"Face-to-Face" or Sim-to-Sim: Pros and cons regarding groupwork using a games based environment

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Tumor infiltration levels of CD3, Foxp3 (+) lymphocytes and CD68 macrophages at diagnosis predict 5-year disease-specific survival in patients with oropharynx squamous cell carcinoma

Head and neck cancer (HNC) is the sixth most common cancer worldwide. Oropharyngeal (OP) cancers are of special interest because of possible underlying HPV infection which is tied to prognosis. Influxes of inflammatory cells into tumors may vary with prognoses. We wanted to study whether the number of tumor-infiltrating lymphocytes (TIL) and tumor-associated macrophages (TAM) in tumors correlated to HPV status and predicted 5-year disease-specific survival (DSS). Formalin-fixed paraffin-embedded (FFPE) biopsies cut sections from 170 patients treated for OP cancer were stained by immunohistochemistry and evaluated for the number of CD68 (+) TAMs, CD3 (+), and Foxp3 (+) (T regulatory) TILs. From FFPE slides HPV by PCR and p16 by immunohistochemistry were established. From FFPE Hematoxylin-Eosin slides, levels of tumor nuclear polymorphism, tumor invasion, desmoplasia, and inflammation were determined as previously published. Levels of TIL CD3 (+) and TIL Foxp3 (+) were increased among the HPV (+) compared to the HPV (−) patients. High levels of TIL Foxp3 (+) and CD68 (+) macrophages predicted better 5-year DSS. TIL Foxp3 (+) levels predicted independent of age, gender, TNM stage, and HPV infection as well as level of stromal desmoplasia, tumor invasion, and nuclear polymorphism, but more pronounced among tumor HPV (+) than HPV (−) patients.publishedVersio

Tumor HPV status, level of regulatory T cells and macrophage infiltration predict up to 20-year non-disease-specific survival in oropharynx squamous cell carcinoma patients

Oropharynx squamous cell carcinoma (OPSCC) is of special interest because human papilloma virus (HPV) and/or smoking cause this disease. Influxes of inflammatory cells into such tumors are known to vary with prognoses. Aims: To study whether the density of tumor-infiltrating T lymphocytes and tumor-infiltrating macrophages predicted general 20-year overall survival (OS), as well as OS with only disease-specific survival (DSS) patients included. Methods: Biopsies from patients treated for OPSCC (n = 180) were stained by immunohistochemistry and the tumor cell macrophage (CD68), pan T lymphocytes (CD3), and regulatory T lymphocytes (Foxp3) densities were determined. The HE-determined percentage of matured tumor cells and the rate of invasion were calculated, and stromal desmoplasia were performed. Tumor HPV presence was studied by PCR. Twenty-year OS and five-year DSS patients were determined. Results: Tumor HPV status strongly predicted survival. High tumor infiltration of CD3, Foxp3 and CD68-positive cells predicted better twenty-year OS, with and without HPV stratification. Foxp3 and CD68 levels predicted OS, and 20-year among DSS patients, primarily among HPV(+) patients. Tumor HE-derived variables did not predict such survival. Conclusions: Tumor HPV status, level of Foxp3 tumor-infiltrating lymphocytes and CD68 tumor-infiltrating macrophages predicted up to 20-year OS of both all patients and disease-specific survived patients.publishedVersio

Blended learning: How to combine different ways to interact online

Adult students need to be activated and engaged to optimize a learning process (Knowles 1984, Rogers 2007). In online learning, it is challenging to obtain engagement and interactivity, even when combining asynchronous and synchronous communication. At The Inland Norway University of Applied Sciences, different takes on creating activity and engagement have been tried out. Projects using mandatory on-campus seminars, different types of media and live tutoring have shown that there is a need for blended learning. This paper present different ways of utilizing both on-campus and online teaching. Our approach to collecting data is a combination of qualitative and quantitative research. We have observed and interviewed students, and on a particular group of students that both have online and on-campus lectures, we have collected data from a survey. Our respondents have been both students and lecturers. Our theoretical backdrop rests mainly on theory on blended learning approaches, adult learning and theory on co-creation of consumer value. Findings and results are a combination of Lervik’s PhD work and Vold’s PhD work. Preliminary results points towards a combination of online and on-campus teaching is preferred and provide an optimized learning outcome. Some students, e.g. full time employees, prefer the blend of online and fewer on-campus seminars as this provide them with the opportunity of studying whilst keeping a full time job. It also allow them to stay at home – most of the time – and not move in order to study. Some students may also have a family situation that makes going away to attend classes e.g. every week is difficult. Our results also show that to start the semesters with an introductory seminar that requires attendance provide the students and teachers with the possibility of being acquainted. This enables the development of trust that lay the ground for involvement and engagement, and also boosts communication between peers (students) and between student – teacher. Lowering the threshold for contacting fellow students allows colloquial groups or “communities” to form easier that for students that only have Access to online learning. Learning from peers is important for the total learning outcome. Different learning styles also require different approaches. A blend of different learning approaches will thus support the individuals learning outcome.publishedVersio

How Can User Generated Content in Games Foster Enhanced Learning Outcome

Games used for learning purposes, also called «serious games» have been a focus for research for several years. However, the content is either developed by pedagogues or game designers. This paper is investigating if using a «dewanian» take on the content development can enhance the learning outcome. Assuming, like in a Socratic dialogue, that the answers lie within the learners themselves, there is no reason as to why the content, or to be more precise; the scenarios, could be developed by the learners. Given a game environment, like a city, a port, or other geographical representation, what is happening there can be based on the learners input. In this way it is also possible for faculty staff to keep on track with the students perception of relevance to a present or future worklife. At The Inland University of Applied Sciences, Campus Rena, we have tested out making the students come up with scenarios depicting different crisis scenarios. These scenarios are then given to the game master for the game environment and played. The class that has tested this, were divided in two groups. Most of the students, though not all, have a background within crisis management, and all attend the 6th semester of their BA in Crisis Management study. Both groups handed in a scenario to the game master. The game master developed the scenario in the game environment and then the group that «owned» the scenario was playing out different issues. The other group were the responding units. When both groups’ scenarios were played, the groups met for an «after action review». The preliminary results show that this increased the realism in the gaming sessions. The paper will present an in-depth presentation of the course layout, and a complete review of the feedback from the students. The data is mainly qualitative and are based on observations and interviews with the students. Using games this way was indeed a ludic way of learning more about crisis. There were some issues that needed to be addressed, like the communication devices, but the total impression were positive. To be able to contribute with a scenario they had built on their own, they also found to be supportive of their learning process.publishedVersio

Flipped Gaming - testing three simulation games

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Flipped Gaming: The Teachers Role When Using the Students as Content Providers

In order to activate students and make them active contributors in a class, the concept of “Flipped Classroom” has been used at several Universities, also at The Inland University of Applied Sciences Norway. Flipping the classroom and making the students contribute, and being active, has supported the students learning outcome. Generally, when using games for learning, the game scenario is either decided by the lecturer/teacher, or defined by the designers and/or producers of the game used. In this paper we will explore how the teachers/lecturers role changes when the scenarios to be played in the game environment are defined and developed by the students themselves. The methodological approach is mainly qualitative and the data are observations from gaming sessions, minutes from review processes and interviews with faculty staff responsible for the course. The paper will present how the lecturer/teacher changes role from being the center of attention and the provider of knowledge, to a facilitator that both empower the students and enables the students to contribute towards developing increased understanding and enhanced learning outcome. By enabling the students to contribute in such a way, the support towards the reflection processes described by Donald Schön in his work “The reflective practitioner” from 1991, is being supported in all stages. The reflection before action is when they discuss and agree on scenario, they need to reflect in action upon action, and they need to reflect on action when finished gaming. These reflection processes need to be facilitated in order to support the learning process and when flipping the gaming, this is one of the roles of the facilitator; the lecturer/teacher. The paper will present a project called “Seed corn 2017 – Pedagogical Use of Games in Crisis Management Education”, using a course at The Inland Norway University of Applied Sciences, Campus Rena, Norway, and the results from the research.publishedVersio

I miss my Office in my home Office: Challenges with work from home

The COVID-19 pandemic has sent many employees to home offices. Some employees enjoy their home office, while for various reasons others experience challenges working from home. Qualitative investigations show that new employees who have been recruited and hired during the COVID-19 pandemic can find life in the home office quite challenging. Despite adequate technological solutions that make it possible to perform the work tasks from home, these employees want to be able to physically attend at their workplace. Our data indicate that it is important that the company not only sees technology and digitalization as "hard core" skills, but that the digital and technological are woven into other aspects of organizational life, for example, structures, culture, and social interaction. New employees need to feel that they are valued, and that the business wants to establish personal and social bonds that support the development of loyalty to the company and quality of the production. These are conditions that are often tied to informal learning in the workplace. Relational development and maintenance are vital for having newcomers to not only function in the digital arena, but also within the physical sphere at the workplace.publishedVersio

The New Normal Worklife: Lessons from the Pandemic

COVID-19 has contributed to a digitalization of communication, and in many cases to a distribution of an organization's workforce. Several organizations in Norway claim that they will adapt to a more flexible approach regarding allowing work from home (WFH) in a post-COVID-19 worklife and allow a more “hybrid” way of working. This paper describes how the long-term crisis has unfolded in a large governmental organization. The focus for the investigations have been on how the employees have experienced working from home, and how this will impact their post-COVID-19 worklife, all with a Knowledge Management (KM) perspective. Through qualitative interviews with managers’ and employees’ issues, like a lack of possibilities regarding informal communication and sharing of knowledge, have arisen. This implies that there is a need for addressing KM practices that secure a flow of information, learning conditions and job satisfaction in the post-COVID-19 workday.publishedVersio