice" (Barab et al. in Inf Soc, 237-256, 2003), which have been shown to have positive impacts on teacher collaboration, communication, and reflection. Specifically, TIN integrated the use of asynchronous, video annotation as an affordance to directly facilitate teachers' reflection on their classroom practices (Tripp and Rich in Teach Teach Educ 28(5):728-739, 2013). This study examines the use of video annotation as a tool for developing reflective practices for beginning secondary science teachers. Teachers were enrolled in an online teacher induction course designed to promote reflective practice and inquiry-based instruction. A modified version of the Learning to Notice Framework (Sherin and van Es in J Teach Educ 60(1):20-37, 2009) was used to classify teachers' annotations on video of their teaching. Findings from the study include the tendency of teachers to focus on themselves in their annotations, as well as a preponderance of annotations focused on lower-level reflective practices of description and explanation. Suggestions for utilizing video annotation tools are discussed, as well as design features, which could be improved to further the development of richer annotations and deeper reflective practices.

A Metacognitive Profile of Vocational High School Student’s Field Independent in Mathematical Problem Solving

NASA Astrophysics Data System (ADS)

Nugraheni, L.; Budayasa, I. K.; Suwarsono, S. T.

2018-01-01

The study was designed to discover examine the profile of metacognition of vocational high school student of the Machine Technology program that had high ability and field independent cognitive style in mathematical problem solving. The design of this study was exploratory research with a qualitative approach. This research was conducted at the Machine Technology program of the vocational senior high school. The result revealed that the high-ability student with field independent cognitive style conducted metacognition practices well. That involved the three types of metacognition activities, consisting of planning, monitoring, and evaluating at metacognition level 2 or aware use, 3 or strategic use, 4 or reflective use in mathematical problem solving. The applicability of the metacognition practices conducted by the subject was never at metacognition level 1 or tacit use. This indicated that the participant were already aware, capable of choosing strategies, and able to reflect on their own thinking before, after, or during the process at the time of solving mathematical problems.That was very necessary for the vocational high school student of Machine Technology program.

Theory in/to Practice: Using Dialogic Reflection to Develop a Writing Center Community of Practice

ERIC Educational Resources Information Center

Hall, R. Mark

2011-01-01

Michael Mattison's "Someone to Watch Over Me: Reflection and Authority in the Writing Center" explores the problem of audience for tutors' reflective writing. In Mattison's case, tutoring practices and learning are undermined because reflective writing leads consultants to feel as though they are being spied upon by the writing center director.…

Defining Tools for Teacher Reflection: The Assessment of Learner-Centered Practices (ALCP).

ERIC Educational Resources Information Center

McCombs, Barbara L.

This paper focuses on the development and validation of survey tools that help teachers engage in a guided reflection process. The guided reflection process assists teachers at all levels, kindergarten through college, to reflect on (1) their own beliefs and practices; (2) how these practices are perceived by their students; and (3) the impact of…

A Practice-Based Approach to Student Reflection in the Workplace during a Work-Integrated Learning Placement

ERIC Educational Resources Information Center

Sykes, Christopher; Dean, Bonnie Amelia

2013-01-01

In the Work-Integrated Learning (WIL) curriculum, reflection on workplace activities is widely used to support student learning. Recent critiques have demonstrated the limitations of current approaches to support students' reflective learning of workplace practices. By employing a practice-based approach, we seek to refocus WIL reflection on…

Two Mentor Practices that Generate Teacher Reflection without Explicit Solicitations: Some Preliminary Considerations

ERIC Educational Resources Information Center

Waring, Hansun Zhang

2013-01-01

Despite the push for fostering reflective practices in teacher education in the last 20 years, true reflection remains rare (Farr, 2011). Based on a detailed analysis of four mentor-teacher meetings in a graduate TESOL program, I show how specific mentor practices generate teacher reflection without explicit solicitations. Findings of this study…

Recommendations for Methicillin-Resistant Staphylococcus aureus Prevention in Adult ICUs: A Cost-Effectiveness Analysis.

PubMed

Whittington, Melanie D; Atherly, Adam J; Curtis, Donna J; Lindrooth, Richard C; Bradley, Cathy J; Campbell, Jonathan D

2017-08-01

Patients in the ICU are at the greatest risk of contracting healthcare-associated infections like methicillin-resistant Staphylococcus aureus. This study calculates the cost-effectiveness of methicillin-resistant S aureus prevention strategies and recommends specific strategies based on screening test implementation. A cost-effectiveness analysis using a Markov model from the hospital perspective was conducted to determine if the implementation costs of methicillin-resistant S aureus prevention strategies are justified by associated reductions in methicillin-resistant S aureus infections and improvements in quality-adjusted life years. Univariate and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness. ICU. Hypothetical cohort of adults admitted to the ICU. Three prevention strategies were evaluated, including universal decolonization, targeted decolonization, and screening and isolation. Because prevention strategies have a screening component, the screening test in the model was varied to reflect commonly used screening test categories, including conventional culture, chromogenic agar, and polymerase chain reaction. Universal and targeted decolonization are less costly and more effective than screening and isolation. This is consistent for all screening tests. When compared with targeted decolonization, universal decolonization is cost-saving to cost-effective, with maximum cost savings occurring when a hospital uses more expensive screening tests like polymerase chain reaction. Results were robust to sensitivity analyses. As compared with screening and isolation, the current standard practice in ICUs, targeted decolonization, and universal decolonization are less costly and more effective. This supports updating the standard practice to a decolonization approach.

Exploring resilience in rural GP registrars--implications for training.

PubMed

Walters, Lucie; Laurence, Caroline O; Dollard, Joanne; Elliott, Taryn; Eley, Diann S

2015-07-02

Resilience can be defined as the ability to rebound from adversity and overcome difficult circumstances. General Practice (GP) registrars face many challenges in transitioning into general practice, and additional stressors and pressures apply for those choosing a career in rural practice. At this time of international rural generalist medical workforce shortages, it is important to focus on the needs of rural GP registrars and how to support them to become resilient health care providers. This study sought to explore GP registrars' perceptions of their resilience and strategies they used to maintain resilience in rural general practice. In this qualitative interpretive research, semi-structured interviews were recorded, transcribed and analysed using an inductive approach. Initial coding resulted in a coding framework which was refined using constant comparison and negative case analysis. Authors developed consensus around the final conceptual model. Eighteen GP registrars from: Australian College of Rural and Remote Medicine Independent Pathway, and three GP regional training programs with rural training posts. Six main themes emerged from the data. Firstly, rural GP registrars described four dichotomous tensions they faced: clinical caution versus clinical courage; flexibility versus persistence; reflective practice versus task-focused practice; and personal connections versus professional commitment. Further themes included: personal skills for balance which facilitated resilience including optimistic attitude, self-reflection and metacognition; and finally GP registrars recognised the role of their supervisors in supporting and stretching them to enhance their clinical resilience. Resilience is maintained as on a wobble board by balancing professional tensions within acceptable limits. These limits are unique to each individual, and may be expanded through personal growth and professional development as part of rural general practice training.

The Effects of Coaching Using a Reflective Framework on Early Childhood Science Teachers' Depth of Reflection and Change in Practice

NASA Astrophysics Data System (ADS)

Bloomquist, Debra L.

This embedded-mixed methods study examined if the use of a reflective framework with guiding prompts could support early childhood science teachers in improving their reflective practice and subsequently changing their pedagogy. It further investigated whether type of cognitive coaching group, individual or collaborative, impacted teacher depth of reflection and change in practice. Data included teacher reflections that were rated using the Level of Reflection-On-Action Assessment, reflective codes and inductive themes, as well as videos of participants lessons coded using the SCIIENCE instrument. Findings demonstrated that through guided reflection, teachers developed reflective thinking skills, and through this reflection became more critical and began to improve their pedagogical practice. Further findings supported that collaborative cognitive coaching may not be the most effective professional development for all teachers; as some teachers in the study were found to have difficulty improving their reflectivity and thus their teaching practice. Based on these findings it is recommended that coaches and designers of professional development continue to use reflective frameworks with guiding prompts to support teachers in the reflective process, but take into consideration that coaching may need to be differentiated for the various reflective levels demonstrated by teachers. Future studies will be needed to establish why some teachers have difficulty with the reflective process and how coaches or designers of professional development can further assist these teachers in becoming more critical reflectors.

Do Different Modalities of Reflection Matter? An Exploration of Adult Second-Language Learners' Reported Strategy Use and Oral Language Production

ERIC Educational Resources Information Center

Huang, Li-Shih

2010-01-01

This paper reports on a small-scale study that was the first to explore raising second-language (L2) learners' awareness of speaking strategies as mediated by three modalities of task-specific reflection--individual written reflection, individual spoken reflection, and group spoken reflection. Though research in such areas as L2 writing, teacher's…

Implementing family nursing: how do we translate knowledge into clinical practice? Part II: The evolution of 20 years of teaching, research, and practice to a Center of Excellence in Family Nursing.

PubMed

Duhamel, Fabie

2010-02-01

The author's reflections on knowledge transfer/translation highlight the importance of the circular process between science and practice knowledge, leading to the notion of "knowledge exchange." She addresses the dilemmas of translating knowledge into clinical practice by describing her academic contributions to knowledge exchange within Family Systems Nursing (FSN). Teaching and research strategies are offered that address the circularity between science and practice knowledge. The evolution of 20 years of teaching, research, and clinical experience has resulted in the recent creation of a Center of Excellence in Family Nursing at the University of Montreal. The three main objectives of the Center uniquely focus on knowledge exchange by providing (a) a training context for skill development for nurses specializing in FSN, (b) a research milieu for knowledge "creation" and knowledge "in action" studies to further advance the practice of FSN, and (c) a family healing setting to support families who experience difficulty coping with health issues.

Using online program development to foster curricular change and innovation.

PubMed

Gwozdek, Anne E; Springfield, Emily C; Peet, Melissa R; Kerschbaum, Wendy E

2011-03-01

Distance education offers an opportunity to catalyze sweeping curricular change. Faculty members of the University of Michigan Dental Hygiene Program spent eighteen months researching best practices, planning outcomes and courses, and implementing an e-learning (online) dental hygiene degree completion program. The result is a collaborative and portfolio-integrated program that focuses on the development of reflective practitioners and leaders in the profession. A team-based, systems-oriented model for production, implementation, and evaluation has been critical to the program's success. The models and best practices on which this program was founded are described. Also provided is a framework of strategies for development, including the utilization of backward course design, which can be used in many areas of professional education.

Educative Mentoring: How a Mentor Supported a Preservice Biology Teacher's Pedagogical Content Knowledge Development

NASA Astrophysics Data System (ADS)

Barnett, Ellen; Friedrichsen, Patricia J.

2015-11-01

Research suggests discipline-specific, educative mentoring can help preservice teachers develop more sophisticated pedagogical content knowledge (PCK). However, there are few studies examining the nature of mentors' practice and how mentors influence preservice teacher's (PST) PCK. The purpose of this case study was to describe the strategies used by a secondary biology mentor teacher to support the development of a PST's PCK. The primary data sources were the transcripts of audio-recorded, daily meetings between the mentor and the PST during two curriculum units: DNA/Protein Synthesis and Evolution. The mentor influenced the PST's teaching orientation by repeatedly comparing teacher- and student-centered approaches, asking him to consider how students learn, and asking him to self-assess whether his instruction aligned with his teaching beliefs. The mentor helped the PST develop topic-specific knowledge of instructional strategies by sharing strategies she used previously, modeling critical reflection, and inviting him to critically reflect on his own instructional strategies. Topic-specific knowledge of students' understanding of science was developed by discussing common student misconceptions revealed in students' conversations and by sharing the results of test-item analysis from previous unit tests. The mentor helped develop the PST's topic-specific knowledge of assessment by helping him critically analyze and revise previous examinations to better align with the current curriculum units. Topic-specific knowledge of curricula was developed by jointly grappling with decisions about concept sequencing within units. The study includes implications for research, science teacher education, and professional development for mentors.

A Reflective Learning Framework to Evaluate CME Effects on Practice Reflection

ERIC Educational Resources Information Center

Leung, Kit H.; Pluye, Pierre; Grad, Roland; Weston, Cynthia

2010-01-01

Introduction: The importance of reflective practice is recognized by the adoption of a reflective learning model in continuing medical education (CME), but little is known about how to evaluate reflective learning in CME. Reflective learning seldom is defined in terms of specific cognitive processes or observable performances. Competency-based…

First year specialist trainees' engagement with reflective practice in the e-portfolio.

PubMed

McNeill, Helen; Brown, Jeremy M; Shaw, Nigel J

2010-10-01

Doctors in specialist training posts in the Mersey Deanery are expected to reflect on their clinical practice and to document their learning experiences in an e-portfolio. This study aims specifically to explore how they have engaged in reflection on their practice and how they utilise their learning portfolio to document evidence of this. A modified Delphi technique was used to develop a grading system to identify the level of reflection recorded by participants in the e-portfolio. Transcripts of the reflective accounts were then analysed using a qualitative approach which involved coding and categorising the data. This study demonstrated a wide variation in both the quantity and quality of reflection. Of particular note in the qualitative data analysis were themes relating to clinical knowledge and skills, learning in practice, communication, feelings, types of learning experience reflected on and wider aspects of medical practice. Findings indicate there is variation is the extent to which doctors both engage in and document evidence of reflection. Further research is needed to explore factors that enable or inhibit the use of the e-portfolio for reflection and whether recorded reflection is a true picture of the cognitive process involved.

Changes Resulting from Reflection Dialogues on Nursing Practice

PubMed Central

Okuda, Reiko; Fukada, Mika

2014-01-01

Background Reflection is defined here as a process by which, through self-conversation, one’s self and one’s behavior acquire meaning. However, people have limitations in terms of what they can express and be aware of during reflection. This finding points to the importance of facilitators. The purpose of this study was to determine what changes can be brought about through reflection dialogues on nursing practice. Methods The Participants were 9 nurses who worked at three institutions in City A, each with about 200 beds. Workplace topics were examined through self-reflections and reflection dialogues. The depth of reflection was assessed using the three levels of reflection described by Mezirow—{reflecting on the content}, {reflecting on the process} and {reflecting on the assumptions}. Results In reflecting on nursing practice, the participants were also divided into those who had already reached the highest level, {reflecting on assumptions}, via self-reflection, and those who remained at the level of {reflecting on processes}, despite the use of reflection dialogues. Conclusion The development of reflective thinking on nursing practice was connected not only to the participants’ desire to explore ways of accepting their individual experiences, but may also be connected to whether or not they are able to question themselves about their thoughts and preconceptions about nursing work. PMID:25067874

Appreciated but Constrained: Reflective Practice of Student Teachers in Learning Communities in a Confucian Heritage Culture

ERIC Educational Resources Information Center

Zhan, Ying; Wan, Zhi Hong

2016-01-01

This study aimed to understand the reflective practice of 23 Chinese student teachers in learning communities (LCs) during their practicum in a Confucian heritage culture. The reflective levels of the student teachers and the factors that mediated the effects of LCs on their reflective practice were explored using journals and post-journal…

The education of health practitioners supporting breastfeeding women: time for critical reflection.

PubMed

Dykes, Fiona

2006-10-01

The protection, promotion and support of breastfeeding has now become a major international priority as emphasized in the Global Strategy for Infant and Young Child Feeding. Health practitioners, such as midwives, nurses and doctors, have a key role to play in providing support to breastfeeding women. This paper provides a critical discussion of educational requirements of health practitioners to equip them for their supportive role. The effective integration of embodied, vicarious, practice-based and theoretical knowledge requires opportunities for deep critical reflection. This approach should facilitate personal reflection and critical engagement with broader socio-political issues, thus allowing for collective understandings and change. Practitioners also need to understand breastfeeding as a biopsychosocial process that is dynamic, relational and changes over time. Recommendations are outlined with regards to multidisciplinary undergraduate education; mentorship schemes with knowledgeable role models supporting student practitioners; involvement of voluntary and peer supporters; post-registration education; setting of national standards for breastfeeding education; tailored education for specific groups; designated funding; and involvement of breastfeeding specialists.

Patterns of Clinical Reasoning in Physical Therapist Students.

PubMed

Gilliland, Sarah; Wainwright, Susan Flannery

2017-05-01

Clinical reasoning is a complex, nonlinear problem-solving process that is influenced by models of practice. The development of physical therapists' clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants' clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis. Participants demonstrated consistent signs of development of physical therapy-specific reasoning processes, yet varied in their approach to the case and use of reflection. Participants who gave greater attention to patient education and empowerment also demonstrated greater use of reflection-in-action during the patient encounter. One negative case illustrates the variability in the rate at which students may develop these abilities. Participants demonstrated development toward physical therapist--specific clinical reasoning, yet demonstrated qualitatively different approaches to the patient encounter. Multiple factors, including the use of reflection-in-action, may enable students to develop greater flexibility in their reasoning processes. © 2017 American Physical Therapy Association

Centres for Leadership: a strategy for academic integration.

PubMed

King, Gillian; Parker, Kathryn; Peacocke, Sean; Curran, C J; McPherson, Amy C; Chau, Tom; Widgett, Elaine; Fehlings, Darcy; Milo-Manson, Golda

2017-05-15

Purpose The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization. Design/methodology/approach Historical documents, tracked output information, and staff members' insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization. Findings The evolutions concerned development of a series of CfLs, and changes over time in leadership and management structure, as well as in operations and targeted activities. Benefits included enhanced clinician engagement in research, practice-based research, and impacts on clinical practice. Transformational learnings concerned the importance of supporting stakeholder engagement, fostering a spirit of inquiry, and fostering leaderful practice. These learnings contributed to three related emergent outcomes reflecting "way stations" on the journey to enhanced evidence-informed decision making and clinical excellence: enhancements in authentic partnerships, greater innovation capacity, and greater understanding and actualization of leadership values. Practical implications Practical information is provided for other organizations interested in understanding how this initiative evolved, its tangible value, and its wider benefits for organizational collaboration, innovation, and leadership values. Challenges encountered and main messages for other organizations are also considered. Originality/value A strategy map is used to present the structures, processes, and outcomes arising from the initiative, with the goal of informing the operations of other organizations desiring to be learning organizations.

The who, what, and how of evaluation within online nursing education: state of the science.

PubMed

Russell, Bedelia H

2015-01-01

The resource capacity in nursing programs has a direct impact on student admissions and number of graduates who enter the nursing workforce. Online delivery of nursing education is identified as a solution to expand nursing program capacity. As nursing programs continue to address capacity with online course delivery, it is essential that nurse educators maintain consistent evaluation practices to ensure successful and positive outcomes, compared with traditional models. Evaluation is a central component to determine program quality and mastery of learning outcomes. This article examines the state of the science around the current evaluation of educational practices, instructional strategies, and outcomes within the context of online nursing education. Thirty-six articles met the inclusion criteria. Despite substantive contributions to the state of the science, the findings reflect evaluation practices that are diffuse and superficial and serve as the basis for future recommendations and research opportunities. Copyright 2015, SLACK Incorporated.

Gap analysis: a method to assess core competency development in the curriculum.

PubMed

Fater, Kerry H

2013-01-01

To determine the extent to which safety and quality improvement core competency development occurs in an undergraduate nursing program. Rapid change and increased complexity of health care environments demands that health care professionals are adequately prepared to provide high quality, safe care. A gap analysis compared the present state of competency development to a desirable (ideal) state. The core competencies, Nurse of the Future Nursing Core Competencies, reflect the ideal state and represent minimal expectations for entry into practice from pre-licensure programs. Findings from the gap analysis suggest significant strengths in numerous competency domains, deficiencies in two competency domains, and areas of redundancy in the curriculum. Gap analysis provides valuable data to direct curriculum revision. Opportunities for competency development were identified, and strategies were created jointly with the practice partner, thereby enhancing relevant knowledge, attitudes, and skills nurses need for clinical practice currently and in the future.

Leadership role of Consultant Nurses working with Older People: a co-operative inquiry.

PubMed

Manley, Kim; Webster, Jonathan; Hale, Nick; Hayes, Nicky; Minardi, Henry

2008-03-01

The aim of the co-operative enquiry undertaken was to explore how the leadership component of the Consultant Nurse for Older People role was reflected in day-to-day working. Leadership is one of the four key elements of the Consultant Nurse role and is the key mechanism for achieving and embedding transformation in practice. However, within the role of the Consultant Nurse this area has not been explored in detail. A 6-month co-operative inquiry approach was used to develop insights into leadership strategies of Consultant Nurses for Older People and involved the five authors of the paper, four Consultant Nurses in Older People nursing and the lead author who was also an experienced Consultant Nurse and practice-based researcher from a different nursing specialism. Through the analysis of the stories shared by the co-authors/participants, two key themes emerged relating to complexity and pathway. These themes provided a major focus for the Consultant Nurses in their leadership role. The outcome of the study is a framework that describes the triggers and enabling factors that precede the use of leadership strategies at the clinical and organizational level and associated outcomes. In defining how leadership is reflected by Consultant Nurses for Older People, a complex picture emerges that is multifaceted and multidimensional. Consultant Nurses need support to make visible the valuable contribution they make to enabling healthcare teams, organizations and work places. Consultant Nurses for Older People are key in ensuring the quality agenda within their organizations as they are well placed to provide leadership at both a strategic and clinical level, while providing influence to operational development. Within the context of the literature this area is under investigated. Understanding how leadership is reflected in the role of Consultant Nurses is complex as Consultant Nurses work across traditional interfaces and between different levels within organizations. Consultant Nurses have been 'challenged' to identify the 'difference' they are making; to do this it is important to understand how leadership (as one element) is reflected in a highly complex, multidimensional role and the links between leadership and enabling, quality person-centred ways of working with Older People within rapidly changing, pressurized healthcare settings.

Applications of Reflective Practice. UCEA Monograph Series.

ERIC Educational Resources Information Center

Wendel, Frederick C., Ed.

The implications of reflective practices for educational leadership are examined in this publication, which contains three papers originally presented at the 1990 Convention of the University Council for Educational Administration. Ann Hart, Nancy Sorensen, and Kerri Naylor report on applications of reflective practice to educational…

Benefits of Reflective Practice

ERIC Educational Resources Information Center

Wagner, Kathi

2006-01-01

In this article, the author discusses what she was able to learn from an exercise in self-reflection regarding her teaching. She also discusses the advantages of reflection for administrators: First, a reflective practice is data-driven, making it a more valid way to evaluate administrators' knowledge and skills. Second, a reflective practice…

Teachers As Researchers: Improving Practice in Rural and Small Schools. Rural, Small Schools Network Information Exchange: Number 11, Fall 1991.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

This packet includes reprints of journal articles and other information exploring reflective practice and action research among rural educators. The four sections of the packet cover concepts of reflective practice and action research; examples of reflective practice at both the elementary and secondary levels; issues such as encouraging…

Reflective practice and daily ward reality: a covert power game.

PubMed

Mantzoukas, Stefanos; Jasper, Melanie A

2004-11-01

The concept of reflection is propounded in the literature as an epistemology for practice that enables practitioners to solve their daily problematic situations through conscious thought processes which eventually leads to practice-based knowledge. Hence, reflection became a central tenet of both theory development and educational provision in nursing. Furthermore, this centrality of reflection was reinforced by statutory nursing bodies and service providers by adopting it as the means for carrying out adequate professional practice. Although this may be the case, issues of implementation of reflection within the daily reality of practitioners are frequently overlooked within the literature. Moreover, little consideration appears to be given on the impact that the organizational culture and the politics of power may exert on the implementation of reflective practices within daily ward reality. This paper explores how reflection is viewed by nurses within their daily reality in the medical wards, examines the relationships between the organizational culture of these wards and the practitioners and investigates whether reflective methods of practice were being implemented when the study was conducted. An interpretative ethnographical methodology was implemented and the data collecting methods used were observation, interviews and qualitative content analysis with a group of 16 practising nurses from four medical wards of one NHS Trust in England. Two interviews were conducted with each nurse within 3-week intervals. The content of these interviews evolved from the analysis of episodes of practice observed when the nurses were giving nursing care. These data were supplemented by narratives from the nurses' in the form of written reflective accounts that were analysed via qualitative content analysis techniques. Four themes were generated: (i) relationships between nurses and doctors; (ii) relationships between nurses and managers; (iii) nursing practice; and (iv) nurses' input in the outcome of a clinical situation. The concept of reflection appears to be invalidated by the organizational hierarchy of the wards on the basis of a power struggle game. The ward structure portrays reflection as an abnormal method of practice and knowledge development. This belittlement of reflection does not mirror the practitioners' reality. Instead, it is an intelligent and intentional act on behalf of the dominant professional groups in the wards to create an illusionary picture of ward reality to allow them to survey and define nursing practice and thus maintain and remain in power. This is explicated by using Foucault's analysis and critical social theory framework. Hence, reflective processes are constrained by this covert power game; reflection, where used, is confined to nurses' personal time and space. The realization of this covert power game by individual clinical nurses can become the incipient point for formally using reflective methods in the practice setting.

The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education.

PubMed

Hatlevik, Ida Katrine Riksaasen

2012-04-01

This paper is a report of a correlational study of the relations of nursing students' acquired reflective skills, practical skills and theoretical knowledge on their perception of coherence between theory and practice. Reflection is considered a key factor in bridging the gap between theory and practice. However, it is not evident whether reflective skills are primarily generic in nature or whether they develop from a theoretical knowledge base or the acquisition of practical skills. This study is a secondary analysis of existing data. The data are part of a student survey that was conducted among third-year nursing students in Norway during the spring of 2007. A total of 446 nursing students participated in this study and the response rate was 71%. Structural equation modelling analyses were performed. The results indicate that students' perception of coherence between theory and practice during initial nursing education is directly influenced by reflective skills and theoretical knowledge. The results also reveal that reflective skills have mediating effects and that practical skills have a fully mediated and theoretical knowledge a partially mediated influence on students' perception of coherence. The findings imply that helping students perceive coherence between theory and practice in nursing education, developing students' reflective skills and strengthening the theoretical components of the initial nursing education programme might be beneficial. The results suggest that reflective thinking is not merely a generic skill but rather a skill that depends on the acquisition of relevant professional knowledge and experience. © 2011 Blackwell Publishing Ltd.

Using Reflective Practice to Facilitate Conversations and Transform Instructional Practice for Middle School Science Teachers

NASA Astrophysics Data System (ADS)

Higdon, Robbie L.

The process of teaching, especially inquiry, is complex and requires extended time for developing one's instructional practice (Loucks-Horsley, Stiles, Mundry, Love, & Hewson, 2010). The implementation of a continued cycle of self-reflection can engage teachers in analyzing their prior experiences and understandings about their instructional practice to promote the accommodation of new concepts and transform their practice. However, many teachers have difficulty engaging in the cognitive dissonance needed to identify those problems and promote their own growth without support. As one's professional practice becomes more repetitive and routine, it is difficult for the practitioner to recognize opportunities in which to contemplate one's habitual actions (Schon, 1983). In this multi-case study, two middle school science teachers who were engaged within a sustained professional development initiative participated in a series of one-on-one reflective dialogues regarding the decisions they made about the utilization of inquiry-based instruction. In addition, these teachers were asked to reflect upon the criteria used to determine how and when to implement these inquiry-based practices. These reflective dialogue sessions provided the opportunity to observe teacher conceptions and stimulate teacher cognitive dissonance about instructional practice. Qualitative analysis of data collected from these reflective dialogues along with informal and formal classroom observations of instructional practice uncovered diverse perceptions regarding the implementation of inquiry-based methods into present teaching practice. The use of reflective dialogue within the existing structure of the professional development initiative allowed for the facilitators of the professional development initiative to tailor ongoing support and their effective implementation of inquiry-based instruction. Additional research is needed to investigate the impact of reflective dialogue in achieving accommodation of new concepts leading to lasting conceptual change about inquiry-based instruction.

Facilitating students' reflective practice in a medical course: literature review.

PubMed

Chaffey, Lisa Jane; de Leeuw, Evelyne Johanna Janet; Finnigan, Gerard Anthony

2012-01-01

Reflection and reflective practice is of increasing importance in medical education curricula. The aim of this review is to summarise the literature published around facilitating reflection in a medical course, and to answer the question : W0 hat is the current evidence regarding learning and development moments across the medical curriculum in developing students' reflective practice? A review of the literature was undertaken using defined databases and the search terms 'medical students', 'medical education', 'reflection', 'reflectFNx01' and 'medicine'. The search was limited to peer-reviewed published material in English and between the years 2001 and 2011, and included research, reviews and opinion pieces. Thirty-six relevant articles were found, identifying enhancing factors and barriers to effectively teaching reflective practice within medical curricula, relating to: The breadth of the meaning of reflection; facilitating reflection by medical educators; using written or web-based portfolios to facilitate reflection; and assessing the reflective work of students. A variety of reflective purposes was found in this literature review. Evidence indicates that, if students are unclear as to the purpose of reflection and do not see educators modelling reflective behaviours, they are likely to undervalue this important skill regardless of the associated learning and development opportunities embedded in the curriculum.

Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams

PubMed Central

McCall, Alan; Davison, Michael; Andersen, Thor Einar; Beasley, Ian; Bizzini, Mario; Dupont, Gregory; Duffield, Rob; Carling, Chris; Dvorak, Jiri

2015-01-01

Purpose The available scientific research regarding injury prevention practices in international football is sparse. The purpose of this study was to quantify current practice with regard to (1) injury prevention of top-level footballers competing in an international tournament, and (2) determine the main challenges and issues faced by practitioners in these national teams. Methods A survey was administered to physicians of the 32 competing national teams at the FIFA 2014 World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies and (4) reflection on their experience at the World Cup. Results Following responses from all teams (100%), the present study revealed the most important intrinsic (previous injury, accumulated fatigue, agonist:antagonist muscle imbalance) and extrinsic (reduced recovery time, training load prior to and during World Cup, congested fixtures) risk factors during the FIFA 2014 World Cup. The 5 most commonly used tests for risk factors were: flexibility, fitness, joint mobility, balance and strength; monitoring tools commonly used were: medical screen, minutes/matches played, subjective and objective wellness, heart rate and biochemical markers. The 5 most important preventative exercises were: flexibility, core, combined contractions, balance and eccentric. Conclusions The present study showed that many of the National football (soccer) teams’ injury prevention perceptions and practices follow a coherent approach. There remains, however, a lack of consistent research findings to support some of these perceptions and practices. PMID:25878078

Spiritual Reflective Practice in Preservice Art Education

ERIC Educational Resources Information Center

Campbell, Laurel H.

2005-01-01

Spirituality is becoming an increasingly significant aspect of contemporary art education theory. The manner in which one conceives of holistic art education curricula is partially shaped by one's understanding of a more spiritual approach to reflective thinking and practice in teacher education. Definitions of reflective practice and…

Exploration of a Reflective Practice Rubric

ERIC Educational Resources Information Center

Young, Karen; James, Kimberley; Noy, Sue

2016-01-01

Work integrated learning (WIL) educators using reflective practice to facilitate student learning require a set of standards that works within the traditional assessment frame of Higher Education, to ascertain the level at which reflective practice has been demonstrated. However, there is a paucity of tested assessment instruments that provide…

Strategies to keep working among workers with common mental disorders - a grounded theory study.

PubMed

Danielsson, Louise; Elf, Mikael; Hensing, Gunnel

2017-11-28

Most people with common mental disorders (CMDs) are employed and working, but few studies have looked into how they manage their jobs while ill. This study explores workers' experiences of strategies to keep working while suffering from CMDs. In this grounded theory study, we interviewed 19 women and eight men with depression or anxiety disorders. They were 19-65 years old and had different occupations. Constant comparison method was used in the analysis. We identified a core pattern in the depressed and anxious workers' attempts to sustain their capacities, defined as Managing work space. The core pattern comprised four categories describing different cognitive, behavioral, and social strategies. The categories relate to a process of sustainability. Two categories reflected more reactive and temporary strategies, occurring mainly in the onset phase of illness: Forcing the work role and Warding off work strain. The third category, Recuperating from work, reflected strategies during both onset and recovery phases. The fourth category, Reflexive adaptation, was present mainly in the recovery phase and involved reflective strategies interpreted as more sustainable over time. The results can deepen understanding among rehabilitation professionals about different work-related strategies in depressed and anxious workers. Increased awareness of the meaning and characteristics of strategies can inform a person-oriented approach in rehabilitation. The knowledge can be used in clinical encounters to reflect together with the patient, exploring present options and introducing modifications to their particular work and life context. Implications for rehabilitation Self-managed work functioning in common mental disorders involves diverse strategies. Strategies interpreted as sustainable over time, seem to be reflective in the sense that the worker consciously applies and adapts the strategies. However, at the onset of illness, such reflection is difficult to develop as the worker might not want to realize their reduced functioning. Rehabilitation professionals' awareness of different strategies can facilitate a person-centered approach and understanding of the vocational rehabilitation process.

Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

PubMed

Merriweather, Judith; Smith, Pam; Walsh, Timothy

2014-03-01

To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

Fostering Teacher Candidates' Reflective Practice through Video Editing

ERIC Educational Resources Information Center

Trent, Margaret; Gurvitch, Rachel

2015-01-01

Recently, interest in using video to promote the reflective practice in preservice teacher education has increased. Video recordings of teaching incidents inspire the reflective practice in preservice teachers by allowing them to analyze instruction and view teaching in an objective light. As an extension of video recording, video editing has…

Confession, In-Service Training and Reflective Practices

ERIC Educational Resources Information Center

Fejes, Andreas

2011-01-01

This article focuses on how confession operates in contemporary discourses on reflective practices. By revisiting and mobilising Foucault's genealogy of confession in relation to how reflective practices are mobilised in an in-service training programme for healthcare assistants (HCA) in elderly care, it is argued that the HCAs are shaped as their…

Reflective Practice in a Pluri-Disciplinary Innovative Design Course

ERIC Educational Resources Information Center

Choulier, Denis; Picard, Fabienne; Weite, Pierre-Alain

2007-01-01

Reflective practice is an important vehicle for the apprenticeship of tacit and procedure-oriented knowledge. This article explores the development of reflective practice in the teaching of an innovative design course. Starting from a characterization of the "materials of a design situation" (problem-solution duality, methods and tools,…

Presence without Being Present: Reflection and Action in a Community of Practice

ERIC Educational Resources Information Center

Enfield, Mark; Stasz, Bird

2011-01-01

Reflection and Communities of Practice are common constructs in teacher education. Co-teaching is often seen as beneficial, yet teacher education students rarely have experiences being co-taught. Thus, reflection, communities of practice, and co-teaching, deserve careful consideration in designing teacher education learning experiences. Based on…

Cross-Continental Reflections on Evaluation Practice: Methods, Use, and Valuing

ERIC Educational Resources Information Center

Kallemeyn, Leanne M.; Hall, Jori; Friche, Nanna; McReynolds, Clifton

2015-01-01

The evaluation theory tree typology reflects the following three components of evaluation practice: (a) methods, (b) use, and (c) valuing. The purpose of this study was to explore how evaluation practice is conceived as reflected in articles published in the "American Journal of Evaluation" ("AJE") and "Evaluation," a…

Reflective Practices in Foreign Language Teacher Education: A View through Micro and Macro Windows

ERIC Educational Resources Information Center

Geyer, Naomi

2008-01-01

As professional development models of teacher education that allow for self-directed, collaborative, inquiry-based learning are increasingly replacing more traditional top-down models, researchers acknowledge the impact of teachers' reflective practices. Although many different types of reflective practices are reported, the differences across…

Political strategy, business strategy, and the academic medical center: linking theory and practice.

PubMed

Souba, W W; Weitekamp, M R; Mahon, J F

2001-09-01

The purpose of this paper is to link external political strategy theory to a specific health care setting-that of the academic medical center (AMC). Political strategy encompasses those activities undertaken by AMCs to acquire, develop, and use power (clout, influence, and credibility) to gain an advantage in situations of conflict. It should be differentiated from internal politics, a topic that will not be dealt with in this review. Political strategy should also be distinguished from but not divorced from competitive strategy. As political and social action can change the competitive landscape and the rules of competition, AMCs must become adept in issues management and stakeholder management. The focus on political strategy is a reflection of the enormous changes in the external environment that have impacted AMCs in recent years. These changes have often emerged out of political and social action and they impact significantly on the organization's more traditional business strategies. We suggest that a tighter alignment between political and business strategies in the future will help ensure organizational survival and success. This article reviews the literature and theory in corporate political strategy and illustrates the application of political strategy with examples of issues and problems faced by AMCs. Models of political strategy are well crafted, and this article concludes with succinct observations on the use of political strategies to enhance the business-based strategies of AMCs. Although the focus is on AMCs, the use of political strategies is applicable to any health care institution. Copyright 2001 Academic Press.

Rational choice and the political bases of changing Israeli counterinsurgency strategy.

PubMed

Brym, Robert J; Andersen, Robert

2011-09-01

Israeli counterinsurgency doctrine holds that the persistent use of credible threat and disproportionate military force results in repeated victories that eventually teach the enemy the futility of aggression. The doctrine thus endorses classical rational choice theory's claim that narrow cost-benefit calculations shape fixed action rationales. This paper assesses whether Israel's strategic practice reflects its counterinsurgency doctrine by exploring the historical record and the association between Israeli and Palestinian deaths due to low-intensity warfare. In contrast to the expectations of classical rational choice theory, the evidence suggests that institutional, cultural and historical forces routinely override simple cost-benefit calculations. Changing domestic and international circumstances periodically cause revisions in counterinsurgency strategy. Credible threat and disproportionate military force lack the predicted long-term effect. © London School of Economics and Political Science 2011.

Depression, diet and exercise.

PubMed

Jacka, Felice N; Berk, Michael

2013-09-16

Unhealthy lifestyle behaviour is driving an increase in the burden of chronic non-communicable diseases worldwide. Recent evidence suggests that poor diet and a lack of exercise contribute to the genesis and course of depression. While studies examining dietary improvement as a treatment strategy in depression are lacking, epidemiological evidence clearly points to diet quality being of importance to the risk of depression. Exercise has been shown to be an effective treatment strategy for depression, but this is not reflected in treatment guidelines, and increased physical activity is not routinely encouraged when managing depression in clinical practice. Recommendations regarding dietary improvement, increases in physical activity and smoking cessation should be routinely given to patients with depression. Specialised and detailed advice may not be necessary. Recommendations should focus on following national guidelines for healthy eating and physical activity.

Experiences of Teacher Reflection: Reggio Inspired Practices in the Studio

ERIC Educational Resources Information Center

Parnell, Will

2012-01-01

A teacher educator phenomenologically researches with two studio teachers, creating a dynamic of three reflective practitioners making meaning of their time in the studios. They are reflective practitioners as they claim to practice learning and teaching in reflection, action and reflective action. In their team of three, they explore the…

Reflection in Work-Based Learning: Self-Regulation or Self-Liberation?

ERIC Educational Resources Information Center

Siebert, Sabina; Walsh, Anita

2013-01-01

This article considers the role of reflective practice in work-based learning in higher education. The benefits of using reflection for learning at work have been widely recognised and the pedagogy to support reflection is now established. However, the use of reflective practice has been subjected to considerable critique, and many of the…

Development and implementation of a longitudinal students as teachers program: participant satisfaction and implications for medical student teaching and learning.

PubMed

Yeung, Celine; Friesen, Farah; Farr, Sarah; Law, Marcus; Albert, Lori

2017-01-31

Teaching is a key component of medical practice, but medical students receive little formal training to develop their teaching skills. A longitudinal Students as Teachers (SAT) program was created at the University of Toronto to provide medical students with opportunities to acquire an understanding of educational pedagogy and practice teaching early in their medical training. This program was 7-months in duration and consisted of monthly educational modules, practical teaching sessions, feedback, and reflective exercises. A mixed methods study design was used to evaluate initial outcomes of the SAT program by obtaining the perspectives of 18 second-year medical students. Participants filled out questionnaires at the beginning and end of the 7-month program to indicate their skill level and confidence in teaching. Differences between pre- and post-intervention scores were further explored in a group interview of 5 participants. Participants expressed a high degree of satisfaction with the SAT program structure and found the educational modules and practical teaching sessions to be particularly beneficial to their learning. Over the course of the program, there were significant increases in students' confidence in teaching, and self-perceived teaching capacity and communication skills. Furthermore, participants discussed improvements in their effectiveness as learners. Teaching is a skill that requires ongoing practice. Our results suggest that a longitudinal program consisting of theoretical modules, practical teaching sessions, feedback, and reflective exercises for medical students may improve teaching and communication skills, and equip them with improved learning strategies. This program also provides students with insight into the experience of teaching while holding other academic and clinical responsibilities.

Examining practical nursing experiences to discover ways in which to retain and invigorate the remaining functions of the elderly with a demented and complex disability in nursing homes.

PubMed

Park, Min-Sun; Lim, Sun-Young; Kim, Eun-Young; Lee, Su-Jung; Chang, Sung-Ok

2018-01-01

The bedridden elderly with moderate-to-severe dementia account for a large proportion of the residents in nursing homes and form a specialized group requiring customized care in order to encourage their remaining functions, which determine the quality of their residual life. The purpose of this study was to search for ways to invigorate and foster the remaining functions of this complex-disability group, based on practical nursing strategies in nursing homes. The qualitative thematic analysis was done by conducting in-depth interviews with 29 nurses working at 11 different nursing homes in South Korea. This study proposed four main themes and 19 sub themes as keys for providing specialized nursing care to the elderly with physical and cognitive disabilities. The main themes encourage the residents' remaining functions: (i) accurate identification of an elderly resident's physical, cognitive, and behavioral baseline is necessary in order to determine their functional levels; (ii) nurses provide meticulous management to support the remaining functions in order to prevent further deterioration; (iii) optimized know-how, based on accumulated experience and knowledge, is reflected in nursing strategies that maximize the effects of nursing interventions; and (iv) steady compliance with nursing guidelines and standards in nursing homes creates the best therapeutic environment and brings unexpected positive changes in the elderly's status. A practical nursing strategy to target the group with a demented and complex disability in nursing homes was developed through thematic analysis of the empirical knowledge of nurses. The findings provide new insights for developing specialized nursing interventions and practical nursing models in long-term care facilities. © 2017 Japan Academy of Nursing Science.

CREATE Two-Year/Four-Year Faculty Workshops: A Focus on Practice, Reflection, and Novel Curricular Design Leads to Diverse Gains for Faculty at Two-Year and Four-Year Institutions †

PubMed Central

Hoskins, Sally G.; Gottesman, Alan J.; Kenyon, Kristy L.

2017-01-01

Improving STEM education through the propagation of highly effective teaching strategies is a major goal of national reform movements. CREATE (Consider, Read, Elucidate the hypotheses, Analyze and interpret the data, and Think of the next Experiment) is a transformative teaching and learning strategy grounded in evidence-based science pedagogy. CREATE courses promote both cognitive (e.g., critical thinking) and affective (e.g., attitudinal and epistemological) student gains in diverse settings. In this study, we look more deeply into the faculty development workshop used to disseminate CREATE pedagogy to instructors at two-year and four-year institutions. We hypothesized that an immersive experience would positively shift faculty participants’ views on teaching/learning, build their understanding of CREATE pedagogy and develop their confidence for course implementation. Internal and external assessments indicate that faculty participants did achieve gains within the timeframe of the CREATE workshop. We discuss the workshop training outcomes in the context of designing effective dissemination models for innovative practices. PMID:29854053

Guidelines for reporting methodological challenges and evaluating potential bias in dementia research.

PubMed

Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C; Gross, Alden L; Hofer, Scott M; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M Maria; Dufouil, Carole

2015-09-01

Clinical and population research on dementia and related neurologic conditions, including Alzheimer's disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on "best practices." We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Understanding emerging treatment paradigms in rheumatoid arthritis

PubMed Central

2011-01-01

Treatment strategies for rheumatoid arthritis (RA) will continue to evolve as new drugs are developed, as new data become available, and as our potential to achieve greater and more consistent outcomes becomes more routine. Many patients will find both symptom relief and modest control of their disease with disease-modifying antirheumatic drugs (DMARDs), yet this course of therapy is clearly not effective in all patients. In fact, despite strong evidence that intensive treatment in the early stages of RA can slow or stop disease progression and may prevent disability, many patients continue to be managed in a stepwise manner and are treated with an ongoing monotherapy regimen with DMARDs. There is now a large body of evidence demonstrating the success of treating RA patients with anti-TNF therapy, usually in combination with methotrexate. As a result of the increased use of anti-TNF therapy, treatment paradigms have changed – and our practice is beginning to reflect this change. In the present review, we summarize the salient points of several recently proposed and emerging treatment paradigms with an emphasis on how these strategies may impact future practice. PMID:21624182

Understanding emerging treatment paradigms in rheumatoid arthritis.

PubMed

Breedveld, Ferdinand C; Combe, Bernard

2011-05-25

Treatment strategies for rheumatoid arthritis (RA) will continue to evolve as new drugs are developed, as new data become available, and as our potential to achieve greater and more consistent outcomes becomes more routine. Many patients will find both symptom relief and modest control of their disease with disease-modifying antirheumatic drugs (DMARDs), yet this course of therapy is clearly not effective in all patients. In fact, despite strong evidence that intensive treatment in the early stages of RA can slow or stop disease progression and may prevent disability, many patients continue to be managed in a stepwise manner and are treated with an ongoing monotherapy regimen with DMARDs. There is now a large body of evidence demonstrating the success of treating RA patients with anti-TNF therapy, usually in combination with methotrexate. As a result of the increased use of anti-TNF therapy, treatment paradigms have changed - and our practice is beginning to reflect this change. In the present review, we summarize the salient points of several recently proposed and emerging treatment paradigms with an emphasis on how these strategies may impact future practice.

RETHINKING ACTIVE LEARNING AS A PARADIGM OF OUR TIMES: TOWARDS POETICIZING AND HUMANIZING NATURAL SCIENCES IN THE AGE OF STEM

PubMed Central

Uskoković, Vuk

2018-01-01

Though practiced since ancient times, active learning has emerged as the dominant educational paradigm in the 1990s. Methodologically, it is more suitable to teach critical thinking skills compared to the classical lecturing approach. On the other hand, most university settings, including those focusing heavily on STEM (Science-Engineering-Technology-Mathematics), have embraced it unreservedly, offering no forums to analyze its pros and cons and thus provide conditions for its progress. This constitutes a fundamental paradox. In this essay, specific drawbacks associated with the practical applications of this educational paradigm are discussed. They include the promotion of mediocrity through classroom “democratization”; the suppression of solitary reflections and introspectiveness, along with the creative potentials associated therewith; the inhibition of extraordinariness through excessive teamwork; and the incompatibility with the dominant learning assessment strategies. It is argued that the absorption of ideas stemming from domains distant from pedagogy and one’s field of research are needed to revitalize the current state of active learning practice. Proposed solutions include the revival of the magic of live lecturing through training teachers in spoken poetry and performance arts; integrating research projects into teaching time; and restructuring the concept of the classroom toward a space and context more reflective of life and more conducive to the learning experience. Continued discussion over the weaknesses of active learning practices are needed to ensure the unhindered progress of this teaching methodology that is currently unrivaled in its popularity and prospect. PMID:29899595

Translating evidence-based guidelines to improve feedback practices: the interACT case study.

PubMed

Barton, Karen L; Schofield, Susie J; McAleer, Sean; Ajjawi, Rola

2016-02-09

There has been a substantial body of research examining feedback practices, yet the assessment and feedback landscape in higher education is described as 'stubbornly resistant to change'. The aim of this paper is to present a case study demonstrating how an entire programme's assessment and feedback practices were re-engineered and evaluated in line with evidence from the literature in the interACT (Interaction and Collaboration via Technology) project. Informed by action research the project conducted two cycles of planning, action, evaluation and reflection. Four key pedagogical principles informed the re-design of the assessment and feedback practices. Evaluation activities included document analysis, interviews with staff (n = 10) and students (n = 7), and student questionnaires (n = 54). Descriptive statistics were used to analyse the questionnaire data. Framework thematic analysis was used to develop themes across the interview data. InterACT was reported by students and staff to promote self-evaluation, engagement with feedback and feedback dialogue. Streamlining the process after the first cycle of action research was crucial for improving engagement of students and staff. The interACT process of promoting self-evaluation, reflection on feedback, feedback dialogue and longitudinal perspectives of feedback has clear benefits and should be transferable to other contexts. InterACT has involved comprehensive re-engineering of the assessment and feedback processes using educational principles to guide the design taking into account stakeholder perspectives. These principles and the strategies to enact them should be transferable to other contexts.

Enhancing reflective practice through online learning: impact on clinical practice

PubMed Central

Sim, J; Radloff, A

2008-01-01

Purpose Traditionally, radiographers and radiation therapists function in a workplace environment that is protocol-driven with limited functional autonomy. The workplace promotes a culture of conformity and discourages practitioners from reflective and critical thinking, essential attributes for continuing learning and advancing workplace practices. As part of the first author’s doctoral study, a continuing professional development (CPD) educational framework was used to design and implement an online module for radiation therapists’ CPD activities. The study aimed to determine if it is possible to enhance healthcare practitioners’ reflective practice via online learning and to establish the impact of reflective learning on clinical practice. Materials and methods The objectives of the online module were to increase radiation therapists’ knowledge in planning for radiation therapy for the breast by assisting them engage in reflective practice. The cyclical process of action research was used to pilot the module twice with two groups of volunteer radiation therapists (twenty-six participants) from Australia, New Zealand and Canada. Results The online module was evaluated using Kirkpatrick’s four-level evaluation model. Evidence indicated that participants were empowered as a result of participation in the module. They began reflecting in the workplace while assuming a more proactive role and increased clinical responsibilities, engaged colleagues in collaborative reflections and adopted evidence-based approaches in advancing clinical practices. Conclusion The study shows that it is possible to assist practitioners engage in reflective practice using an online CPD educational framework. Participants were able to apply the reflective learning they had developed in their workplace. As a result of their learning, they felt empowered to continue to effect changes in their workplace beyond the cessation of the online module. PMID:21614319

Strategy Differences Between Reflective and Impulsive Children.

ERIC Educational Resources Information Center

Adams, Wayne V.

In an investigation of search strategies, it was predicted that reflective children would have developmentally more mature problem-solving strategies than impulsive children, and the presence of these strategies would be found in both 6- and 8-year-old subjects. From a sample given the Matching Familiar Figures Test, half of the 20 boys and 20…

Understanding Influence within the Context of Nursing: Development of the Adams Influence Model Using Practice, Research, and Theory.

PubMed

Adams, Jeffrey M; Natarajan, Sudha

2016-01-01

Acquiring influence, and knowing how to use it, is a required competency for nurse leaders, yet the concept of influence and how it works is not well described in the nursing literature. In this article, the authors examine what is known about influence and present an influence model specific to nurse leaders. The Adams Influence Model was developed through an iterative process and is based on a comprehensive review of the influence literature, expert commentary, multiple pilot studies, evaluation of nursing theories, and validation by an external data source. Rather than defining "how to" influence, the model serves as a guide for personal reflection, helping nurse leaders understand and reflect on the influence process and factors, tactics, and strategies they can use when seeking to influence others.

Leading interprofessional practice: a conceptual framework to support practitioners in the field of learning disability.

PubMed

McCray, Janet

2003-11-01

One of the key challenges for practitioners in present day health and social care has been responding effectively in the interprofessional teamwork setting, where collaboration is at the centre of professional activity. For whilst practitioners are expected to work interprofessionally there often remains limited attention to the actual process of interprofessional practice itself, within organizational strategy, local workforce development planning and individual continuing professional development. These concerns were a driver for this research with practitioners in the field of learning disability which resulted in the development of a conceptual framework for interprofessional practice. This paper sets out the process of conceptual framework development, underpinned by the concepts of knowledge of learning disabilities, contextual socialisation, empowerment, conflict management, transforming capability and interprofessional reflection on action. The researcher suggests that the framework may offer clinical leaders in learning disabilities and a range of other practice settings a tool to facilitate individual practitioner development, enabling as it does, the identification of a range of critical factors which impact on the outcomes of interprofessional practice intervention.

A COMMUNITY MENTAL HEALTH PROFESSIONAL DEVELOPMENT MODEL FOR THE EXPANSION OF REFLECTIVE PRACTICE AND SUPERVISION: EVALUATION OF A PILOT TRAINING SERIES FOR INFANT MENTAL HEALTH PROFESSIONALS.

PubMed

Shea, Sarah E; Goldberg, Sheryl; Weatherston, Deborah J

2016-11-01

The Michigan Association for Infant Mental Health identified a need for reflective supervision training for infant mental health (IMH) specialists providing home-based services to highly vulnerable infants and their families. Findings indicate that this pilot of an IMH community mental health professional development model was successful, as measured by the participants' increased capacity to apply reflective practice and supervisory knowledge and skills. Furthermore, IMH clinicians demonstrated an increase in the frequency of their use of reflective practice skills, and their supervisors demonstrated an increase in their sense of self-efficacy regarding reflective supervisory tasks. Finally, the evaluation included a successful pilot of new measures designed to measure reflective practice, contributing to the growing body of research in the area of reflective supervision. © 2016 Michigan Association for Infant Mental Health.

An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

PubMed Central

Laws, Rachel A; Kemp, Lynn A; Harris, Mark F; Davies, Gawaine Powell; Williams, Anna M; Eames-Brown, Rosslyn

2009-01-01

Background Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed. Methods The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data. Results The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices. Conclusion The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices. PMID:19825189

Multimodal strategy to improve the adherence to hand hygiene and self-assessment of the institution for the promotion and practice of hand hygiene.

PubMed

Oliveira, A C; Gama, C S; Paula, A O

2018-03-01

Hand hygiene (HH) has a low rate of adherence worldwide. This study aimed to estimate the HH adherence rate before and after the implementation of the multimodal strategy and to perform a self-assessment of an institution for promotion and practice of HH. Before and after study, conducted in a university hospital. Professionals of the medical and nursing staff were included. Data collection was from October 2013 to July 2015, through observations of the HH opportunities and application of the HH self-assessment instrument for the institution. Descriptive and univariate analysis were performed. A total of 9500 HH opportunities were observed. The rate of adherence to HH in pre-intervention period was 20.8%, compared to 16.2% and 15.7% in post-intervention. Regarding the evaluation of the institution, it did not have an established ongoing program of training of professionals, no feedback of HH rates to professionals. The low rate of HH adherence reflected the evaluation of the institution in relation to its investment in the practice and promotion of HH, showing that the investment policy for HH adherence needs to be reviewed, considering that before the study the hospital has not been trained in the 'My Five Moments for HH'.

A work observation study of nuclear medicine technologists: interruptions, resilience and implications for patient safety

PubMed Central

Larcos, George; Prgomet, Mirela; Georgiou, Andrew; Westbrook, Johanna

2017-01-01

Background Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. Methods We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel). We catalogued specific safety-oriented strategies used by technologists. Results Technologists completed 5227 tasks and experienced 569 interruptions (mean, 4.5 times per hour; 95% CI 4.1 to 4.9). The highest interruption rate occurred when technologists were in transit between rooms (10.3 per hour (95% CI 8.3 to 12.5)). Interruptions during radiopharmaceutical preparation occurred a mean of 4.4 times per hour (95% CI 3.3 to 5.6). Most (n=426) tasks were interrupted once only and all tasks were resumed after interruption. Multitasking occurred 16.6% of the time. At least some interruptions were initiated by other technologists to convey important information and/or to render assistance. Technologists employed a variety of verbal and non-verbal strategies in all work areas (notably in the hot-lab) to minimise the impact of interruptions and optimise the safe conduct of procedures. Although most were due to individual choices, some strategies reflected overt or subliminal departmental policy. Conclusions Some interruptions appear beneficial. Technologists' self-initiated strategies to support safe work practices appear to be an important element in supporting a resilient work environment in nuclear medicine. PMID:27707869

L'integration des savoirs theoriques a la pratique par l'analyse reflexive: Formation a la gestion de classe (The Integration of Theoretical Knowledge with the Practice of Reflective Analysis: Formation of Class Management).

ERIC Educational Resources Information Center

Bourgeois, Noella

1999-01-01

Explores whether reflective analysis promotes integration of theoretical knowledge presented in a course on motivation, with the practice of classroom management during a practice teaching round. Analyzes narrative accounts of practice where subjects recorded observations and reflections of experiences. Results indicate the presence of principal…

Teacher Reflective Practice in Jesuit High Schools

ERIC Educational Resources Information Center

Klug, Joseph H.

2010-01-01

Teachers who engage in reflective practice are more effective and may encourage higher student achievement. The purpose of this study is to explore and describe the methods that teachers use in order to engage in reflective practice. Further, it is essential to gain an understanding of how schools, including Jesuit high schools, promote reflective…

If These Walls Could Talk: Reflective Practice in Addiction Studies among Undergraduates in New Zealand

ERIC Educational Resources Information Center

Shepherd, Robin

2010-01-01

This exploratory study examined reflective practice among a class of students studying a "communities and addictions" course as part of the undergraduate health science degree. Most reflective practice publications are focused on medical or teachers' training rather than undergraduates in general. This is surprising given that reflective…

Research: Reflecting Practice. Papers from the SCUTREA Annual Conference (23rd, Manchester, England, July 6-8, 1993).

ERIC Educational Resources Information Center

Miller, Nod, Ed.; Jones, David J., Ed.

The following papers are included: "Social Classification of Women's Work" (Benn, Burton); "Developing Models of Learning from Experience" (Boud, Walker); "'Research Reflecting Practice?'" (Edwards, Usher); "Metaphors and Their Implications for Research and Practice in Adult and Community Education" (Hunt); "'Common-Sense' Approach to Reflection"…

Diversifying Geoscience by Preparing Faculty as Workshop Leaders to Promote Inclusive Teaching and Inclusive Geoscience Departments

NASA Astrophysics Data System (ADS)

Macdonald, H.; Manduca, C. A.; Beane, R. J.; Doser, D. I.; Ebanks, S. C.; Hodder, J.; McDaris, J. R.; Ormand, C. J.

2017-12-01

Efforts to broaden participation in the geosciences require that faculty implement inclusive practices in their teaching and their departments. Two national projects are building the capacity for faculty and departments to implement inclusive practices. The NAGT/InTeGrate Traveling Workshops Program (TWP) and the Supporting and Advancing Geoscience Education in Two-Year Colleges (SAGE 2YC) project each prepares a cadre of geoscience educators to lead workshops that provide opportunities for faculty and departments across the country to enhance their abilities to implement inclusive teaching practices and develop inclusive environments with the goal of increasing diversity in the geosciences. Both projects prepare faculty to design and lead interactive workshops that build on the research base, emphasize practical applications and strategies, enable participants to share their knowledge and experience, and include time for reflection and action planning. The curriculum common to both projects includes a framework of support for the whole student, supporting all students, data on diversity in the geosciences, and evidence-based strategies for inclusive teaching and developing inclusive environments that faculty and departments can implement. Other workshop topics include classroom strategies for engaging all students, addressing implicit bias and stereotype threat, and attracting diverse students to departments or programs and helping them thrive. Online resources for each project provide support beyond the workshops. The TWP brings together educators from different institutional types and experiences to develop materials and design a workshop offered to departments and organizations nationwide that request the workshop; the workshop leaders then customize the workshop for that audience. In SAGE 2YC, a team of leaders used relevant literature to develop workshop materials intended for re-use, and designed a workshop session for SAGE 2YC Faculty Change Agents, who then incorporate aspects of the session in workshops they lead for their regional faculty networks. Both projects prepare faculty to lead workshops on inclusive practices and programs as a strategy to diversify the geosciences by pervasively changing the way that faculty and departments support students.

General practitioners in partnership with management: an organisational model for debate.

PubMed Central

Starey, N; Bosanquet, N; Griffiths, J

1993-01-01

The role of general practitioners is changing and expanding. Doctors have more control over the treatment received by their patients but remain largely unaccountable to the public and management. This article proposes an organisational model for integrating primary and secondary care which retains the advantages of fund-holding while giving management control over overall strategy. It proposes that general practitioners control funds for all primary and secondary care. Secondary care will be contracted through a joint team of managers and an elected general practice executive committee. A new health care purchasing authority will contract for primary services with individual practices or primary care provider units. General practitioners will have local contracts reflecting their desire to provide an expanded range of services and the needs of the community. PMID:8461651

Analysis of adverse events as a contribution to safety culture in the context of practice development

PubMed

Hoffmann, Susanne; Frei, Irena Anna

2017-01-01

Background: Analysing adverse events is an effective patient safety measure. Aim: We show, how clinical nurse specialists have been enabled to analyse adverse events with the „Learning from Defects-Tool“ (LFD-Tool). Method: Our multi-component implementation strategy addressed both, the safety knowledge of clinical nurse specialists and their attitude towards patient safety. The culture of practice development was taken into account. Results: Clinical nurse specialists relate competency building on patient safety due to the application of the LFD-tool. Applying the tool, fosters the reflection of adverse events in care teams. Conclusion: Applying the „Learning from Defects-Tool“ promotes work-based learning. Analysing adverse events with the „Learning from Defects-Tool“ contributes to the safety culture in a hospital.

Teaching and Assessing Clinical Reasoning Skills.

PubMed

Modi, Jyoti Nath; Anshu; Gupta, Piyush; Singh, Tejinder

2015-09-01

Clinical reasoning is a core competency expected to be acquired by all clinicians. It is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process used to arrive at a diagnosis. Problems with clinical reasoning often occur because of inadequate knowledge, flaws in data gathering and improper approach to information processing. Some of the educational strategies which can be used to encourage acquisition of clinical reasoning skills are: exposure to a wide variety of clinical cases, activation of previous knowledge, development of illness scripts, sharing expert strategies to arrive at a diagnosis, forcing students to prioritize differential diagnoses; and encouraging reflection, metacognition, deliberate practice and availability of formative feedback. Assessment of clinical reasoning abilities should be done throughout the training course in diverse settings. Use of scenario based multiple choice questions, key feature test and script concordance test are some ways of theoretically assessing clinical reasoning ability. In the clinical setting, these skills can be tested in most forms of workplace based assessment. We recommend that clinical reasoning must be taught at all levels of medical training as it improves clinician performance and reduces cognitive errors.

Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice.

PubMed

Hallas, D; Fernandez, J B; Herman, N G; Moursi, A

2015-01-01

Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice.

Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice

PubMed Central

Hallas, D.; Fernandez, J. B.; Herman, N. G.; Moursi, A.

2015-01-01

Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice. PMID:25653873

The Effect of a Self-Reflection and Insight Program on the Nursing Competence of Nursing Students: A Longitudinal Study.

PubMed

Pai, Hsiang-Chu

2015-01-01

Nurses have to solve complex problems for their patients and their families, and as such, nursing care capability has become a focus of attention. The aim of this longitudinal study was to develop a self-reflection practice exercise program for nursing students to be used during clinical practice and to evaluate the effects of this program empirically and longitudinally on change in students' clinical competence, self-reflection, stress, and perceived teaching quality. An additional aim was to determine the predictors important to nursing competence. We sampled 260 nursing students from a total of 377 practicum students to participate in this study. A total of 245 students nurse completed 4 questionnaires, Holistic Nursing Competence Scale, Self-Reflection and Insight Scale, Perceived Stress Scale, and Clinical Teaching Quality Scale, at 2, 4, and 6 months after clinical practice experience. Generalized estimating equation models were used to examine the change in scores on each of the questionnaires. The findings showed that, at 6 months after clinical practice, nursing competence was significantly higher than at 2 and 4 months, was positively related to self-reflection and insight, and was negatively related to practice stress. Nursing students' competence at each time period was positively related to clinical teachers' instructional quality at 4 and 6 months. These results indicate that a clinical practice program with self-reflection learning exercise improves nursing students' clinical competence and that nursing students' self-reflection and perceived practice stress affect their nursing competence. Nursing core competencies are enhanced with a self-reflection program, which helps nursing students to improve self-awareness and decrease stress that may interfere with learning. Further, clinical practice experience, self-reflection and insight, and practice stress are predictors of nursing students' clinical competence. Copyright © 2015 Elsevier Inc. All rights reserved.

Chronic Care Management evolves towards Integrated Care in Counties Manukau, New Zealand.

PubMed

Rea, Harry; Kenealy, Tim; Wellingham, John; Moffitt, Allan; Sinclair, Gary; McAuley, Sue; Goodman, Meg; Arcus, Kim

2007-04-13

Despite anecdotes of many chronic care management and integrated care projects around New Zealand, there is no formal process to collect and share relevant learning within (but especially between) District Health Boards (DHBs). We wish to share our experiences and hope to stimulate a productive exchange of ongoing learning. We define chronic care management and integrated care, then summarise current theory and evidence. We describe national policy development (relevant to integrated care, since 2000) including the New Zealand Health Strategy, the NZ Primary Care Strategy, the development of Primary Health Organisations (PHOs), capitation payments, Care Plus, and Services to Improve Access funding. We then describe chronic care management in Counties Manukau, which evolved both prior to and during the international refinement of theory and evidence and the national policy development and implementation. We reflect on local progress to date and opportunities for (and barriers to) future improvements, aided by comparative reflections on the United Kingdom (UK). Our most important messages are addressed as follows: To policymakers and funders--a fragile culture change towards teamwork in the health system is taking place in New Zealand; this change needs to be specifically and actively supported. To PHOs--general practices need help to align their internal (within-practice) financial signals with the new world of capitation and integrated care. To primary and secondary care doctors, nurses, and other carers - systematic chronic care management and integrated care can improve patient quality of life; and if healthcare structures and systems are properly managed to support integration, then healthcare provider professional and personal satisfaction will improve.

Resilience: surviving and thriving in the paediatric workplace.

PubMed

Suri, Sanjay; Nash, Eleanor

2018-03-26

The health of the medical workforce, within the UK, has been described as an unmet public health need. Reports of stress, burnout and ill health are continuing to rise. Burnout is when meaningful and challenging work becomes unpleasant and unfulfilling; energy turns into exhaustion; enthusiasm turns into cynicism and efficacy turns into ineffectiveness. Stress is an individual's physical and psychological response to single or multiple pressures. Low-level stress, or 'healthy stress', is essential. Stress becomes unhealthy when pressures exceed one's perceived ability to cope and the response to the pressures becomes counterproductive, leading to a decrease in performance. Resilience is the capability to develop and adapt to challenges and discover new ways forward, without negative consequences on one's well-being. This paper discusses stress and burnout within the healthcare profession; strategies to cope with the demands of the workplace through a reflective scenario, along with well-being and mindfulness resources for managing stress and promoting resilience. The five ways to well-being and mindfulness practice are simple measures that can be built into one's daily life to increase resilience against excess stress and pressures. The coping matrix is a practical tool to encourage reflecting upon and developing one's own coping strategies. A good healthcare professional is one who is compassionate to themselves and their own well-being, enabling them to care and treat their patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The need to implement the landscape of fear within rodent pest management strategies

PubMed Central

Belmain, Steven R; Singleton, Grant R; Groot Koerkamp, Peter WG; Meerburg, Bastiaan G

2017-01-01

Abstract Current reactive pest management methods have serious drawbacks such as the heavy reliance on chemicals, emerging genetic rodenticide resistance and high secondary exposure risks. Rodent control needs to be based on pest species ecology and ethology to facilitate the development of ecologically based rodent management (EBRM). An important aspect of EBRM is a strong understanding of rodent pest species ecology, behaviour and spatiotemporal factors. Gaining insight into the behaviour of pest species is a key aspect of EBRM. The landscape of fear (LOF) is a mapping of the spatial variation in the foraging cost arising from the risk of predation, and reflects the levels of fear a prey species perceives at different locations within its home range. In practice, the LOF maps habitat use as a result of perceived fear, which shows where bait or traps are most likely to be encountered and used by rodents. Several studies have linked perceived predation risk of foraging animals with quitting‐harvest rates or giving‐up densities (GUDs). GUDs have been used to reflect foraging behaviour strategies of predator avoidance, but to our knowledge very few papers have directly used GUDs in relation to pest management strategies. An opportunity for rodent control strategies lies in the integration of the LOF of rodents in EBRM methodologies. Rodent management could be more efficient and effective by concentrating on those areas where rodents perceive the least levels of predation risk. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. PMID:28556521

Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities.

PubMed

Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

2014-03-01

The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. Copyright © 2014 World Health Organization. Published by Mosby, Inc. All rights reserved.

Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities

PubMed Central

Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

2014-01-01

Background The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. Methods From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Results Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Conclusion Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. PMID:24581011

Honesty in Critically Reflective Essays: An Analysis of Student Practice

ERIC Educational Resources Information Center

Maloney, Stephen; Tai, Joanna Hong-Meng; Lo, Kristin; Molloy, Elizabeth; Ilic, Dragan

2013-01-01

In health professional education, reflective practice is seen as a potential means for self-improvement from everyday clinical encounters. This study aims to examine the level of student honesty in critical reflection, and barriers and facilitators for students engaging in honest reflection. Third year physiotherapy students, completing summative…

Enabling Critical Reflection on Research Supervisory Practice

ERIC Educational Resources Information Center

Pearson, Margot; Kayrooz, Carole

2004-01-01

This paper describes the development of an instrument--The Reflective Supervisor Questionnaire (RSQ). The RSQ maps the domain of research supervisory practice as a facilitative process involving educational tasks and activities. It is designed to assist research supervisors explore, by means of self-reflection and reflection on feedback from…

Educational Assistance to Improve Reflective Practice among Student Teachers

ERIC Educational Resources Information Center

Mauri, Teresa; Clarà, Marc; Colomina, Rosa; Onrubia, Javier

2016-01-01

Introduction: Recent educational research suggests that joint reflection can enhance student teachers' reflections on their own practice if they have adequate tutor support. This study aims to identify and characterize the assistance offered by college tutors in situations of joint reflection and analyses their contribution to the development of…

Reflections on Clinical Learning in Novice Speech-Language Therapy Students

ERIC Educational Resources Information Center

Hill, Anne E.; Davidson, Bronwyn J.; Theodoros, Deborah G.

2012-01-01

Background: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice…

Reflective Practice: Origins and Interpretations

ERIC Educational Resources Information Center

Reynolds, Michael

2011-01-01

The idea of reflection is central to the theory and practice of learning--especially learning which is grounded in past or current experience. This paper proposes a working definition of reflection and reviews its origins and recent developments. The author also provides an account of "critical reflection", including its rationale and…

Implementing simulated learning modules to improve students’ pharmacy practice skills and professionalism

PubMed Central

Fejzic, Jasmina; Barker, Michelle

2015-01-01

Background: Effective communication enables healthcare professionals and students to practise their disciplines in a professional and competent manner. Simulated-based education (SBE) has been increasingly used to improve students’ communication and practice skills in Health Education. Objective: Simulated learning modules (SLMs) were developed using practice-based scenarios grounded in effective communication competencies. The effect of the SLMs on Pharmacy students’ (i) Practice skills and (ii) Professionalism were evaluated. Methods: SLMs integrating EXCELL competencies were applied in the classroom to study their effect on a number of learning outcomes. EXcellence in Cultural Experiential Learning and Leadership (EXCELL) Program is a schematic, evidence-based professional development resource centred around developing participants’ self-efficacy and generic communication competencies. Students (N=95) completed three hours of preliminary lectures and eight hours of SLM workshops including six scenarios focused on Pharmacy Practice and Experiential Placements. Each SLM included briefing, role-plays with actors, facilitation, and debriefing on EXCELL social interaction maps (SIMs). Evaluations comprised quantitative and qualitative survey responsed by students before and post-workshops, and post-placements, and teachers’ reflections. Surveys examine specific learning outcomes by using pharmacy professionalism and pharmacy practice effectiveness scales. Responses were measured prior to the commencement of SLMs, after completion of the two workshops and after students completed their block placement. Self-report measures enabled students to self-assess whether any improvements occurred. Results: Student responses were overwhelmingly positive and indicated significant improvements in their Pharmacy practice and professionalism skills, and commitment to professional ethics. Qualitative feedback strongly supported students’ improved communication skills and confidence. Teacher reflections observed ecological validity of SLMs as a method to enhance professionalism and communication skills, and suggested ways to improve this teaching modality. Conclusion: Inclusion of SLMs centred on practice and professionalism was evaluated as an effective, teaching strategy by students and staff. The integration of SIMs in SLMs has potential for wider application in clinical teaching. PMID:26445619

Motion and Marking in Reflective Practice: Artifacts, Autobiographical Narrative and Sexuality

ERIC Educational Resources Information Center

Risner, Doug

2017-01-01

This paper introduces a reflective methodology of the body as a resource for reflective practice based on an analysis of my personal response and experience of autobiographical narrative. It offers an approach in which the movements and markings of the body serve as important sites for collecting additional evidence of the daily practices that…

Improving Your Reflective Practice through Stories of Practitioner Research. Pen Green Books for Early Years Educators

ERIC Educational Resources Information Center

Arnold, Cath, Ed.

2012-01-01

"Improving Your Reflective Practice through Stories of Practitioner Research" shows how research has informed and created effective and valuable reflective practice in early years education, and offers depth to the arguments for a research-orientated stance to this vital field of study. This thought-provoking text explores and documents a variety…

Step Back and Consider: Learning from Reflective Practice in Infant Mental Health

ERIC Educational Resources Information Center

Gatti, Shelley Neilsen; Watson, Christopher L.; Siegel, Carol F.

2011-01-01

Reflective practice is used in different fields such as education and mental health. The educational form of reflective practice has been around since the 1930s (Dewey, as cited in Pedro, 2006); it is a problem-solving process that facilitates examination of behavior and responses to behavior. It takes into consideration multiple factors,…

Becoming Critical Thinkers: The Impact of Treatments on Student Reflective Practice in the College Classroom

ERIC Educational Resources Information Center

Depinet, Andrea

2012-01-01

The purpose of the study was to determine the effect of instructional treatments on reflective practice and critical thinking in the college classroom at Bowling Green State University in the College of Business. The study employed a quasi-experimental pretest posttest control group design to examine student reflective practice among three…

Prospective faculty developing understanding of teaching and learning processes in science

NASA Astrophysics Data System (ADS)

Pareja, Jose I.

Historically, teaching has been considered a burden by many academics at institutions of higher education, particularly research scientists. Furthermore, university faculty and prospective faculty often have limited exposure to issues associated with effective teaching and learning. As a result, a series of ineffective teaching and learning strategies are pervasive in university classrooms. This exploratory case study focuses on four biology graduate teaching fellows (BGF) who participated in a National Science Foundation (NSF) GK-12 Program. Such programs were introduced by NSF to enhance the preparation of prospective faculty for their future professional responsibilities. In this particular program, BGF were paired with high school biology teachers (pedagogical mentors) for at least one year. During this yearlong partnership, BGF were involved in a series of activities related to teaching and learning ranging from classroom teaching, tutoring, lesson planning, grading, to participating in professional development conferences and reflecting upon their practices. The purpose of this study was to examine the changes in BGF understanding of teaching and learning processes in science as a function of their pedagogical content knowledge (PCK). In addition, the potential transfer of this knowledge between high school and higher education contexts was investigated. The findings of this study suggest that understanding of teaching and learning processes in science by the BGF changed. Specific aspects of the BGF involvement in the program (such as classroom observations, practice teaching, communicating with mentors, and reflecting upon one's practice) contributed to PCK development. In fact, there is evidence to suggest that constant reflection is critical in the process of change. Concurrently, BGFs enhanced understanding of science teaching and learning processes may be transferable from the high school context to the university context. Future research studies should be designed to explore explicitly this transfer phenomenon.

Developing psychotherapists’ competence through clinical supervision: protocol for a qualitative study of supervisory dyads

PubMed Central

2013-01-01

Background Mental health professionals face unique demands and stressors in their work, resulting in high rates of burnout and distress. Clinical supervision is a widely adopted and valued mechanism of professional support, development, and accountability, despite the very limited evidence of specific impacts on therapist or client outcomes. The current study aims to address this by exploring how psychotherapists develop competence through clinical supervision and what impact this has on the supervisees’ practice and their clients’ outcomes. This paper provides a rationale for the study and describes the protocol for an in-depth qualitative study of supervisory dyads, highlighting how it addresses gaps in the literature. Methods/Design The study of 16–20 supervisor-supervisee dyads uses a qualitative mixed method design, with two phases. In phase one, supervisors who are nominated as expert by their peers are interviewed about their supervision practice. In phase two, supervisors record a supervision session with a consenting supervisee; interpersonal process recall interviews are conducted separately with supervisor and supervisee to reflect in depth on the teaching and learning processes occurring. All interviews will be transcribed, coded and analysed to identify the processes that build competence, using a modified form of Consensual Qualitative Research (CQR) strategies. Using a theory-building case study method, data from both phases of the study will be integrated to develop a model describing the processes that build competence and support wellbeing in practising psychotherapists, reflecting the accumulated wisdom of the expert supervisors. Discussion The study addresses past study limitations by examining expert supervisors and their supervisory interactions, by reflecting on actual supervision sessions, and by using dyadic analysis of the supervisory pairs. The study findings will inform the development of future supervision training and practice and identify fruitful avenues for future research. PMID:23298408

Developing psychotherapists' competence through clinical supervision: protocol for a qualitative study of supervisory dyads.

PubMed

Schofield, Margot J; Grant, Jan

2013-01-08

Mental health professionals face unique demands and stressors in their work, resulting in high rates of burnout and distress. Clinical supervision is a widely adopted and valued mechanism of professional support, development, and accountability, despite the very limited evidence of specific impacts on therapist or client outcomes. The current study aims to address this by exploring how psychotherapists develop competence through clinical supervision and what impact this has on the supervisees' practice and their clients' outcomes. This paper provides a rationale for the study and describes the protocol for an in-depth qualitative study of supervisory dyads, highlighting how it addresses gaps in the literature. The study of 16-20 supervisor-supervisee dyads uses a qualitative mixed method design, with two phases. In phase one, supervisors who are nominated as expert by their peers are interviewed about their supervision practice. In phase two, supervisors record a supervision session with a consenting supervisee; interpersonal process recall interviews are conducted separately with supervisor and supervisee to reflect in depth on the teaching and learning processes occurring. All interviews will be transcribed, coded and analysed to identify the processes that build competence, using a modified form of Consensual Qualitative Research (CQR) strategies. Using a theory-building case study method, data from both phases of the study will be integrated to develop a model describing the processes that build competence and support wellbeing in practising psychotherapists, reflecting the accumulated wisdom of the expert supervisors. The study addresses past study limitations by examining expert supervisors and their supervisory interactions, by reflecting on actual supervision sessions, and by using dyadic analysis of the supervisory pairs. The study findings will inform the development of future supervision training and practice and identify fruitful avenues for future research.

Discussing a sensitive topic: Nurse practitioners' and physician assistants' communication strategies in managing patients with erectile dysfunction.

PubMed

Green, Roger; Kodish, Slavica

2009-12-01

To examine strategies used by nurse practitioners (NPs) and physician assistants (PAs) when discussing the sensitive topic of erectile dysfunction (ED) with patients. A total of 456 NPs and PAs combined responded to a 22-item online survey posted on NP and PA association websites. Four derived categories reflect communication strategies that NPs and PAs applied when addressing ED: initiating the topic directly, initiating the topic with an introduction, initiating the topic when there is a high risk factor, and allowing the patient to bring up the topic. There was also interest in continuing education on the topic of ED and a perceived need for greater emphasis on developing communication strategies within the patient-provider relationship. There is no one best way to address the topic and different situations may require an approach best suited to the specifics of the situation. Therefore, no single "best practice" of discussing sensitive topics can be identified. Critical thinking skills and the ability to comprehend the totality of the situation are likely to be of higher importance.

Improving the management and referral of patients with transient ischaemic attacks: a change strategy for a health community

PubMed Central

Wright, J; Harrison, S; McGeorge, M; Patterson, C; Russell, I; Russell, D; Small, N; Taylor, M; Walsh, M; Warren, E; Young, J

2006-01-01

Problem Rapid referral and management of patients with transient ischaemic attacks is a key component in the national strategy for stroke prevention. However, patients with transient ischaemic attacks are poorly identified and undertreated. Design and setting Before and after evaluation of quality improvement programme with controlled comparison in three primary care trusts reflecting diverse populations and organisational structures in an urban district in the North of England. Key measures for improvement The proportion of patients receiving antiplatelet drugs and safe driving advice on referral to a speciality clinic, and the numbers of referrals, adjusted for age, to the specialist clinic before and after the improvement programme. Strategies for change Interviews with patient and professionals to identify gaps and barriers to good practice; development of evidence based guidelines for the management of patients with transient ischaemic attacks; interactive multidisciplinary workshops for each primary care trust with feedback of individual audit results of referral practice; outreach visits to teams who were unable to attend the workshops; referral templates and desktop summaries to provide reminders of the guidelines to clinicians; incorporation of standards into professional contracts. Effects of change A significant improvement occurred in identification and referral of patients with transient ischaemic attacks to specialist clinics, with a 41% increase in referrals from trained practices compared with control practices. There were also significant improvements in the early treatment and safety advice provided to patients before referral. Lessons learnt A strategic approach to effective quality improvement across a diverse health community is feasible and achievable. Careful planning with patient and professional involvement to develop a tailored and multifaceted quality improvement programme to implement evidence based practice can work in very different primary care settings. Key components of the effectiveness of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication, and use of established networks and opinion leaders. PMID:16456203

Determinants of nursing competence of nursing students in Taiwan: the role of self-reflection and insight.

PubMed

Eng, Cheng-Joo; Pai, Hsiang-Chu

2015-03-01

A nursing practicum course is critical to strengthening the nursing competence of nursing students. Research has found that practice stress and coping behaviors can have either a negative or positive influence on the learning and practice performance of nursing students. Nevertheless, there are few evidence-based studies related to the relationship between self-reflection and insight and nursing competence in Taiwanese nursing students. To test the determinants and the effect of self-reflection and insight on nursing competence in nursing students during the first 2 months of their practice experience. Cross-sectional and correlational research designs were employed. From September to November 2013, a total of 312 nursing students at a junior college in southern Taiwan served as participants in this study. Four questionnaires were used to collect data: Self-reflection and Insight Scale (SRIS), Perceived Stress Scale (PSS), Coping Behavior Inventory (CBI), and Holistic Nursing Competence Scale (HNCS). The research model was evaluated through structural equation modeling (SEM), with the use of the partial least squares (PLS) method. Results indicated that self-reflection and insight, practice stress, and practice coping behavior were statistically significantly associated with nursing competence. In addition, self-reflection and insight were significantly and positively associated with practice coping behavior and negatively associated with practice stress. Students' coping behavior partially mediates the effect of self-reflection and stress on nursing competence. Overall, these variables explained 39.4% of the variance in these students' nursing competence. Self-reflection and insight affected nursing competence during the practice period. These variables have not only had a direct influence on nursing competence but also an indirect effect through the mediating effect of coping behavior and stress. Copyright © 2014 Elsevier Ltd. All rights reserved.

Improving Student Engagement in Veterinary Business Studies.

PubMed

Armitage-Chan, Elizabeth; Jackson, Elizabeth

2018-01-01

Improving Student Engagement in Veterinary Business StudiesIn a densely packed veterinary curriculum, students may find it particularly challenging to engage in the less overtly clinical subjects, yet pressure from industry and an increasingly competitive employment market necessitate improved veterinary student education in business and management skills. We describe a curriculum intervention (formative reflective assignment) that optimizes workplace learning opportunities and aims to provide better student scaffolding for their in-context business learning. Students were asked to analyze a business practice they experienced during a period of extra-mural studies (external work placement). Following return to the college, they were then instructed to discuss their findings in their study group, and produce a group reflection on their learning. To better understand student engagement in this area, we analyzed individual and group components of the assignment. Thematic analysis revealed evidence of various depths of student engagement, and provided indications of the behaviors they used when engaging at different levels. Interactive and social practices (discussing business strategies with veterinary employees and student peers) appeared to facilitate student engagement, assist the perception of relevance of these skills, and encourage integration with other curriculum elements such as communication skills and clinical problem solving.

The interaction between reflection and practice in the professional development of a secondary education science teachers: Case study

NASA Astrophysics Data System (ADS)

Vazquez Bernal, Bartolome

The work that we describe here is a case study of two secondary education science teachers about how action-oriented reflection and action itself interact, and their influence on professional development. The study was carried out from two different viewpoints: a study with a qualitative orientation on the one hand, using diverse data collection and analysis instruments, and collaborative action research on the other, to form the backbone of professional development. In our theoretical outline, we stress the concepts of reflection which sustain the theoretical-practical dialectic, and of complexity which is seen to be a progression hypothesis of central importance, and in which we distinguish three dimensions: technique, practice, and criticism. The reflection data collection instruments were the teacher's diaries and memos, transcriptions of the work group meetings, questionnaires, and interviews. For the classroom practice the ethnographic notes and extracts from the videotapes of the class sessions, and other documentary sources such. The fundamental instrument for data analysis, both for reflection and practice, was the System of Categories that includes six analytical frames: ideological, teacher education, psychological, contextual, epistemological, and curricular. We also used third-order instruments for the representation, such as complexity spheres for reflection and practice and the reflection-practice integration horizon, which allowed the evolution of the teachers to be viewed over the course of the two school years that the research lasted, as well as giving an overall representation of the integration of reflection and practice. The results showed the teachers to be in transition from a technical to a practical dimension, with both her reflection and her classroom practice in the process of becoming more complex, and with the two being closely integrated. It was also found that she had a hard core of obstacles impeding her professional development. We believe that the action-research program has had a very positive impact on the professional development of all the participating teachers. The results, however, far from meaning the end of the process, are merely the beginning of a new cycle in the action-research process, now with far solider starting data.

Using segmented regression analysis of interrupted time series data to assess colonoscopy quality outcomes of a web-enhanced implementation toolkit to support evidence-based practices for bowel preparation: a study protocol.

PubMed

Ramsey, Alex T; Maki, Julia; Prusaczyk, Beth; Yan, Yan; Wang, Jean; Lobb, Rebecca

2015-06-07

While there is convincing evidence on interventions to improve bowel preparation for patients, the evidence on how to implement these evidence-based practices (EBPs) in outpatient colonoscopy settings is less certain. The Strategies to Improve Colonoscopy (STIC) study compares the effect of two implementation strategies, physician education alone versus physician education plus an implementation toolkit for staff, on adoption of three EBPs (split-dosing of bowel preparation, low-literacy education, teach-back) to improve pre-procedure and intra-procedure quality measures. The implementation toolkit contains a staff education module, website containing tools to support staff in delivering EBPs, tailored patient education materials, and brief consultation with staff to determine how the EBPs can be integrated into the existing workflow. Given adaptations to the implementation plan and intentional flexibility in the delivery of the EBPs, we utilize a pragmatic study to balance external validity with demonstrating effectiveness of the implementation strategies. Participants will include all outpatient colonoscopy physicians, staff, and patients from a convenience sample of six endoscopy settings. Aim #1 will explore the relative effect of two strategies to implement patient-level EBPs on adoption and clinical quality outcomes. We will assess the change in level and trends of clinical quality outcomes (i.e., adequacy of bowel preparation, adenoma detection) using segmented regression analysis of interrupted time series data with two groups (intervention and delayed start). Aim #2 will examine the influence of organizational readiness to change on EBP implementation. We use a PRECIS diagram to reflect the extent to which each indicator of the study was pragmatic versus explanatory, revealing a largely pragmatic study. Implementation challenges have already motivated several adaptations to the original plan, reflecting the nature of implementation in real-world healthcare settings. The pragmatic study responds to the evolving needs of its healthcare partners and allows for flexibility in intervention delivery, thereby informing clinical decision-making in real-world settings. The current study will provide information about what works (intervention effectiveness), for whom it works (influence of Medicaid versus other insurance), in which contexts it works (setting characteristics that influence implementation), and how it works best (comparison of implementation strategies).

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

PubMed

Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Citizen cartography, strategies of resistance to established knowledge and collective forms of knowledge building.

PubMed

Sannazzaro, Jorgelina

2016-04-01

Cultivation of genetically modified soybeans with the use of herbicides is now becoming widespread in Argentina. This work addresses an emblematic case of knowledge articulation between experts, professionals and communities, namely, the case of an association of people affected by fumigation Grupos de Pueblos Fumigados (GPF). The GPF warns against agrochemical spraying in urban areas, and its activists collect and disseminate information about its impact with a view to banning the practice. Here, we apply Parthasarathy's framework, used to analyse the strategies employed by activists to break the expertise barrier, to the case of the GPF, adding a new category to her original four strategies. There is an institutionalizing potential in these social and environmental movements, many of which are organized in the form of Civic Assemblies. The composition of the assemblies reflects a heterogeneous and multi-sectorial character; they articulate a new kind of knowledge that can be an appropriate interlocutor for traditional expert knowledge. © The Author(s) 2014.

The teaching-learning approach and critical thinking development: a qualitative exploration of Taiwanese nursing students.

PubMed

Lin, Chun-Chih; Han, Chin-Yen; Pan, I-Ju; Chen, Li-Chin

2015-01-01

Health care professionals are challenged by the complexities of the health care environment. This study uses a qualitative approach to explore how teaching strategy affects the development of critical thinking (CT) among Taiwanese baccalaureate-level nursing students. Data collected from 109 students' reflection reports were analyzed using content analysis. Three categories generated by the analysis were the teaching-learning strategy, enhancing CT, and transiting into a different learning style. The teaching-learning strategy consisted of concept mapping, question and answer, and real-life case studies. CT was enhanced alternately by self-directed learning, the realization of the gap between known and unknown, and connecting the gap between theoretical nursing knowledge and clinical practice. The study results emphasize participants' perceptions of becoming a critical thinker, turning into an active learner, and eventually achieving self-confidence. These learning effects invest the wisdom of teaching-learning with a far-reaching significance. Copyright © 2015 Elsevier Inc. All rights reserved.

Monitoring biological diversity: strategies, tools, limitations, and challenges

USGS Publications Warehouse

Beever, E.A.

2006-01-01

Monitoring is an assessment of the spatial and temporal variability in one or more ecosystem properties, and is an essential component of adaptive management. Monitoring can help determine whether mandated environmental standards are being met and can provide an early-warning system of ecological change. Development of a strategy for monitoring biological diversity will likely be most successful when based upon clearly articulated goals and objectives and may be enhanced by including several key steps in the process. Ideally, monitoring of biological diversity will measure not only composition, but also structure and function at the spatial and temporal scales of interest. Although biodiversity monitoring has several key limitations as well as numerous theoretical and practical challenges, many tools and strategies are available to address or overcome such challenges; I summarize several of these. Due to the diversity of spatio-temporal scales and comprehensiveness encompassed by existing definitions of biological diversity, an effective monitoring design will reflect the desired sampling domain of interest and its key stressors, available funding, legal requirements, and organizational goals.

Concise Review: Biomimetic Functionalization of Biomaterials to Stimulate the Endogenous Healing Process of Cartilage and Bone Tissue

PubMed Central

Taraballi, Francesca; Bauza, Guillermo; McCulloch, Patrick; Harris, Josh

2017-01-01

Abstract Musculoskeletal reconstruction is an ongoing challenge for surgeons as it is required for one out of five patients undergoing surgery. In the past three decades, through the close collaboration between clinicians and basic scientists, several regenerative strategies have been proposed. These have emerged from interdisciplinary approaches that bridge tissue engineering with material science, physiology, and cell biology. The paradigm behind tissue engineering is to achieve regeneration and functional recovery using stem cells, bioactive molecules, or supporting materials. Although plenty of preclinical solutions for bone and cartilage have been presented, only a few platforms have been able to move from the bench to the bedside. In this review, we highlight the limitations of musculoskeletal regeneration and summarize the most relevant acellular tissue engineering approaches. We focus on the strategies that could be most effectively translate in clinical practice and reflect on contemporary and cutting‐edge regenerative strategies in surgery. Stem Cells Translational Medicine 2017;6:2186–2196 PMID:29080279

A framework for sensitivity analysis of decision trees.

PubMed

Kamiński, Bogumił; Jakubczyk, Michał; Szufel, Przemysław

2018-01-01

In the paper, we consider sequential decision problems with uncertainty, represented as decision trees. Sensitivity analysis is always a crucial element of decision making and in decision trees it often focuses on probabilities. In the stochastic model considered, the user often has only limited information about the true values of probabilities. We develop a framework for performing sensitivity analysis of optimal strategies accounting for this distributional uncertainty. We design this robust optimization approach in an intuitive and not overly technical way, to make it simple to apply in daily managerial practice. The proposed framework allows for (1) analysis of the stability of the expected-value-maximizing strategy and (2) identification of strategies which are robust with respect to pessimistic/optimistic/mode-favoring perturbations of probabilities. We verify the properties of our approach in two cases: (a) probabilities in a tree are the primitives of the model and can be modified independently; (b) probabilities in a tree reflect some underlying, structural probabilities, and are interrelated. We provide a free software tool implementing the methods described.

Improving patient safety in Libya: insights from a British health system perspective.

PubMed

Elmontsri, Mustafa; Almashrafi, Ahmed; Dubois, Elizabeth; Banarsee, Ricky; Majeed, Azeem

2018-04-16

Purpose Patient safety programmes aim to make healthcare safe for both patients and health professionals. The purpose of this paper is to explore the UK's patient safety improvement programmes over the past 15 years and explore what lessons can be learnt to improve Libyan healthcare patient safety. Design/methodology/approach Publications focusing on UK patient safety were searched in academic databases and content analysed. Findings Several initiatives have been undertaken over the past 15 years to improve British healthcare patient safety. Many stakeholders are involved, including regulatory and professional bodies, educational providers and non-governmental organisations. Lessons can be learnt from the British journey. Practical implications Developing a national patient safety strategy for Libya, which reflects context and needs is paramount. Above all, Libyan patient safety programmes should reference internationally approved guidelines, evidence, policy and learning from Britain's unique experience. Originality/value This review examines patient safety improvement strategies adopted in Britain to help developing country managers to progress local strategies based on lessons learnt from Britain's unique experience.

An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce.

PubMed

Palermo, C; Hughes, R; McCall, L

2010-06-01

Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P < 0.05) across a broad range of competency elements. Many participants described re-orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post-intervention. Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.

User and carer involvement in the training and education of health professionals: a review of the literature.

PubMed

Repper, Julie; Breeze, Jayne

2007-03-01

Health policy requires consumer involvement in services, research and education but little is known about how consumers are being involved in healthcare education, the effect on learning and practice, nor how involvement initiatives are being evaluated. To describe methods of involving consumers in healthcare education, discuss ways in which initiatives have been evaluated, and identify areas for development in education, practice and research. All papers reporting specific initiatives involving consumers in health care worker training and education were included. Viewpoint articles and studies of consumers training consumers were excluded. Cinahl, Medline, Assia, PsycINFO, British Nursing Index, Social Science Citation Index, citations from reference lists, relevant websites and personal communication with key people known to be working in this area. A narrative approach was taken with categorisation of data to reflect objectives of selected studies; method of involvement; process issues and evaluation. Thirty-eight papers were included; most provide small-scale qualitative studies of mental health service users and focus on process rather than outcome. Various methods of involvement are described and consumers consistently prioritise the need for training in interpersonal skills over 'technical' skills. There is little research into organisational strategies and no studies investigate the effect of consumer involvement on practice. Two studies indicated that students exposed to consumer involvement demonstrate more empathic understanding and better communication skills. There is tentative evidence that consumer involvement in training enhances workers' skills in the manner prioritised by consumers. However, if consumer involvement in training and education is to facilitate services that reflect the priorities of the people using them, it must be developed in partnership with service providers; further research is needed to explore the impact of consumer involvement and to track the development of organisational consumer involvement strategies, also systems for supporting consumers need to be established, including training for both consumers and staff.

Synergies in Critical Reflective Practice and Science: Science as Reflection and Reflection as Science

ERIC Educational Resources Information Center

Mathieson, Luke

2016-01-01

The conceptions of reflective practice in education have their roots at least partly in the work of Dewey, who describes reflection as "the active, persistent, and careful consideration of any belief or supposed form of knowledge in the light of the grounds that support it and the further conclusions to which it tends" (Dewey 1933, p.9).…

Achieving Change through Reflective Practice: Closing the Loop.

ERIC Educational Resources Information Center

Page, Susie; Meerabeau, Liz

2000-01-01

A study in which reflection was used to identify nurses' learning needs regarding cardiopulmonary resuscitation found that an unexpected outcome of reflection was "apathy": action issues were not prioritized or acted upon. In order to effect changes in practice, planning and management of change should be part of the reflective cycle.…

Critical Reflection and Arts-Based Action Research for the Educator Self

ERIC Educational Resources Information Center

Clarke, Amber; Bautista, Darryl

2017-01-01

Research suggests many educators are challenged to incorporate self-reflection into daily routines. Most often, self-reflection is practiced as a cognitive and text-based activity. This first-person action research project explores if alternative methods used for self-reflection achieves a more reflexive practice. In phase one, arts-based…

The Reflective Practitioner: A Contemporary Paradigm's Relevance for Social Work Education.

ERIC Educational Resources Information Center

Papell, Catherine P.; Skolnik, Louise

1992-01-01

A discussion of the role of reflective thinking in the social work professional's training and practice looks at theories on the relationship of reflection and skilled action and at contemporary social work theories. It is suggested that Donald Schon's reflection-in-action model has applications in social work education and practice. (MSE)

Counterfactual Mutation of Critical Classroom Incidents: Implications for Reflective Practice in Initial Teacher Education

ERIC Educational Resources Information Center

McGarr, Oliver; McCormack, Orla

2016-01-01

This study explores reflective practice through the lens of counterfactual thinking and examines its role in encouraging student teachers to reflect on negative "critical incidents". The study posits that reflections on critical incidents are often not "critical" in nature. They more frequently result in counterfactual thinking…

A Commitment to Socially Just Teacher Preparation: Novice Teacher Educators' Reflections on Participation in a Community of Practice

ERIC Educational Resources Information Center

Curcio, Rachelle; Schroeder, Stephanie

2017-01-01

Through reflective narrative, we present our experiences in a Community of Practice (CoP) committed to teacher preparation for social justice. First, we discuss the CoP's origination and then reflect upon how our participation informed our practice as novice teacher educators. Specifically, we propose that novice teacher educators' participation…

The Effect of Stakeholders on the Reflective Practice of School Principals: Practices in Istanbul and Copenhagen

ERIC Educational Resources Information Center

Dalgiç, Gülay; Bakioglu, Aysen

2014-01-01

The purpose of this study was to determine with whom Turkish and Danish school principals engage in reflective practice and how this interaction helps to develop them as reflective practitioners. A phenomenological approach was followed in the study. Data were collected from 37 school principals (24 from Istanbul and 13 from Copenhagen) who were…

A Teacher Educator's Lessons Learned from Reflective Practice

ERIC Educational Resources Information Center

Russell, Tom

2018-01-01

This article has two major goals. The first is to establish a distinction between the idea of critical reflection (as required today in many teacher education courses) and the concept of reflective practice (as set out by Schön in the context of active professional practice). The second is to present some of the important lessons a teacher…

Urban Teachers' Professed Classroom Management Strategies: Reflections of Culturally Responsive Teaching

ERIC Educational Resources Information Center

Brown, Dave F.

2004-01-01

Thirteen urban educators teaching from 1st through 12th grade selected from 7 cities across the United States were interviewed in this qualitative research study to determine if the classroom management strategies they use reflect the research on culturally responsive teaching. Participants revealed using several management strategies that reflect…

Teacher Talk: One Teacher's Reflections during Comprehension Strategies Instruction

ERIC Educational Resources Information Center

Robertson, Dana A.

2013-01-01

This study examined one tutor's evolving use of particular talk moves during comprehension strategies instruction in a university-based clinical setting. Through engaging in audiotape reflection and transcript analysis with a coach, the tutor made shifts toward more explicit and purposeful strategies instruction, yet did not consistently…

Feedback Providing Improvement Strategies and Reflection on Feedback Use: Effects on Students' Writing Motivation, Process, and Performance

ERIC Educational Resources Information Center

Duijnhouwer, Hendrien; Prins, Frans J.; Stokking, Karel M.

2012-01-01

This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students' writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the control feedback condition (n = 41) received…

The transformative experiences of a scientist-professor with teacher candidates

NASA Astrophysics Data System (ADS)

Lashley, Terry Lee Hester

This case study documented the pedagogical and philosophical change experiences of a senior research scientist-professor at a large Research I University as he implemented an open inquiry immersion course with secondary science teacher candidates. The 4-semester hour graduate-level credit course (Botany 531) is titled "Knowing and Teaching Science: Just Do-It!" The students were 5th-year education students who possessed an undergraduate degree in the biological sciences. The premise for the course is that to teach science effectively, one must be able to DO science. Students were provided with extensive opportunities to design and carry out experiments and communicate the results both orally and in a written format. The focus of this dissertation was on changes in the pedagogical philosophy and practice of the scientist-professor as he taught this course over a 4-year period, 1997--2000. The data used in this study include the scientist-professor's reflective journals (1997--2000), the students' journals (1997--2000), and interviews with the scientist-professor (2001--2002). HyperRESEARCH 2.03 software was used to code and analyze the reflective journals and transcribed interviews. Data were reviewed and then placed into original codes. The codes were then grouped into themes for analysis. Identified themes included (1) Reflective Practice, (2) Social Construction of Knowledge, (3) Legitimate Peripheral Participation, and (4) the Zone of Proximal Development. There is clear evidence that the scientist-professor experienced transformative changes in his philosophy and practice over the 4-year period. This is shown by (1) differences in learning outcomes and expectations for Do-It! course students and traditional course students, (2) documentation of the scientist-professor's movement through the Concerns Based Adoption Model (CBAM) Stages of Concern, (3) increased collaboration and support from the college of education, (4) development and delivery of two other courses patterned after the Do-It! course, (5) interest and participation in education research, (6) presentation and participation in national and regional science education conferences, and (7) efforts to influence colleagues regarding teaching and learning. Furthermore, questioning strategies are an instructional strategy and dialogue is a component of all his university courses. Moreover, his professional research interest includes science pedagogy and he coauthors research articles with science educators.

Impact of reflective mulch on yield of strawberry plants and incidence of damage by tarnished plant bug (Heteroptera: Miridae).

PubMed

Rhainds, N; Kovach, J; Dosa, E L; English-Loeb, G

2001-12-01

The current study investigated the impact of reflective mulch on yield of strawberry plants and incidence of damage by tarnished plant bugs, Lygus lineolaris (Palisot de Beauvois), for three strawberry cultivars: 'Honeoye', 'Earliglow', and two sibling Dayneutrals ('Tribute' and 'Tristar', herein considered as one cultivar). Of all cultivars tested, Honeoye was the most productive and least susceptible to tarnished plant bug. For Earliglow and Honeoye, reflective mulch enhanced productivity of strawberry plants and suppressed density of nymphs per flower cluster and proportion of damaged fruits, but did not significantly impact numbers of nymphs or damaged fruits per hectare, Results with Dayneutrals were not consistently significant. Both in the presence or absence of reflective mulch, proportion of damaged fruits increased with increasing density of nymphs per flower cluster and with decreasing number of fruits harvested per row section, suggesting that planting productive strawberry cultivars or maintaining cultural practices that promote high yield may provide an effective line of defense against tarnished plant bug. These results also suggest that reflective mulch may suppress incidence of damage by tarnished plant bug both directly, by reducing number of nymphs per flower cluster, and indirectly, by enhancing productivity of strawberry plants. Economic analyses evaluating costs and benefits of using reflective mulch, as well as studies investigating mechanisms that underlie the impact of reflective mulch on yield and incidence of damage by tarnished plant bug, are still needed before reflective mulch can be implemented as a management strategy in commercial strawberry fields.

Change Management in Dental Education: A Professional Learning Community.

PubMed

Palatta, Anthony M

2018-06-01

Professional learning communities (PLCs) are defined as "a group of people sharing and critically interrogating their practice in an ongoing, reflective, collaborative, inclusive, learning-oriented, growth-promoting way." PLCs have been found to be an effective change management strategy in business and education when confronted by rapid change. The American Dental Education Association's Commission on Change and Innovation in Dental Education new national program-ADEA CCI 2.0-includes the development of a PLC. By employing an "engage and learn" model PLC centered on continuous quality improvement and systems thinking, dental faculty can identify internal and external barriers to change that could lead to innovative solutions to complex issues. This article argues that a PLC is a viable change management strategy to counteract the effect of multiple external forces impacting dental education and thus to develop future-ready faculty.

Reflective processes of practitioners in head and neck cancer rehabilitation: a grounded theory study.

PubMed

Caty, Marie-Ève; Kinsella, Elizabeth Anne; Doyle, Philip C

2016-12-01

This study systematically examined how experienced Speech-Language Pathologists (SLPs) use the processes of reflection to develop knowledge relevant for practice in the context of head and neck cancer (HNC) rehabilitation. In-depth, semi-structured interviews were conducted with 12 SLPs working in HNC rehabilitation in North America. Grounded theory methodology was adopted for data collection and analysis. The findings inform a preliminary reflective practice model that depicts the processes of reflection used by practitioners interviewed. Nine categories of reflective processes were identified by participant SLPs in terms of the processes of reflection: ongoing questioning, experimenting through trial and error, integrating knowledge from past cases, embracing surprise, thinking out of the box, being in the moment, consulting with colleagues, putting oneself in the patients' shoes, and discerning ethical issues. These findings provide empirical evidence that supports Schön's theory of reflective practice and contribute to knowledge about the ways in which SLPs use processes of reflection in the context of HNC rehabilitation. The findings of this study have implications for how SLPs perceive and consider their role as knowledge-users and knowledge producers in their day-to-day clinical work, as well as for building capacity for reflective practice.

Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

PubMed

Trebble, Timothy M; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M

2014-11-21

Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. The current systems of managing the performance of individual clinicians in a secondary healthcare organisation were reviewed through the study of practice in 10 successful partnership organisations, including knowledge worker predominant, within commercial, public and voluntary sector operating environments. Reciprocal visits to the secondary healthcare environment were undertaken. Six themes in performance related HRM were identified across the external organisations representing best practice and considered transferrable to managing clinicians in secondary care organisations. These included: performance measurement through defined outcomes at the team level with decision making through local data interpretation; performance improvement through empowered formal leadership with organisational support; individual performance review (IPR); and reward, recognition and talent management. The role of the executive was considered essential to support and implement effective HRM, with management of staff performance, behaviour and development integrated into organisational strategy, including through the use of universally applied values and effective communication. These approaches reflected many of the key aspects of high performance work systems and strategic HRM. There is the potential to develop systems of HRM of individual clinicians in secondary healthcare to improve practice. This should include both performance measurement and performance improvement but also engagement at an organisational level. This suggests that effective HRM and performance management of individual clinicians may be possible but requires an alternative approach for the NHS.

Theory and practice in the construction of professional identity in nursing students: a qualitative study.

PubMed

Arreciado Marañón, Antonia; Isla Pera, Ma Pilar

2015-07-01

The problem of nurses' professional identity continues to be seen in the disjunction between theoretical training and clinical placements. Moreover, it is not known how nursing students perceive these contradictions or how this discrepancy influences the construction of professional identity. To gain insight into nursing students' perception of their theoretical and practical training and how this training influences the process of constructing their professional identity. Qualitative, ethnographic study. Third-year nursing students at the l'Escola Universitària d'Infermeria Vall d'Hebron de Barcelona. Participant observation was conducted in the hospital setting and primary care. Discussion groups were held. The constant comparative method was used for the analysis. The study adhered to the criteria of credibility, transferability, dependability and confirmability. Students believed that both theoretical and practical trainings were indispensable. Nevertheless, clinical placements were considered essential to confer sense to the theory and to shape their identity, as they helped student nurses to experience their future professional reality and to compare it with what they had been taught in theoretical and academic classes. The role of the clinical placement mentor was essential. With regard to theory, the skills developed in problem-based learning gave novice nurses' confidence to approach the problems of daily practice and new situations. Equally, this approach taught them to reflect on what they did and what they were taught and this ability was transferred to the clinical setting. For students, both strategies (theory and practice) are vital to nursing education and the construction of a professional identity, although pride of place is given to clinical placements and mentors. The skills developed with problem-based learning favor active and reflective learning and are transferred to learning in the clinical setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

A review of developmental and applied language research on African American children: from a deficit to difference perspective on dialect differences.

PubMed

Stockman, Ida J

2010-01-01

The contemporary practices of delivering speech, language, and hearing services in schools reflect palpable gains in professional sensitivity to linguistic and cultural diversity. This article reviews the dominant research themes on the oral language of African American preschoolers who contribute to such diversity in the United States. Specifically, it contrasts the historical and current frameworks that have guided studies of (a) such children's acquisition and use of English and (b) the strategies used to assess and modify their language. Research initiatives that can expand knowledge about this group are proposed.

Moral education for nursing decisions.

PubMed

van Hooft, S

1990-02-01

This paper attacks the Kantian conception of mortality that predominates in our society and the rationalist educational strategies that flow from it. In its place it offers an Aristotelian conception of ethics in which sensitivity and feeling are important components of practical reason. It argues that a nurse's ethical concerns extend further than the several moral dilemmas discussed in the daily press and that those concerns should be responded to in moral education by a process called 'empowerment'. Empowerment seeks to develop confidence and sensitivity in the making of difficult decisions and does so by training habits, developing attitudes, and encouraging reflection on actions performed.

A step ahead: strategies for excellence in critical care nursing practice.

PubMed

Albano, Amy; Elliott, Sheila; Lusardi, Paula; Scott, Susan; Thomas, Diane

2005-06-01

The adult intensive care unit (ICU) at Baystate Medical Center is a 24-bed medical-surgical-trauma ICU that provides high-quality care to critically ill patients. Collaboration and expertise among the nursing staff, intensivists, and interdisciplinary colleagues have contributed to its development into a Beacon Award-winning unit. Its primary goal is reflected in the unit's mission: "Care for our patients is guided by knowledge, motivated by compassion, and performed in collaboration with others." Common interests, values, and purposes have created an environment of communication that supports the delivery of exceptional critical care to patients and their families.

Righting writing: strategies for improving nursing student papers.

PubMed

Bickes, Joan T; Schim, Stephanie M

2010-01-01

The ability to clearly express complex ideas in writing is necessary for nurses in professional practice at all levels from novice to expert. The community health nursing course is specially designated as writing intensive to provide students with the experience of preparing a major scholarly paper. To address issues of poor paper quality and grade inflation we implemented a program including a writing workshop for faculty, a revision of the grading rubric, and a system of blind review for grading student papers. Changes resulted in a major shift in paper grades which more closely reflects the actual quality of the work.

Learning With Reflection: Practices in an Osteopathic Surgery Clinical Clerkship Through an Online Module.

PubMed

Lewis, Kadriye O; Farber, Susan; Chen, Haiqin; Peska, Don N

2015-11-01

The value of reflective practices has gained momentum in osteopathic medical education. However, the use of reflective pedagogies has not been explored in the larger context of medical course delivery and design, to the authors' knowledge. To determine the types of reflection demonstrated by osteopathic medical students on an online discussion board and to explore differences in discussion engagement caused by the use of a reflective learning self-assessment tool. Using a mixed-method approach, reflection processes in an osteopathic surgery clinical clerkship online module were investigated in third-year osteopathic medical students. Discussion board messages were captured and coded. Both manual coding techniques and automated interrogation using NVivo9 (a computer program) for qualitative data were applied. Correlations of scores across 4 case-based discussion tasks and scores for self-reflection were computed as quantitative data. Twenty-eight students were included. Four main types of reflection (ie, content, contextual, dialogic, and personal) along with corresponding differentiated subthemes for each type of case-based discussion board group message were identified. Group collaboration revealed insights about the reflection process itself and also about the evidence of collective efforts, group engagements, and intragroup support among students. Student preparation revealed that students' metacognition was triggered when they judged their own contributions to group work. Challenges in completing readings and meeting deadlines were related to the students' long work hours. Reflective practices are essential to the practice of osteopathic medicine and medical education. Curricula can promote the development of reflective skills by integrating these deliberate practices in educational activities.

Responding to climate change: A toolbox of management strategies: Chapter 11

USGS Publications Warehouse

Cole, David; Stephenson, Nathan L.; Millar, Constance I.

2010-01-01

Climate change and its effects are writ large across the landscape and in the natural and cultural heritage of parks and wilderness. They always have been and always will be. The sculpted walls of Yosemite National Park and the jagged scenery of the Sierra Nevada wilderness would not be as spectacular if periods of glaciation had not been followed by periods of deglaciation. High biodiversity in forests of the Great Smoky Mountains reflects a legacy of climate change, migrating species, and isolated climatic refugia. Fossils unearthed at Dinosaur National Monument reflect a time when the climate was very different than it is today, as do ruins left by peoples who practiced agriculture in places in the American Southwest where food production is not possible today. Over eons, climate change has molded the diversity of life and landscape in areas now protected as parks and wilderness.

Lifelong learning in obstetrics and gynaecology: how theory can influence clinical practice.

PubMed

Mukhopadhyay, S; Smith, S; Cresswell, J

2011-08-01

Lifelong learning refers to the systematic acquisition, renewal, updating and completion of knowledge. It is synonymous with the term 'self-directed learning'. This is a new educational strategy meant to consolidate knowledge in a fashion that is reproducible for a lifetime with successful application to both known and unknown clinical exercises. The development of lifelong learning is based on the principles of andragogy (autonomy and independence in one's learning activities), reflection and learning from experience. This paper deals with the development of these theories culminating in the advent of self-directed learning. Evidence to support experiential, reflective and self-directed learning is provided, including the use of rating scales. An example from obstetrics is used to highlight the application of these principles. There are barriers to adopting a new educational paradigm, however, lifelong learning remains an excellent tool for continuous professional development.

Yearning for the Vastness of the Sea: Reflections and Commentary on Professional Training in Hypnosis.

PubMed

Baker, Elgan L

2017-01-01

Educational programs are a major focus of most professional hypnosis societies. Many of these programs rely on traditional curricula and teaching strategies with variable success. The articles in this special issue examine and critique these training models and suggest innovative approaches to professional education with an emphasis on more uniform course content and goals and more dynamic and effective educational processes. A convergence of themes is noted and examined including the need to continue to expand the acceptance and utilization of clinical hypnosis, the importance of attending to broader clinical competence beyond hypnosis skills, the need for faculty development and evaluation, and the imperative that course content reflects academic rigor and contemporary science as well as providing for demonstration and supervised clinical practice. These themes are explicated for the development of new training paradigms and for continued programs in the field of clinical hypnosis.

[The managerial practice of the nurse within the FHP (Family Health Program) from the perspective of his/her educational and pedagogical action: a brief reflection].

PubMed

Villas Bôas, Lygia Maria de Figueiredo Melo; Araújo, Marize Barros de Souza; Timóteo, Rosalba Pessoa de Souza

2008-01-01

This article deals with the educational and managerial actions of nurses in the Family Health Program (FHP). It traces the reality of the FHP within the institutional setting of the city of Natal/RN, raises some questions and analyzes the educational action of the program in the daily routine of the Health Units in the light of the literature. Its objective is to contribute to the reflection about the managerial action of the nurse in that setting, in connection with pedagogical and educational action. The study demonstrates that, as a result of its innovative nature, the Family Health Strategy is facing challenges such as the need to define the profile of competencies for these professionals, their qualification processes, continued and permanent education, and new managerial models for nursing that should specifically meet the daily demands.

Deeper than rhizomes, becoming decalcomaniacal: a reflexive response to Murakami and Siegel's "Becoming Bermuda grass"

NASA Astrophysics Data System (ADS)

Mitchell, Debra Bailey

2017-09-01

In responding to Murakami and Siegel's "Becoming Bermuda grass," one is led to reflect on one's own practice in what becomes an example of reflexivity. Following the authors' lead of incorporating Deleuze and Guattari's rhizomatic theory and the art form of decalcomania to reflect on practice, discoveries are made regarding the practice of a middle school science teacher. These reflective discoveries can be used to inform teaching practice in a manner that supports the development of identities of participation.

Enhancing Self-Practice/Self-Reflection (SP/SR) approach to cognitive behaviour training through the use of reflective blogs.

PubMed

Farrand, Paul; Perry, Jon; Linsley, Sue

2010-07-01

Self-Practice/Self-Reflection (SP/SR) is increasingly beginning to feature as a central component of CBT training programmes (Bennett-Levy et al., 2001). Programmes including a reflective element, however, are not unproblematic and it has been documented that simply setting time aside for reflection does not necessarily result in trainees using such time to reflect. Such limitations may be overcome by including a requirement to post reflections on reflective blogs. To examine the effect that a requirement to contribute to a reflective blog had upon a SP/SR approach to CBT training. A focus group methodology was adopted with data analyzed using a general inductive qualitative approach. The requirement to use blogs to reflect upon the self-practice of CBT techniques enhanced SP/SR, established a learning community, and improved course supervision, although some technical difficulties arose. Consideration should be given towards using reflective blogs to support a SP/SR approach to CBT training. Benefits afforded by the use of reflective blogs further establish SP/SR as a valid and flexible training approach.

The STTI Practice-Academe Innovative Collaboration Award: honoring innovation, partnership, and excellence.

PubMed

Kirschling, Jane Marie; Erickson, Jeanette Ives

2010-09-01

To describe the benefits and barriers associated with practice-academe partnerships and introduce Sigma Theta Tau International's (STTI's) Practice-Academe Innovative Collaboration Award and the 2009 award recipients. In 2008, STTI created the CNO-Dean Advisory Council and charged it with reviewing the state of practice-academe collaborations and developing strategies for optimizing how chief nursing officers (CNOs) and deans work together to advance the profession and discipline of nursing. The Council, in turn, developed the Practice-Academe Innovative Collaboration Award to encourage collaboration across sectors, recognize innovative collaborative efforts, and spotlight best practices. A call for award submissions resulted in 24 applications from around the globe. An award winner and seven initiatives receiving honorable mentions were selected. The winning initiatives reflect innovative academe-service partnerships that advance evidence-based practice, nursing education, nursing research, and patient care. The proposals were distinguished by their collaborators' shared vision and unity of purpose, ability to leverage strengths and resources, and willingness to recognize opportunities and take risks. By partnering with one another, nurses in academe and in service settings can directly impact nursing education and practice, often effecting changes and achieving outcomes that are more extensive and powerful than could be achieved by working alone. The award-winning initiatives represent best practices for bridging the practice-academe divide and can serve as guides for nurse leaders in both settings.

Reflective dialogue in clinical supervision: A pilot study involving collaborative review of supervision videos.

PubMed

Hill, Hamish R M; Crowe, Trevor P; Gonsalvez, Craig J

2016-01-01

To pilot an intervention involving reflective dialogue based on video recordings of clinical supervision. Fourteen participants (seven psychotherapists and their supervisors) completed a reflective practice protocol after viewing a video of their most recent supervision session, then shared their reflections in a second session. Thematic analysis of individual reflections and feedback resulted in the following dominant themes: (1) Increased discussion of supervisee anxiety and the tensions between autonomy and dependence; (2) intentions to alter supervisory roles and practice; (3) identification of and reflection on parallel process (defined as the dynamic transmission of relationship patterns between therapy and supervision); and (4) a range of perceived impacts including improvements in supervisory alliance. The results suggest that reflective dialogue based on supervision videos can play a useful role in psychotherapy supervision, including with relatively inexperienced supervisees. Suggestions are provided for the encouragement of ongoing reflective dialogue in routine supervision practice.

The "R" Word in Teacher Education: Understanding the Teaching and Learning of Critical Reflective Practice

ERIC Educational Resources Information Center

McCabe, Michael; Walsh, Steve; Wideman, Ronald; Winter, Eileen

2009-01-01

The case for critical reflective practice (CRP) among teachers has been advocated for some time. Reflective practice is now at the heart of a number of teacher education programmes and is regarded as an important element in the preparation of new teachers. While it is clear that CRP is highly regarded by teacher educators, less clear is whether…

Reflective Practices in Professional Learning Communities: A Case Study of the Missouri Professional Learning Communities Project

ERIC Educational Resources Information Center

Burns, Mary Ann

2012-01-01

Dewey (1933) provided the foundation for reflective practice in education with the notion that learning is not in the doing, but rather it is in the thinking about the doing that creates learning. Evidence is growing about the importance of reflection for improving teaching and learning practices to increase student achievement (York-Barr, et al.,…

Shaping the Epistemology of Teacher Practice through Reflection and Reflexivity

ERIC Educational Resources Information Center

Hofer, Barbara K.

2017-01-01

Reflection on practice is a core principle for guiding improvement in professional work such as teaching and can be enhanced by reflection on epistemic cognition, the way we think about knowledge and knowing. Viewed as an intellectual virtue, a habit of mind, and a learnable skill, epistemic reflection can help teachers learn to critically…

Negotiating the Conflicts: Reexamining the Structure and Function of Reflection in Science Teacher Learning

ERIC Educational Resources Information Center

Danielowich, Robert

2007-01-01

Many researchers and teacher educators propose that reflection is an important way teachers can think about changing their views and practices. The hierarchical constructs used to describe reflection, however, are often interpreted in ways that promote reflection as a "tool" teachers use to elevate their views and practices toward ideal "end…

Diffracting Mandates for Reflective Practices in Teacher Education and Development: Multiple Readings from Australia, New Zealand, and the United States

ERIC Educational Resources Information Center

Myers, Casey Y.; Smith, Kylie A.; Tesar, Marek

2017-01-01

Despite the ubiquity of reflective practice in education, mandating reflective processes within sanctioned frameworks is inherently problematic, as it may lead to reproduction, standardization, and forced universalities, rather than the critical and innovative pedagogy they intend. This article engages with reflection through both the metaphor and…

Removing Our Masks: Using the Visual and Performing Arts to Promote Deep Reflection in Pre-Service Teachers

ERIC Educational Resources Information Center

McHattan, Patty Alvarez; McCray, Erica D.

2009-01-01

The role of reflection is central to teacher preparation. As individuals integrate new information within their existing schema, they refine their practice. Through reflection pre-service teachers examine, evaluate, and adjust. Yet, the practice of reflection is rarely explicitly taught. Often teacher educators found their students aligning their…

Reflections around Artefacts: Using a Deliberative Approach to Teaching Reflective Practices in Fashion Studies

ERIC Educational Resources Information Center

Ryan, Michael; Brough, Dean

2012-01-01

While requiring students to think reflectively is a desirable teaching goal, it is often fraught with complexity and is sometimes poorly implemented in higher education. In this paper, we describe an approach to academic reflective practices that fitted a design subject in fashion education and was perceived as effective in enhancing student…

The Effect of Reflective Thinking on the Teaching Practices of Preservice Physical Education Teachers

ERIC Educational Resources Information Center

Dervent, Fatih

2015-01-01

The purpose of this study is to determine the effect of reflective thinking on the professional teaching practices of preservice physical education teachers and to explore their reflective levels. Within the qualitative research paradigm, action research was used to gain a deeper understanding of the reflective experiences of preservice physical…

The utility of vignettes to stimulate reflection on professionalism: theory and practice.

PubMed

Bernabeo, E C; Holmboe, E S; Ross, K; Chesluk, B; Ginsburg, S

2013-08-01

Professionalism remains a substantive theme in medical literature. There is an emerging emphasis on sociological and complex adaptive systems perspectives that refocuses attention from just the individual role to working within one's system to enact professionalism in practice. Reflecting on responses to professional dilemmas may be one method to help practicing physicians identify both internal and external factors contributing to (un) professional behavior. We present a rationale and theoretical framework that supports and guides a reflective approach to the self assessment of professionalism. Guided by principles grounded in this theoretical framework, we developed and piloted a set of vignettes on professionally challenging situations, designed to stimulate reflection in practicing physicians. Findings show that participants found the vignettes to be authentic and typical, and reported the group experience as facilitative around discussions of professional ambiguity. Providing an opportunity for physicians to reflect on professional behavior in an open and safe forum may be a practical way to guide physicians to assess themselves on professional behavior and engage with the complexities of their work. The finding that the focus groups led to reflection at a group level suggests that effective reflection on professional behavior may require a socially interactive process. Emphasizing both the behaviors and the internal and external context in which they occur can thus be viewed as critically important for understanding professionalism in practicing physicians.

A Professionalism Curricular Model to Promote Transformative Learning Among Residents.

PubMed

Foshee, Cecile M; Mehdi, Ali; Bierer, S Beth; Traboulsi, Elias I; Isaacson, J Harry; Spencer, Abby; Calabrese, Cassandra; Burkey, Brian B

2017-06-01

Using the frameworks of transformational learning and situated learning theory, we developed a technology-enhanced professionalism curricular model to build a learning community aimed at promoting residents' self-reflection and self-awareness. The RAPR model had 4 components: (1) R ecognize : elicit awareness; (2) A ppreciate : question assumptions and take multiple perspectives; (3) P ractice : try new/changed perspectives; and (4) R eflect : articulate implications of transformed views on future actions. The authors explored the acceptability and practicality of the RAPR model in teaching professionalism in a residency setting, including how residents and faculty perceive the model, how well residents carry out the curricular activities, and whether these activities support transformational learning. A convenience sample of 52 postgraduate years 1 through 3 internal medicine residents participated in the 10-hour curriculum over 4 weeks. A constructivist approach guided the thematic analysis of residents' written reflections, which were a required curricular task. A total of 94% (49 of 52) of residents participated in 2 implementation periods (January and March 2015). Findings suggested that RAPR has the potential to foster professionalism transformation in 3 domains: (1) attitudinal, with participants reporting they viewed professionalism in a more positive light and felt more empathetic toward patients; (2) behavioral, with residents indicating their ability to listen to patients increased; and (3) cognitive, with residents indicating the discussions improved their ability to reflect, and this helped them create meaning from experiences. Our findings suggest that RAPR offers an acceptable and practical strategy to teach professionalism to residents.

An exploration of emotional protection and regulation in nurse-patient interactions: The role of the professional face and the emotional mirror.

PubMed

Cecil, Penelope; Glass, Nel

2015-01-01

While interpersonal styles of nurse-patient communication have become more relaxed in recent years, nurses remain challenged in emotional engagement with patients and other health professionals. In order to preserve a professional distance in patient care delivery however slight, nurses need to be able to regulate their emotions. This research aimed to investigate nurses' perceptions of emotional protection and regulation in patient care delivery. A qualitative approach was used for the study utilising in-depth semi-structured interviews and researcher reflective journaling. Participants were drawn from rural New South Wales. Following institutional ethics approval 5 nurses were interviewed and reflective journaling commenced. The interviews and the reflective journal were transcribed verbatim. The results revealed that nurses' emotional regulation demonstrated by a 'professional face' was an important strategy to enable delivery of quality care even though it resulted in emotional containment. Such regulation was a protective mechanism employed to look after self and was critical in situations of emotional dissonance. The results also found that nurses experience emotional dissonance in situations where they have unresolved personal emotional issues and the latter was a individual motivator to manage emotions in the workplace. Emotions play a pivotal role within nurse-patient relationships. The professional face can be recognised as contributing to emotional health and therefore maintaining the emotional health of nurses in practice. This study foregrounds the importance of regulating emotions and nurturing nurses' emotional health in contemporary practice.

How a science methods course may influence the curriculum decisions of preservice teachers in the Bahamas

NASA Astrophysics Data System (ADS)

Wisdom, Sonya L.

The purpose of this study was to examine how a science methods course in primary education might influence the curriculum decisions of preservice teachers in The Bahamas related to unit plan development on environmental science topics. Grounded in a social constructivist theoretical framework for teaching and learning science, this study explored the development of the confidence and competence of six preservice teachers to teach environmental science topics at the primary school level. A qualitative case study using action research methodologies was conducted. The perspectives of preservice teachers about the relevancy of methods used in a science methods course were examined as I became more reflective about my practice. Using constant comparative analysis, data from student-written documents and interviews as well as my field notes from class observations and reflective journaling were analyzed for emerging patterns and themes. Findings of the study indicated that while preservice teachers showed a slight increase in interest regarding learning and teaching environmental science, their primary focus during the course was learning effective teaching strategies in science on topics with which they already had familiarity. Simultaneously, I gained a deeper understanding of the usefulness of reflection in my practice. As a contribution to the complexity of learning to teach science at the primary school level, this study suggests some issues for consideration as preservice teachers are supported to utilize more of the national primary science curriculum in The Bahamas.

Exploring a Model of Situated Professional Development: Impact on Classroom Practice

NASA Astrophysics Data System (ADS)

Singer, Jonathan; Lotter, Christine; Feller, Robert; Gates, Harry

2011-04-01

A hallmark of current science education reform involves teaching through inquiry. However, the widespread use of inquiry-based instruction in many classrooms has not occurred (Roehrig and Luft in Int J Sci Educ 26:3-24, 2004; Schneider et al. in J Res Sci Teach 42:283-312, 2005). The purpose of this study was to investigate the impact of a professional development program on middle school science teachers' ability to enact inquiry-based pedagogical practices. Data were generated through evaluation of teacher practice using the Reformed Teaching Observation Protocol (RTOP) (Sawada et al. in School Sci Math 102:245-253, 2002) at three distinct junctures, before, during, and after the professional development treatment. Analysis of teacher-participant post-institute reflections was then utilized to determine the perceived role of the various institute components. Statistical significant changes in RTOP scores indicated that the teachers were able to successfully transfer the enactment of the inquiry-based practices into their classrooms. The subsequent discussion provides connection between these pedagogical changes with use of professional development strategies that provide a situated learning environment.

Valuing the gap: a dialectic between theory and practice in graduate nursing education from a constructive educational approach.

PubMed

Moss, Cheryle; Grealish, Laurie; Lake, Sarah

2010-05-01

Within nursing education, graduate pedagogies are relatively unexplored, with research commonly focused upon undergraduate and continuing education. In order to address the increasingly complex organisational challenges in the workplace, mid-career nurses and midwives are turning to graduate education. In one graduate course on cultures of learning in the workplace, a constructivist approach to learning was adopted. Post-course analysis of data, from the feedback on the course from students, student choice of assignment topics, and reflections of the course facilitators, revealed three pedagogies unique to graduate education. The pedagogies were labelled 'keeping the space open', 'theoretical concepts as tools', and 'resonance and action as praxis'. The intended outcome of the course is revealed in a fourth theme, 'developing practice in the workplace'. This evaluation suggests that constructivist pedagogies used with graduate students may be different to those pedagogies used with undergraduate and continuing education students. We argue that graduate pedagogies move nursing education beyond strategies that seek integration of theory and practice, towards a dialectic between theory and practice. Copyright 2009 Elsevier Ltd. All rights reserved.

Mobilizing Foucault: history, subjectivity and autonomous learners in nurse education.

PubMed

Darbyshire, Chris; Fleming, Valerie E M

2008-12-01

In the past 20, years the impact of progressive educational theories have become influential in nurse education particularly in relation to partnership and empowerment between lecturers and students and the development of student autonomy. The introduction of these progressive theories was in response to the criticisms that nurse education was characterized by hierarchical and asymmetrical power relationships between lecturers and students that encouraged rote learning and stifled student autonomy. This article explores how the work of Michel Foucault can be mobilized to think about autonomy in three different yet overlapping ways: as a historical event; as a discursive practice; and as part of an overall strategy to produce a specific student subject position. The implications for educational practice are that, rather than a site where students are empowered, nurse education is both a factory and a laboratory where new subjectivities are continually being constructed. This suggests that empowering practices and disciplinary practices uneasily co-exist. Critical reflection needs to be directed not only at structural dimensions of power but also on ourselves as students and lecturers by asking a Foucauldian question: How are you interested in autonomy?

Impact of Guided Reflection with Peers on the Development of Effective Problem Solving Strategies and Physics Learning

ERIC Educational Resources Information Center

Mason, Andrew J.; Singh, Chandralekha

2016-01-01

Students must learn effective problem solving strategies in order to develop expertise in physics. Effective problem solving strategies include a conceptual analysis of the problem followed by planning of the solution, and then implementation, evaluation, and reflection upon the process. Research suggests that converting a problem from the initial…

[Empowering a group of seniors in a rural community].

PubMed

Machado, Ana Rita Marinho; Santos, Walterlânia Silva; Dias, Flavia Aparecida; Tavares, Darlene Mara Dos Santos; Munari, Denize Bouttelet

2015-02-01

To describe the stages of the empowerment process of a group of seniors in a rural community. Convergent care research whose foundation is to use the scope of practice. Conducted with the proposal to change the practice of 21 seniors and nine health professionals, with the aim of health promotion empowerment. Data were collected during 22 meetings, and group interviews at the end of the intervention. Showed that despite the initial impact of the change, the group was able to welcome the new change, taking advantage of the space to express anxieties, share joys, and build new knowledge, which led to the incorporation of changes that reflected in the development of healthy habits and improvements in interpersonal relationships. The convergent care research consisted of strategy that changed the group's lives, empowering them with health promoting actions.