The Design Discourse of Professional Instructional Designers

The design discourse of professional instructional designers (IDs) exposes the inner workings of instructional design because collaboration is integral to instructional design practice. Despite the importance of collaboration, there has been little examination of the collaboration in Instructional Design and Technology (IDT). To examine IDs’ collaboration, I examined the design discourse of IDs in design meetings with clients through a content analysis of their discourse. Analysis revealed areas of design expertise that frequented those discussions. I collected audio recordings of five discussions between one or more IDs and a client. Overall, six IDs and five clients participated in this study. A codebook of 16 codes provided ten codes of design discourse that appeared in the data and six subsequent codes that emerged as discourse management strategies. Among IDs, the most prominent type of design discourse was problem solving. When aggregating design discourse types, discussions surrounding problems, users, and tools were the three most frequent types and accounted for almost three-fourths of the design discourse of these designers in these discussions. Further analysis of the design discourse types revealed that precedent and user experience were the most complex areas of design discourse, suggesting that expressing precedent and user experience are advanced design skills. An analysis by gender revealed that male and female IDs focused on different areas of design discourse in practice. Female IDs focused on user experience and problem solving while male IDs concentrated on problem solving and tools. These findings have implications for how learners in IDT are trained, how design expertise is recognized, and how the design process is understood

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication