Practice-based Education Research Articles

Evaluating the effectiveness of a peer-led education intervention to improve the patient safety attitudes of junior pharmacy students: a cross-sectional study using a latent growth curve modelling approach

ObjectiveDespite the recognition that educating healthcare students in patient safety is essential, changing already full curricula can be challenging. Furthermore, institutions may lack the capacity and capability to deliver patient...

Getting Inside Rehearsals

In recent years, work in practice-based teacher education has focused on identifying and elaborating how teacher educators (TEs) use pedagogies of enactment to learn in and from practice. However, research on these pedagogies is still in its early development. Building on prior analyses, this article elaborates a particular pedagogy of enactment, rehearsal, developed through a collaboration of elementary mathematics TEs across three institutions. Rehearsals are embedded within learning cycles that provide repeated opportunities for novice teachers (NTs) to investigate, reflect on, and enact teaching through coached feedback. This article shares a set of insights gained from 5 years of developing, studying, and learning how to support NTs’ enactment in rehearsal. The insights we share in this article contribute to building a knowledge base for pedagogies of teacher education.

From ESA to ESCAPE: A conceptual model for teaching English in vocational higher education

The study develops a modified model generating a procedural guide in lesson planning construction for teaching English within the Vocational Higher Education (VHE). The work elaborates six essential elements in constructing ELT lesson plan, they are: engage, study, create, activate, practice, and evaluate, and it is so-called ESCAPE. Each element of the model represents pedagogical theories and practical approaches that constitute a guided direction and/or instruction for the construction of a practice-based teaching lesson plan. The study employed Research and Development (R&D) design through a focus group discussion (FGD) involving three experts specializing on ELT methodology, English course material development, and English curriculum development. A RASCH measurement analysis using WINSTEP and Factor Analysis using SPSS were employed in the study. The work suggests this modified model to be used in VHE and recommends further development on pedagogical theories underpinning each element, clarity of instructions, and method of implementation. Some limitations to this model were also identified.

Implementing mathematics teaching that promotes students’ understanding through theory-driven lesson study

Lesson study (LS) has been practiced in China as an effective way to advance teachers’ professional development for decades. This study explores how LS improves teaching that promotes students’ understanding. A LS group including didacticians (practice-based teaching research specialist and University-based mathematics educators) and mathematics teachers in China explored and documented how teacher participants shifted their attention to students’ learning by incorporating two notions of teaching: learning trajectory (LT) and variation pedagogy (VP). The former describes conjectured routes of children’s thinking and learning with pertinent tasks to move towards the learning goals along the route, while the latter suggests strategies for using systematic tasks progressively. The concepts of LT and VP are used to guide planning, teaching, and debriefing throughout the LS process. Data consist of lesson plans, videotaped lessons, post-lesson discussions, post-lesson quizzes, and teachers’ reflection reports. This study reveals that by building on the learning trajectory and by strategically using variation tasks, the lesson has been improved in terms of students’ understanding, proficiency, and mathematical reasoning. In addition, the LT was refined through the LS. This study displays how theory-driven LS could help teachers improve their teaching and develop the linkage between theory and practice.

Making it Real: A Practice-Based Early Childhood Teacher Education Program

In early childhood teacher education programs, the reality of educational systems must be understood and teacher candidates must be ready to deal with the current challenges schools face. The rationale and application of the principles of practice based teacher education are presented in this article. Practice-based teacher education programs offer experiences for candidates to begin to understand the complexities of teaching and integrate knowledge from learning and developmental theories into practice. Grossman et al. (Teach Teach Theor Pract 15(2):273–289, 2009) identify three key concepts in how teaching candidates understand the complex practice of teaching: representations of practice, decomposition of practice, and approximations of practice. In this practice-based teacher education program, the epistemic practices are experienced in conjunction with one another, allowing candidates to explore and question a particular phenomenon about teaching or learning (focused inquiry), observe the teaching or learning about the phenomenon (directed observation), participate in planning and enacting teaching (guided practice), deconstruct experiences and create meaning (focused inquiry) followed by directed observation and/or opportunities to reenact (Hollins in J Teach Educ 62(4):395–407, 2011). High leverage practices were focused on through the Classroom Assessment Scoring System (CLASS, Pianta et al. in Classroom assessment scoring system manual Pre-K. Brookes Publishing Co., Baltimore, 2008a). Benefits and drawbacks of a practice-based program are discussed.

Developing educational competencies for dissemination and implementation research training programs: an exploratory analysis using card sorts.

BackgroundWith demand increasing for dissemination and implementation (D&I) training programs in the USA and other countries, more structured, competency-based, and tested curricula are needed to guide training programs. There are many benefits to the use of competencies in practice-based education such as the establishment of rigorous standards as well as providing an additional metrics for development and growth. As the first aim of a D&I training grant, an exploratory study was conducted to establish a new set of D&I competencies to guide training in D&I research.MethodsBased upon existing D&I training literature, the leadership team compiled an initial list of competencies. The research team then engaged 16 additional colleagues in the area of D&I science to provide suggestions to the initial list. The competency list was then additionally narrowed to 43 unique competencies following feedback elicited from these D&I researchers. Three hundred additional D&I researchers were then invited via email to complete a card sort in which the list of competencies were sorted into three categories of experience levels. Participants had previous first-hand experience with D&I or knowledge translation training programs in the past. Participants reported their self-identified D&I expertise level as well as the country in which their home institution is located. A mean score was calculated for each competency based on their experience level categorization. From these mean scores, beginner-, intermediate-, and advanced-level tertiles were created for the competencies.ResultsThe card sort request achieved a 41 % response rate (n = 124). The list of 43 competencies was organized into four broad domains and sorted based on their experience level score. Eleven competencies were classified into the “Beginner” category, 27 into “Intermediate,” and 5 into “Advanced.”ConclusionsEducation and training developers can use this competency list to formalize future trainings in D&I research, create more evidence-informed curricula, and enable overall capacity building and accompanying metrics in the field of D&I training and research.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0304-3) contains supplementary material, which is available to authorized users.

Creating frames of practice for teacher education

Conceptualising teacher learning as being immersed in and arising from the totality of professional practice, this paper reports experiences and insights from practice-based teacher education. Initial data are drawn from two sites of seven involved in the federally funded School Centres for Teaching Excellence programme conducted in the state of Victoria, Australia. This programme is arranged as a partnership between the Department of Education and Early Childhood Development and various school clusters and universities. Each university is working with a cluster of primary and secondary schools and with large numbers (20–100) of pre-service teachers allocated to schools across each cluster. In general, PSTs in Victoria University’s two clusters are placed at each school for 2 days per week with some block time throughout the year. Some university units of study are taught on-site by visiting lecturers with a strong emphasis being placed on the mentoring of PSTs by classroom teachers. Interviews with mentors/mentees and teachers, PSTs and principals indicate a particular understanding or approach to an issue of learning or relationship that provides a frame/scaffold of practice. Further practice begins to detail the frame for continuing application. We are considering the notion of frame as a conceptual skeleton of understanding that arises from school and classroom practice and is formatted in practice. Cases of practice have been reported in the paper below that indicate preliminary understandings and engagement with this concept for the learning of teachers.

Interprofessional learning on a stroke unit.

The importance of a collaborative approach to patient care in improving safety and outcomes has been highlighted by medical regulatory organisations. The World Health Organization has advocated that future health care professionals should be 'collaborative practice ready', and there is a global drive to incorporate interprofessional learning into health education. Interprofessional learning promotes the development of effective teamworking skills and improves the understanding of roles in the multidisciplinary team. This article outlines the development of a practice-based interprofessional learning initiative on a stroke unit. The World Health Organization has advocated that future health care professionals should be 'collaborative practice ready' A half-day seminar was developed by King's College London in conjunction with an interprofessional clinical team from the Stroke Unit at St Thomas' Hospital. Students were assigned discipline-specific supervisors who allocated them to care for a patient within the confines of their usual professional role. They were asked to present the patient to a mixed-discipline group of students within the seminar from the perspective of their individual disciplines. This was followed by supervisor-led group discussions concerning the care of the patient and interprofessional working. Sixty-seven students from different disciplines participated in nine seminars over a 2-year period. Thematic analysis of participants' comments revealed an improvement in the students' awareness of: the varying roles and responsibilities of professionals; how differing disciplines share functions; and the importance of effective communication. All students stated that they would recommend the seminar to other students. Effective interprofessional learning programmes are imperative to promote collaborative practice amongst health care professionals. Stroke units are ideal learning environments for practice-based interprofessional education.

Learning about Professionalism within Practice-based Education: What are we looking for?

Health and social care professions are being held to account concerning their professionalism in ways that would have been unprecedented in the recent past. Students of the School of Health Sciences (HSC) within the University of East Anglia (UEA) in the United Kingdom have professionalism taught and assessed in a number of ways and have overt opportunities to develop their professional performance during practice education. In order to augment this further, a UEA Professionalism Charter has been developed, which helps students to define, learn and apply professionalism in a particular way. Since professionalism is being scrutinised by a number of bodies it is important that there is agreement about its nature. Without an overt definition of professionalism from the Health and Care Professions Council (the regulatory body for occupational therapy, physiotherapy and speech and language therapy) this study set out to explore what could be learned about this body’s perspective through analysis of its Fitness to Practice hearings. The outcome revealed that a definition could be identified and that this bears a close resemblance to that used within the UEA Professionalism Charter. The study therefore supports the continued use of the Charter

Interprofessional Education in Community Health Contexts

This pilot study explores an interprofessional, practice-based education initiative that placed students from four different professions (medicine, nursing, social work, and pharmacy) in a community health clinic ½ day per week for 8 months. The study was guided by two research questions: (1) How do clinic experiences contribute to students’ understanding of social determinants of health? (2) What factors influence the creation of an effective learning environment? To address these questions, we conducted a qualitative, ethnographic study that included participant observation, focus groups, and textual analysis. This study allowed us to explore the experiences of students and staff as they interacted in a community-based clinic setting. We found that the interprofessional, clinic-based experience improved students’ knowledge- and practice-based competencies in a variety of areas, including awareness of social determinants of health, skills in securing resources for patients with financial limitations, appreciation for health education and health promotion in clinical practice, and experience working interprofessionally. We observed that creating environments that support this kind of student learning requires time and effort on the part of the clinic staff. We discuss implications of these findings for supporting future interprofessional, practice-based health education initiatives.

Practice Weeks @ Bedfordshire: An innovative response to criticisms of management education

The purpose of this paper is to position and appraise the University of Bedfordshire Business School's initiative – ‘Practice Weeks’ – as a potentially innovative response to the current criticisms facing Management Education (ME). Criticisms of ME, we argue, are founded on the ‘irrelevancy’ debate, which is conceptualised in the first half of our literature review. The second half of the literature review examines Association of Business Schools (ABS) reports and reviews how business schools are responding to these critiques, reliant primarily on the tried and tested experiential learning models to do so. Building on these, ‘Practice Weeks’ are then presented as a case example from the University of Bedfordshire Business School (UBBS) as an innovative response to surfaced criticisms. Data is drawn from interviews carried out with students and employers who have participated in UBBS Practice Weeks, supported by quantitative insights from student survey questionnaires. Findings evidence that Practice Weeks have the potential to go further than existing experiential learning models to deliver practice-based education to business school students, whilst also capturing an effective and efficient approach to supporting business and community organisations in meeting their objectives.

Enhancing Education Activities for Health Care Trainees and Professionals Using Audience Response Systems: A Systematic Review.

This review examines the effect of incorporating clickers within practice-based education sessions on educational outcomes of health care trainees and professionals. A systematic literature review was conducted on primary research studies published up until August 2014. Studies were identified by database searching (Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and PsychInfo), citation searching, and reference list checking. Studies were restricted to those evaluating the use of clickers as part of the provision of postgraduate education or continuing education programs and were evaluated according to Kirkpatrick's four levels of training evaluation (reaction, learning, behavior, and results). Seventeen studies met the eligibility criteria. Twelve studies assessed learner and/or speaker reactions, with feedback overwhelmingly positive in all studies. Reported learner benefits included increased attentiveness, engagement, and enjoyment of presentations. Speakers reported that using clickers engaged the audience and assisted in assessing audience comprehension. Eight studies assessed learning outcomes. Higher level evidence obtained from four randomized studies demonstrated significant improvements in knowledge with the use of clickers compared with traditional didactic presentations, but no differences when clickers were compared with an interactive lecture with integrated questions. No studies adequately assessed higher level educational outcomes (behavior and results). Although the use of clickers improves learning environment and learner satisfaction, the limited high-quality data for improvements in learning and behavior outcomes make it uncertain whether the acceptance and implementation of clickers within routine practice-based education programs are warranted at this stage.

Experiential Learning With Children: An Essential Component of Professional Physical Therapy Education.

The Section on Pediatrics of the American Physical Therapy Association has developed a number of resources to support and improve the consistency of professional pediatric physical therapy education, including a set of core competencies that all graduates must attain. The purpose of this article is to advocate for the inclusion of experiential learning activities with children, including children with participation restrictions, as a necessary component to achieve the core competencies. Experiential learning is a form of practice-based education that provides exposures and opportunities for students to explore the work, roles, and identities they will encounter as future professionals. Experiential learning is learning by doing, and occurs within a relevant setting. Six representative curricular exemplars are presented to provide readers with a variety of suggestions for development and integration of experiential learning. Recommendations for future research are provided and 4 key recommendations are provided.

Prevention of Work-related Musculoskeletal Injuries in Rehabilitation Nursing.

Work-related musculoskeletal injuries remain a concern for the nursing profession. The purpose of this study was to reduce work-related musculoskeletal nursing injuries by 10% on the rehabilitation unit in a Midwestern hospital. Using a quality improvement and evidence-based practice lens, one group time-series design was employed. Shift reports, interdisciplinary collaboration, self-study educational packets, and journal club sessions were implemented. Results, although not statistically significant, indicated over a 50% reduction in work-related musculoskeletal nursing injuries. Self-engagement and the Hawthorne effect are thought to have contributed to this decline in injury rates. A cost-benefit analysis indicates an estimated savings of $90,000 over 4months. A yearly practice-based education program and improvement in electronic health records is advocated to sustain this decrease in nursing injury rates. Context-specific interventions, communication, algorithm approach to patient transfers, and research knowledge are needed to decrease rehabilitation work-related musculoskeletal nursing injuries.

Clinical practice and self-awareness as determinants of empathy in undergraduate education: a qualitative short survey at three medical schools in Germany.

Study aim: Physician empathy constitutes an outcome-relevant aim of medical education. Yet, the factors promoting and inhibiting physician empathy have not yet been extensively researched, especially in Germany. In this study, we explored German medical students’ views of the factors promoting and inhibiting their empathy and how their experiences were related to their curricula. Methods: A qualitative short survey was conducted at three medical schools: Bochum University, the University of Cologne and Witten/Herdecke University. Students were invited to complete an anonymous written questionnaire comprised of open-ended questions inquiring about the educational content of and situations during their medical education that positively or negatively impacted their empathy. Data were analyzed through qualitative content analysis according to the methods of Green and Thorogood. Results: A total of 115 students participated in the survey. Respondents reported that practice-based education involving patient contact and teaching with reference to clinical practice and the patient’s perspective improved their empathy, while a lack of these inhibited it. Students’ internal reactions to patients, such as liking or disliking a patient, prejudice and other attitudes, were also considered to influence their empathy. Although each of the three schools takes a different approach to teaching interpersonal skills, no relevant differences were found in their students’ responses concerning the possible determinants of empathy. Conclusion: Providing more training in practice and more contact with patients may be effective ways of promoting student empathy. Students need support in establishing therapeutic relationships with patients and in dealing with their own feelings and attitudes. Such support could be provided in the form of reflective practice training in order to promote self-awareness. More research is needed to evaluate these hypothetical conclusions.

Mathematics teacher education as a multifaceted field of study

Mathematics teacher education, the field of study of this journal, is a multifaceted phenomenon with links and connections to many other fields within and outside mathematics education. Teacher education takes place in many settings, deals with all stages and roles of the profession involving prospective and practicing teachers, the induction phase, and teacher educators, and includes the informal learning processes that take place during the life span of a teacher’s career. It also is concerned with the programs, curricula, and resources used for the practice and the study of teacher education, as well as national and international policies and assessments for teacher education. The three articles in this issue of the journal depict in interesting ways many of such features of this field. The education of prospective teachers is not just a step in the preparation of new teachers but it is also a fundamental element in the constitution of teaching as a profession. In a quasi-experimental study that draws on the perspective of practice-based teacher education, Rossella Santagata and Cathery Yeh analyze the impact of a videoand practice-based teacher education course in prospective elementary school teachers’ capacity to teach following a student-centered approach. In a university course that took place at the same time as field-based activities unfolded, the prospective teachers were presented with images of teaching that value students’ thinking and were encouraged to use reasoning based on evidence to assess the effectiveness of their own teaching. The authors sought to develop such skills in prospective teachers by engaging them in activities such as role playing, planning, teaching, and analyzing teaching. As a result, the prospective teachers improved their ability to analyze the teaching of others and also learned to analyze their own teaching as well as to teach in ways that enable the analysis of student thinking. In addition, they used in their classroom teaching and in the analysis of their own teaching the knowledge that they learned in the university course. The authors conclude that structured opportunities for developing the ability to focus on students’ thinking during teaching and

Using Of CD-Rom Breastfeeding Learning Package In Training Of Different Caregivers

AbstractMidwives nurses in conjunction with other caregivers play an important role in promoting breastfeeding to women. Although many have positive breastfeeding attitudes, significant knowledge deficits often limit their capacity to effectively encourage, support and assist breastfeeding women and their infants. Aim: To explore the effect of using CD-ROM breastfeeding learning package in training of different caregivers Design: Quasi experimental. Methods: One hundred caregivers (30 physicians, 50 internship nursing students, and 20 nurses midwives). Materials: The intervention comprised a CD-ROM with accompanying information sheets on drugs for lactating women. Study setting: Departments of Obstetric and Pediatric at Obstetric and Pediatric University Hospital at El Minia University, Egypt from first of July to last of September/ 2013. Results: There was an increase in scores relating to knowledge about breastfeeding after training, especially for the physicians and for those who did not have children. Internship nursing students improved their scores on recognition of the symptoms of poor attachment at the breast, and physicians showed greatest improvement in resolving sore nipples and recognizing nipple thrush. Changes in practice were reported and positive comments made about involving physicians and internship nursing students together in practice-based education. Conclusion: There is a need for using an electronic teaching resource and it is feasible for updating the knowledge of the caregivers. It can help to improve breastfeeding expertise and advice about breastfeeding problem management. Also caregive.rs need training about breastfeeding, as well as refresher courses for trained caregivers. Recommendation: Larger evaluation which also explored the training in terms of women's experiences of care and measured breastfeeding outcomes.

Conflict in Practice-based Settings: Nature, Resolution and Education

In this masterclass we review the evidence regarding the nature of conflict within healthcare practice settings, discuss ways of preventing and resolving conflict, and consider how practice-based education, focusing on conflict and negotiation, may help learners achieve positive outcomes. Conflict is a serious state, which is often prolonged and arises from incompatibility or divergent interests and values. However, conflict may also be used as a productive force for change. Conflict has been included as a core competence for healthcare professionals in a number of competency frameworks because of the recognition that inter- and intra-professional conflict affect patient safety and outcomes, as well as having detrimental effects on staff morale, and on physical and mental health. We discuss how conflict may arise from several triggers – personal, professional and organisational. In particular, disparities in values may lead to conflict, while good communication is fundamental to optimal practice. The history of the development of the health professions includes many examples of conflict between professional groups. A healthy practice environment should encourage constructive conflict management, recognising that conflict will always arise. Early experiences of working and learning together represent important learning opportunities for students, enabling the development and practice of teamwork skills, as well as helping them to recognise and understand the different values, perspectives, roles and responsibilities of team members. Learning opportunities based on real-life scenarios and patient experiences provide a focus common to all professional groups, allowing students the opportunity to explore their differences and similarities. The key messages are: conflict occurs frequently in practice-based settings both inter- and intra-professionally, and learners need to be able to recognise and deal with conflict, including through negotiation.

The impact of integrating community health workers into the patient-centered medical home.

Establishing patient-centered medical homes (PCMHs) that deliver comprehensive care can be challenging for practices serving diverse populations. Integrating community health workers (CHWs) as members of the care team is one approach to deliver such care; however, little is known about this process. We study an approach of integrating CHWs into PCMHs with predominantly Latino, pediatric asthma patients and examine the impact on care delivery. A case study was conducted to examine the integration of 8 CHWs into 5 PCMHs in an academic medical center located in a large, urban setting. Data associated with referrals to CHW practice-based education and support and to a care coordination program, as well as survey results from providers on the impact of CHWs in PCMHs were collected and analyzed over the study period. More than 750 families of children with asthma received education and support from CHWs from February 2011 through December 2013. The number of referrals to the care coordination program increased 7-fold during this time (P < .001). Of providers surveyed (n = 55), those who reported not referring to care coordination decreased from 22% to 6% and those who reported referring patients to care coordination increased from 67% to 79%. Additionally, 39% of providers reported giving a care plan to patients when prompted by the CHW. CHWs can be successfully integrated into the PCMH care team. They may also impact the identification of high-risk populations for care coordination and delivery of comprehensive care.

The effect of education on community nursing practice in improving the patient-carer experience at the end of life.

Successfully completing the 'Foundations in End of Life/Palliative Care' distance-learning module has had a measurable effect on the knowledge, competence and confidence of community nurses in the principles and practice of palliative and end-of-life care. An appropriate practice-based education module can empower community nursing practice and have a direct impact on improving the patient-carer experience at the end of life. This article provides evidence from the quantitative and qualitative data from pre- and post-module self-assessment questionnaires along with the successful completion of an electronic multiple-choice questionnaire and short-answer classroom test to demonstrate this.