Peer versus staff tutoring in problem-based learning

Effects of student versus staff tutoring on student learning in a problem-based, health sciences curriculum were studied. Academic achievement of 334 tutorial groups guided by staff tutors was compared with achievement of 400 groups guided by student tutors. In addition, students rated their tutor''s performance on four behaviors considered critical to facilitating student learning. Overall, students guided by a staff tutor achieved somewhat better. In terms of practical significance, the difference was, however, fairly small. Staff tutors were rated as more knowledgeable and their contributions as more relevant. In addition, they asked stimulating questions to a larger extent. However, an interaction effect was found between the ratings and the year of study: Peer tutors displayed the supportive behaviors more extensively in the first year, whereas staff tutors'' ratings were higher as the curriculum advanced. These results were interpreted in terms of the cognitive congruence framework

Influence of tutors' subject-matter expertise on student effort and achievement in problem-based learning

Purpose. To investigate the effects of tutors' subject-matter expertise on students' levels of academic achievement and study effort in a problem-based health sciences curriculum. Also, to study differences in turors' behaviors and the influences of these differences on students' performances. Method. Data were analyzed from 336 staff-led tutorial groups involving student participants in seven four-year undergraduate programs at the University of Limburg Faculty of Health Sciences in 1989-90. Overall, 1,925 data records were studied, with each student participating in an average of 1.7 groups led by either content experts or non-experts. The basic analyses were of (1) students' achievement scores as a function of tutors' expertise levels and students' curriculum year; (2) students' estimates of self-study time as a function of tutors' expertise levels and students' curriculum year; and (3) the average ratings of the tutors' behaviors as a function of tutors' expertise levels. Statistical methods included analysis of variance and Pearson correlations. Results. The students guided by subject-matter experts were shown to spend more time on self-directed study, and they achieved somewhat better than did the students guided by non-expert tutors. The effect of subject-matter expertise on achievement was strongest in the first curriculum year, suggesting that novice students are more dependent on their tutors' expertise than are more advanced students. Also, the content-expert tutors made more extensive use of their subject-matter knowledge to guide students. However, in addition to the tutors' knowledge-related behaviors, the tutors' process-facilitation skills affected student achievement. Moreover, these two sets of behaviors were correlated, indicating that both are necessary conditions for effective tutoring. Conclusion. The results indicate that, at least for the curriculum studied, the assumption in the literature that tutors do not necessarily need content knowledge so long as they are skilled in the tutoring process is not entirely justified: the students who were guided by content experts achieved somewhat better and spent more time on self-directed learning. More important, tutoring skill and content knowledge seemed to be necessary and closely related conditions for effective tutoring

"Vertical Governance, National Regulation and Autonomy of Local Policy Making"

International audienceThis chapter introduces a categorization of the 11 European countries according to their general vertical governance structures between national, regional and local levels in welfare policy making. It investigates the extent to which, and how, local policies and service provision are regulated and controlled from the national state level, and how much space this leaves for local policy actors in welfare policy formation. The analysis takes into account that local welfare policies are formulated in the context of national and to some extent international policies. The 11 countries can be divided into three groups, having a centralized (England, Ireland), multi-level (Italy, Spain, France, Germany) or decentralized (Denmark, Finland, Estonia, Hungary, the Czech Republic) vertical governance system. More detailed analysis of different policy fields shows that vertical governance between territorial levels differs from one sector to another

Non-traumatic causes of perianal hemorrhage and excoriation in the young

© 2008 Springer. Part of Springer Science+Business MediaThe discovery at autopsy or at a death scene of fresh perianal hemorrhage and/or cutaneous excoriation in a young child is always of concern as this raises the possibility of inflicted injury. Three cases are reported where perianal bleeding and excoriation that were initially considered due to possible sexual assault were subsequently found to be of a non-suspicious nature. Case 1: A previously well 18-month-old boy was accidentally hanged. Fresh perianal hemorrhage that had raised the possibility of sexual assault was subsequently shown to be due to perineal streptococcal dermatitis. Case 2: A 2-year-old girl vomited and then stopped breathing. Fresh blood at the anus, that was also thought to be patulous, raised suspicions of sexual assault. At autopsy, however, bleeding around the normally configured anus was due to a midgut volvulus associated with intestinal malrotation. Case 3: A 21-month-old girl was found dead in her cot. Sexual abuse was suspected when lacerations were allegedly found around her anus. These were, however, due to skin lesions from her previously diagnosed ectodermal dysplasia clefting syndrome. Death was due to upper airway obstruction from acute and chronic inflammation. There was no evidence of anogenital trauma or sexual assault in any of the cases. Although inflicted traumatic causes of perianal hemorrhage and excoriation must be judiciously sought in the young, the current cases demonstrate that organic etiologies must also be considered. Perianal infections, congenital malformations of the mesentery and intestines, and inherited disorders of the skin may all produce findings that may initially suggest that sexual assault has occurred. Careful examination with appropriate photography and/or microbiological testing are required.Roger W. Byard, Terence G. Donald and Guy N. Rutt