Physiotherapy students' perspectives of online e-learning for interdisciplinary management of chronic health conditions: A qualitative study

© 2016 Gardner et al. Background: To qualitatively explore physiotherapy students' perceptions of online e-learning for chronic disease management using a previously developed, innovative and interactive, evidence-based, e-learning package: Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL). Methods: Physiotherapy students participated in three focus groups in Perth, Western Australia. Purposive sampling was employed to ensure maximum heterogeneity across age, gender and educational background. To explore students' perspectives on the advantages and disadvantages of online e-learning, ways to enhance e-learning, and information/learning gaps in relation to interdisciplinary management of chronic health conditions, a semi-structured interview schedule was developed. Verbatim transcripts were analysed using inductive methods within a grounded theory approach to derive key themes. Results: Twenty-three students (78 % female; 39 % with previous tertiary qualification) of mean (SD) age 23 (3.6) years participated. Students expressed a preference for a combination of both online e-learning and lecture-style learning formats for chronic disease management, citing flexibility to work at one's own pace and time, and access to comprehensive information as advantages of e-learning learning. Personal interaction and ability to clarify information immediately were considered advantages of lecture-style formats. Perceived knowledge gaps included practical application of interdisciplinary approaches to chronic disease management and developing and implementing physiotherapy management plans for people with chronic health conditions. Conclusions: Physiotherapy students preferred multi-modal and blended formats for learning about chronic disease management. This study highlights the need for further development of practically-oriented knowledge and skills related to interdisciplinary care for people with chronic conditions among physiotherapy students. While RAP-eL focuses on rheumatoid arthritis, the principles of learning apply to the broader context of chronic disease management

Nonpoor children in head start: Explanations and implications

According to the Head Start Act (1998), children are income-eligible for the program if their “families' incomes are below the poverty line.” There are a number of statutory exceptions to this general rule and, according to the Head Start Bureau, the result is that about 6 percent of the children in the program are not poor. But the major national surveys of Head Start families report that 30 percent or more of Head Start children are not “poor.” This paper confirms and explains the high proportion of nonpoor children in Head Start: at enrollment, at least 28 percent are not poor; at midyear, at least 32 percent are not poor; and by the end of the program year, at least 34 percent and perhaps more than 50 percent are not poor. Although the presence of some of these nonpoor children seems to be an appropriate or at least understandable aspect of running a national program with Head Start's current organizational structure, the presence of others seems much less warranted and raises substantial questions of horizontal equity. Moreover, taken together, the large number of nonpoor children suggests that the program is not well targeted to fulfill its mission of providing compensatory services to developmentally disadvantaged children-and reveals the essential ambiguity of Head Start's role in the wider world of early care and education. The income and program dynamics that have led to so many nonpoor children being in Head Start are also at work in many other programs, and, thus, our findings demonstrate the need to understand better how income eligibility is determined across various means-tested programs.