Adult Learners' Motivation in Self-Directed e-Learning

Thesis (PhD) - Indiana University, School of Education, 2005As with traditional instruction, learner motivation is important in designing effective e-learning courses. However, lack of motivation has been a major concern in theory and practice for facilitating successful online learning environments. A review of literature indicated that there is little empirical knowledge on how to motivate online learners, particularly in self-directed e-learning settings (SDEL). Research questions addressed in this study included: 1) what motivates or inhibits adult learning in SDEL? 2) does adult learner motivation change as he or she goes through SDEL? 3) what factors are related to motivational change during SDEL? This study used mixed methods. A content analysis was conducted on three SDEL courses in order to better understand the learning context. Twelve qualitative interviews of typical learners were conducted to identify major motivational factors. Analysis of these interview results led to construction of a 60-item Web survey of adult learners who had taken one or more SDEL courses (n = 368). Approximately 60 percent of the respondents were from corporate settings and 40 percent from higher education. A factor analysis of 33 survey items led to identification of three strong factors: 'e-learning is not for me'; 'e-learning is right for me'; and 'I don't want to be all by myself'. Results from both qualitative and quantitative analyses indicated that learners started SDEL for personal or professional development, and that they chose the online training option because of its flexibility and convenience. Both qualitative and quantitative results suggested that lack of motivational quality in the e-learning course was a key factor for some learners who decided not to complete the course, followed by lack of time. A stepwise multiple regression analysis resulted in five factors that significantly contributed to predicting the learner's reported motivational change: 1) E-learning is right for me; 2) satisfaction with their learning experience; 3) interactivity with an instructor or technical support personnel; 4) age (negative relationship); and 5) learning setting (corporate more than higher education). Implications of findings from this study are discussed for design of self-directed e-learning environments that may help increase or sustain learner motivation

Enhancing students’ active learning and self-efficacy using mobile technology in medical English classes

Purpose This study investigated student experiences of mobile technology in a medical English course using a free mobile classroom application, Socrative and its impact on student learning to help them achieve the competency expected in the course. Methods Questionnaires were administered of year 2 medical students enrolled in a medical English course between 2016 and 2017 to investigate their experience in using Socrative. Learning outcomes were assessed by comparing students’ academic performance with that of the 2015 cohort, who had taken the same course without using mobile technology, and also by measuring changes in their self-efficacy in English over time during the course. Results This study found students’ positive perceptions of and overall satisfaction with their experience in using mobile technology in the medical English course. There were no differences in the academic performance between the study cohort and the comparison group. The ratio of students who were in the remediation program after the mid-term examination was 11%, whereas the remediation ratio of the 2015 cohort was 21%. Students’ self-efficacy in English improved significantly in the writing and reading domains (p<0.05). Conclusion This study found several benefits of using Socrative in the medical English course. Socrative fostered the classroom interaction by encouraging input from every student and sharing it instantly with the whole class. There was also learning improvement with the use of Socrative. Furthermore, it has the potential to enhance assessment by offering more various forms of assessment than that of conventional audience response systems

Designing Personalized Online Learning Environments for Adult Learners

2002Customizing instruction to meet individual needs is one of the foundational cornerstones of today's learner-centered paradigms. Adult learners have a wide range of differences in their backgrounds, interests, abilities, and learning styles; instruction, therefore, needs to be designed in such a way as to meet the highly diverse needs of adult education settings. The World Wide Web presents enormous potential for providing a technological environment for the optimal delivery of personalized instruction for individual learners. It is argued, however, that existing Web-based instruction fails to effectively customize instructions for individual learners. Therefore, we are in need of an ongoing refinement and creativity in our generation and treatment of theories of instruction geared towards the generation of personalized learning environments. Here, the attempt is made to develop an instructional-design theory for personalized online learning for online adult learners, with a special focus on the question of solving ill-structured problems. Theory, on a general level, is discussed insofar as it has emerged from the goals, preconditions, and underlying values, with an eye to the methods of instruction that are optimal for achieving the goals. The methods of instruction in this instructional-design theory are composed of four major components (goal-setting activities, engaging in the learning task, performing the task, and reviewing and reflecting upon the output of the task), with some corollaries detailing each major component. These methods incorporate the use of such Web technology as the learner management system, the learning objects system, and pedagogical agents to foster personalized learning process in online learning environments

Relationships between 24-Hour Blood Pressures, Subcortical Ischemic Lesions, and Cognitive Impairment

Background and Purpose The most important treatment for subcortical vascular dementia (SVaD) is controlling the blood pressure (BP). However, the few studies that have investigated the relationships between diurnal BP rhythm and subcortical ischemic vascular cognitive impairment have produced inconclusive results. In the study presented here, the 24-hour BP values of three groups of subjects-patients with subcortical vascular mild cognitive impairment (SvMCI), patients with SVaD, and normal controls-were compared using working criteria and 24-hour ambulatory BP (ABP) monitoring. Methods The subjects (42 patients with SVaD, 37 patients with SvMCI, and 30 controls) were selected according to the Study`s inclusion/exclusion criteria. All subjects underwent brain magnetic resonance (MR) imaging and MR angiography, detailed neuropsychological testing, and 24-hour ABP monitoring. Results The prevalence of nondippers differed markedly between the control group and both the SVaD and SvMCI groups. Loss of nocturnal dipping was significantly associated with SVaD [odds ratio (OR), 4.827; 95% confidence interval (CI), 1.07-12.05]. Conclusions It was found that SVaD is associated with loss of nocturnal BP dipping combined with increased pulse pressure and systolic BP (SBP) variability. Correction of these factors could therefore be important in the prevention of SVaD, independent of measures used to reduce BP. J Clin Neurol 2009;5:139-145Ohmine T, 2008, HYPERTENS RES, V31, P75van Boxtel MPJ, 2006, J HUM HYPERTENS, V20, P5, DOI 10.1038/sj.jhh.1001934van der Flier WM, 2005, STROKE, V36, P2116Birns J, 2005, STROKE, V36, P1308, DOI 10.1161/01.STR.0000165901.38039.5fYamamoto Y, 2005, CEREBROVASC DIS, V19, P302, DOI 10.1159/000084498BOWLER JV, 2005, J NEUROL NEUROSUR S5, V76, P35KU HM, 2004, J KOREAN NEUROPSYCHI, V43, P189O`Brien E, 2003, J HYPERTENS, V21, P821, DOI 10.1097/01.hjh.0000059016.82022.caKANG Y, 2003, INCHEON HUMAN BRAINOhkubo T, 2002, J HYPERTENS, V20, P2183de Leeuw FE, 2002, BRAIN, V125, P765O`Brien JT, 2002, ANN NY ACAD SCI, V977, P436Kario K, 2001, HYPERTENSION, V38, P852Wahlund LO, 2001, STROKE, V32, P1318Dufouil C, 2001, NEUROLOGY, V56, P921Puisieux F, 2001, EUR NEUROL, V46, P115Staessen JA, 1999, JAMA-J AM MED ASSOC, V282, P539Swan GE, 1998, NEUROLOGY, V51, P986Blacher J, 1998, HYPERTENSION, V32, P570Cummings JL, 1998, J PSYCHOSOM RES, V44, P627Kilander L, 1998, HYPERTENSION, V31, P780Guo ZC, 1997, AM J EPIDEMIOL, V145, P1106Liao DP, 1996, STROKE, V27, P2262LAUNER LJ, 1995, JAMA-J AM MED ASSOC, V274, P1846YAMAMOTO Y, 1995, STROKE, V26, P829VERDECCHIA P, 1994, HYPERTENSION, V24, P793KUUSISTO J, 1993, HYPERTENSION, V22, P771SHIMADA K, 1992, J HYPERTENS, V10, P875SCHERR PA, 1991, AM J EPIDEMIOL, V134, P1303TOHGI H, 1991, STROKE, V22, P603OBRIEN E, 1988, LANCET, V2, P397PARATI G, 1987, J HYPERTENS, V5, P93HACHINSKI VC, 1975, ARCH NEUROL-CHICAGO, V32, P632

Relation between Obesity and Bone Mineral Density and Vertebral Fractures in Korean Postmenopausal Women

PURPOSE: The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. MATERIALS AND METHODS: A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. RESULTS: After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p < 0.001) whereas body weight was still positively related to BMD of all sites (p < 0.001). Percentage body fat and waist circumference were much higher in the fracture group than the non-fracture group (p = 0.0383, 0.082 respectively). Serum glucose levels were positively correlated to lumbar BMD (p = 0.016), femoral neck BMD (p = 0.0335), and femoral trochanter BMD (p = 0.0082). Serum high density lipoprotein cholesterol (HDLC) was positively related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). CONCLUSION: In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fractureope

Association between cardiorespiratory fitness and the prevalence of metabolic syndrome among Korean adults: a cross sectional study

BACKGROUND: The purpose of the current study was to investigate the association between cardiorespiratory fitness (CRF), measured by a simple step test, and the prevalence of metabolic syndrome among Korean adults, in a cross sectional design. METHODS: A total of 1,007 Korean adults (488 men and 519 women) who underwent routine health checkups were recruited. CRF was measured by Tecumseh step test. The National Cholesterol Education Program’s Adult Treatment Panel III guideline was used to determine the prevalence of metabolic syndrome. A logistic regression was performed to reveal possible associations. RESULTS: The results of the study showed that a lower level of CRF was significantly associated with a higher prevalence of metabolic syndrome in men, but not in women. On the other hand, higher BMI was associated with a higher prevalence of metabolic syndrome in both men and women. However, BMI was not associated with fasting glucose nor hemoglobinA1c in men. When the combined impact of BMI and CRF on the prevalence of metabolic syndrome was analyzed, a significantly increased prevalence of metabolic syndrome was found in both men (odds ratio [OR]: 18.8, 95% Confidence Interval [CI]: 5.0 - 70.5) and women (OR: 8.1, 95% CI: 2.8 - 23.9) who had high BMI and low cardiorespiratory fitness. On the other hand, the prevalence of metabolic syndrome was only increased 7.9 times (95% CI: 2.0 - 31.2) in men and 5.4 times (95% CI: 1.9 - 15.9) in women who had high level of CRF and high BMI. CONCLUSION: In conclusion, the current study demonstrated the low CRF and obesity was a predictor for metabolic syndrome in Korean adults

Analysis of reports on orphan lung diseases in Korean children

PurposeOrphan lung diseases are defined as lung diseases with a prevalence of 1 or less in 2,000 individuals. Despite an increase in the numbers of patients with such diseases, few studies on Korean children have appeared. To obtain epidemiologic and demographic data on these diseases, we systematically reviewed reports on pediatric orphan lung diseases in Korea over the last 50 years.MethodsWe reviewed 223 articles that have appeared since 1958 on orphan lung diseases in Korean children. These articles described a total of 519 patients aged between 0 and 18 years. We classified patients by year of publication, diagnosis, geographic region, and journal.ResultsOf 519 patients, 401 had congenital cystic lung diseases and 66 had bronchiolitis obliterans. About 80% of patients were described in reports published in three journals, Pediatric Allergy and Respiratory Disease (Korea), the Korean Journal of Pediatrics, and the Korean Journal of Thoracic and Cardiovascular Surgery, in which papers on 157 (30.2%), 138 (26.6%), and 111 (21.4%) patients appeared, respectively. The frequency of publication of case reports has increased since 1990. Of the 519 patients, 401 (77.3%) were from Seoul/Gyeonggi-do and 72 (13.9%) from Busan/Gyeongsangnam-do.ConclusionThe prevalence of pediatric orphan lung disease has increased since 1990, and some provinces of Korea have a higher incidence of these diseases than do others. Studies exploring the incidence of pediatric orphan lung diseases in Korea are needed for effective disease management

A pilot study comparing three bend angles for lighted stylet intubation

Background For successful lighted stylet intubation, bending the lighted stylet with an appropriate angle is a prerequisite. The purpose of this study was to compare three different bend angles of 70, 80, and 90 degrees for lighted stylet intubation. Methods The patient trachea was intubated with a lighted stylet bent at 70, 80, or 90 degrees according to the randomly allocated groups (group I, II, and III, respectively). A lighted stylet combined with a tracheal tube was prepared with a bend angle of 70, 80, or 90 degrees according to the assigned group. We checked the success rate at the first attempt and overall success rate for the two attempts. Additionally, we measured search time, which was time from insertion of the bent union into the patient mouth to the start of advancing the tracheal tube while separating it from the lighted stylet, and evaluated postoperative sore throat (POST) at 2, 4, and 24 h after the recovery from anesthesia. Results There was no statistically significant difference between group I, II, and III for success rate at first attempt (73.9 %, 88.2 %, and 94.7 %, respectively, p = 0.178), even though there was a trend of increasing success rate with increasing bend angles. For overall success rate, there was similar result to that in the first attempt between the groups I, II, and III (82.6 %, 94.1 %, and 100 %, respectively, p = 0.141). However, search time took significantly longer in group I than groups II and III (p < 0.001). When group II and III were compared for POST with numeric rating scale (0–10), it was significantly lower in group II than III at 2, 4 h after the recovery (0.5 vs. 2.3, p = 0.016, and 0.4 vs. 1.8, p = 0.011, respectively). Conclusions The bend angle of the lighted stylet affected the time required for tracheal intubation and POST in our study. 80 and 90 degrees as a bend angle seem to be acceptable for clinicians in regard to success rate of lighted stylet intubation. Considering the success rate of lighted stylet intubation and POST, the bend angle of 80 degrees might be better than 70 and 90 degrees. Trial registration ClinicalTrials.gov Identifier NCT03693235 , registered on 30 September 2018

Adapting performance and emotional support feedback to cultural differences

This paper investigates adaptation of feedback to learners' cultural backgrounds. First, we investigate how to portray the cultural background of a learner. Second, we present a qualitative focus-group study, investigating how participants from different cultures believe culture affects the kind of feedback given to a learner. Finally, we present an empirical study on how humans adapt feedback based on the cultural background of learners to inspire an algorithm. Our investigations resulted in a set of stories which can be used to reliably portray a person's culture when investigating cultural adaptation in indirect experiments and user as wizard studies. They also provided insights into the adaptations people make to cultural differences