Cultural Norms of Clinical Simulation in Undergraduate Nursing Education

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a rich contextualization of the relationships, beliefs, practices, environmental factors, and theoretical underpinnings encoded in cultural norms of the students’ situated practice within simulation. Our findings add to the evidence linking learning in simulation to the development of broad practice-based skills and clinical reasoning for undergraduate nursing students

Learning recursively: integrating PBL as an authentic problem experience [Plenary presentation]

[Abstract]: Problem based learning (PBL) is widely recognised as a desirable approach to education of future professionals. One strong basis for its appeal is the use of authentic problems of practice, which make the relevance of what is being learned apparent to the learners and encourage development of attitudes and skills that will be central to continuing professional growth beyond graduation. However, the change from traditional lecture-based courses to PBL presents challenges to educators and the institutions in which they work. In many respects, the implementation of PBL can be itself an experience in PBL for the educator. This presentation will address some of the challenges associated with integrating PBL in a university setting from the perspective of those who design and teach courses using PBL, which will be understood as a spectrum of practices rather than a single approach that must be replicated in every instance

Challenges Experienced by Korean Medical Students and Tutors During Problem-Based Learning: A Cultural Perspective

How people learn is influenced by the cultural contexts in which their learning occurs. This qualitative case study explored challenges Korean medical students and tutors experienced during their PBL sessions from a cultural perspective using Hofstede’s cultural dimensions. Twelve preclinical medical students and nine tutors from a large Korean medical school participated in interviews. The interview data were analyzed using the constant comparative method and classified according to Hofstede’s cultural dimensions. Twenty-two themes emerged within the following overarching categories: large power distance (6 themes), high uncertainty avoidance (6), individualism (3), collectivism (4), and masculinity/short-term orientation (3). This article discusses culturally responsive solutions with regard to each cultural dimension, which would help overcome these challenges and enhance the experiences of students and tutors with PBL

The Telehealth Skills, Training, and Implementation Project: An evaluation protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Comparing Learning Platform Impact on Low Vision Education for Occupational Therapists

This pilot study examines the impact of face-to-face, remote, and hybrid learning platforms on satisfaction, confidence, and knowledge-application of occupational therapy practitioners during a synchronous low vision continuing education program. Fifteen participants were divided into three groups, each corresponding to one learning platform. They engaged in two 45-min learning sessions and completed pre, post, and follow-up surveys to measure the impact of the learning platform on the dependent variables of satisfaction, confidence, and knowledge application. No significant differences were found between learning platforms for the three variables, but improvements from pre to follow-up survey were found to be significant for confidence and knowledge application for all groups. These findings indicate that similar education provided to occupational therapy practitioners may result in improved confidence and knowledge application to clinical practice from the beginning to the end of the educational program, despite the learning platform. Flexibility with online learning options increased participation and adherence rates. Synchronous remote and hybrid learning platforms may be as effective as traditional face-to-face methods, specifically with increasing practitioner confidence and knowledge application. Remote options may reduce peer interactions but increase flexibility and convenience with scheduling for program scalability and accessibility

Exposing piaget's scheme: Empirical evidence for the ontogenesis of coordination in learning a mathematical concept

The combination of two methodological resources-natural-user interfaces (NUI) and multimodal learning analytics (MMLA)-is creating opportunities for educational researchers to empirically evaluate seminal models for the hypothetical emergence of concepts from situated sensorimotor activity. 76 participants (9-14 yo) solved tablet-based non-symbolic manipulation tasks designed to foster grounded meanings for the mathematical concept of proportional equivalence. Data gathered in task-based semi-structured clinical interviews included action logging, eye-gaze tracking, and videography. Successful task performance coincided with spontaneous appearance of stable dynamical gaze-path patterns soon followed by multimodal articulation of strategy. Significantly, gaze patterns included uncued non-salient screen locations. We present cumulative results to argue that these 'attentional anchors' mediated participants' problem solving. We interpret the findings as enabling us to revisit, support, refine, and elaborate on central claims of Piaget's theory of genetic epistemology and in particular his insistence on the role of situated motor-action coordination in the process of reflective abstraction

Beyond deficit-based models of learners' cognition: Interpreting engineering students' difficulties with sense-making in terms of fine-grained epistemological and conceptual dynamics

Researchers have argued against deficit-based explanations of students' troubles with mathematical sense-making, pointing instead to factors such as epistemology: students' beliefs about knowledge and learning can hinder them from activating and integrating productive knowledge they have. In this case study of an engineering major solving problems (about content from his introductory physics course) during a clinical interview, we show that "Jim" has all the mathematical and conceptual knowledge he would need to solve a hydrostatic pressure problem that we posed to him. But he reaches and sticks with an incorrect answer that violates common sense. We argue that his lack of mathematical sense-making-specifically, translating and reconciling between mathematical and everyday/common-sense reasoning-stems in part from his epistemological views, i.e., his views about the nature of knowledge and learning. He regards mathematical equations as much more trustworthy than everyday reasoning, and he does not view mathematical equations as expressing meaning that tractably connects to common sense. For these reasons, he does not view reconciling between common sense and mathematical formalism as either necessary or plausible to accomplish. We, however, avoid a potential "deficit trap"-substituting an epistemological deficit for a concepts/skills deficit-by incorporating multiple, context-dependent epistemological stances into Jim's cognitive dynamics. We argue that Jim's epistemological stance contains productive seeds that instructors could build upon to support Jim's mathematical sense-making: He does see common-sense as connected to formalism (though not always tractably so) and in some circumstances this connection is both salient and valued.Comment: Submitted to the Journal of Engineering Educatio