The affective component of learning in simulation-based education – facilitators’ strategies to establish psychological safety and accommodate nursing students’ emotions

Background Active learning situations such as simulation-based education (SBE) are found to trigger a wide range of emotions among students. Facilitators have an important educational role in SBE which include being attentive and adaptive to students’cognitive and affective responses. Although the importance of emotions in SBE is recognized in facilitator guidelines, little is known about how facilitators accommodate student affect. Hence, this study explores facilitators’ strategies for addressing students’ emotions in SBE. Method Individual interviews with nine facilitators were performed and transcripts were subjected to qualitative analyses in accordance with interpretive description approach. Results Findings show that facilitators are attentive to and continuously assess students’ emotional responses in SBE. Both positive emotions, such as interest and surprise, and negative emotions such as anxiety are cultivated, yet adapted to the perceived needs of the individual student. Psychological safety was seen as a prerequisite for optimal learning, regardless of the students’ previous level of knowledge. Furthermore, significant learning was seen as something that might also arise from uncomfortable experiences, such as students realizing their own mistakes or uncertainty. Hence facilitators were found to balance levels of difficulty, emotional arousal and psychological safety during the various phases of SBE. Conclusion Facilitators recognize the emotional dimension of learning in SBE and have numerous strategies for accommodating students’ emotions. This study highlights the complexity of the facilitator’s role in adapting training to individual cognitive and emotional needs. These findings have implications for facilitator training which should include awareness of the role of emotions in learning and strategies for observing and accommodating training to meet emotional needs.publishedVersio

A rollercoaster of emotions: An integrative review of emotions and its impact on health professional students' learning in simulation-based education

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Health professional students’ self-reported emotions during simulation-based education: An interpretive descriptive study

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Aim: This study aimed to explore active students’ experiences of emotions during simulation-based education (SBE) sequences when a simulation was performed as a part of formal curriculum in natural educational settings and to consider the practical educational implications of the findings. Background: An SBE approach is used widely in nursing education. Emotions are necessary for learning to take place and some of these can prevent or promote learning. This is an active and affective learning activity that can trigger various emotions. Previous research in SBE has studied student anxiety, which has been frequently measured quantitatively. An understanding of students’ emotions can give valuable insight into the learning process and improve nursing educational practice. Methods: The study took place in four Norwegian universities. It was guided by interpretive descriptions, which involve qualitative methodology. This study was approved by the Norwegian Centre for Research Data (No: 59059). Data were collected using an interpersonal process interview with eight healthcare professional students after participating in SBE. Results: The results show that students experienced coexisting and changing emotions during the shifting academic scenes in the simulations. During briefing, scenario and debriefing, students experienced being activated and had coexisting pleasant and unpleasant emotions. Unpleasant emotions were found to decrease during the simulation. Numerous identified emotions were found to be valuable for learning. Conclusion: The insight into students’ experience of arousal, negative emotions and the potential for SBE to trigger students’ comprehensive academic emotions have implications for nurse educators when planning and facilitating simulations.publishedVersio

The affective component of learning in simulation-based education – facilitators’ strategies to establish psychological safety and accommodate nursing students’ emotions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data..Background: Active learning situations such as simulation-based education (SBE) are found to trigger a wide range of emotions among students. Facilitators have an important educational role in SBE which include being attentive and adaptive to students’cognitive and afective responses. Although the importance of emotions in SBE is recog nized in facilitator guidelines, little is known about how facilitators accommodate student afect. Hence, this study explores facilitators’ strategies for addressing students’ emotions in SBE. Method: Individual interviews with nine facilitators were performed and transcripts were subjected to qualitative analyses in accordance with interpretive description approach. Results: Findings show that facilitators are attentive to and continuously assess students’ emotional responses in SBE. Both positive emotions, such as interest and surprise, and negative emotions such as anxiety are cultivated, yet adapted to the perceived needs of the individual student. Psychological safety was seen as a prerequisite for optimal learning, regardless of the students’ previous level of knowledge. Furthermore, signifcant learning was seen as some thing that might also arise from uncomfortable experiences, such as students realizing their own mistakes or uncer tainty. Hence facilitators were found to balance levels of difculty, emotional arousal and psychological safety during the various phases of SBE. Conclusion: Facilitators recognize the emotional dimension of learning in SBE and have numerous strategies for accommodating students’ emotions. This study highlights the complexity of the facilitator’s role in adapting training to individual cognitive and emotional needs. These fndings have implications for facilitator training which should include awareness of the role of emotions in learning and strategies for observing and accommodating training to meet emotional needs.publishedVersio

Climatic controls of aboveground net primary production in semi‑arid grasslands along a latitudinal gradient portend low sensitivity to warming

Although climate models forecast warmer temperatures with a high degree of certainty, precipitation is the primary driver of aboveground net primary production (ANPP) in most grasslands. Conversely, variations in temperature seldom are related to patterns of ANPP. Thus forecasting responses to warming is a challenge, and raises the question: how sensitive will grassland ANPP be to warming? We evaluated climate and multi-year ANPP data (67 years) from eight western US grasslands arrayed along mean annual temperature (MAT; ~7–14 °C) and mean annual precipitation (MAP; ~250–500 mm) gradients. We used regression and analysis of covariance to assess relationships between ANPP and temperature, as well as precipitation (annual and growing season) to evaluate temperature sensitivity of ANPP. We also related ANPP to the standardized precipitation evaporation index (SPEI), which combines precipitation and evapotranspiration to better represent moisture available for plant growth. Regression models indicated that variation in growing season temperature was negatively related to total and graminoid ANPP, but precipitation was a stronger predictor than temperature. Growing season temperature was also a significant parameter in more complex models, but again precipitation was consistently a stronger predictor of ANPP. Surprisingly, neither annual nor growing season SPEI were as strongly related to ANPP as precipitation. We conclude that forecasted warming likely will affect ANPP in these grasslands, but that predicting temperature effects from natural climatic gradients is difficult. This is because, unlike precipitation, warming effects can be positive or negative and moderated by shifts in the C3/C4 ratios of plant communities

Gene co-expression analysis identifies brain regions and cell types involved in migraine pathophysiology

Migraine is a common disabling neurovascular brain disorder typically characterised by attacks of severe headache and associated with autonomic and neurological symptoms. Migraine is caused by an interplay of genetic and environmental factors. Genome-wide association studies (GWAS) have identified over a dozen genetic loci associated with migraine. Here, we integrated migraine GWAS data with high-resolution spatial gene expression data of normal adult brains from the Allen Human Brain Atlas to identify specific brain regions and molecular pathways that are possibly involved in migraine pathophysiology. To this end, we used two complementary methods. In GWAS data from 23,285 migraine cases and 95,425 controls, we first studied modules of co-expressed genes that were calculated based on human brain expression data for enrichment of genes that showed association with migraine. Enrichment of a migraine GWAS signal was found for five modules that suggest involvement in migraine pathophysiology of: (i) neurotransmission, protein catabolism and mitochondria in the cortex; (ii) transcription regulation in the cortex and cerebellum; and (iii) oligodendrocytes and mitochondria in subcortical areas. Second, we used the high-confidence genes from the migraine GWAS as a basis to construct local migraine-related co-expression gene networks. Signatures of all brain regions and pathways that were prominent in the first method also surfaced in the second method, thus providing support that these brain regions and pathways are indeed involved in migraine pathophysiology

Cerebral small vessel disease genomics and its implications across the lifespan

White matter hyperintensities (WMH) are the most common brain-imaging feature of cerebral small vessel disease (SVD), hypertension being the main known risk factor. Here, we identify 27 genome-wide loci for WMH-volume in a cohort of 50,970 older individuals, accounting for modification/confounding by hypertension. Aggregated WMH risk variants were associated with altered white matter integrity (p = 2.5×10-7) in brain images from 1,738 young healthy adults, providing insight into the lifetime impact of SVD genetic risk. Mendelian randomization suggested causal association of increasing WMH-volume with stroke, Alzheimer-type dementia, and of increasing blood pressure (BP) with larger WMH-volume, notably also in persons without clinical hypertension. Transcriptome-wide colocalization analyses showed association of WMH-volume with expression of 39 genes, of which four encode known drug targets. Finally, we provide insight into BP-independent biological pathways underlying SVD and suggest potential for genetic stratification of high-risk individuals and for genetically-informed prioritization of drug targets for prevention trials.Peer reviewe

Meta-analysis of 375,000 individuals identifies 38 susceptibility loci for migraine

Migraine is a debilitating neurological disorder affecting around one in seven people worldwide, but its molecular mechanisms remain poorly understood. There is some debate about whether migraine is a disease of vascular dysfunction or a result of neuronal dysfunction with secondary vascular changes. Genome-wide association (GWA) studies have thus far identified 13 independent loci associated with migraine. To identify new susceptibility loci, we carried out a genetic study of migraine on 59,674 affected subjects and 316,078 controls from 22 GWA studies. We identified 44 independent single-nucleotide polymorphisms (SNPs) significantly associated with migraine risk (P < 5 × 10−8) that mapped to 38 distinct genomic loci, including 28 loci not previously reported and a locus that to our knowledge is the first to be identified on chromosome X. In subsequent computational analyses, the identified loci showed enrichment for genes expressed in vascular and smooth muscle tissues, consistent with a predominant theory of migraine that highlights vascular etiologies

Ecological consequences of increased nitrogen deposition in three northern Great Plains grasslands

2012 Fall.Includes bibliographical references.Increased nitrogen deposition is an important driver of plant species composition change in terrestrial ecosystems globally. Plant composition change from increased nitrogen inputs can result in substantial species richness declines especially where atmospheric inputs already exceed critical loads. Shifts in community structure can occur through changes in basic ecosystem conditions (such as soil properties) or through alterations in competitive interactions potentially disrupting feedbacks that maintain an ecosystem at a given fertility level. Although there has been a substantial amount of research on the effects of increased N on communities and ecosystems, most studies add large and, relative to natural inputs, unrealistic amounts of N. Thus, responses are often immediate and drastic. This "two-point" approach, comparing control to high-N plots, provides little information about the levels of N inputs at which responses first occur, which is more important for managing and mitigating the effects of increased N deposition in a proactive rather than reactive manner. The overarching goal of this study was to identify response thresholds to N addition in Northern Great Plains grasslands that differed markedly in productivity and soil fertility. Over two years we assessed responses to increased N inputs (from 2.5 to 100 kg N/ha) in soils, leaf tissue, plant community composition, and aboveground net primary production (ANPP) in three northern mixed prairie grasslands that varied 3-fold in ANPP. The results of the study will enable us to better forecast both ecosystem and community responses to increased fertilization in this understudied region. After two years of fertilization (with and without water addition) at levels ranging from 0 to 100 kg N/ha, we found significant effects from increased N inputs on ANPP when nitrogen levels exceeded 68 kg N/ha/year and effects on leaf tissue nitrogen, soil nitrogen content and N mineralization rates, particularly when levels exceeded 45 kg/ha/year. Alterations in soil and leaf nitrogen content and ANPP tended to have linear responses and remained consistent across sites. Significant responses occurred even in low ANPP sites (Badlands NP) which experienced a higher relative response. No significant and consistent effects were found on total species richness, and community metrics such as evenness and diversity indices, plant cover by functional group or canopy cover. Our results suggest that though high fertility and production sites may have a greater absolute biomass response, low fertility and production environments can be quite responsive to nitrogen addition as well. Community change may occur more slowly with these northern grasslands which show little response to two years of increased N inputs