Follow-up Focus Group Discussions Research Articles

Implementation Analysis of a Perioperative Patient Safety Program in Guatemala.

The implementation of programs to improve patient safety remains challenging in low- and middle-income countries. The goal of our study was to define the barriers and facilitators to implementation of a perioperative patient safety program in Guatemala. We conducted semi-structured interviews with 16 staff pre-intervention and a follow-up focus group discussion 1year later in the perioperative department at the Roosevelt Hospital in Guatemala. We performed qualitative thematic analysis to identify barriers and facilitators to the implementation process, with analysis guided by the Consolidated Framework for Implementation Research. We found several dominant themes affecting implementation of a patient safety program. Implementation facilitators included strong prioritization of patient needs, program compatibility with existing workflow, and staff attributes. Barriers included a lack of knowledge about patient safety, limited resources, limited leadership engagement, and lack of formal implementation leaders. Several program modifications were made to enhance successful implementation iteratively during the implementation process. Our analysis highlights several dominant themes which affect the implementation of a perioperative safety program in Guatemala. Understanding the barriers and facilitators to implementation during program deployment allows for program modification and improvement of the implementation process itself.

Exploring young people’s understanding of culture: a study from Northern Ireland

ABSTRACT This article highlights the need for greater understanding of the role that historical, socio-cultural and political context play in shaping perceptions of culture and cultural value. Findings draw on the annual attitudinal survey of 16-year-olds in Northern Ireland, Young Life and Times (2016), and four follow-up focus group discussions. Results complement existing cultural participation research, which relates forms of engagement with intersectional factors: age, location of residence, gender and income. Reflecting, to some degree, the specificities of the study’s location in Northern Ireland, we also found that cultural participation and understandings of what counts as culture have strong connections to history, place, religion, tradition and family. Furthermore, while participants placed a high level of personal importance on the informal activities in which they engage daily, those activities associated with tradition and family were perceived as having higher cultural importance.

A MIXED-METHODS STUDY ON THE INFLUENCE OF CHINESE CULTURE ON CAREGIVING AND IMPACTS OF CSMP

As a pilot study, the CSMP utilizes a mixed-methods design to tackle a lack of previous evidence and form a well-rounded perspective, using a randomized controlled trial with pre, post and 3-month follow-up assessments and focus group discussions. The CSMP not only targets cultural practices that exacerbates caregiving burden but also forms its basis upon Chinese culture and philosophies. New cultural factors together with previously-identified ones surfaced in discussions, including guanxi (Chinese relationship), renqing (favor), mianzi (self-esteem), social status, respect of authority, communication pattern, age respect, and more. The implications of cultural factors are discussed, together with corresponding areas for future improvement in CSMP and suggestions for professions working with this population. On the other side of the coin, participants who finished the CSMP achieved statistically significantly lower depression level, higher self-efficacy, and lower caregiver burden, compared to the control group.

Professional learning communities: Enhancing collaborative leadership in Singapore early childhood settings

Leadership in early childhood education has been promoted as a collaborative process in which all teachers, rather than just the positional leader, are involved. Collaborative leadership practices are not well understood within the marketised Singapore early childhood education context. Beyond mandatory leadership training, little is known about how leaders are supported to strengthen their leadership practices and involve others in leadership activities. School-based literature suggests that learning through professional learning communities expands the collective capacity of organisations; however, literature on professional learning communities in early childhood education is limited. This article reports on the findings of an interpretive case study examining the current understandings and leadership practices of principals in the Singapore early childhood education context, and investigating how participation in professional learning communities can support the development of collaborative leadership practices. The participants in two professional learning communities established as part of this study were six principals from an anchor-operator childcare provider and five principals from private childcare centres in Singapore. Two teachers working with each of the respective principals were also involved in focus group interviews to ascertain if there were changes in their principals’ leadership practices. Data was collected from professional learning community meetings, online reflections, pre- and post-professional learning community interviews with the principals, and follow-up focus group discussions with the teachers. The key findings indicate that praxis as a result of participation in a professional learning community led to some shifts in principals’ thinking about collaborative leadership practices and resulted in reported changes to their leadership approaches, distribution of leadership, and improved collegiality and collaborative learning for teachers. The results indicate that considering and implementing collaborative leadership practices through professional learning communities in the Singapore early childhood education context requires sensitivity towards Asian Singapore sociocultural values related to hierarchy and economic pragmatism.

216. Evaluation of the PIERS on the MOVE mobile health tool for pre-eclampsia triage: The users’ perspective

Background The PIERS on the Move (POM) mobile health (mHealth) application was implemented as part of a complex community health system intervention in the CLIP (Community Level Interventions for Pre-eclampsia; NCT01911494) Trials. In this context, community health workers (CHWs) were trained to use the app and to take on new clinical skills, such as measuring blood pressure and assessing symptoms. Objective To evaluate the perceived impact on pre-eclampsia knowledge, self-efficacy and CHW role from use of the POM app. Method This study used mixed methods including closed and open-ended survey questions and focus group discussions (FGDs) based on the SALT (Stimulate, Appreciate, Learn, Transfer) approach. All health care workers who participated in the CLIP Trials in Pakistan and India were eligible to participate. A random sample, stratified by age and years of experience, was drawn to target participants for qualitative evaluation after completion of recruitmentfor the Trials. Survey results were summarized and qualitative data analyzed using grounded theory. Results In India, 24 CHWs completed the survey and were interviewed. In Pakistan, 219 CHWs completed the survey and 18 participated in 3 follow-up FGDs. CHWs in both countries reported a high level of pre-eclampsia knowledge and self-efficacy. Qualitative data analyzed from the interviews in India and FGDs in Pakistan indicate a high level of job satisfaction with themes emerging related to positive ability to manage pregnancy complications; happiness with supporting healthy pregnancy and birth and satisfaction with new knowledge and responsibilities. Challenges reported included initial difficulties learning to use a smart phone and technical issues with the device itself (battery life and screen size). Conclusions This study supports the ability and desire of community health workers to use mobile health tools such as the PIERS on the Move app to support their performance of clinical tasks related to pre-eclampsia care.

Assessing Japanese teachers\u2019 classroom English \u201cinternationally\u201d: implications for the development of classroom English language benchmarks in Japan

BackgroundThis study aims to develop a low-stakes assessment tool to establish a classroom English language benchmark that Japanese teachers of English can use for their own professional development purposes. To start with, we describe the differences between CLA (Classroom Language Assessment) in Hong Kong and the IDS (Integrative Diagnostic Scale) in Japan with regard to agenda, characteristics, and implementation. Then, we report findings made from both of these assessment types and from a group discussion we had in order to clarify the rationale behind the CLA experts’ assessment.MethodsThe participants of the present study consisted of two groups: (1) four project members of the IDS in Japan and (2) two CLA raters in Hong Kong. Following an initial assessment of videotaped performances by the IDS developers (based on the IDS benchmark) and assessment of the same videotaped performance by the CLA experts (based on the CLA), a follow-up focus-group discussion between the IDS developers and the CLA experts was held.ResultsThe results of the study offer some evidence to support the thesis that a classroom English benchmark helps capture aspects of classroom English language proficiency that are indispensable for students’ language acquisition. Accordingly, on the basis of the findings, suggestions for further revisions of the IDS were made.ConclusionThe study showed that, with some revisions, the IDS can be an apt professional development tool through which Japanese teachers of English can improve their classroom English proficiency. It also suggested that more research is needed to contextualize the IDS as such a professional tool more fully.

Improving Pediatric Resident Communication During Family-Centered Rounds Using a Novel Simulation-Based Curriculum.

While family-centered rounds (FCR) have become increasingly important in pediatrics, there is often no training for residents on appropriate FCR practice. This curriculum was developed to address this identified gap in pediatric trainee education through a combination of didactic presentation, direct observation, and simulated FCR. Residents participated in a didactic presentation on key components of FCR and tenets of communication with families. A subset of residents participated in a simulated intervention in which they practiced an FCR encounter using a mock patient case and received immediate feedback from a multidisciplinary team. Following the simulation, residents completed follow-up surveys and focus group discussions to assess their experience and comfort. Resident trainees were observed and rated during FCR by trained parent advisors using a novel FCR checklist both before and after participation in the simulation. This curriculum was implemented with 10 pediatric interns (intervention group). These residents demonstrated statistically significant improvements in the areas of greeting family by name and soliciting rounding preferences, enhancing family comfort in participating in FCR, and increasing family engagement in FCR. Compared to controls, intervention group residents had higher ratings on the majority of performance items. Resident-reported self-efficacy in conducting FCR increased following the intervention, and the feedback portion of the intervention was highly valued. Simulation-based training is an effective model for teaching residents best practices in FCR with lasting impact on resident communication skills as seen in comparative analysis from before and after the intervention.

Teacher autonomy development through reading teacher research: agency, motivation and identity

ABSTRACTThis study highlights the need to promote more personal and informal processes in Teacher Autonomy and focuses on university Language Teachers’ processes in reading Teacher Research (TR) in order to understand how this impacts their autonomy development processes. In particular, it addresses teachers’ interactions with TR articles during the reading process, and aims to gain insights into autonomy development from the teachers’ reflection during the process. This study uses two well-known research tools, Think Aloud Protocol (TAP) and Focus Group Discussions (FGDs) for an innovative purpose: to fulfil both research and teacher education purposes, thus exemplifying a particular way to promote and investigate critical reading in teacher education. The analysis of the TAPs, and follow-up focus group discussions reveal the key theme of autonomy. Three autonomy-related sub-themes emerged: gaining agency, developing motivation and gaining awareness of a more democratic form of teacher development. 11 participants undertook a task that allowed a highly personalized interpretation of all aspects of the text. It is argued that conditions for autonomy development were created by offering freedom to choose and interpret a text that is comprehensible and relevant. Teachers were entirely free to interpret their texts, and responsible for their learning from it. Teachers interpreted the articles in a variety of ways, and differed according to their emphasis on the particular aspects: motivation, agency and identity. The study concludes that the task provided an opportunity for autonomy to emerge according to the developmental needs of the individual.

Factors enabling and constraining research in a small, research-intensive South African University

Research is increasingly regarded a core facet of university endeavours globally, and research profiles of universities, institutes, and colleges are commonly used as one measure for ranking them. University administrations and funders would be better able to stimulate research if they had insights into context-specific, institutional constraints, and enablers. Yet, there is surprisingly little research on the determinants of research productivity amongst academics employed in the higher education sector, particularly in the global south. Barriers and enablers of research at the individual level may differ, and experience of such may vary across career stage. The objective of the research reported here was to determine what enables and motivates some academics at Rhodes University (South Africa) to do research, what problems and constraints may be making it difficult for those who may wish to do more, and how do these vary in relation to research career stage. An anonymous online survey, with follow-up focus group discussions was used to collect the data. Results show similarities to studies in developed countries, but also reveal disciplinary and career stage differences, which suggest that institutional policies need to take these factors into account when designing support or incentives.

What do students believe about effective classroom management? A mixed-methods investigation in Western Australian high schools

Students’ views about teaching, learning, and school experiences are important considerations in education. The purpose of this study was to examine students’ perceptions of teachers who create and maintain safe and supportive learning environments. To achieve this, a survey was conducted with 360 students to capture students’ views on their classroom experiences. Follow-up focus group discussions were used to further elaborate and clarify students’ perceptions. Despite varying school contexts, students provided consistent reports that effective classroom managers meet students’ needs by developing caring relationships and controlling the classroom environment while developing student responsibility and engaging students in their learning.

Delivery of library and information science curriculum

PurposeAdvancement in Information and communication technologies (ICTs) has revolutionised Library and Information Science (LIS) education and libraries. Both theory and practice have been transformed completely. LIS education programmes have become highly competitive and must be market-driven and technology-oriented. At the same time, academic libraries have been transformed and have become dynamic. Fostering a close collaboration between LIS educators and practitioners can multiply their strength and abilities by sharing educational resources and theoretical and practical knowledge. This paper aims to present the findings of a study carried out to investigate the current status of collaboration among LIS educators and library practitioners at the University of Botswana.Design/methodology/approachData were collected using self-administered structured questionnaires from both LIS educators at the Department of Library and Information Studies (DLIS) and practicing librarians working at the University of Botswana Library (UBL). To follow-up some of the issues, an interview was carried out with a subject librarian and a focus group discussion method was used to discuss some of the challenges from the findings.FindingsThe major collaborative activities from the DLIS staff were identified as the following: creating awareness of library resources and promoting library usage among students, facilitating library material selection and inviting librarians as guest lecturers to teach in the classroom. The main collaborative activities from practicing librarians were found to be the following: delivering information literacy instruction, providing professional/practical experience to students and information sharing with the DLIS teaching staff. The major challenges were identified as the following: different cultures of educators and librarians, lack of need to collaborate and lack of formal policy at the department and the university level.Research limitations/implicationsThe UBL has 51 library staff members. All the librarians were not included in this research study, only senior librarians and library management were involved in the study. No theoretical framework was used to carry out the study. The questionnaire was designed based on the general literature in the field of professional collaboration among faculty and educators in the information profession. The follow-up interview and focus group discussion were conducted to address the collaborative activities and challenges that were acknowledged by at least 50 per cent of the participants. Issues with less than 50 per cent responses were considered insignificant to follow-up. Follow-up interview was conducted only with one subject librarian. As all subject librarians have the same job profile and undertake the similar activities, it was assumed that one subject librarian can represent others.Originality/valueThis research paper contributes to the body of literature. It may be useful for other LIS schools and libraries that work in similar environments, and it also opens up avenues for further research on this topical issue.

“Broadening horizons” optional modules in the Nottingham MPharm degree

In Year 3 of the MPharm degree at the University of Nottingham, many of the students undertake 20-credits of “broadening horizons” optional modules, chosen from a wide and diverse range from across the university. This study presents student views regarding their module choices and on their performances with such diverse module choices of varied levels. Follow-up surveys and focus group discussions with alumni will determine the contribution of this breadth to a student’s education, in providing them with a different perspective on life, to their chosen profession and future career paths.Keywords: Electives, optional modules, MPharm, pharmacy

English

Second language (henceforth L2) motivation has been traditionally studied from the lens of integrative motivation. However, this framework presents problems in that it is limiting and lacks insights from emerging cognitive motivational research. This paper investigated the L2 motivation of Timorese English language learners (henceforth ELLs) using Dornyei’s (2009) L2 Motivational Self System and Markus and Nurius’s (1986) possible-selves theory. Ten Timorese ELLs studying in a school of higher learning in the Philippines participated in a free writing task and a follow-up focus group discussion. These activities aimed to examine the content and functions of the students’ two most important types of possible selves: ‘ideal L2 self’ and ‘ought-to L2 self.’ The results revealed that the students’ ‘ideal L2 self’ coincides with the original theoretical construct, which includes a promotion-focused function for studying English, i.e., to achieve personal goals and to communicate with other people. Interestingly, however, the present study corroborated Chen’s (2012) findings in the Taiwanese context that the ‘ought-to L2 self’ is not simply prevention-focused, but a mixture of prevention- and promotion-focused functions of learning English. The findings pointed to necessary research, curriculum design and pedagogical implications, which are discussed as this paper closes. DOI: http://doi.org/10.17576/gema-2016-1603-05

"It is meaningful; I feel that I can make a difference" -A qualitative study about GPs' experiences of work at nursing homes in Sweden.

BackgroundSwedish nursing homes (NH) have limited capacity. As a result elderly people living in NH represent the part of the elderly population in most need of care. In Sweden a General Practitioner (GP) is usually responsible for the medical care of all subjects living in a NH. The residents in NH seldom have adequate pharmacological treatment according to diagnosis and often have polypharmacy and/or inappropriate medical treatment regarding concerns of declining renal function. What prevents optimal care for the elderly is multifaceted, but there is limited research on how GPs experience their work with the elderly in NH in Sweden. This study aims to illuminate the GPs’ work with the elderly in NH to provide input on how the care can be improved, as well as to identify potential obstacles for good quality of care.MethodsThis qualitative study is based on individual semi-structured interviews with 12 GPs and a follow-up focus group discussion with six of the interviewed GPs. The interviews were analysed with systematic text condensation, with the process leading to identify categories and themes. Thereafter, the themes were discussed among six of the participating GPs in a focus group interview.ResultsTwo main themes were identified: concern for the patient and sustainable working conditions. The principal focus for the GPs was to contribute to the best possible quality of life for the patients. The GPs described discordance between the demand from staff for medications and the patients’ actual need of care. GPs found their work with NH enjoyable. Even though the patients at the NH often suffered from multiple illnesses, which could lead to difficult decisions being made, the doctors felt confident in their role by having a holistic view of the patient in tandem with reliable support from the nurse at the NH.ConclusionWorking with NH patients was considered important and meaningful, with the GPs striving for the patient’s well-being with special consideration to the continuum of ageing. A continuous and well-functioning relationship between the GP and the nurse was crucial for the patients´ well-being.

Using diaries to collect data

During 1993- 1995 CERLIM carried out research on franchised higher education courses. The aim of the project was to provide a clear understanding of how library services are being and could be provided to support franchised courses, how students meet their library and information needs, and
 what might improve the nature and level of library support. The core of the project was an investigation of the actual experience of students on franchised courses in relation to the provision and availability of library resources. A sample of 45 off-campus students together with a control sample of 46 in-house students was selected from a range of five subject disciplines. Participating students kept diaries to record their
 everyday experiences of using libraries as they completed pieces of assessed work and were engaged in follow-up focus group discussions with the researcher. This article describes the use of diaries as a research tool in this context.

Can student teachers acquire core skills for teaching from part‐time employment?

Part‐time employment among university students has become commonplace internationally. Research has largely focused on the impact of part‐time employment on academic performance. This research takes an original approach in that it poses the question whether students can acquire core skills relevant to teaching from their part‐time employment. The research was conducted in a university college of education. A case study approach was adopted using an opportunistic sample of 285 students drawn from two BEd programmes. The project is based on an interpretive paradigm, focusing on students’ perceptions of their part‐time employment. The research methodology included a questionnaire containing both closed and open questions, a follow‐up focus group discussion and two case histories. The results showed that the majority of students believed that they had acquired core skills from their part‐time employment. The findings of this research raise important issues about how university courses can effectively build on such learning experiences.

Pre-service teachers’ conceptions of creativity in elementary school English

Widely thought to be something worth encouraging in young learners, creativity has popularly been associated more with music and art than with other areas of the curriculum. There have been many studies of creativity but few that focus explicitly on what counts as creative thinking in specific subject areas. The aim of the research reported here was to determine pre-service teachers’ conceptions of creativity within the curriculum for English. The study involved analyses of primary school trainee teachers’ responses to questionnaires and follow-up focus group discussion to identify their conceptions. A group of 48 trainees in the final year of an undergraduate degree in primary education leading to qualified teacher status in England completed the questionnaire. Of these, eight volunteered to participate in a follow-up focus group discussion to further explore ideas. Responses were analysed quantitatively and qualitatively. Conceptions of creativity in English were found to be limited, focused mainly on naïve views of story writing and dramatic activity. Responses indicated that they were often unable to distinguish clearly between the concept of creativity, an example of its occurrence in the classroom, and what feature of that example made it creative. Consequently, their limited constructions of creativity were confused. It is important that teachers in schools as well as those responsible for training teachers in universities are advised that trainees’ conceptions of creativity in English may be inadequate in several respects and that they may not recognise opportunities for creativity. Pre-service training programmes could well benefit from structured courses on the forms and applications of creativity.

Why I Wanted More: Inspirational Experiences of the Teaching–Research Nexus for Engineering Undergraduates

What is it about the teaching-research nexus that inspires engineering undergraduates to want more and become researchers themselves? In this study, we sought to discover more about the influences on current PhD students’ choices to embark on higher degrees by research in various fields in engineering in an Australian research-intensive university. An online survey and follow-up focus group discussion revealed that these students are driven primarily by a genuine interest in research itself, rather than other factors such as career advancement (although this too, plays a role). While this is not particularly surprising, what did become apparent was the specific undergraduate experiences that most strongly influenced their decision to undertake research degrees, including enjoying doing project-based work, being exposed to lecturers who were passionate about their own research, and working on a vacation research scholarship. Further analysis reveals that the weighting of various influences changes according to whether the students are local Australian graduates or international PhD candidates.

Evaluation of a school-based physical activity intervention in Alexandra Township

Objectives. Non-communicable diseases and limited participation in school physical education have become increasing concerns in South Africa. In response to these concerns, a schoolbased physical activity intervention, Healthnutz, was implemented in three primary schools in Alexandra Township, Johannesburg. Evaluation of Healthnutz included assessing its feasibility and acceptability, and short-term changes in learners’ physical fitness, knowledge and attitudes. Methods. To assess feasibility and acceptability, a situational analysis and focus groups with teachers and programme monitors were conducted. Pre-post fitness testing (3-month interval) was conducted with learners, and a questionnaire assessed changes in learners’ knowledge, attitudes, self-efficacy, and perceived barriers to physical activity, in control and intervention schools. Results. At implementation, teachers identified the need for more physical activity in the school environment and were positive about Healthnutz. Follow-up focus group discussions suggested that it was positively impacting teachers, learners and the school in general. Scores for sit and reach (p<0.001), sit ups (p<0.02) and shuttle run (p<0.0001) improved significantly in intervention but not control schools. A significant decrease was observed in learners’ perceived external barriers to physical activity (p<0.0001) along with a positive change in learners’ self-efficacy for physical activity (p<0.05). Conclusions. Healthnutz raised awareness of the importance of physical activity in intervention schools. Findings indicate that even limited exposure to a physical activity intervention can lead to a significant improvement in aspects of learners’ fitness, knowledge, attitudes and perceptions regarding physical activity. Furthermore, training and support of teachers needs to be nonjudgemental and empowering.

Care and caring culture as experienced by nurses working in different care environments: A phenomenological–hermeneutic study

Aim The aim is to understand and develop the concept of care and caring culture and to do so based on the empirical/phenomenological standpoint of nurses’ lived experiences of working in different environments. Background Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the ‘caring culture’ as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means. Method A phenomenological–hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working on different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses 1 year later for validation of the findings. Findings Thematic analyses revealed five themes: you have to adapt to the existing care culture; seeing the invisible; being yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as “homelike”, nurses may act in a way that reflects their own values. Discussion The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring.