An Intervention Study on the Effectiveness of Digital Storytelling Pedagogy in Early Childhood Education Professional Ethics Using a Parallel Mixed-Methods Approach

Learning in medical education involves a multitude of practical tasks and skills that are amenable to feedback provision. Though passive feedback is given, there is a consistent gap in feedback provision and its receipt. This study aims to assess provider perspectives on feedback and learner attributes influencing the receipt of feedback in medical educational settings. A parallel mixed methods study was conducted in September 2023 at a tertiary care teaching institute. A convenience sample of 40 medical teachers comprising two faculties per department and 30 students were included. Focus group discussions (FGDs) were conducted with students from each academic year for assessing the student-level factors (facilitators and barriers) in the receipt of feedback. Among the 40 medical teachers who were interviewed, the majority of 23 (57.5%) were assistant professors and nearly half of them (18; 45.0%) were below the age of 30 years. The majority of the respondents (28; 70.0%) were females, and 34 (85.0%) of them were postgraduates. Most of them (24; 60.0%) had worked for more than 10 years at the institute. It was observed that 80.0% of the respondents had given feedback to their students at some point in their careers. The major barriers for providing feedback were lack of curricular guidelines, fear of affective responses from students, burden of clinical, administrative work, and lack of perceived need by both students and teachers. DESTEP analysis of the student-level factors governing the receipt of feedback shows the effects of institutional ethics and culture, feedback model utilized, and the influence of learner behaviors, motivations, and teacher attributes. The study elucidates mentor- and mentee-level influencers for providing and receiving feedback. Effective teacher-student partnerships along with an optimal skill set are required to recognize the need, opportunities, and processes to provide and seek feedback. Shifting the focus from feedback giving to active feedback seeking would be a step toward creating effective and pragmatic feedback systems.

BackgroundSocial needs inhibit receipt of timely medical care. Social needs screening is a vital part of comprehensive cancer care, and patient navigators are well-positioned to screen for and address social needs. This mixed methods project describes social needs screening implementation in a prospective pragmatic patient navigation intervention trial for minoritized women newly diagnosed with breast cancer.MethodsTranslating Research Into Practice (TRIP) was conducted at five cancer care sites in Boston, MA from 2018 to 2022. The patient navigation intervention protocol included completion of a social needs screening survey covering 9 domains (e.g., food, transportation) within 90 days of intake. We estimated the proportion of patients who received a social needs screening within 90 days of navigation intake. A multivariable log binomial regression model estimated the adjusted rate ratios (aRR) and 95% confidence intervals (CI) of patient socio-demographic characteristics and screening delivery. Key informant interviews with navigators (n = 8) and patients (n = 21) assessed screening acceptability and factors that facilitate and impede implementation. Using a convergent, parallel mixed methods approach, findings from each data source were integrated to interpret study results.ResultsPatients’ (n = 588) mean age was 59 (SD = 13); 45% were non-Hispanic Black and 27% were Hispanic. Sixty-nine percent of patients in the navigators’ caseloads received social needs screening. Patients of non-Hispanic Black race/ethnicity (aRR = 1.25; 95% CI = 1.06–1.48) and those with Medicare insurance (aRR = 1.13; 95% CI = 1.04–1.23) were more likely to be screened. Screening was universally acceptable to navigators and generally acceptable to patients. Systems-based supports for improving implementation were identified.ConclusionsSocial needs screening was acceptable, yet with modest implementation. Continued systems-based efforts to integrate social needs screening in medical care are needed.

The experiment was targeted to develop design strategies and methods by testing the complex interplay between the dynamics of daylight and electrical lighting in an office. The double dynamic lighting design concept is based on the idea of adding task lighting, with a directionality referring to the daylight inflow and a variation on direct/diffuse lighting and respective changes in colour temperature respond to sky conditions and daylight levels. The experiment was conducted in an office space at Aalborg University in Copenhagen from September to December 2019. Four participants moved in and worked in the office with four-week periods of respective standard static lighting as a baseline, and dynamic lighting. In a parallel mixed method approach with interviews and questionnaires, the dynamic lighting was compared to the baseline and to a control group. The results indicate that the dynamic lighting periods had a positive effect on visual comfort, perceived atmosphere and work engagement. The studies helped to develop the definition of five dynamic light settings. Seasonal changes, time of day, dynamic sunscreens and individual needs for task lighting can be implemented in future field experiments as additional dynamic parameters to meet individual needs and circadian potentials for double dynamic light.

Background: Traumatic exposures are often assessed in clinical and research settings by a list of events chosen because they meet the definition of trauma required for the ICD-11 or DSM-5 diagnosis of posttraumatic stress disorder (PTSD). Some trauma measures include an ‘other’ option, with a text box enabling participants to describe an event not listed. Objective: There were three aims in this study: (1) to identify commonly endorsed ‘other’ events not listed on a standard measure of trauma exposure, (2) to identify thematic commonalities among these other events, and (3) to assess the prevalence of provisional lifetime and past month PTSD associated with these other events. Method: We used a parallel mixed methods approach and data from 2653 women in the Nurses’ Health Study II to categorize ‘other’ events reported in free text and named as participants’ ‘worst’ traumatic event. We assessed the prevalence of provisional lifetime and past month PTSD based on DSM-5 criteria associated with these ‘worst’ events. Results: ‘Other’ events fell into six thematic categories: non-violent death of a family member or close friend, distressing event occurring in the workplace, a family member being harmed in some way, a family member managing a distressing problem, problems with an intimate partner, or a personally distressing event/ problem. ‘Other’ event themes, such as a family member managing a problem distressing to the participant, were associated with high prevalence of provisional lifetime PTSD (33.7%; n = 101). Common ‘other’ events (within themes) were also associated with high provisional lifetime PTSD (e.g. verbal abuse or harassment, 43.8%; n = 89). Conclusions: Results suggest that events not typically defined as trauma may still be associated with clinically significant PTSD symptoms. Future studies should further investigate these events and consider including additional events to capture the range of clinically relevant experiences in research.

Telephone and video appointments are still common post-pandemic, with an estimated 25%-50% of kidney appointments in the United Kingdom still conducted remotely. This is important as remote consultations may exacerbate pre-existing inequalities in those from underserved groups. Those from underserved groups are often not represented in health research and include those with learning disability, mental health needs, hearing/sight problems, young/older people, those from ethnic minority groups. The aim was to develop a Toolkit to improve the quality of remote kidney care appointments for people from different underserved groups. A parallel mixed methods approach with semistructured interviews/focus groups and survey. We also conducted workshops to develop and validate the Toolkit. Seventy-five renal staff members completed the survey and 21patients participated in the interviews and focus groups. Patients (n = 11) and staff (n = 10) took part in the Toolkit development workshop, and patients (n = 13) took part in the Toolkit validation workshop. Four themes from interviews/focus groups suggested areas in which remote appointments could be improved. Themes were quality of appointment, patient empowerment, patient-practitioner relationship and unique needs for underserved groups. Staff reported difficulty building rapport, confidentiality issues, confidence about diagnosis/advice given, technical difficulties and shared decision making. This study is the first to explore experiences of remote appointments among both staff and those from underserved groups living with kidney disease in the United Kingdom. Whileremote appointments can be beneficial, our findings indicate that remote consultations need optimisation to meet the needs of patients. The project findings informed the development of a Toolkit which will be widely promoted and accessible in the United Kingdom during 2024.

The coronavirus disease 2019 (COVID-19) pandemic impacted life for older adults living in residential settings, affecting their psychosocial well-being. Risk for COVID-19 is associated with increasing age and pre-existing health conditions. The current study aimed to describe the challenges of COVID-19 and post-traumatic growth (PTG) for residents of a continuing care retirement community (CCRC) in South Florida. A parallel mixed methods approach was used to explore the experience of older adults with PTG. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using content analysis to identify emergent themes. Ninety-eight older adults living in a single CCRC completed a survey. Age ranged from 67 to 99 years (mean age = 86 years), with >90% identifying as non-Hispanic White and female (78%). Using the PTG theoretical framework, experiences were categorized into five dimensions: new possibilities, relating to others, personal strength, spiritual growth, and appreciation for life. The current study focused on the challenges and growth experienced by older adults, as framed by PTG theory. Findings shed light on the capacity of this demographic, with an average age of 86 years, to overcome obstacles and achieve PTG. [Journal of Gerontological Nursing, 50(6), 25-33.].

This study examined the extent to which pre-service teachers participating in a 16-week SCE 4310 Teaching Elementary Science methods course enhanced their (a) dispositions toward teaching sustainable systems, (b) self-efficacy, and (c) content knowledge. The re-oriented curriculum and teaching were framed and guided by the nine themes of sustainability literacy (Nolet, Teachers College Record 111(2):409–442, 2009). The study included ninety-two participants and used the parallel mixed methods approach where investigators independently collected and analyzed qualitative data and quantitative data simultaneously developing inferences that were independently constructed. Results indicated that the newly designed course improved participants’ dispositions towards providing sustainable systems instruction, self-efficacy, and content knowledge, as demonstrated by both the quantitative measures and analysis of qualitative artifacts including professional portfolios, lesson development and teaching practice reflections.

This study examines pre-service teachers' Technological Pedagogical Content Knowledge (TPACK) development and analyses their conceptions of learning and teaching with technology. With this aim in mind, researchers designed and implemented a computerbased mathematics course based on a TPACK framework. As a research methodology, a parallel mixed method approach was used. The data were collected from 71 pre-service teachers taking the course. The TPACK survey, a semi-structured interview, and evaluation scores of pre-service teachers' microteaching performance, which also included analysis of lesson plans, were used as data collection instruments. The findings indicated that the implemented instructional processes affected pre-service teachers' TPACK development positively. There were significant differences before and after the course implementation concerning Technology Knowledge, Technological Content Knowledge, Technological Pedagogical Knowledge, and TPACK in general. Qualitative findings support and overlap the statistical inferences. There should be more courses which require pre-service teachers to develop computerbased instructional materials and use their materials with microteaching sessions. Instructors of faculties of education should use technology in their instructional environments not only for presentation purposes.

BackgroundCardiac surgeries rank among the most frequent surgical procedures and present a risk of chronic postsurgical pain (CPSP). A continuum approach is required to prevent the development of CPSP. As a first step, a tailored web-based intervention was developed and successfully tested to tackle pain management during hospitalization. Before proceeding to further development, preliminary acceptability of the intervention including the postdischarge phase must be evaluated.PurposeThe purpose of this study was to examine nurses’ perception of a tailored Web-based intervention for pain management in the early recovery phase. The objectives were to evaluate intervention’s acceptability and to identify ways to enhance its acceptability.MethodsA parallel mixed methods approach was used to assess the acceptability of the intervention in the early recovery phase (first month after surgery).ResultsIn total, 249 participants completed the online survey and 10 participants were individually interviewed. Overall, the intervention was rated as acceptable. No difference was found in acceptability ratings by demographics. The intervention was rated as appropriate to very much appropriate by 79% of participants. Although nurses seemingly would recommend it to their patients, they did not perceive that their patients would be as highly willing to use it. Interviews highlighted several strengths of the intervention, such as postoperative pain awareness, customization of content, and flexible dosage and schedule. However, the main weakness was related to patient adherence. Opting for a hybrid format and integrating individual preferences could enhance the coaching experience.ConclusionThe innovative intervention was judged as acceptable for pain management in the early recovery phase. Considering that the intervention has demonstrated positive effects on the pain experience in the first week after cardiac surgery, it seems logical to explore its potential impact after discharge on the transition to CPSP.

Training is a means to an end. It is not an end itself. Training is teaching or developing once knowledge, skills, capabilities and performance. In today’s world it is believe that training plays a vital role in developing human capabilities. So every training institute or training organization needs to understand their internal strengths, weakness and external opportunities and threats. Training institute for technical instruction (TITI) a pioneer institute in Nepal especially for providing skill based training in technical education and vocational training (TEVT) sector also need to identify its internal strengths, weakness, opportunities and threats. During its 25 years of excellence in training throughout Nepal and abroad its necessary to know TITI trainees satisfaction towards training services. In this context, we pursued to gain an in-depth understanding on satisfaction of trainees towards training services of TITI in respect towards teaching methodology. Kathmandu, Bhaktapur and Lalitpur districts of Kathmandu Valley, Nepal were selected for the study. Eight key participants voluntarily participated in this study where as 343 respondents were surveyed using five points likert scale. A parallel mixed method approach was employed to gain insight into TITI trainee’s satisfaction towards TITI training services in respect to teaching methodology.

ABSTRACTSouth Africa is faced with water scarcity crisis. In recent years, conservation campaigns have emerged to encourage citizens in developing a social ethic of water conservation essential in creating sustainability of resource use. The conservation campaigns are disseminated using conventional media often with messages couched in English language with the attendant highfalutin jargon which obfuscates and limits reach and effectiveness. To this end, negative attitudes towards water resources persist. Using the parallel mixed methods approach, this paper examines the potency of Folk Theatre in creating awareness about water issues as well as in alleviating and advocating attitudinal and behavioural changes against the backdrop of a worsening water crisis. Based on data on a rural community, Folk Theatre is found to be effective in raising awareness and educating rural folks about water issues and breaking down misconceptions about water conservation. In conclusion, Folk Theatre offers a sustainable alternative approach to communicating water conservation in rural South Africa.

Although African American breast cancer survivors are most likely to gain weight following diagnosis and treatment compared to women from other ethnic groups, limited information is available on psychological and behavioral reactions to weight change in this population. To explore perceptions and reactions to weight change in African American breast cancer survivors. A parallel mixed methods approach was used to explore experiences with and reactions to weight change following breast cancer diagnosis and treatment. Participants were 16 short- and long-term African American breast cancer survivors. Nine out of 16 participants gained weight following diagnosis and treatment and most participants were concerned about these changes. Most participants were also interested in diet and exercise programs; however, a holistic and common sense approach to diet and physical activity emerged as key themes. Although prior reports have found that African American women in the general population report a greater tolerance for larger body sizes, most participants in this study were concerned about changes in their weight and were actively trying to minimize weight gain. Several themes emerged regarding physical activity and dietary behaviors; overall, participants described a holistic and practical approach to these behaviors.

PurposeThe purpose of this paper is twofold: first, to identify and rank the challenges influencing the delivery of the housing public-private partnership (HPPP) in Tanzania; and second, to suggest solutions in the form of a conceptual public-private partnership (PPP) framework model that will address the identified challenges and boost the chances of success.Design/methodology/approachUsing a convergent parallel (concurrent) mixed method approach, data were collected from 28 stakeholders involved with HPPP projects in Tanzania using a hand-delivered and e-mail survey and 13 semi-structured interviews with public and private sector respondents. The quantitative data included subjecting the 19 challenges as identified from the literature to parametric tests such as one-sample t-tests and descriptive statistics tests such as measures of central tendencies and frequency analysis through Statistical Package for Social Sciences (SPSS 22.0). Qualitative data employed content analysis. The research was further underpinned by a number of theoretical perspectives such as Gidden’s structuration theory, contingency theory, relational and equity theory.FindingsThe top five ranked challenges influencing the delivery of HPPP were “inadequate PPP skills and knowledge”; “poor contracting and tendering documents”; “inadequate project management”; “inadequate legal framework”; and “misinformation on financial capacity of private partners”. The least six ranked and most significant challenges based on the one-sample (single) t-tests were as follows: “Poor risk allocation”; “inexperienced private partner”; “unequal qualification and contributions of expertise”; “poor enabling environment to attract competent partners”; “inadequate mechanisms for recovery of private investors’ capital”; and “high costs in procuring PPP projects”. The qualitative study further confirmed the challenges and cited the reason for the failure of joint venture projects as the lack of motivation for undertaking similar PPP projects. Despite the increased awareness of PPP projects and associated marginal benefits, the main impediment to the uptake and delivery of PPP housing projects remained the lack of skills and expertise.Research limitations/implicationsThe proposed framework model is not yet tested, but since this paper is part of the ongoing research, the next stage involves the testing and validation of the model. Future studies could test the applicability of the proposed framework in other HPPP projects in Tanzania, and in other similar developing countries. Second, the validated framework can contribute towards addressing similar challenges as well as providing guidance. The proposed framework model is not yet tested, but since this paper is part of the ongoing research, the next stage involves the testing and validation of the model. Furthermore, recommendation for future research is to test the alignment of the identified challenges to the proposed remedial solutions across the five phases within the proposed PPP framework with a number of case studies.Practical implicationsThe identified challenges were used to form the basis of the framework presented in this paper. Furthermore, these provide useful information, thus leading to increased awareness to enable successful delivery of HPPP in Tanzania. Similarly, both the government and policy makers could use the findings as the basis for re-examining the existing PPP policy and regulations, and reflecting on the existing situation with a view to improving the delivery of future HPPP projects.Originality/valueThe empirical study is among the first that identifies and ranks the challenges of PPP for housing projects delivery within the Tanzanian context. The identification of the challenges enabled their ranking, resulting in the mapping out of the most critical challenges. Furthermore, using the Gidden’s structuration theory, the study illustrates how institution mechanisms (structures) address these delivery challenges, thus influencing the implementation of HPPP in Tanzania, and how individual stakeholders (human agents or agency) are able to make choices (advocated solutions) in dealing with the challenges. More so, these constraints (challenges) as identified and viewed through the contingency and equity theoretical lenses form the foundation for developing the PPP conceptual framework. The proposed framework would thus serve as a mechanism for providing practical solutions as well as reducing the level of severity of the identified challenges.

Child obesity is a major global public health issue. This study sought to identify means to improve children’s dietary behaviors through horticultural activities and effectively enhance their health and quality of life. The 129 participants were children in third grade through sixth grade in Hsinchu City, Taiwan. A quasi-experimental design was adopted as an intervention for school horticultural activities. The 68 students in the intervention group engaged in 40-minute horticultural sessions for 6 weeks. The pretest and post-test scores of both groups were measured using the Physical Questionnaire for older Children, the Connection to Nature Index, the Willingness to Taste Fruits and Vegetable Scale, and the Children’s Quality of Life Scale, as well as questionnaire items. The qualitative and quantitative data were analyzed through a parallel mixed-method approach. The findings showed that the intervention group’s physical activity levels, nature connectedness, and overall health were higher than those of the control groups. There were no significant differences in willingness to taste fruits and vegetables. This study demonstrates that engaging in natural school spaces and participating in horticultural activities improved the physical and mental health of children. Natural elements should be incorporated into the campus design, and children should be encouraged to participate in school horticultural activities.

Despite the scale-up of intervention, malaria remains a burden in the Upper River Region of The Gambia. Climate changes and non-climatic conditions can substantially influence malaria prevalence, and further affect the coverage of preventive interventions. This work aimed at exploring the different climatic and non-climatic risk factors associated with malaria. Using a descriptive research method and a parallel mixed-method approach, 381 households from seven districts were surveyed from 4th to 24th September 2023. Data were analyzed with StataSE 18 and Nvivo. Descriptive statistics were performed, in addition to thematic analysis, and the significant influence of environmental and socioeconomic factors on malaria prevalence in the region was further analyzed using Chi-square (Χ2). The work revealed an influence of rainfall and flood on the prevalence of malaria in the region, with a significant association of some measured environmental and socioeconomic factors at a p-value of 0.05. These results will provide individuals, professionals, government, and policymakers valuable information for better-targeting malaria control efforts.