Didactic Intervention Research Articles

Teaching science to students with special educational needs: a systematic review of science teaching-learning approaches in regular and special education settings

ABSTRACT In this systematic review, a series of didactic proposals and experiences that have been developed over recent years in formal education are presented with the common purpose of ensuring that students with special educational needs learn science. Initially, only 54 publications on the topic were identified, which underlines the scarce research over the last 20 years and the small percentage of papers published in research journals and conference proceedings within this area. From among those publications, our review is focused on the 27 that report the implementation of didactic interventions: 11 at specific special education centres and 16 at regular educational centres. Explicit instruction was considered a fundamental strategy in the first group, while varied experiences and methods were among the most relevant approach in the second group. In addition, both educational environments involve learner-centred teaching approaches, with the implementation of inquiry-based and hands-on activities, in line with the general results of research in Science Education that does not specifically deal with SSEN. Ensuring that all learners have the opportunity to learn science requires more specific and complementary studies that consolidate the evidence of these results, taking into account the diversity of learners in classrooms for the benefit of all.

Effect of Health Education Intervention On Diarrhea Prevention Practices Among Mothers of Under-5 Children in Abia State, Nigeria

Delayed response to the onset of diarrhea in infants caused by poor sanitation and delay in responding to signs and symptoms can be fatal, as evidenced by mortality in children attributable to diarrhea, occasioned by inadequate understanding of the dangers and consequences involved due to poor knowledge of far-reaching consequences, inadequate prevention and skills to manage the condition as it develops. This study evaluated the effect of a health education intervention on diarrhea prevention practices among mothers with children under the age of five in Aba, Abia State, Nigeria. This study employed a quasi-experimental research design. From population of 350 under-5 mothers in the Local government, a sample size of 60 was determined using power formula. Systematic sampling was used to select the mothers. The health education intervention involved a control and experimental group. The duration of program was one hour weekly didactic intervention for six weeks. A structured validated questionnaire was used to collect data at baseline, at 6th and 12th week post intervention. The Cronbach’s alpha reliability coefficients for the constructs ranged from 0.75 to 0.87. The mother’s prevention practices were measured on a 27-point rating scale. Data collected were analyzed using descriptive and inferential statistics at α = 0.05 level of significance.Findings showed that between the baseline and the post-immediate there was a significant difference in the mean prevention score in the experimental group (from 19.03±5.91 to 22.20±3.67 at p< 0.05. However, there was no significant difference (p >0.05) in the mean prevention score of the control group (from20.13 ± 4.89 to 20.8 ± 3.41). In conclusion, the health education intervention was effective increasing the mother’s prevention and home management practices of diarrhea. It is recommended that matrons and nurses in charge of antenatal and postnatal clinics should teach mothers about prevention andhome management of diarrhea.

Metaphors in Child Discourse: Interpretive Research from a Participatory Perspective

This article presents the study results of an educational project focused on visual metaphor in initiated child discourse. The objective of the study was to assess the knowledge of children between the ages of 9 and 10 years old regarding the target domain of metaphorical projection (concerning togetherness) and children’s metaphorisation skills in the area of recognising similarities and differences between the target domain and the source domain of visual metaphor in an artistic picture book. In the designed didactic intervention activities, the research material originated from participant observation, focus interviews,and analysis of children’s creations (graphic visualisations). The research was conducted on two groups of third graders in selected primary schools in the metropolitan environment of Łódź, Poland. The results illustrate children’s preferences for translating one domain ofmetaphor with another, as well as the strategies for constructing children’s knowledge with respect to life in a relationship. Furthermore, they point towards the need for expanding the educational environment in Polish educational culture.

The construction of the integral for the arc length of a curve based on van Heuraet and Fermat’s works

We present the research outcomes of a project in Mathematics Education about the design and implementation of an instrument to learn the integral for the arc length of a function by using differential elements as the strategy for its construction. The research was done via a didactic intervention in a regular Integral Calculus course. The instrument was designed based on historical-epistemological analyses of the works of van Heuraet and Fermat. The main result of this research was that students achieve a more robust conceptualization of the integral for the arc length, supported by its construction with differential elements and its geometric foundation.

An analysis from teaching interventions focused on levels of conceptualization

In this article, the didactic interventions of a future physics teacher are analyzed during the joint construction, with the group of students, of school scientific explanations of everyday phenomena in a secondary education classroom. The work aims to contribute to an under-researched territory, related to how teachers guide the construction of explanations in science classrooms. A case study focused on qualitative methodology was used, using thematic content analysis. Transcripts, class diaries and working sessions between residents and teachers were analyzed. An initial category system was built that was expanded inductively. A typology of discursive strategies used by the future teacher was developed, which includes strategies to promote conceptualization at different levels of representation of matter and meta-explanatory strategies to explicate aspects of the structure of explanations.

Exploring the Effect of Adding an Interactive Lecture to a Standardized Patient Curriculum on the Attitudes of Third-Year Medical Students About Patients With Obesity: A Quasi-Experimental Study.

Anti-obesity bias is pervasive among medical professionals, students, and trainees. Stigmatization of patients leads to suboptimal care and clinical outcomes. Educational strategies in medical training are needed to reverse these attitudes. The aim of this study was to evaluate the effect of an innovative didactic intervention and a standardized patient (SP) exercise on attitudes towards patients with obesity among medical students. In 2016, a quasi-experimental study design was used at a US medical school. The class was divided into 2 groups according to a pre-determined protocol based on their clinical schedule, one assessed after exposure to a SP group and the other after exposure to the SP and an interactive lecture (IL + SP group) with real patients. The Attitudes about Treating Patients with Obesity and The Perceived Causes of Obesity questionnaires measured changes in several domains. A generalized estimating equations model was used to estimate the effect of the interventions both within and between groups. Both groups showed improvements in negative and positive attitudes, although the reduction in scores for the negative attitude domain did not reach statistical significance in the IL + SP group (for the SP group, P = .01 and < .001, respectively; for the IL + SP group, P = .15 and .01, respectively). For perceived causes of obesity, there were no statistically significant changes for pre-post survey measures within each group, except for the physiologic causes domain in the SP group (P = .03). The addition of an IL to a SP curriculum did not result in any changes for any domain in between-group analyses. Although adding a novel intervention utilizing real patients to a SP curriculum failed to show an additional educational benefit, our study showed that it is possible to influence attitudes of medical students regarding patients with obesity.

Augmented reality strategy as a didactic alternative in rural public schools in Colombia

AbstractThere are access restrictions to the technologies of the Fourth Industrial Revolution for rural schools in Colombia. These schools, with few students and teachers geographically dispersed, do not benefit from the possibilities of these technologies in the classroom. These educational institutions are governed by the “Escuela Nueva” model that defines several specific methodological moments. The objective of this study was to design a strategy based on augmented reality (AR) for didactic intervention in the classroom, which allows students to interact with educational resources and break down barriers both related to access to technology and related to the role in learning processes. Educational activities were defined, and a mobile application based on AR was developed for schools in Samaná‐Colombia, integrated with the pedagogical moments of the educational model and at the same time strengthening AMID skills (information literacy and digital media) in the teaching work. Instruments were applied seeking to know the benefits in the classroom and the perception of students and teachers. The results show, preliminarily, that the use of AR in learning activities in this rural school makes it possible to bring students and teachers closer to these technologies, generating motivation and improving the effectiveness of the process, additionally is well accepted in the academic community. Experiments show that if they are included harmoniously in the pedagogical model, it does not interfere, nor is it a distraction for other academic activities. The Contribution paper to empirically validate AR in education generate learning in students of armed conflict zones.

Learning about multiplication by comparing algorithms: “One times one, but actually they are ten times ten”

Multiplication algorithms in primary school are still frequently introduced with little attention to meaning. We present a case study focusing on a third grade class that engaged in comparing two algorithms and discussing “why they both work”. The objectives of the didactical intervention were to foster students' development of mathematical meanings concerning multiplication algorithms, and their development of an attitude to judge and compare the value and efficiency of different algorithms. Underlying hypotheses were that it is possible to promote the simultaneous unfolding of the semiotic potential of two algorithms, considered as cultural artifacts, with respect to the objectives of the didactical intervention, and to establish a fruitful synergy between the two algorithms. As results, this study sheds light onto the new theoretical construct of “bridging sign”, illuminating students’ meaning-making processes involving more than one artifact; and it provides important insight into the actual unfolding of the hypothesized potential of the algorithms.

Game Space and Game Situation as Mediators of the External Load in the Tasks of School Handball.

The teacher’s didactic intervention also requires knowledge and control of learning tasks’ workloads. The objectives of the study were as follows: (i) to quantify the subjective external load-eTL of tasks framed in didactic units designed by in-service teachers; and (ii) to analyze the differences in the subjective eTL according to the game situation and the game space. A total of 306 learning tasks designed by seven in-service teachers (five men and two women), with more than 10 years of teaching practice, were analyzed. These tasks were coded through the Integral System for Training Task Analysis (SIATE, acronym in Spanish). The interobserver reliability of the coded variables obtained a considerable concordance (MKfree > 0.70). The results indicated that there were significant differences in the subjective eTL according to the game situation and game space. The situations of small-sided games in numerical equality or inequality and full games, in medium spaces or large spaces, presented a higher subjective eTL and therefore the highest physiological and motor demands on students. The inclusion of attacking or defending players and an adequate selection of the game space indicated the importance of planning and organizing learning tasks.

De los debates globales a las prácticas locales: pedagogías emergentes para el fomento de la interculturalidad en el aula de español para adultos migrantes

ABSTRACT Recent theoretical debates in the field of intercultural language education reveal a “cosmopolitan turn”, which implies a glocal, critical, and transformative perspective of interculturality as praxis. This article explores the promotion and development of interculturality from a critical cosmopolitan perspective and reports on the results of an empirical study carried out in a Spanish language classroom for adult migrants in Barcelona through a didactic intervention based on emergent pedagogies. The results enrich the conception of a “cosmopolitan agenda” for language teaching and contribute to bridging the methodological gap between global theoretical debates and local practices of intercultural language education.

Is sustainability an exhausted concept? Bridging the gap from environmental awareness to emotional proficiency in science education through integral sustainability

Sustainability has recently become a common context for science teaching due to its potential in terms of learning the content and promoting such universal values as respect for human rights and for other forms of life, the integral development of the person, or participation in democratic processes. The treatment of the Sustainable Development Goals in higher education, improving environmental awareness and promoting sustainable attitudes through didactic interventions of some depth, is the responsibility of teachers and researchers. This study describes a didactic intervention based on the design, implementation, and testing of a Slow Sand Filter. It was carried out in a science seminar with primary teacher education students (n = 69), and served to promote sustainable awareness in addition to other skills, knowledge and competencies required for the professional development of prospective teachers. The results provide evidence that prospective teachers who feel positive and activating emotions during the implementation of the program think that the experience will modify their way of teaching science when they are teachers. Through this intervention, prospective teachers face real problems, develop sensitivity and critical thinking towards problematic situations that are being experienced on the planet, and improve their environmental attitudes, scientific knowledge, and emotional dimension towards learning the sciences.

Area Measurement of Flat Rectangular Surfaces by Students 10-11 Years Old: Traditional vs Inquiry-Based Teaching Intervention

The main purpose of this work is to determine the requirements during the design and implementation of inquiry-based teaching interventions (structured and guided inquiry-based teaching), as well as to record their effect on the perception of the area and its measurement by children aged 10-11 in relation with traditional didactic intervention. Initially, the students of three classes completed pre-test with tasks that aimed to detect their knowledge of the concept of area and its measurement. Then three different didactic interventions were applied (traditional, structured and guided inquiry-based), one in each class. Finally, after the completion of the interventions, the students completed a post-test similar to the pre-test in order to compare their answers and to record the results of each teaching intervention. The type of activities and the degree of guidance by the teacher during the interventions were the main criteria for differentiating the design and implementation of the inquiry-based teaching interventions from the traditional one. The results showed that the students of the traditional teaching intervention (TI) had a better general response, both in pre-test and in the post-test, than the other two groups of students. However, a greater improvement in the students' response to the post-test, compared to the pre-test, was recorded in the guided inquiry-based intervention (GIBI), with the structured inquiry-based intervention (SIBI) and the TI following. There was also a greater improvement in the response of low-achieving students, regardless of the teaching method, with students of the GIBI and the TI mid-achieving following. Regarding high-achieving students, greater improvement was observed in students in the SIBI with those in the GIBI following.

Rethinking Digital Technology versus Paper and Pencil in 3D Geometry

Recognising the relevance of learning Geometry, and in particular 3D Geometry, this study aims to discuss the contributions that digital technology and paper and pencil approaches can bring to students’ learning. We seek, therefore, to identify the differences between the two approaches, and specifically: What factors are relevant in one and the other approach? What does one approach facilitate over the other? A quantitative and a qualitative and interpretive methodology was adopted, and based on a didactic intervention, the students' resolutions of the proposed tasks were analysed. The results obtained show that the experience and prior knowledge of the students with each of the solids involved seems to be decisive in the approach with paper and pencil. However, technology emerges as an enhancing resource when prior knowledge is more fragile. The study also shows differences between the representations supported by the two resources, suggesting the mobilisation of different knowledge by the students in relation to each of the resources.Recognising the relevance of learning Geometry, and in particular 3D Geometry, this study aims to discuss the contributions that digital technology and paper and pencil approaches can bring to students’ learning. We seek, therefore, to identify the differences between the two approaches, and specifically: What factors are relevant in one and the other approach? What does one approach facilitate over the other? A quantitative and a qualitative and interpretive methodology was adopted, and based on a didactic intervention, the students' resolutions of the proposed tasks were analysed. The results obtained show that the experience and prior knowledge of the students with each of the solids involved seems to be decisive in the approach with paper and pencil. However, technology emerges as an enhancing resource when prior knowledge is more fragile. The study also shows differences between the representations supported by the two resources, suggesting the mobilisation of different knowledge by the students in relation to each of the resources.

The Importance of Ethics in Socio-Educational Robotics

Socio-educational robotics can be defined as investigating teaching-learning processes involving robots capable of bonding, learning and communicating. These robots are used as a didactic tool for their ability to interact with people, and they are designed to meet their objectives and benefit the human beings involved in the process. Therefore, it is essential to recognize the social and educational purpose of the intervention itself that will be carried out with them. However, the deontological code of the pedagogy profession does not include social robotics since it is a relatively new phenomenon in education. All the didactic interventions using robots must be designed to be compatible with the ideals of human dignity, rights, freedoms and cultural diversity.

Tracking relations between development of tactical knowledge and tactical behaviour: a season-long action research study

ABSTRACT Background: Specific learning experiences are vital for athletes to continuously interact with developing knowledge of the performance environment, through the refined design of representative learning contexts (ecological paradigm), and appropriate didactical interventions (constructivist paradigm). Although there is a well-established relationship between tactical knowledge (TK) and tactical behaviours (TB), research has investigated the development of both separately. Thus, the inter-dependency between knowledge and behaviour has been inferred, but not contextually interpreted in a process-oriented analysis of performance. Purpose: Through an insider action-research (AR) design, and adopting a mix-methods approach, this study aimed to: (i) investigate in-depth the influence of a constructivist-ecological pedagogical intervention on developing players’ TK and TB; (ii) explore effects of integrated tactical knowledge and behaviour on competitive performance. Participants and settings: Fifteen female volleyballers participated in this study. An insider-AR (first author assumed the dual role of coach and researcher) was conducted from September 2017 to June 2018. In total, four AR-cycles were completed. A mixed-method approach was used to obtain distinct, but complementary, data on the impact of a constructivist-ecological pedagogical intervention on development of players’ TK and TB. Qualitative data were used to explore the development of TK, while TB was analysed through quantitative methods. Data collection: Qualitative data on the coach’s perceptions were collected using a reflexive diary and field notes, while players’ perceptions were recorded through four semi-structured focus-group interviews, one per AR-cycle. Quantitative data from four official competitive matches, one per AR-cycle, were analysed. Players’ positional coordinates were used to calculate the synchronisation tendencies of lateral blocking and defensive lines through the cluster-phase method. Data analysis: Qualitative data were analysed using thematic analysis, in which inductive procedures deepened understanding of the development of the players’ TK. A 4 (matches) x 1 (court direction) repeated-measures ANOVA was used to analyse quantitatively the differences in the mean cluster-amplitude values of lateral blocking and defensive lines between matches. Main findings: The unique integration of constructivist and ecological principles scaffolded the development of players’ TK and TB. Players evolved from an initial stage in which they verbally described competitive game scenarios (using knowledge about environment), to an endpoint where they revealed superior tactical understanding and action intentionality. Increments in tactical complexity favoured the development of TK and TB in a long-term analysis. However, over the short-term, TB was reduced. The development of players’ TK (supported by interactions yielding knowledge of practice and performance environments) shaped a basis for the acquisition of co-adaptive TB during competitive performance. Practical implications: First, sport practitioners could benefit from combining strategies from different theoretical approaches so that they can satisfy the daily needs of athletes in practice. Second, we advise coaches to adopt didactical and representative learning designs, grounded on video analysis and the co-creation of game-plans. Third, the data imply that time and the continuous exposure of players to meaningful and representative practice tasks in learning environments are needed so that athletes can enrich their tactical behaviours, using knowledge of the performance environment to interact effectively its constraints.

Project BRA: Breast cancer risk assessment.

10549 Background: In Kansas, breast cancer (BC) incidence is similar in Black and white women, yet Black women are 42% more likely to die from the disease. In models where screening is equal, there is no difference in survival from early-stage BC. Barriers to BC early detection in Black women include provider lack of knowledge in cancer risk, performing risk assessments and providing culturally sensitive education to patients. Our team developed a didactic and case-based learning intervention using Project ECHO (Extension for Community Health Outcomes) to improve provider knowledge on performing BC risk assessment and enhance risk stratified screening in Community Health Clinics (CHCs). A Community Advisory Board (CAB) was established to address barriers to early detection. Methods: CHCs participated in five 1-hour ECHO sessions June thru August 2021. Session topics focused on calculating BC risk, community resources, and cultural sensitivity and were led by experts in breast oncology, risk, genetics, screening, and health care equity. Pre/post surveys administered to participants assessed knowledge and satisfaction and continuing education credits were offered. A CAB member survey gained insight into organizational characteristics and community reach. Asset mapping identified barriers, resources, and opportunities to promote BC screening. Descriptive statistical analyses and the RE-AIM framework were used to assess reach and scalability of the ECHO. Results: Seventy-seven individuals from 16 CHCs registered to participate with a mean of 26 attendees at each session and 34% attending two or more. Participants were physicians (19%), advanced practice providers (18%), nurses (29%), and allied health professionals (34%). Sixty-three (82%) completed the baseline survey and 10 (13%) completed the post-ECHO survey. At baseline, 32% of participants reported lack of training and time as barriers to performing risk assessment. While post-ECHO survey responses were low, 60% reported their knowledge greatly or moderately improved across all topics. Participants reported clinical practice change in assessing personal history of cancer and collecting family history beyond first degree relatives. CAB members reported a broad range of expertise in community engagement and development (44%), direct patient care (15%), healthcare access (15%) and patient advocacy (26%). CAB education and collaboration led to support for tomosynthesis for women screened in our state funded BC screening program, Early Detection Works (EDW). Ongoing asset mapping identified gaps in access for Black women to the EDW program. Conclusions: Project BRA demonstrated successful participation in a limited series Project ECHO and achieved perceived changes in knowledge on performing BC risk assessment. Next steps include incorporating CAB informed opportunities to expand risk-based screening across Kansas and advocate for improved access to risk stratified screening.

Mathematics education and social-environmental crises: an interdisciplinary proposal for didactic innovation with rural communities in Mexico

ABSTRACT We report our progress on the “River Memorial Museum” didactic intervention project developed with schools, in the basin of the Atoyac River in Mexico, that are significantly impacted by the pollution produced through industrialisation. The teachers of the elementary schools in these communities, environmental scientists, educators, and community activists participated jointly in a co-construction process, designing interdisciplinary educational activities to study local environmental issues and recovering the principles of a socio-critical perspective of mathematical modelling. In this paper, we centre on presenting the methodology of the didactic intervention with the teachers of one school of an Atoyac River basin community and the principles for designing educational activities we developed collaboratively with them. We believe this methodology could be helpful to support others in thinking about similar opportunities in their communities.

The Effectiveness of Didactic and Perspective-Taking Interventions on Reducing Multiple Dimensions of Heterosexism

ABSTRACT This study examined the effect of two interventions (didactic and perspective-taking) on five dimensions of heterosexism (hostile, aversive, amnestic, paternalistic, and positive stereotypic). Participants were 117 undergraduate students, randomly assigned to one of three groups in this posttest-only control group experiment. After the intervention, the participants completed measures of sexual prejudice, right-wing authoritarianism (RWA), gender role beliefs (GRB), and a demographic questionnaire. Results from the first step of hierarchical regression models showed that RWA and GRB were significantly predictive of all dimensions of heterosexism except for positive stereotypic, accounting for 13.8% to 56.7% of the variance. This suggests that interventions targeting sexual prejudice should examine both variables. When between-group comparisons were added during the second step, the didactic intervention in comparison with the control group was significantly predictive of lower paternalistic heterosexism; the perspective-taking intervention in comparison with the control group was significantly predictive of lower positive stereotypic heterosexism.

A Brief Educational Intervention to Increase ED Initiation of Buprenorphine for Opioid Use Disorder (OUD).

BackgroundDespite the evidence in support of the use of buprenorphine in the treatment of OUD and increasing ability of emergency medicine (EM) clinicians to prescribe it, emergency department (ED)-initiated buprenorphine is uncommon. Many EM clinicians lack training on how to manage acute opioid withdrawal or initiate treatment with buprenorphine. We developed a brief buprenorphine training program and assessed the impact of the training on subsequent buprenorphine initiation and knowledge retention.MethodsWe conducted a pilot randomized control trial enrolling EM clinicians to receive either a 30-min didactic intervention about buprenorphine (standard arm) or the didactic plus weekly messaging and a monetary inducement to administer and report buprenorphine use (enhanced arm). All participants were incentivized to complete baseline, immediate post-didactic, and 90-day knowledge and attitude assessment surveys. Our objective was to achieve first time ED buprenorphine prescribing events in clinicians who had not previously prescribed buprenorphine in the ED and to improve EM-clinician knowledge and perceptions about ED-initiated buprenorphine. We also assessed whether the incentives and reminder messaging in the enhanced arm led to more clinicians administering buprenorphine than those in the standard arm following the training; we measured changes in knowledge of and attitudes toward ED-initiated buprenorphine.ResultsOf 104 EM clinicians enrolled, 51 were randomized to the standard arm and 53 to the enhanced arm. Clinical knowledge about buprenorphine improved for all clinicians immediately after the didactic intervention (difference 19.4%, 95% CI 14.4% to 24.5%). In the 90 days following the intervention, one-third (33%) of all participants reported administering buprenorphine for the first time. Clinicians administered buprenorphine more frequently in the enhanced arm compared to the standard arm (40% vs. 26.3%, p = 0.319), but the difference was not statistically significant. The post-session knowledge improvement was not sustained at 90 days in the enhanced (difference 9.6%, 95% CI − 0.37% to 19.5%) or in the standard arm (difference 3.7%, 95% CI − 5.8% to 13.2%). All the participants reported an increased ability to recognize patients with opioid withdrawal at 90 days (enhanced arm difference .55, 95% CI .01–1.09, standard arm difference .85 95% CI .34–1.37).ConclusionsA brief educational intervention targeting EM clinicians can be utilized to achieve first-time prescribing and improve knowledge around buprenorphine and opioid withdrawal. The use of weekly messaging and gain-framed incentivization conferred no additional benefit to the educational intervention alone. In order to further expand evidence-based ED treatment of OUD, focused initiatives that improve clinician competence with buprenorphine should be explored.Trial RegistrationClinicalTrials.gov Identifier: NCT03821103.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13181-022-00890-7.

Effect of an Educational Intervention on Infection Control Clinical Practices in a Dental School Environment

Introduction: Infection control compliance in dental schools has been reported as less than ideal and requires improvement. The goal of our study was to evaluate the effectiveness of a centralized educational strategy that used multimedia to improve subject understanding and compliance with infection control guidelines and practices.Materials and Methods: The training strategy was created to show clinical scenarios and to outline all information relevant to using proper infection control and safety procedures. Pre- and post-intervention observation scores were collected for 59 students, with the scores being used to assess proper use or handling of barriers, personal protective equipment, sharps, handwashing, and disinfection. Scores were summed to form a Total score that was assessed with the non-parametric Wilcoxon-test for paired samples.Results: For Total scores, 24 of the 59 students (41%) had higher post-video scores whereas only 14 students (24%) had higher pre-intervention scores (P = 0.04).Discussion: This study revealed overall improvements in the infection control practices after an educational intervention, especially for personal protective equipment with 15 positive differences and 6 negative differences, and hand washing scores with 26 positive differences and 16 negative differences.Conclusions: We consider the higher post-training scores to be clinically important and indicate that didactic intervention is effective in improving IC practices in the school clinic.