Online vs. face-to-face discussions in a web-based research methods course for postgraduate nursing students : A quasi-experimental study

Background: Web-based technologies are increasingly being used to create modes of online learning for nurses but their effect has not been assessed in nurse education. Objectives: Assess whether participation in face-to-face discussion seminars or online asynchronous discussion groups had different effects on educational attainment in a webbased course. Design: Non-randomised or quasi-experimental design with two groups – students choosing to have face-to-face discussion seminars and students choosing to have online discussions. Setting: The Core Methods module of a postgraduate research methods course. Participants: All 114 students participating in the first 2 years during which the course teaching material was delivered online. Outcome: Assignment mark for Core Methods course module. Methods: Background details of the students, their choices of modules and assignment marks were collected as part of the routine course administration. Students’ online activities were identified using the student tracking facility within WebCT. Regression models were fitted to explore the association between available explanatory variables and assignment mark. Results: Students choosing online discussions had a higher Core Methods assignment mark (mean 60.8/100) than students choosing face-to-face discussions (54.4); the difference was statistically significant (t = 3.13, df = 102, p = 0.002), although this ignores confounding variables. Among online discussion students, assignment mark was significantly correlated with the numbers of discussion messages read (Kendall’s taub = 0.22, p = 0.050) and posted (Kendall’s taub = 0.27, p = 0.017); among face-to-face discussion students, it was significantly associated with the number of non-discussion hits in WebCT (Kendall’s taub = 0.19, p = 0.036). In regression analysis, choice of discussion method, whether an MPhil/PhD student, number of non-discussion hits in WebCT, number of online discussion messages read and number posted were associated with assignment mark at the 5% level of significance when taken singly; in combination, only whether an MPhil/PhD student (p = 0.024) and number of non-discussion hits (p = 0.045) retained significance. Conclusions: This study demonstrates that a research methods course can be delivered to postgraduate healthcare students at least as successfully by an entirely online method in which students participate in online discussion as by a blended method in which students accessing web-based teaching material attend face-to-face seminar discussions. Increased online activity was associated with higher assignment marks. The study highlights new opportunities for educational research that arise from the use of virtual learning environments that routinely record the activities of learners and tutors

The Digital Revolution in Qualitative Research: Working with Digital Audio Data Through Atlas.Ti

Modern versions of Computer Assisted Qualitative Data Analysis Software (CAQDAS) are enabling the analysis of audio sound files instead of relying solely on text-based analysis. Along with other developments in computer technologies such as the proliferation of digital recording devices and the potential for using streamed media in online academic publication, this innovation is increasing the possibilities of systematically using media-rich, naturalistic data in place of transcribed 'de-naturalised' forms. This paper reports on a project assessing online learning materials that used Atlas.ti software to analyse sound files, and it describes the problems faced in gathering, analysing and using this data for report writing. It concludes that there are still serious barriers to the full and effective integration of audio data into qualitative research: the absence of 'industry standard' recording technology, the underdevelopment of audio interfaces in Atlas.ti (as a key CAQDAS package), and the conventional approach to data use in many online publication formats all place serious restrictions on the integrated use of this data. Nonetheless, it is argued here that there are clear benefits in pushing for resolutions to these problems as the use of this naturalistic data through digital formats may help qualitative researchers to overcome some long-standing methodological issues: in particular, the ability to overcome the reliance on data transcription rather than 'natural' data, and the possibility of implementing research reports that facilitate a more transparent use of 'reusable' data, are both real possibilities when using these digital technologies, which could substantially change the shape of qualitative research practice.CAQDAS, Recording Technology, Online Publication

Clinic consultations with children and parents on the dietary management of cystic fibrosis

The aim of this paper is to examine clinic consultations on the dietary management of cystic fibrosis with particular consideration to the role of children.  The role of parents is also examined to determine how their involvement impacts on the role of children during consultations. The data are drawn from interviews with 32 Irish school aged children with cystic fibrosis and their parents, and participant observations during clinic consultations with a sub-group of 21 children. Data were analysed concurrently with data collection using a method of constant comparison, which involved comparing and contrasting incidents in the data to develop themes. Theoretical sampling was used to further explore and develop emergent themes. Discourse analysis was applied to clinic conversations. Children were seen to have little active involvement during consultations leaving them marginalised as conversations were directed at parents primarily and their accounts were privileged over those of children. A surveillance approach to consultations  involving interrogative style questioning and generally closed conversations  was seen to contribute to the marginalised position of children. In addition, dietary advice limited children s involvement because it was of little relevance to children s understandings of being healthy and to the dietary implications of these. The findings highlight a need to acknowledge children as active participants in their dietary care. Implications for developing a child-centred approach to dietary consultations are discussed including implications for working with children towards improved health outcomes of managing CF diet.  

Living with childhood asthma: parental perceptions of risk in the household environment and strategies for coping

Aim To explore parents’ perceptions of environmental household risks to their child’s asthma and to identify the strategies they adopt in relation to these perceived risks. Background The prevalence of childhood asthma is increasing worldwide and especially in the UK. Asthma is more common in areas of socio-economic disadvantage. Household environmental factors have been implicated in some of this increase. A number of factors in the home environment have been found to act as triggers to asthma symptoms, including high humidity levels, poor ventilation, mould, second-hand tobacco smoke and pet allergens. Little is known about how parents, as the main care-givers and decision makers in the home, perceive and cope with the risks posed by these triggers. Methods Semi-structured interviews were conducted with a purposive sample of parents of 32 children with asthma aged 4 to 16 years and living in a socio-economically disadvantaged urban community in the North East of England. Interviews were audiotaped, transcribed verbatim and analysed using constant comparison techniques. Findings All parents were aware of some of the risks their children faced at home. Some appeared to know more than others and coping styles varied. A typology of three groups of parents was identified: those who actively seek advice and adopt clear preventative strategies (preventers); those who minimize the risks and only react when things go wrong (reactors); and those who engage in compensatory activities in an attempt to trade-off between harms and benefits (compensators). The unifying themes underpinning these different styles are that all parents are motivated to maintain normal family life but that they adopt different strategies to achieve this

Integrating community children’s nursing in urgent and emergency care: a qualitative comparison of two teams in North West England

Background: Despite the policy principle that "children are best cared for at home whenever possible" children continue to have high rates of emergency department (ED) attendance andemergency hospital admission. Community Children's Nursing Teams(CCNTs) can care for acutely ill children at home but their potential to provide an alternative to ED attendance and hospitalisation depends on effective integration with other services in the urgent care system, such as EDs and Observation and Assessment Units (OAUs). Although challenges of integrating CCNTs have been identified, there has been no comparative assessment of the factors that facilitate or hinder integration of care of acutely ill children by CCNTs with the urgent care system. The aim of this study was to identify enablers and barriers to integration of CCNTs with urgent and emergency care. Methods: Comparative case studies were conducted of two CCNTs serving Primary Care Trusts in North West England. Twenty-two health professionals including CCNT managers and staff; paediatricians; nurses; children's ward, ED and OAU staff; commissioners of children's services; GPs and primary care staff were interviewed between June 2009 and February 2010. Qualitative data were analysed thematically using the Framework approach. Results: Barriers to integration included paediatricians' perceived lack of ownership of the CCNT, poor communication between consultants and community children's nurses (CCNs), and weak personal relationships. This prevented early referral to the CCNT as an alternative to hospital care. Enablers of integration included co-location and rotation of CCNs through urgent care settings including OAUs and EDs. This enabled nurses to develop skills, make decisions about referral to home care and gain the confidence of referring clinicians. Conclusions: Integration of CCNTs at multiple points in the urgent care system is required in order to provide an alternative to inappropriate ED attendances and emergency admission. The principal enablers and barriers are both aspects of normative integration, which involves shared understanding of the contribution of CCNTs and trusting relationships between practitioners. Co-location and rotation of CCNs through acute services can promote integration and appropriate referrals to CCNTs to support families to care for children at home

Parental migration, intergenerational obligations and the paradox for left-behind boys in rural China

Drawing on in-depth interviews with caregivers of left-behind children (LBC) in rural China, this article seeks to explore their understanding of migration motives and the social process of taking on care-giving roles for LBC. The authors argue that there are underlying socio-cultural explanations pertaining to economic motives for migration; such as, making contributions to social events (weddings and funerals) in village life, and fulfilling social obligations for left-behind sons’ futures. Parents migrate to save for sons’, but not daughters’, adult lives. Grandparents, particularly on the paternal side, are expected to fulfil social obligations to care for left-behind grandchildren, even without immediate financial returns. These suggest that left-behind boys, and in particular boys cared for by paternal grandparents, may be at greater risk than other LBC, as they may receive even fewer resources in the form of remittances from migrant parents in their early childhood

Communication with young people in paediatric and adult endocrine consultations: an intervention development and feasibility study

Background: Communication is complex in endocrine care, particularly during transition from paediatric to adult services. The aims of this study were to examine the feasibility of interventions to support young people to interact with clinicians. Methods: Development and evaluation of a complex intervention in 2 phases: Pre-intervention observational study; Intervention feasibility study. Purposive sample of recordings of 62 consultations with 58 young people aged 11-25 years with long-term endocrine conditions in two paediatric and two adult endocrine clinics. Proportion of time talked during consultations, number and direction of questions asked; Paediatric Consultation Assessment Tool (PCAT); OPTION shared decision making tool; Medical Information Satisfaction Scale (MISS- 21). Young people were invited to use one or more of: a prompt sheet to help them influence consultation agendas and raise questions; a summary sheet to record key information; and the www.explain.me.uk website. Results: Nearly two thirds of young people (63%) chose to use at least one communication intervention. Higher ratings for two PCAT items (95% CI 0.0 to 1.1 and 0.1 to 1.7) suggest interventions can support consultation skills. A higher proportion of accompanying persons (83%) than young people (64%) directed questions to clinicians. The proportion of young people asking questions was higher (84%) in the intervention phase than in the observation phase (71%). Conclusions: Interventions were acceptable and feasible. The Intervention phase was associated with YP asking more questions, which implies that the availability of interventions could promote interactivity

Letter, Addressed to Anabel and Frank Baxter from Phillip and James Callery, September 4, 1939

A letter written by Phillip and James Callery sent to Anabel and Frank Baxter on September 4, 1939 asking how they are doing and informing them that there is an upcoming war