559 research outputs found
Attitudes towards, and patterns of use, of published research evidence in clinical decision making amongst intensive care clinicians.
An evidence-practice gap is defined as the difference between what we know from the best available research evidence and what actually happens in current practice. The highly respected ARDSNet low-tidal-volume ventilation trial was published in 2000, however, in 2016 an observational study conducted in over 50 countries documented that up to one third of eligible patients failed to receive the ARDSNet low-tidal-volume ventilation strategy. In this thesis, we undertook a sequence of studies to better understand research evidence use in intensive care, with the intention of developing a tool that may help close evidence-practice gaps. To better understand research evidence use, we conducted a self-administered mail-out survey of intensive care specialists in Australia and New Zealand, and a self-administered online survey of a multinational group of intensive care clinicians. Based on knowledge gained from these surveys, we developed a concise evidence summary tool designed to overcome 27 explicit barriers to the use of research evidence. To evaluate the evidence summary tool, we developed a clinical case-based scenario. Ninety-three multinational intensive care clinicians were invited to review the casebased scenario and then read the evidence summary tool. Reading the evidence summary tool led to a significant increase in the belief that the intervention described in the tool would benefit the realistic patient in our case-based scenario (mean score change 0.32, 95% CI 0.19 to 0.46, P<0.001). Interestingly, the group most influenced by the evidence summary tool were those who appeared to be less up to date. Whilst it is not known whether this success in increasing intensive care clinicians’ belief in the benefit of a treatment would translate into a change in clinical practice behaviours, these promising results clearly indicate a need for further investigation into the use of evidence summary tools as an intervention to help close evidence-practice gaps
Prevalence of antibodies anti-bartonella henselae in western sicily: children, blood donors, and cats.
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A Case Study of a School Science Department: A Site for Workplace Learning?
This descriptive and illuminative case study of one science department in a successful, urban, secondary school in the south of England considers the science department as a site of workplace learning and the experience of beginning teachers in this context. Policy change in initial teacher training (ITT) has given schools a major role in the recruitment of trainees and emphasized the schools’ role in their training. Additionally, there continue to be significant challenges to recruit science specialist teachers despite substantial bursaries.
For the purposes of this study, a community of practice of those involved with ITT and beginning teachers was defined: this included six teachers, three beginning teachers, one technician and the University tutor from the higher education institution. Interviews, focus groups, and mentor meetings, field observation notes and scrutiny of relevant documents were used to construct a rich description of the sociocultural milieu.
Two interpretivist approaches were used: an inductive phenomenological study of the lived experiences and a deductive approach using a conceptual framework developed from theories of workplace learning.
Findings show that there is considerable tension in the mentor’s professional life; the role and the learning needs of the mentors were poorly understood; the ‘community of practice – Beginning teachers’ was not as originally perceived because the mentors were not engaged in a joint endeavour; the perceived value of accountability measures for ITT, Ofsted and performativity measures affected the learning environment for the beginning teachers and there is a dissonance between the values and practices of the workplace learning culture. This has been explored through the lenses of balkanization (Hargreaves and Macmillan, 1992), addictive presentism (Hargreaves, 2010) and Hodkinson and Hodkinson’s model of an expansive/restrictive workplace for teachers (2005).
This study may be of interest to those in teacher education and involved with recruitment and retention of science teachers
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