Foster Autonomy Research Articles

Student perceptions and experiences of problem-based learning in first year undergraduate sports therapy

Problem-based learning (PBL) has long been used as a means to foster critical thinking and student autonomy. However, few studies have investigated the effectiveness of PBL in Sports Therapy. The aim of this study was to examine first year Sports Therapy students' perceptions of PBL. Results revealed that students perceived PBL as vocationally relevant, by enabling them to work in and across groups, whilst also engaging with a wider range and depth of information compared to more traditional methods of curriculum delivery. External observations of the lecturers input sessions were made by an impartial researcher. The implications of the study are that PBL appears to be a professionally suitable and appropriate learning modality for Sports Therapy students.

Return to Asylums? NEVER!

Return to Asylums? NEVER!

The Implications of Centre-local Relations on Service Delivery in Local Authorities in Zimbabwe: The Case of Chitungwiza

The area of centre-local relations in local government is a contemporary and topical debate in Zimbabwe. It was on this background that the research on centre-local relations was undertaken with a view to assessing the implications of service delivery in Chitungwiza Municipality (CM). The views of different authorities on centre-local relations were reviewed to further analyse the implications of centre-local relations on service delivery in municipalities. The study triangulated different data collection methods such as key informant interviews, documentary search, in-depth interviews, observation and survey to obtain detailed data on the state of centre-local relations and its implications on service delivery in CM. The findings of the study revealed that centre-local relations between the Ministry of Local Government and the CM are highly centralised. The parent ministry retains overall powers and control over the municipality. The Minister who is supposed to play a strategic role in policy formulation and implementation is involved in the day to day running of the municipality leaving little room for elected councillors and residents in general to determine their own destiny. It has been established that centre-local relations that are supposed to foster independence and autonomy of the municipality has turned into a master-subordinate relationship that has negatively affected service delivery. The study concluded that hyper-centralised governance relations are hindering effective service delivery in the municipality. This has been evidenced by erratic water supply, potholed roads, poor refuse collection and bursting of sewer pipes. The study recommends that the central government through the Ministry of Local Government must grant the municipality more autonomy as a measure of improving service delivery.

A new long-term care manifesto.

This article argues for a fresh look at how we provide long-term care (LTC) for older persons. Essentially, LTC offers a compensatory service that responds to frailty. Policy debate around LTC centers on costs, but we are paying for something we really don't want. Building societal enthusiasm (or even support) for LTC will require re-inventing and re-branding. LTC has three basic components: personal care, housing, and health care (primarily chronic disease management). They can be delivered in a variety of settings. It is rare to find all three done well simultaneously. Personal care (PC) needs to be both competent and compassionate. Housing must provide at least minimal amenities and foster autonomy; when travel time for PC raises costs dramatically, some form of clustered housing may be needed. Health care must be proactive, aimed at preventing exacerbations of chronic disease and resultant hospitalizations. Enhancing preferences means allowing taking informed risks. Payment incentives should reward both quality of care and quality of life, but positive outcomes must be defined as slowing decline. Paying for services but not for housing under Medicaid would automatically level the playing field between nursing homes (NH) and community-based services. Regulations should achieve greater parity between NH and community care and include both positive and negative feedback. Providing post-acute care should be separate from LTC. Using the tripartite LTC framework, we can create innovative flexible approaches to providing needed services for frail older persons in formats that are both desirable and affordable. Such care will be more socially desirable and hence worth paying for.

Cancer patient decision making related to clinical trial participation: an integrative review with implications for patients' relational autonomy.

Oncology clinical trials are necessary for the improvement of patient care as they have the ability to confirm the efficacy and safety of novel cancer treatments and in so doing, contribute to a solid evidence base on which practitioners and patients can make informed treatment decisions. However, only 3-5 % of adult cancer patients enroll in clinical trials. Lack of participation compromises the success of clinical trials and squanders an opportunity for improving patient outcomes. This literature review summarizes the factors and contexts that influence cancer patient decision making related to clinical trial participation. An integrative review was undertaken within PubMed, CINAHL, and EMBASE databases for articles written between 1995 and 2012 and archived under relevant keywords. Articles selected were data-based, written in English, and limited to adult cancer patients. In the 51 articles reviewed, three main types of factors were identified that influence cancer patients' decision making about participation in clinical trials: personal, social, and system factors. Subthemes included patients' trust in their physician and the research process, undue influence within the patient-physician relationship, and systemic social inequalities. How these factors interact and influence patients' decision-making process and relational autonomy, however, is insufficiently understood. Future research is needed to further elucidate the sociopolitical barriers and facilitators of clinical trial participation and to enhance ethical practice within clinical trial enrolment. This research will inform targeted education and support interventions to foster patients' relational autonomy in the decision-making process and potentially improve clinical trial participation rates.

A Study on ELT High School Teachers’ Practices to Foster Learner Autonomy

The present study aims to identify the practices of ELT high school teachers to foster learner autonomy and to examine the differences with respect to the background variable of gender. The participants of the study were ELT high school teachers in the province of Izmir, Turkey ( N =118). Data were collected by means of Autonomy Practices Questionnaire, which is a structured quantitative and qualitative measure. The analysis revealed that ELT teachers are highly motivated to foster autonomy through some particular practices such as activity-based practices, material-based practices, student-centered practices, and objective-based practices. Moreover, gender has significant effect on ELT teachers' student-centered practices to foster autonomy. The results were discussed with regard to real practices of ELT teachers and ELT curriculum implementation.

'These places are like a godsend': a qualitative analysis of parents' experiences of health visiting outside the home and of children's centres services.

In 2011-2012, we carried out a programme of research to inform the Department of Health's strategy for strengthening health visiting services in England. Our research included a study of parents' views of their experiences with health visiting services in two geographical areas in England. Here, we draw upon data from this work to illustrate valuable aspects of family support outside the home reported in parents' accounts of their experiences of health visiting. We also explore the usefulness of relational autonomy as a theoretical lens for understanding the mechanisms through which this support operates. We draw upon data from semi-structured interviews with 44 parents across two 'Early Implementer Sites' of the 'new service vision' in England. Our thematic analysis of the data was informed by grounded theory principles. Parents valued being able to attend child health clinics and group activities outside the home; this helped them to avoid social isolation and to identify, choose and use the forms of advice and support that best suited them. We suggest that health visiting outside the home and children's centres services may also foster parental autonomy, especially when this is understood in relational terms. Health visiting outside the home and children's centres services are an important complement to health visiting in the home; both dimensions of family support should be available in the community. Relational readings of autonomy can help illuminate the ways in which these services can foster (or undermine) parents' autonomy.

Establishing Group Autonomy through Self-Access Center Learning Experiences

In this article, I argue that a self-access center (SAC) should be able to foster group autonomy, although SACs were originally developed for individually autonomous L2 learning experiences—i.e., each student studying L2 on his or her own. Along with offering learning materials and chances for individual self-study, a SAC should provide opportunities for building and maintaining a learner community. The data obtained by a narrative frame and subsequent e-mail correspondence demonstrated that active users often come to SACs to do homework and prepare for classes. They are happy to work together and have opportunities to make friends with students in different classes and in different year groups—i.e., mutual peer support is vital. Fun activities for establishing rapport and boosting L2 learning motivation are worth implementing. Learner autonomy ultimately involves interdependence between learners in a well-functioning learner community, and for this purpose a SAC can and should be a physical space where students can comfortably spend time and interact with other students, as well as with counselors and teachers.

Developing Writing Through Blogs and Peer Feedback

Results are presented from a study conducted online with a population of students of an English teacher education program. The study inquired into the role that peer feedback played in the development or maintenance of coherence in non-fictional narrative blog writing. Participant students produced narrative blog entries and peer feedback, which were double-assessed to establish the possible relationship between feedback and coherence. Learner's logs were also kept to obtain second-order data. Findings suggest that peer-feedback and blogging can act as boosting factors to enhance or maintain levels of coherence in text, through the shaping of students' cognition and affection. The potential is revealed of student-centered strategies to enhance learning and foster autonomy through a higher degree of student's control over learning. In addition, it is proposed that new language assessment paradigms be applied in the classroom, acknowledging students as a valid and reliable source of assessment information.

The Role of Peer Assessment in Developing Adolescent Learners’ Autonomy

The aim of language education is no longer limited to developing learners’ linguistic skills only. In order to promote language learning as a life-long process, a growing impact in the language classroom is placed on non-linguistic aspects, such as motivation or learner autonomy. The latter can be fostered in the classroom by means of alternative assessment methods, such as portfolio, project, observation and peer assessment. This article provides an account of a quasi­-experiment conducted in the first and second year of lower secondary school in Poland in order to investigate whether and to what extent the application of peer assessment affects the level of autonomy in adolescent learners aged 13-14. The study is based on mixed methods research comprising both quantitative and qualitative data elicitation tools such as a questionnaire, classroom observation and interviews. The applied methodology helped to discover that although the overall level of autonomy did not change as the result of the treatment, a number of autonomous behaviours emerged. It can be concluded that peer assessment does not suffice to foster autonomy in adolescent learners; still, it might appear as a useful element of a wide­-ranging teaching scheme aiming at involving learners in the teaching and learning processes.

O uso da entrevista na pesquisa-intervenção participativa em saúde mental: o dispositivo GAM como entrevista coletiva

This paper seeks to assess a way of conducting interviews in line with the ideology of Brazilian Psychiatric Reform. In the methodology of participative intervention and research in mental health, the interview is less a data collection than a data harvesting procedure. It is designed to apply the principles of psychosocial care, autonomy as the basis for treatment, the predominance of the users and of their social networks and civic participation. Inspired by the Explicitation Interview technique, the contention is that the handling of the interview presupposes an open attitude able to promote and embrace different viewpoints. This attitude makes the interview a collective experience of sharing and belonging, allowing participants to reposition themselves subjectively in treatment with the emergence of groupality. As an example of using the interview as a methodological tool in mental health research, we examine research into adaptation of the tool of Autonomous Medication Management (GAM). It is an interventionist approach guided by principles that foster autonomy and the protagonist status of users of psychotropic medication, their quality of life, their rights and recognition of the multiple significances of medication, understood here as a collective interview technique.

Dynamics of curriculum and the evolution of autonomy in learning English as a Foreign Language

This research, carried out at the language teaching graduate program of Universidad de San Buenaventura, studies how autonomy evolves when learning English from basic to higher levels. It considers the management of learning and some components of curricular dynamics, such as the contents of subjects, classwork and independent tasks. This is a descriptive-comparative type of research of diachronic nature which, by means of analysis of quantitative and qualitative data, allowed us to characterize and compare the elements being studied. The results led to the conclusion that although the curriculum implicitly offers many elements which foster autonomy, autonomy evolves relatively slowly from one level to the other. For this reason, an organized and well supported plan to promote learners' autonomy must be implemented explicitly if students are to evolve in this area.

Staff and youth views on autonomy and emancipation from residential care: A participatory research study

The use of participatory approaches in designing services is still relatively uncommon. In this study, we helped design a service to support the transition of youth from residential care to independent living by exploring the perspectives of staff and of youth regarding: (a) the concept and development of autonomy; and (b) key factors in developing this type of service. We gathered the data through 10 interviews with staff (n=10) and 4 focus groups with youth (n=21), and subjected the data to a thematic content analysis. Staff defined autonomy as self-regulation and self-care, and identified three paths to foster autonomy – a sense of normality, meaningful relationships, and planning for emancipation. The staff and youth identified the following important aspects in designing the service: achieving normality (e.g. limited number of residents), promoting youth capacity (e.g. skill-building activities), providing social support (e.g. trust and respect between residents), and assuring guidance and boundaries (e.g. supervision of youth).

How Tobacco Health Warnings Can Foster Autonomy

I investigate whether tobacco health warnings' interference with autonomy is ethically justifiable in order to deter people from smoking. I dissociate first the informational role and the persuasiv ...

JASAL Forum 2012: Making a Difference Through Self Access.

This article reports on the JASAL Forum held at the JALT Conference in Hamamatsu on October 13th, 2012. JASAL, the Japanese Association of Self Access Learning, was set up in 2005 by Garold Murray and Lucy Cooker to provide a support network for educators and administrators involved with self-access language learning centers (hereafter SACs) in Japan. It holds a forum annually at JALT (the Japan Association for Language Teaching) conference. It has been a great success and providing information and support to those who are involved with SACs in Japan. I am also blessed with all the information and support from the JASAL Forum as I work for a SAC as the director. The 2012 JASAL Forum consisted of a poster session, three paper presentations and an open forum discussion, with the theme of ‘Making a difference through Self Access.’ The presentations this year focused on how to foster autonomy, how to develop understanding of the value of self-access among faculty and administration, and how to integrate self-access with the curriculum. All the presentations provided a brighter vision for SACs in Japan.

The ethics of Canadian entry-to-practice pain competencies: how are we doing?

Although unrelieved pain continues to represent a significant problem, prelicensure educational programs tend to include little content related to pain. Standards for professional competence strongly influence curricula and have the potential to ensure that health science students have the knowledge and skill to manage pain in a way that also allows them to meet professional ethical standards. To perform a systematic, comprehensive examination to determine the entry-to-practice competencies related to pain required for Canadian health science and veterinary students, and to examine how the presence and absence of pain competencies relate to key competencies of an ethical nature. Entry-to-practice competency requirements related to pain knowledge, skill and judgment were surveyed from national, provincial and territorial documents for dentistry, medicine, nursing, pharmacy, occupational therapy, physiotherapy, psychology and veterinary medicine. Dentistry included two and nursing included nine specific pain competencies. No references to competencies related to pain were found in the remaining health science documents. In contrast, the national competency requirements for veterinary medicine, surveyed as a comparison, included nine pain competencies. All documents included competencies pertaining to ethics. The lack of competencies related to pain has implications for advancing skillful and ethical practice. The lack of attention to pain competencies limits the capacity of health care professionals to alleviate suffering, foster autonomy and use resources justly. Influencing professional bodies to increase the number of required entry-to-practice pain competencies may ultimately have the greatest impact on education and practice.

Leadership Styles and Clinical Decision Making Autonomy among Critical Care Nurses: A Comparative Study

Nurses require greater autonomy and participation in decision making, nurse participation in decision making in an organization varies depending on many factors, including the influence of nurse manager leadership and collaboration with physicians. Aim. The aim of the current study was to assess dominant leadership styles , level of decision making autonomy among critical care nurses and relationship between leadership style and decision making autonomy. Design. A descriptive cross-sectional correlation research design was utilized in this research. Setting .The current study was carried out at two hospitals' namely; King Fahd Hospital of the University (KFHU) in Saudi Arabia and at Tanta Main University Hospital in Egypt in Intensive Care Units (ICUs). Subjects. The study subjects encompassed all full time nursing staff convenient sample in previous settings (n = 27) Head nurses 16 from Egypt, 11 from KSA, and Critical Care nurses ( n= 74 ) divided as the following ; 35 from Egypt and 39 from KSA . Tools. Two tools were used in this study. Tool I. It was structured questionnaire , assessed decision making autonomy . It included two parts ; part one was demographic data (7 items), part two was autonomy issue (18 items). The autonomy domain comprised 18 items ( knowledge 6, action 6, value 6 ). Tool II Assessed leadership styles , it included two parts ;part one was demographic data (6 items) ; age, sex, experience (general and specific in the unit), last education, type of hospital, type of unit , part two: Leadership styles Questionnaire this questionnaire was designed to measure three common styles of leadership: authoritarian, democratic, and laissez -fair. It composed of 18 statements. The respondents were presented with a five point likert scale, the number indicates the degree to which the respondents agree or disagree (5-1). Results. In KSA studied nurses had the highest mean score. for total autonomy scale. A s well as, there are statistical significant difference for two bases of autonomy knowledge, and action bases also total autonomy. Conclusion. Overall, results of the present study revealed head nurses applied situational leadership theory in both countries. As well as, in KSA nurses had higher decision making autonomy than nurses in Egypt. Recommendation. ICU nurse managers should foster nurses' autonomy by enabling them to exercise clinical decision-making, and Actively supporting nursing decisions and nursing accountability.

Fostering Autonomous Learning: A Holistic View

This paper brings together a range of literature addressing components of autonomous teaming. Autonomous teaming provides the opportunity to transform leaming from teacher centered towards student-oriented teaming. Although self-assessment, self-regulation, self- access leaming ,technology, and implementing e-portfolios are different components and strategies to foster autonomy, these strategies cannot facilitate autonomous teaming automatically. Educators are required to transform their traditional role as controllers of teaming to facilitators of teaming in order to support and facilitate autonomous teaming.

Autonomy-Supportive Medical Education

Autonomy-Supportive Medical Education

The Ethical and Economic Impact of Defaults

Medical care offered to the critically ill often occurs by default, unfolding automatically unless concerted effort is made to do otherwise. In their scope, defaults include traditional approaches to treatment and decision making, as well as policies deliberately set to promote specific health outcomes. Defaults are ethically sound to the extent that they foster patient well-being and autonomy. Unfortunately in practice, some defaults lead to ineffective, unwanted, and expensive care. This article reviews the ethical and economic impact of defaults, paying special attention to their influence on the practice of cardiopulmonary resuscitation and admission to the intensive care unit.