Use Of Visual Aids Research Articles

Evaluating co-created patient-facing materials to increase understanding of genetic test results.

Patients often have difficulty understanding genetic test reports. Technical language and jargon can impede comprehension and limit patients using results to act on findings. One potential way to improve patient understanding of genetic test reports is to provide patient-facing materials. This study aimed to examine understandability and actionability of co-created patient-facing materials for genetic test results in a research context. We combined interprofessional perspectives and patient engagement to co-create patient-facing materials for patients undergoing research genetic testing for congenital hypogonadotropic hypogonadism (Kallmann syndrome). The iterative development process was guided by principles of health literacy and human-centered design (i.e., design thinking). Readability was assessed using eight validated algorithms. Patients and parents evaluated materials using a web-based survey. The gold standard Patient Education Materials Assessment Tool for print materials (PEMAT-P) was employed to measure understandability (content, style, use of numbers, organization, design, use of visual aids) and actionability. PEMAT-P scores >80% were considered high quality. Results were analyzed descriptively and correlations performed to identify relationships between education/health literacy and PEMAT-P ratings. A consensus score of eight algorithms indicated the materials were an 8th -9th grade reading level. Our findings are consistent with the U.S. Department of Health and Human Services 'average difficulty' classification (i.e., 7th-9th grade). In total, 61 patients/parents evaluated the materials. 'Visual Aids' received the lowest mean PEMAT-P rating (89%). All other parameters scored 90%-97%. PEMAT-P scores did not differ according to educational attainment (less than college vs. college or more, p=0.28). Participants with adequate health literacy were more likely to approve of the 'organization' of information (p<0.05). Respondents with low health literacy had more favorable views of 'visual aids' (p<0.01). Involving patients in a co-creation process can produce high-quality patient-facing materials that are easier to understand.

Assessing health professionals\u2019 perception of health literacy in Rhode Island community health centers: a qualitative study

BackgroundLimited health literacy is linked with poor health behaviors, limited health care access, and poor health outcomes. Improving individual and population health outcomes requires understanding and addressing barriers to promoting health literacy.MethodsUsing the socio-ecological model as a guiding framework, this qualitative study (Phase 1 of a larger ongoing project) explored the interpersonal and organizational levels that may impact the health literacy levels of patients seeking care at federally qualified community health centers (FQCHCs) in Rhode Island. Focus groups were conducted with FQCHC employees (n = 37) to explore their perceptions of the health literacy skills of their patients, health literacy barriers patients encounter, and possible strategies to increase health literacy. The focus groups were audio-recorded and transcribed, and transcripts were coded using a process of open, axial, and selective coding. Codes were grouped into categories, and the constant comparative approach was used to identify themes.ResultsEight unique themes centered on health literacy, sources of health information, organizational culture’s impact, challenges from limited health literacy, and suggestions to ameliorate the impact of limited health literacy. All focus group participants were versed in health literacy and viewed health literacy as impacting patients’ health status. Participants perceived that some patients at their FQCHC have limited health literacy. Participants spoke of themselves and of their FQCHC addressing health literacy through organizational- and provider-level strategies. They also identified additional strategies (e.g., training staff and providers on health literacy, providing patients with information that includes graphics) that could be adopted or expanded upon to address and promote health literacy.ConclusionsStudy findings suggest that strategies may need to be implemented at the organizational-, provider-, and patient- level to advance health literacy. The intervention phase of this project will explore intervention strategies informed by study results, and could include offering health literacy training to providers and staff to increase their understanding of health literacy to include motivation to make and act on healthy decisions and strategies to address health literacy, including the use of visual aids.

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites.

Nationally, Hispanics experience health disparities manifested as a higher prevalence of chronic diseases in comparison to non-Hispanic Whites. Factors that influence health disparities in this population include inadequate dissemination of culturally and linguistically appropriate health information. Our qualitative analysis is based on data obtained from three focus groups with Spanish-speaking Hispanic adults conducted at a clinic in Nebraska. Participants were asked about their perceptions of health information in the form of videos, brochures, and websites. We followed the consolidated criteria for reporting qualitative research and used the theoretical framework of content analysis. For videos, attributes associated with higher levels of trust included a friendly health professional, the logo or name of a health care institute, and a reference specifying "se habla Español." For brochures, attributes associated with trust included use of visual aids, use of numerous colors and big font sizes, the year of printing, and a health care agency logo. For websites, characteristics associated with trust were inclusion of plain language, use of pictures and videos, and date of last update. In all focus groups, participants perceived the use of mixed English/Spanish language in health information from pamphlets and websites as unprofessional. The use of unknown governmental logos in health promotional videos and websites was perceived as untrustworthy information. Spanish-speaking Hispanics prefer health information supported by a health care agency or delivered by a health care professional. Health communication strategies should avoid the use of mixed English/Spanish language in sensitive information especially when combined with governmental logos.

A quality improvement project to assess the use of visual aids to improve understanding and motivation in periodontal patients

AimsA quality improvement project was carried out in a General Dental Practice in London. The aim was to improve understanding and motivation in periodontal patients.MethodsResearch into interventions in the medical field to improve understanding and motivation amongst patients, lead to the idea of using visual aids to help motivate periodontal patients and to improve their understanding of the disease. The results from the first Plan-Do-Study-Act cycle using visual aids are presented.ResultsAfter the use of visual aids, patients felt more motivated in maintaining good oral hygiene, felt the visual aids improved their understanding of gum disease and how to take care of their gums and teeth. One hundred percent of patients preferred their diagnosis to be explained to them with visual aids.DiscussionThe project supported the increase in motivation and understanding in periodontal patients. However further data is required to learn more about how visual aids influence patient behaviour, how effective they are in improving patients’ understanding and motivation, and other factors which play a role in this.ConclusionsThe results of this quality improvement project are promising; it has highlighted that visual aids can have a place in the management of periodontitis in general practice.

Parents'/Patients' Perception of the Informed Consent Process and Surgeons Accountability in Corrective Surgery for Adolescent Idiopathic Scoliosis: A Prospective Study.

Prospective study. To determine the parents'/patients' perception on the informed consent process prior to posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) patients. Understanding parents/patients perspective on the process is important in order to achieve the goal of consent and prevent medico-legal implications. Fifty AIS patients operated between August 2019 and November 2019 were prospectively recruited. Parents'/patients' perceptions on three sections were evaluated: the process of the informed consent, specific operative risk which they were most concerned with and the accountability of surgeons for the surgical risks. These data were ranked and scored using a 5-point Likert Scale. Preferences were reported in mean and standard deviation. Differences in terms of preferences were studied using One-way analysis of variance (ANOVA) analysis and deemed significant when P < 0.05. There were 30 females (60.0%) and 20 males (40.0%) with a mean age of 41.8 ± 10.6 years. Majority of parents/patients preferred the inform consent to be explained more than once (P = 0.021), once during clinic consultation and once during admission (4.2 ± 1.0). Consent taking by both attending surgeons was preferred (4.5 ± 0.6) compared with other healthcare providers, P < 0.001. Death (60.0%) and neurological deficit (30.0%) were the two most concerned surgical risks. Parents/patients would still hold the surgeon accountable for any complications despite signing the informed consent and they felt that surgeons were directly responsible for screw-related injuries (3.9 ± 0.9), neurological injury (3.8 ± 0.9), and intraoperative bleeding (3.7 ± 0.9). Parents/patients preferred the attending surgeons to personally explain the informed consent, more than once with the use of visual aid. They would still hold the surgeons accountable when complications occur despite acceptance of the informed consent. 2.

Adaptation of One-Session Treatment for Specific Phobias for Children with Autism Spectrum Disorder Using a Non-concurrent Multiple Baseline Design: A Preliminary Investigation.

Anxiety disorders are among the most common co-occurring disorders for individuals with ASD. Several adaptations to cognitive behavioral approaches have been proposed for this population (Moree & Davis, 2010). The current study examined feasibility and preliminary efficacy of an ASD-specific adaptation of one-session treatment (OST) for specific phobia (SP). Standard OST consists of one 3-h session followed by four weekly phone calls. Modifications for ASD included increased parental involvement, use of visual aids, and inclusion of four 1-h booster sessions in place of the four weekly phone calls. Visual inspection and Friedman tests revealed significant reductions in fear ratings and phobia severity from pre- to post-treatment and follow-up assessments. Modest changes were observed in behavioral avoidance. These findings provide initial evidence that this treatment merits further study.

B1 seviyesinde dilbilgisi ölçen çıkartmalı sınavlarda görsel araçların kullanılmasının etkisi: Yarı-deneysel bir çalışma

A considerable amount of literature has been published about the use of visual aids in language classrooms to see if they foster learning or classroom participation. Visuals have been used in test format for years, as well; however, there is a dearth of research to indicate how effective the presence and the type of visuals in testing grammar through multiple-choice cloze tests. To close the gap in the literature, the current study aims to identify the effect of using visual aids, specifically real pictures, diagrams, and no pictures in a cloze test on students’ grades and test completion times. This is a quasi-experimental, quantitative study. The data was collected through cloze tests that tested grammar via multiple-choice items within a context about synesthesia. The sample consisted of 64 B1 level preparatory school students (27 females, 37 males) studying at a state university in Istanbul. The participants were from different majors. The data were analyzed through SPSS. The results revealed a significant difference between the visual types and students’ completion time of the texts. It took different groups between 2 minutes to 7 minutes to complete the test. The real picture group spent the most time (M= 4.45), which was followed by the diagram group (M= 3.47) and no visual test group (M=3.45). However, no significant differences were found between the grades of the students who took tests with different visuals.

Causes of vision loss at China's largest blind school during a period of significant economic growth: 2008-2016

To investigate the different causes of vision loss and school-based treatment regimens at Quanzhou Blind School (QBS), China's largest blind school, in 2008 and2016. In 2008, 144 students received comprehensive eye examinations along with a complete family and ophthalmic history; in 2016, 125 students were examined. Vision loss was categorized into visual impairment and blindness classifications based on WHO guidelines. The etiologies of impairment and blindness in 2008 were compared to those in 2016 using the Fisher exact test. The prevalence and type of visual aids were also analyzed during this period. The leading cause of visual impairment significantly shifted from corneal scarring in 2008 to retinopathy of prematurity (ROP) in 2016 (P=0.020). Congenital cataracts remained the leading cause of blindness in 2008 and 2016. In 2016 there was a significant increase in the use of visual aids, with 63.2% of students using them in 2016 compared to 8.3% in 2008 (P=0.0001). Between 2008 and 2016, the leading cause of visual impairment shifted from corneal scarring to ROP, while congenital cataracts remained the leading cause of blindness.

The Untapped Potential of Preschool Classroom Volunteers in Language–Literacy Instruction: A Feasibility Study

Purpose This pretest–posttest study examined the effects of a professional development training on five volunteer instructors' (VIs) utilization of language and literacy facilitation strategies within interactive shared book readings with low-income preschool children. The training specifically targeted the VIs' use of wh -questions, expansions, and references to story grammar elements (SGEs) with use of a corresponding visual aid. Method VIs participated in a 3-hr training composed of lecture, video models, role playing, four opportunities to explicitly practice the target strategies, and four opportunities to receive immediate feedback from the investigators. The VIs led storybook readings that were video-recorded for comparison prior to and after the training sessions (two pretraining, two posttraining). The investigators analyzed the VIs' language and literacy strategy usage in the readings. The investigators compared the raw number of wh -questions asked, expansions of child responses or comments, the number of references (out of 20) to SGEs, and use of the visual aid pre- and posttraining. Results After the training, four of the five VIs increased the number of wh -questions asked during readings, and one VI maintained a large number of questions asked, compared to pretraining readings. All VIs provided an increased number of references to SGEs (character, setting, problem, fixing problem, solution) in a variety of capacities (name, definition, book-specific element, visual aid use) to reinforce narrative concepts. VIs had inconsistent increases in expansions of child responses or comments posttraining. Conclusion Results revealed the VIs generally increased their facilitation of language and literacy strategies after participating in a professional development training, suggesting utilization of volunteers as instructors may be a valuable area to explore, especially in low-income environments where children may be at risk for language and literacy delays. Supplemental Material https://doi.org/10.23641/asha.12070824

A Semester Long Teaching Practicum For Graduate Students In Biomedical Sciences

IntroductionTeaching assistants are often given little or no guidance before receiving their first teaching assignment. As a result they feel underprepared and overwhelmed by the experience, which undoubtedly reduces their effectiveness in the classroom. Therefore we developed a one‐semester teaching practicum to better prepare new graduate students for the rigors of college teaching.PurposeTo provide students with a mentored experience in college teaching while simultaneously exploring topics in the pedagogy of college teaching.MethodsWe developed a 15‐week course for first year graduate students in the Department of Biomedical Sciences at Grand Valley State University. Student teaching assistants were assigned to shadow a faculty‐mentor teaching an introductory laboratory course in Anatomy and Physiology, or Microbiology. Students performed basic teaching duties including grading and assisting students during the lab. In addition they completed a curriculum, which included weekly readings and writing assignments on topics in college teaching pedagogy. Selected readings, links to external content, and writing reflections were managed through a course website on Blackboard.Learning ObjectivesAfter completing the course the student should be able to: critically read and apply current concepts in the pedagogy of college teaching, facilitate student‐centered learning activities, make effective use of visual aids in classroom instruction, plan, execute, and evaluate classroom instruction.Evaluation and AssessmentWeekly assignments included readings on topics in college teaching pedagogy ranging from – setting the right tone in the classroom on day one, managing the classroom, to developing a teaching philosophy. Each assignment required a brief writing reflection and a discussion with the faculty‐teaching mentor. As part of the course students completed two teaching demonstrations. The first teaching demonstration was video taped and later reviewed and evaluated by the student and faculty mentor. Both teaching demonstrations were graded and the grading rubric was provided to the student prior to the demonstration. The course culminated with the student drafting a statement of teaching philosophy.SummaryWe developed a 15‐week teaching practicum designed to provide students with a mentored experience in college teaching. The course was initially piloted with two graduate students in the Department of Biomedical Sciences at Grand Valley State University but could easily be scaled up to a larger cohort of students and different academic disciplines.

Integrating new knowledge into everyday practices: teacher pedagogy in early grade literacy in rural Mozambique

AbstractImproving literacy outcomes in sub‐Saharan Africa is a central focus of national governments, donors and non‐governmental organisations alike, as evidenced by the inclusion of literacy as a target in the United Nations' Sustainable Development Goal 4. Though significant international development funding has been devoted to teacher training in the region, little evidence is available on how teachers improve their literacy instruction in practice. This study profiles how 20 teachers in eight schools in rural Mozambique translated training in literacy instruction into classroom instruction. We used three domains of teacher knowledge – content knowledge, pedagogical knowledge and pedagogical content knowledge – to analyse interview and observation data. While some aspects of training translated into classroom practices, including explicit literacy instruction and use of visual aids, teachers rarely used activities for oral language development or reading comprehension, which are critical to producing skilled readers. We discuss the research and policy implications of these findings.

An assessment of provider satisfaction with the use of a standardized visual aid for informed consent for appendectomy in children

PurposeWe previously validated a visual aid for the use in the consent process for an appendectomy showing improved parental satisfaction and understanding. In this study, we evaluated provider satisfaction and perceived value of using the visual aid. MethodsAn IRB approved survey was developed assessing provider experience with use of the visual aid. This was distributed and analyzed via Research Electronic Data Capture (RedCap) Database. ResultsWe administered 58 surveys (45% response rate). Participants included faculty (n = 2), fellows (n = 1), residents (n = 6), and physician assistants (n = 17). The visual aid was used >10 times by 50% of providers. The most common reason for not using the visual aid was not remembering it was available. Nearly half (40%) did not feel the visual aid added any time. 9/20 (45%) felt it added a small amount of time. Slightly over half of providers (52%) felt using the visual aid significantly increased family ability to give informed consent and made the consenting process easier for both providers and families. ConclusionUsing a visual aid in consenting families for appendectomy does not add significant time and subjectively improves the process for providers and increases provider perception of parental understanding. Level of EvidenceCost effectiveness, Level IV.

An Effective Use of Visual Aids for Teaching Computer Aided Manufacturing (CAM) Laboratory - A Case Study

An Effective Use of Visual Aids for Teaching Computer Aided Manufacturing (CAM) Laboratory - A Case Study

СТРУКТУРУВАННЯ ТА КОНСТРУЮВАННЯ ЗМІСТУ ПРОГРАМИ НАВЧАЛЬНОЇ ДИСЦИПЛІНИ «ХІМІЯ З ОСНОВАМИ БІОГЕОХІМІЇ»

Introduction. The ecologist has to understand the causes of environmental issues and know how to solve them, thus he has to possess a set of knowledge in chemical sciences, which includes knowledge of the properties of chemicals and conditions of their transformation, ways of spreading harmful substances in the environment to predict their impact on the environment. The purpose of the article is to substantiate the structure of the curriculum of the discipline "Chemistry with the fundamentals of biogeochemistry" and identify factors in constructing the content of educational material for the training of future environmentalists. The following research methods are used in the article: theoretical - analysis of educational and methodical literature; study of scientific publications on research topics; systematization and generalization of information; study of regulatory documentation of the organization of the educational process in higher education institutions. As a result of the research we determined, the main factors in constructing the content of the discipline are taking into account the target component for designing the content of the discipline; content of the discipline in accordance with certain forms of educational activities in higher education institutions and features of the discipline; improvement of methods, forms and means of training for effective mastering of chemical competencies; constant monitoring of academic achievements of applicants for higher education and adjustment of the content of modules of the discipline. Originality. For the first time we have proposed a rational and practice-oriented approach to structuring and constructing the content of the curriculum of the discipline "Chemistry with the fundamentals of biogeochemistry" taking into account the specifics of training future environmentalists. Conclusion. We state that structuring sections of the curriculum and constructing the content of the discipline taking into account modern scientific advances in chemistry system and sequence of mastering subject competencies, availability of theoretical and practical material, nsuring the relationship of theory with practice, rational use of visual aids, complexity of development professional competence will improve the quality of the educational process. The introduction of modern approaches to the study of the chemistry of natural processes, modeling their impact on living organisms is promising.

610: Effect of general anesthesia at time of cesarean delivery on perinatal outcomes and childhood neurodevelopment

In 2016, the FDA expressed concern that general anesthesia or sedation exposure in pregnancy or before 3 years of age may impact pediatric neurodevelopment and called for further research examining the impact of anesthesia, including single, short exposures. We examine the impact of general anesthesia (GA) during cesarean delivery (CD) on neurodevelopment at two years of age among infants born preterm. Secondary analysis of a multicenter RCT assessing magnesium for prevention of cerebral palsy in preterm infants. Women were included if they delivered a singleton, non-anomalous infant < 37wks by CD. The exposure of interest was general anesthesia. The primary outcome was mild to moderate developmental delay at 24 mos by Bayley Scales of Infant Development II (BSID). Secondary outcomes were BSID subdomains, periventricular leukomalacia, seizures, abnormal tone, hypotension, ventilator need, duration of oxygen use, and use of visual aids. Chi square, Fisher Exact, student’s t-test, Wilcoxon Rank Sum tests, and multivariable logistic regression models were performed. Of 557 women, 119 (21%) received GA. Women receiving GA were more likely to be unmarried, non-white, delivering more preterm (28.6 vs 29.7 wks, p< 0.01), undergoing CD for fetal distress (49% vs 36%, p=0.01), and in preterm labor >4cm (11% vs 3%, p< 0.01). Betamethasone and magnesium exposure were similar between groups, as was substance use. Mild to moderate developmental delay was not increased in those exposed to GA (Table). When BSID subdomains were analyzed individually, nominal increases in mild and moderate mental delay among infants exposed to GA did not persist after controlling for significant variables, including gestational age at delivery. Secondary outcomes did not differ significantly between groups. General anesthesia at time of CD does not appear to increase the risk of neurodevelopmental delay at two years in infants born preterm. Future studies should evaluate the impact of longer or multiple anesthetic exposures on neurodevelopment among all infants.

Identifying Strategies for English Language Learner Literacy Development at the Secondary Level Using Whole-class Readings

This study seeks to identify literacy strategies that support English language learner literacy development in secondary English courses. The study occurs over a six-week unit where whole-class reading of the novella Animal Farm takes place. The study features qualitative methods of data collection and analysis situated in an advocacy, change-oriented perspective. Data include teaching journal entries, lesson plans, field notes, student conference interviews (conferring notes), and student records and artifacts. Constant comparison and grounded theory methods of analysis are used, along with open coding and pattern matching. Findings reveal four emergent patterns that have a significant positive correlation to comprehension, participation, and academic achievement: the frequency of teacher read-alouds, the use of visual aids with graphic organizers, the use of group activities as part of scaffolding exercises, and sustained repetition of strategies and material.

THE EFFECTS OF USING VISUAL AIDS IN TEACHING SPEAKING TO THE SECOND YEAR STUDENTS AT MTS. MA’ARIF NU TUBAN ACADEMIC YEAR 2016/2017

Language is a means of communication. It is used by human beings as a method of communicating ideas, feelings and desires by means of a system of sounds and sounds symbols. It is not only as means of communication but also as media to access knowledge and technology. English is used in daily or formal communication and it has an important role in the activity of life either in written or oral form related to the science and technology written or spoken such as in the books, magazine, newspaper, radio and television. Therefore, to be able to express and understand English especially for educated people is a must. In Indonesia, English is the first foreign language which has an important role in almost every aspect. It is important not only for students who want to elevate themselves into the higher education institution but also the people who look for better job or position. That is why, English is taught from elementary school to the university with the hope that government may prepare them in their future life. To get this target, the government has applied many methods, techniques, and media to gain successful result.&#x0D; For Junior high school students, instructional media (especially visual Aids) can be interesting things for motivating them to study more diligently because in fact they like them. Students or children like to see and use things as picture, car, maps or the other visual Aids because they have been familiar with them so that they may easy to understand, to memorize and to transform things they learn with things they see. Visual Aids can also prevent students from misunderstanding since they can see and even touch what the teacher means. If the students are given chance to see the media used when they are learning English, especially in speaking lesson, so the media will be enable to attract them to understand the subject more. MTs Ma’arif NU Tuban is one of the secondary Schools Under the control of YP. Maarif NU Cabang Tuban. The location of this institution is in the complex of education area in Manunggal street NO 10 – 12 Tuban East Java. To reach good result of its output, the Institution creates small classes with around 15-20 students in it. It is done to make teachers may be able to control, to manage and to pay attention to the class fully so that it may increase the quality of the graduation. The teachers, especially English teacher has implemented many kinds of methods, techniques and media and he also equips himself with the knowledge of teaching he has taken from Diklat, workshops and seminars. Besides it, he is also diligent to learn, to find knowledge and to consult things he does not understand yet to other persons he thinks capable in the education. Formerly, he often uses other media when he teaches English speaking. But some of the students feel bored. They are not enthusiastic, not active and even sleepy. That is why, he tries to use media for him it is something new, visual aids.&#x0D; Based on the description, he formulates statement of the problem as follows: 1. What are the effects of visual Aids in teaching speaking for the second year students of MTs. Ma’arif NU Tuban ?, 2. How are the visual aids used in teaching speaking for the second year students of MTs. Ma’arif NU Tuban?, 3. How are students’ attitudes toward the use of visual aids in teaching speaking for the second year students of MTs. Ma’arif NU Tuban?. That is why the objective of the researches are as follows: 1. To describe the effects of visual aids in teaching speaking for the second year students of MTs Ma’arif NU Tuban, 2. To describe how are visual aids used in teaching speaking for the second year students of MTs. Ma’arif NU and 3. to describe how are students’ attitudes towards the use of visual aids in teaching speaking for the second year students of MTs. Ma’arif NU Tuban. Based on the researarch, it is seen that visual aids have significant effects in developing english speaking skill for the students. The students are motivated to learn English. In choosing the visual aids, teacher usually produces by himself or asked students to bring or to preapre them. The students attitude on the teaching of speaking using visual aids are that they become motivated and interested to learn english so that their speaking skill increase and increase. Therefore, it is sugested that the Englkish teachers have to use visual aids to get the objective of English learning.

Using an E-book in the secondary English classroom: Effects on EFL reading and listening

This study investigated the effects of incorporating e-books into instructional material on reading and listening development among secondary school students with different levels of English proficiency. The experimental group utilized an e-book in regular English class, and the control group used a print version with the same content. An achievement test and focus-group interview followed the six-week e-book intervention. The test results showed that the e-book had a positive impact on listening comprehension, particularly for low-proficiency students. For these students, multimedia input combined with a standard accent seemed more effective for the development of listening skills than access to only the foreign-accented English spoken by the teacher. Furthermore, the use of visual aids, such as images and captions, might support listening comprehension by helping the students visualize auditory input and providing contextual information. Audio-only input might not be enough for low-proficiency students, who have relatively limited capability to recognize words from speech. With regard to reading, the e-book intervention resulted in higher test scores compared to the print book, but the between-group difference did not reach statistical significance. Possible reasons include a small sample size in each proficiency group as well as technical restrictions and distraction caused by multimedia material. The interview data indicates that the use of technology was not perceived as particularly beneficial for learning. Instead, diverse classroom activities and interactions were considered more important than the technology itself to draw students’ attention and sustain their motivation. Pedagogical implications of the results are discussed.

How to do a naked presentation

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay. A "naked" presentation solely relies upon good storytelling. Learn how to enrapture an audience without the use of visual aids.

Quality improvement can reduce unintended extubations

Studies spanning the last thirty years have examined contributors to unintended extubation (UE) in neonatal intensive care units (NICUs).1 Common themes emerge: low staff-to-patient ratios, less stable securement methods, procedures which cause patient movement and insufficient patient sedation.1 Implementation of comprehensive and multifaceted quality improvement (QI) initiatives to reduce UE has more recently been demonstrated effective in multiple NICUs.2, 3 Galiote et al report a single-centre QI project designed to reduce UE in a Level IV NICU in the USA through which a reduction in UE rate to the recommended benchmark of <1 per 100 ventilation days was achieved.1 The QI methodology used is appropriate, and the manuscript follows the reporting guidelines for QI in health care (http://www.equator-network.org/reporting-guidelines/squire/). Overall, the implementation project is well structured and designed. For QI efforts to be effective in a healthcare service, it is vital to have clear leadership combined with an environment where frontline staff are empowered to actively engage in the process.4, 5 There is evidence of positive cultural change in this project's NICU, with one intervention point focused on enabling nurses and respiratory therapists to speak up with their concerns. It appears that the project was appropriately multidisciplinary, with dedicated QI teams for UE prevention assembled in Epochs 1 and 2 of the intervention. It is assumed the overall QI team for UE was made up of neonatologists, nursing staff, respiratory therapists and administrators. However, given the composition of NICU clinical teams varies between units and neonatal networks, it would have been useful for the background and roles of each team member in this project to be described in more detail. It does not appear that there was formal parent or caregiver involvement in the study: while not commonly reported at present, collaboration with families for QI in NICUs can add great value to these endeavours.6 This implementation project was first prompted by an observation that UE had increased to an unacceptable level in this NICU. The process of intervention planning was well structured, and spanned across several elements of NICU care including bolstering staff presence at high UE risk timepoints, procedure standardization for endotracheal tube securement, guidance for managing patient position and episodes of high-risk movement, real-time reporting and analysis of adverse events, optimising communication and the use of visual aids for clear identification of at-risk infants. Further information on why each particular intervention was selected over other potential interventions would be informative for NICUs planning similar projects. It is also not clear in the paper whether the team appraised reasons for the initial rise in UE in their unit that prompted the project in the first place: this may have provided valuable insight to the key UE drivers identified. It is clear from this study and others that UE can be successfully reduced through the use of multiple, well-selected interventions that are driven by a dedicated QI team.2, 3, 7 Future QI endeavours for UE in NICUs should focus on the sustainability of these initiatives, with a view to ensuring longevity of a safety culture in NICUs. https://ebneo.org/2019/09/unintended-extubations/ None.