The Effects of Instructional Media on Learning Outcomes in Graduate Nursing and Physical Therapy Students at Angelo State University

Instructional media is the use of aids by an instructor to supplement student learning. Such aids have improved over the years in congruence with advances in technology. In this study, graduate physical therapy students (DPT) and graduate nursing students (GN) enrolled at Angelo State University were divided into two groups to examine the effects of supplemental instructional media on their learning experience. One group received instructional media resources in addition to PowerPoint lectures, while the control group received only the PowerPoint lectures. The intent was to determine if these additional resources contributed to improvements in the students’ grades as well as their level of engagement during a DPT and GN course. Students were separated into two GPA-matched groups with researchers blinded to participants’ group assignment. Learning outcomes were 3 quizzes, a written assignment, a test, and a survey regarding the instructional media interactions (administered to only the intervention group). Increased age of participants was negatively correlated with lack of engagement in the instructional media while all other outcomes were not found to be statistically significant. At this point, supplemental instructional media may not be necessary for students at the graduate level of healthcare education. However, as exposure to technology occurs at an earlier age, it may be necessary for teaching styles to adapt to accommodate technology influenced learning styles. Further studies should be conducted to determine if such adjustments will be necessary

A Comprehensive Review of Serious Games in Health Professions

Education of healthcare professionals is of primary importance for patient safety. In some health related professions, education and training have to be practiced during the entire working period and not only limited to school years. The use of new technology such as virtual reality and e-learning brings new possibilities with significant improvement in learning outcomes. Serious gaming describes a technology that can educate and train while entertaining users. This type of training can be very useful for health professions because it improves learning outcomes creating a learner oriented approach and providing a stealth mode of teaching. In some fields it represents an ideal instrument for continuous health professions education also in terms of costs because it is cheaper than traditional training methods that use cadavers or mannequins. In this paper we make a scoping review of serious games developed for health professions and health related fields in order to understand if they are useful tools for health related fields training. Many papers confirmed that serious gaming is a useful technology that improves learning and skills development for health professionals

Brief history of serious games

Serious Games are now an established field of study. In this field most would attribute the rise of Serious Games to Clark C Abt’s creation of the term in 1970, or indeed Ben Sawyer’s popularization of it in 2002. However, considering the rich history of purposing non-digital games, itself preceded by discussions of purposing play that are traceable to the work of Plato, it can be said that Serious Games is a contemporary manifestation of centuries old theories and practices. In this chapter, we explore the pre-history of Serious Games, beginning with the suggested purpose, and purposing of play. Throughout this historical review we identify key in research and practice that are apparent in the contemporary Serious Games field

The effectiveness of computer based interactive oral health education

The Western Isles of Scotland have historically high levels of dental disease in the five year old age group amongst the worst in the UK. The “Action Plan for Scotland” has implemented a multidisciplinary approach to deal with this problem. This includes a major role for schools in supporting and improving oral health, by reducing the availability of cariogenic produce in schools and actively promoting healthier diets. In light of this the researcher created an interactive computer programme, designed to educate children about healthy eating and improve their ability to identify cariogenic foods. The interactive computer programme was designed to integrate into the school curriculum providing a combined teaching tool and learning resource; for elements of both the health curriculum and IT attainment targets. To assess the efficacy of the interactive computer programme a blind randomised controlled trial was designed to measure: • Its ability to teach children the difference between healthy and unhealthy food. • If it could positively influence the children’s selection of playtime snack. The computer programme was initially assessed by a peer group consisting of Primary School Teachers, Dental staff (Glasgow University Dental School) and Dieticians (Western Isles Health Board). This was to ensure the content contained the correct nutritional and oral health message and that the interactive computer programme was educationally appropriate, for the age group within the study. The computer programme was then assessed by a user group, consisting of pupils from Sandwick Hill Primary School, aged from four and a half to seven. Changes were then made in relation to the format and content of the programme to improve and refine it. An initial pilot study was undertaken within Sandwick Hill Primary School to assess the methodology of the controlled trial and the randomisation and blinding of the participants. This also allowed refinement of the assessment tool to be used within the study. The assessment tool was designed to determine the children’s ability to identify healthy and unhealthy foods and to record their playtime snack. Two schools were involved in the controlled trial, Stornoway Primary School and Laxdale Primary School. Positive consent was received for Eighty-six pupils in total. There were forty five boys (52.3%) and forty one girls (47.7%). The mean age was 5.7, (range 4 to 7 years). The teaching staff involved within the study were given a tutorial to explain the use of the programme and the protocols relating to randomisation and blinding. The participants were then randomly allocated to one of two groups, the intervention or control group. Both groups were then assessed to provide a comparative baseline. The intervention group were provided with the interactive computer programme. They were to use the programme for fifteen minutes a time over three weeks. The teachers were encouraged to allow the children to access the programme at least five to six times during this period. The control group were provided with traditional paper based educational material which was completed during class time. After three weeks the children were reassessed and the educational materials removed. The children were then assessed again after three months to assess longevity and retention of the acquired knowledge. The researcher remained blind to group allocation until the key was broken after analysis of the results. Regarding identification of healthy food, regression analysis showed significant improvement in both groups, but t-tests revealed no significant difference between them. The groups matched well at baseline [Two- Sample T-test for means, p=0.979 95% CI -4.88, 4.76]; the intervention group showed greater improvement at 3 weeks but this was not significant [Two- Sample T-test for means, p= 0.135 95% CI -7.56, 1.04]. There was no difference seen at 3 months [Two- Sample T-test for means. P= 0.547, 95% CI -5.12, 2.74]. There was neither an improvement nor a difference between the two groups in snack selection. This study provides evidence as to the effectiveness of interactive technology in relation to oral health education. It shows that interactive computer technology can provide an alternative to paper based educational materials. This study does not however show it to be significantly more effective. The study also shows that the use of the interactive computer programme was ineffective in modifying behaviour, in relation to diet, in this age group

Critical reflection: a process for generating high quality engaged learning?

Critical reflection in social work is explicitly taught as an on going professional skill in one of the fourth year units. Students are encouraged to select an event or incident from their first field placement to reflect on from a number of different theoretical perspectives, including poststructrualism (Fook 2001; 2002). In class students present their selected incident, reflect on how they have made sense of it and in dialogue with other students explore commonly held assumptions (Ramsden 1992). This process is often “transformative in that learners become aware and critical of their own and other’s assumptions” (Mezirow 1997, p. 10). These classes reflect Bell Hook’s (1989) approach to teaching, where she describes the focus as “staff and students working together to explore the real world”. By using various theoretical lenses and many specific examples drawn from students’ “lived experience”, students practise how to recognise “frames of reference and using their imagination to redefine problems from a different perspective” (Mezirow 1997, p. 10). Their learning is contextual, invites peer collaboration and develops “autonomous thinking through challenging points of view and habitual ways of thinking” (Mezirow 1997, p. 5; Lynch 2005). In this paper we will illustrate how this approach facilitates students’ active engagement in learning

Effect of a ward-based outreach team and adherence game interventions on retention in care and virological suppression of HIV-infected patients newly initiated on antiretroviral treatment in Tshwane

Thesis (PhD (Family Medicine))--University of Pretoria, 2022.This PhD research project was conducted in Tshwane district of Gauteng province, South Africa. This project was subdivided into four different papers. First abstract The aim of this study was to understand potential benefits and barriers to delivering HIV care at the community level in Tshwane district and develop recommendations for improvement. Seven focus group discussions were conducted with 58 participants. While home-based human immunodeficiency virus (HIV) care was seen as a support strategy which could motivate patients to take their medication, the unpredictability of patients’ responses to HIV test results, incorrect addresses (driven by the need for identity documents), fear of stigma through association with ward-based primary health care outreach teams (WBPHCOTs), especially those in uniform, little or no preparation of patients for home-based care, and lack of confidentiality and trust were raised as potential barriers. Second abstract The aim of this study was to assess the acceptability of community-based HIV services offered by community health workers (CHWs). A survey was conducted in 10 clinics across Tshwane district, Gauteng, South Africa. CHWs conducted interviewer-administered standardised questionnaires with 674 adult participants. Overall, 95.5% of participants thought that home-based HIV care is a good initiative and rated screening for illnesses and referral to health facilities highly. Although the vast majority (>94%) were willing to disclose their status to health professionals in clinics, women were more willing to do so. However, only 53.6% of participants were willing to disclose their HIV status to a CHW from the same neighbourhood and 28.8% would find it problematic if CHWs visited them at home with branded cars. Third abstract This 2 x 2 factorial cohort study assessed the effect of two interventions - WBPHCOTs and an adherence game - on 12-month retention in care and virological suppression in participants newly initiated on ART. Clinics were randomized into four comparator arms: WBPHCOT; Game; WBPHCOT-Game in combination; and Control (standard of care). A total of 467 participants were included in the analysis: WBPHCOT (n=72); Games (n=126); WBPHCOT-Games (n=85); and Control (n=184). After 12 months, 340 participants (86.2%) remained in care. The Games group had the highest retention compared to the Control group (96.8% vs 77.8%; relative risk [RR] 1.25; 95% CI 1.13–1.38; p=0.01). While retention was better in the WBPHCOT-containing interventions than in the Control group, the differences were not statistically significant. Younger participants (<35 years) were significantly less likely to remain in care (71% vs 89%; RR 0.80; 95% CI 0.69 – 0.93; p=<0.001). The overall virological suppression rate was 75.3% and was similar across the four arms. Fourth abstract Following the reporting requirements of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, an aggregative narrative synthesis approach was used to summarize the results of qualitative studies published between 1 January 2000 and 6 November 2020. In total, 17 studies met the selection criteria and were included in the analysis. They reported on a range of roles played by CHWs in HIV care, including 1) Education: home visits; health education and promotion; 2) HIV-specific care: HIV testing services; screening for opportunistic infections and acute illness; medication delivery; tracing persons who had defaulted from care; and 3) Support: treatment support; referral; home-based care; and psychosocial support. Many different barriers to community-based HIV care were reported and centred on the following themes: 1) Stigma and non-disclosure: stigma; non-disclosure of HV status; concerns about confidentiality; 2) Inadequate support: lack of resources, inadequate training, lack of support, poor communication, inadequate funding, and inadequate monitoring; and 3) Health care system challenges: patient preference for more frequent visits, and poor integration. Most articles also provided a set of recommendations to mitigate these barriers, most notably: Professionalizing CHW programmes; intensifying health campaigns; strengthening CHW supervision, providing CHWs with the necessary equipment, and improving CHW attitudes. Conclusion The 2 x 2 factorial cohort study was the first to demonstrate that a physical adherence game improved the retention of people living with HIV (PLWHIV) newly initiated on ART and hence has the potential to improve treatment outcomes. In addition, home-based HIV care was largely accepted as an important and positive intervention. To successfully implement effective home-based HIV care in South Africa, it is important to address perceived barriers to such care and involve all stakeholders, from decision makers to CHWs and PLWHIV.South African Medical Research CouncilFamily MedicinePhD (Family Medicine)Unrestricte

Innovation through Cross-Fertilization: Serious games and gamification in the EU-funded research projects

[eng] In recent years, ecosystems of innovation have gained substantial momentum in academic research. As a response to recent calls in open innovation literature for novel research, this doctoral thesis extends the study of the process and ecosystems of innovation in projects that include serious games and gamification by considering the cross-fertilization of knowledge and technologies. Organizations’ orchestration of activities within their activity systems and transformation of their business models through innovation to realize opportunities with the objective to increase value creation are part of the topic of this dissertation. It has endeavoured to improve the understanding of how cross-fertilized alliances are formed, what their outcomes are, what causes them to generate value (or not) and what capabilities organizations need in order to successfully manage and reap value from the innovation process. For this purpose, two approaches that support innovation have been complementarily taken into account: the knowledge-technological perspective and the management perspective. These perspectives are analysed with the information retrieved from a database of 87 H2020 projects including serious games and/or gamification, 519 organizations and 597 observations. Later, in order to get more insights into the Innovation Management Strategies, a project coordinators survey was conducted. The Knowledge-Technology perspective presents how creating adequate multidisciplinary knowledge and technology is fundamental to ensuring the long-term success of an emerging technology including serious games and/or gamification, and how important is the research and innovation that takes place in the practitioners’ communities. The Management perspective presents the analysis of the innovation management strategies that boost the cross-fertilization of technologies that include serious games and/or gamification. These strategies were analysed by considering literature on innovation and network theories, absorptive capacity and dynamic capabilities. Some personal interviews were conducted with independent experts to understand and have elements for the analysis and discussion of the previous results. Findings suggest that the multidisciplinarity of a project is highly influenced by the creation of knowledge and technology. Furthermore, the management strategies boosting high levels of cross-fertilization of knowledge and technologies -including serious games and/or gamification- are principally market and customer-oriented strategies. Practical and methodological contributions from this study could enrich innovation literature from the point of view of technological and management approaches. The thesis concludes with fruitful avenues for future research.[nor] I de senere årene har økosystemer for innovasjon fått vesentlig fart i akademisk forskning. Nylig har det oppstått et større behov for mer forskning i området åpen innovasjon. Som et respons til dette, utvider denne avhandlingen seg på studier om prosesser og økosystemer av innovasjon i prosjekter. Prosjektene inkluderer seriøse spill og det som kalles for gamification. Målet er å vurdere kryss-befruktning av kunnskap og teknologi. En del av tema for denne avhandling er hvordan organisasjoner, gjennom innovasjon, virkeliggjør mulighetene for å øke verdiskapning. Dette vurderes ut ifra organisasjoners orkestrering av aktiviteter innenfor deres aktivitetssystemer og transformasjon av forretningsmodellene. Det har lenge vært forsøkt på å forbedre forståelsen av hvordan kryss-befruktet allianser dannes, hva er resultatene, hva skal til for å generere verdi (eller ikke), og hvilke evner organisasjoner trenger for å kunne forvalte og innhente verdier. På bakgrunn av dette, har to tilnærminger som støtter innovasjon, blitt komplementært tatt med i betraktningen. Disse er, den kunnskaps-teknologiske perspektiv og ledelses perspektivet. Perspektivene blir analysert med informasjon hentet fra en database med 87 H2020 prosjekter, inkludert seriøse spill og eller gamification. Det er totalt 519 organisasjoner og 597 observasjoner. I senere tid, for å få et større innblikk i strategier for innovasjonsledelse, ble det gjennomført en prosjekt koordinator undersøkelse. Det kunnskaps-teknologiske perspektivet innebærer hvordan en kan skape tilstrekkelig tverrfaglig kunnskap. Her er teknologi grunnleggende for å sikre langsiktig suksess til en fremtredende teknologi, som inkluderer seriøse spill og eller gamification, og viktigheten av forskningen og innovasjonen som fremkommer i utøvernes samfunn. På den andre siden, ledelses perspektivet inkluderer analysen av innovasjonsstrategier som har som mål å øke kryss-befruktning av teknologier som inkluderer seriøse spill og eller gamification. Strategiene ble analysert ved å vurdere innovasjon- og nettverks teorier, evnen til å absorbere, og dynamisk kapasitet litteratur. For å forstå og samle elementer for analysen og diskusjonen av tidligere resultater, bestemte personlige intervjuer ble gjennomført med uavhengige eksperter. Funnene viser at flerfaglighet av et prosjekt er sterkt påvirket av etablering av kunnskap og teknologi. Videre, ledelses strategier er med på å øke nivåer av kryss-befruktning av kunnskap og teknologi. Dette inkluderer seriøse spill og eller gamification, men hovedsakelig markeds- og kundeorienterte strategier. De praktiske og metodologiske bidrag fra denne studien er med på å berike innovasjons litteratur fra det teknologiske og det ledelsesmessig synspunkt. Avhandlingen avsluttes med fruktbare veier for fremtidig forskning.[cat] Al llarg dels darrers anys, els ecosistemes d’innovació han pres un impuls substancial en la recerca acadèmica. Com a resposta a les darreres crides a noves recerques en la literatura sobre innovació oberta, aquesta tesi doctoral amplia l’estudi del procés i els ecosistemes d’innovació en projectes que inclouen jocs seriosos i gamificació al considerar la fertilització creuada de coneixement i tecnologies. L’orquestració d’activitats per part de les organitzacions dins dels seus sistemes d’activitats i la transformació dels seus models comercials a través de la innovació per generar oportunitats amb l’objectiu d’augmentar la creació de valor són part dels temes d’aquesta tesi. Hi ha hagut un esforç per millorar la comprensió de com es formen aliances amb la fertilització creuada, quins són els seus resultats, què fa que generin valor (o no) i quines capacitats necessiten les organitzacions per gestionar i assolir valor a través del procés d’innovació. Amb aquest propòsit, dos enfocaments que recolzen la innovació s’han tingut en compte de manera complementària: la perspectiva coneixement-tecnologia i la perspectiva de gestió. Aquestes perspectives s’analitzen amb la informació obtinguda d’una base de dades de 87 projectes H2020 que inclouen jocs seriosos i/o gamificació, 519 organitzacions i 597 observacions. Posteriorment, amb l’objectiu d’obtenir informació addicional sobre les Estratègies de Gestió de la Innovació, es va realitzar una enquesta adreçada als coordinadors dels projectes. La perspectiva de Coneixement i Tecnologia mostra com la creació adequada de coneixement i tecnologia multidisciplinaris és fonamental per garantir l’èxit a llarg termini d’una tecnologia emergent, que inclogui els jocs seriosos i la gamificació, i com d’important és la recerca i la innovació que té lloc en les comunitats de professionals. La perspectiva de Gestió mostra l’anàlisi de les estratègies de gestió de la innovació que fomenten la fertilització creuada de tecnologies que inclouen jocs seriosos i/o gamificació. Aquestes estratègies es van analitzar a partir de la literatura en innovació i teories de xarxes, capacitat d’absorció i capacitats dinàmiques. També, es van dur a terme entrevistes personals amb experts independents per comprendre i tenir elements per a l’anàlisi i la discussió dels resultats anteriors. Els resultats suggereixen que la multidisciplinarietat d’un projecte està molt influenciada per la creació de coneixement i tecnologia. A més, les estratègies de gestió que impulsen els alts nivells de fertilització creuada de coneixement i tecnologies –inclosos els jocs seriosos i/o la gamificació- són principalment estratègies orientades al mercat i al client. Les contribucions pràctiques i metodològiques d’aquest estudi podrien enriquir la literatura sobre innovació des del punt de vista dels enfocaments tecnològics i de gestió. La tesi conclou amb suggeriments de línies de recerca futures.[spa] Durante los últimos años, los ecosistemas de innovación han tomado un impulso sustancial en la investigación académica. Como respuesta a las recientes llamadas a nuevas investigaciones en la literatura sobre innovación abierta, esta tesis doctoral amplía el estudio del proceso y los ecosistemas de innovación en proyectos que incluyen juegos serios y gamificación al considerar la fertilización cruzada de conocimiento y tecnologías. La orquestación de actividades por parte de las organizaciones dentro de sus sistemas de actividades y la transformación de sus modelos comerciales a través de la innovación para generar oportunidades con el objetivo de aumentar la creación de valor son parte de los temas de esta tesis. Ha habido un esfuerzo por mejorar la comprensión de cómo se forman alianzas con fertilización cruzada, cuáles son sus resultados, qué hace que generen valor (o no) y qué capacidades necesitan las organizaciones para gestionar y cosechar valor a través del proceso de innovación. Con este propósito, dos enfoques que apoyan la innovación se han tenido en cuenta de manera complementaria: la perspectiva conocimiento-tecnología y la perspectiva de gestión. Estas perspectivas se analizan con la información obtenida de una base de datos de 87 proyectos H2020 que incluyen juegos serios y/o gamificación, 519 organizaciones y 597 observaciones. Posteriormente, con el objetivo de obtener información adicional sobre las Estrategias de Gestión de la Innovación, se realizó una encuesta a los coordinadores de los proyectos. La perspectiva de Conocimiento y Tecnología muestra cómo la creación adecuada de conocimiento y tecnología multidisciplinarios es fundamental para garantizar el éxito a largo plazo de una tecnología emergente, que incluya los juegos serios y la gamificación, y cómo de importante es la investigación y la innovación en las comunidades de profesionales. La perspectiva de Gestión muestra el análisis de las estrategias de gestión de la innovación que fomentan la fertilización cruzada de tecnologías que incluyen juegos serios y/o gamificación. Estas estrategias se analizaron a partir de la literatura en innovación y teorías de redes, la capacidad de absorción y las capacidades dinámicas. También, se realizaron entrevistas personales con expertos independientes para comprender y tener elementos para el análisis y la discusión de los resultados anteriores. Los hallazgos sugieren que la multidisciplinariedad de un proyecto está muy influenciada por la creación de conocimiento y tecnología. Además, las estrategias de gestión que impulsan los altos niveles de fertilización cruzada de conocimientos y tecnologías -incluidos los juegos serios y/o la gamificación- son principalmente estrategias orientadas al mercado y al cliente. Las contribuciones prácticas y metodológicas de este estudio podrían enriquecer la literatura sobre innovación desde el punto de vista de los enfoques tecnológicos y de gestión. La tesis concluye con sugerencias de líneas de investigación futuras

Machine Medical Ethics

In medical settings, machines are in close proximity with human beings: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. Machines in these contexts are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for empathy and emotion detection necessary? What about consciousness? The essays in this collection by researchers from both humanities and science describe various theoretical and experimental approaches to adding medical ethics to a machine, what design features are necessary in order to achieve this, philosophical and practical questions concerning justice, rights, decision-making and responsibility, and accurately modeling essential physician-machine-patient relationships. This collection is the first book to address these 21st-century concerns