Instructional English as a Second Language Practices for Oral Proficiency Development in Chinese English as a Second Language Classrooms

AbstractForeign language instructors inconsistently implement instructional practices to support Chinese high school students’ learning of oral English language. Although China has several programs to enhance English second language related competencies and assist students in completing mandatory exams, instructional methodologies do not always allow for achievement of these goals. The purpose of this basic qualitative study was to explore the perceptions of foreign language teachers working in the Hangzhou region of China, specifically regarding their implementation of instructional strategies to support Chinese high school students’ learning of oral English language. Sato and McNamara’s general-purpose second-language oral competency theory served as the conceptual framework. The research questions queried self-addressed foreign language teachers\u27 perceptions concerning the instructional practices they use in in Chinese ESL classrooms. Data were obtained from interviews with eight purposively sampled foreign ESL instructors living and teaching in China at a public school and learning center. Inductive, deductive, and NVivo coding were used to analyze data. Themes included preparation methods for ESL instruction, classroom management strategies for courses and individual learners, and ways institutional-related educators prepare students for exigent pressures. Findings indicated that while instructors utilize effective classroom management methodologies, their approaches regarding classroom and exigent demand preparation show the need to implement instructional and classroom management changes. This study contributes to social change in local settings as well as contributes to other educational reform movements in China

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society