DISCOURSE IN INQUIRY SCIENCE CLASSROOMS (DiISC): REFERENCE MANUAL

One of the greatest challenges facing scholars and funding agencies interested in reform is determining the impact of classroom practice on student achievement. The degree to which this effect can be determined is contingent upon instruments that measure teachers’ ability to enact specific instructional strategies. Frequently, a general instrument will not do because it was not designed to measure the unique focus of a professional development program or a set of variables of interest to researchers. Consequently, specific instruments should be developed to allow researchers to measure fidelity of classroom implementation. Fidelity of implementation is always the first step in determining effectiveness. For without fidelity of implementation, it is impossible to determine whether what the teacher does has an impact on student achievement. This manual reports on the development of just such an instrument, called the Discourse in Inquiry Science Classrooms (DiISC). The instrument was developed to measure teachers’ use of strategies in their classrooms to foster a science classroom discourse community (SCDC) as a way of furthering achievement in science. The DiISC instructional strategies that support the creation of a SCDC address oral and written discourse, and academic language development embedded in inquiry and they also reflect learning principles. We believe that the creation of the DiISC is especially timely for two reasons. First, science educators are beginning to focus on communication in science as a learning tool to increase students’ conceptual understanding and achievement in science. Second, we need an instrument to measure teachers’ ability to support the academic language development in science of the increasing number of English Language Learners (ELLs) in our schools. The DiISC is an instrument for observing teachers, not students. It describes what teachers do and focuses on five sets of instructional strategies that form the scales of the DiISC. These scales are Inquiry, Oral Discourse, Writing, Academic Language Development and Learning Principles. Consequently, the stems of many of the items start with the phrase, The teacher… , as in “The teacher creates an environment that supports inquiry”

Considerations and methods for placebo controls in surgical trials (ASPIRE guidelines)

Placebo comparisons are increasingly being considered for randomised trials assessing the efficacy of surgical interventions. The aim of this Review is to provide a summary of knowledge on placebo controls in surgical trials. A placebo control is a complex type of comparison group in the surgical setting and, although powerful, presents many challenges. This Review outlines what a placebo control entails and present understanding of this tool in the context of surgery. We consider when placebo controls in surgery are acceptable (and when they are desirable) in terms of ethical arguments and regulatory requirements, how a placebo control should be designed, how to identify and mitigate risk for participants in these trials, and how such trials should be done and interpreted. Use of placebo controls is justified in randomised controlled trials of surgical interventions provided there is a strong scientific and ethical rationale. Surgical placebos might be most appropriate when there is poor evidence for the efficacy of the procedure and a justified concern that results of a trial would be associated with high risk of bias, particularly because of the placebo effect. Feasibility work is recommended to optimise the design and implementation of randomised controlled trials. This Review forms an outline for best practice and provides guidance, in the form of the Applying Surgical Placebo in Randomised Evaluations (known as ASPIRE) checklist, for those considering the use of a placebo control in a surgical randomised controlled trial

The Communication in Science Inquiry Project (CISIP): A Project to Enhance Scientific Literacy through the Creation of Science Classroom Discourse Communities

This study reports on the context and impact of the Communication in Science Inquiry Project (CISIP) professional development to promote teachers’ and students’ scientific literacy through the creation of science classroom discourse communities. The theoretical underpinnings of the professional development model are presented and key professional development activities are described. Data are provided on teachers’ fidelity of implementation of the CISIP instructional strategies, their understanding of the nature of science communication, and their ability to write scientific investigation reports. Student data includes an analysis of scientific arguments and the perception of their classroom as a science classroom discourse community. Two instruments to measure fidelity of implementation are introduced; the Discourse in Inquiry Science Classrooms for classroom observations of teachers and My Science Classroom Survey to measure students’ perceptions of their teachers’ use of the CISIP instructional strategies in their classroom

Challenges of conducting a randomised placebo-controlled trial of spinal surgery: the SUcceSS trial of lumbar spine decompression

Abstract Although placebo-controlled trials are considered the gold standard for evaluating the efficacy of healthcare interventions, they can be perceived to be controversial and challenging to conduct for surgical treatments. The SUcceSS trial is the first placebo-controlled trial of lumbar decompression surgery for symptomatic lumbar canal stenosis. The SUcceSS trial has experienced common issues affecting the implementation of randomised placebo-controlled surgery trials, accentuated by the COVID-19 pandemic. Using the SUcceSS trial as an example, we discuss key challenges and mitigation strategies specific to the conduct of a randomised placebo-controlled surgical trial. Overall, the key lessons learned were (i) involving key stakeholders early and throughout the trial design phase may increase clinician and patient willingness to participate in a placebo-controlled trial of surgical interventions, (ii) additional resources (e.g. budget, staff time) are likely required to successfully operationalise trials of this nature, (iii) the level of placebo fidelity, timing of randomisation relative to intervention delivery, and nuances of the surgical procedure under investigation should be considered carefully. Findings are based on one example of a placebo-controlled surgical trial; however, researchers may benefit from employing or building from the strategies described and lessons learned when designing or implementing future trials of this nature

Placebo comparator group selection and use in surgical trials: the ASPIRE project including expert workshop.

BACKGROUND The use of placebo comparisons for randomised trials assessing the efficacy of surgical interventions is increasingly being considered. However, a placebo control is a complex type of comparison group in the surgical setting and, although powerful, presents many challenges. OBJECTIVES To provide a summary of knowledge on placebo controls in surgical trials and to summarise any recommendations for designers, evaluators and funders of placebo-controlled surgical trials. DESIGN To carry out a state-of-the-art workshop and produce a corresponding report involving key stakeholders throughout. SETTING A workshop to discuss and summarise the existing knowledge and to develop the new guidelines. RESULTS To assess what a placebo control entails and to assess the understanding of this tool in the context of surgery is considered, along with when placebo controls in surgery are acceptable (and when they are desirable). We have considered ethics arguments and regulatory requirements, how a placebo control should be designed, how to identify and mitigate risk for participants in these trials, and how such trials should be carried out and interpreted. The use of placebo controls is justified in randomised controlled trials of surgical interventions provided that there is a strong scientific and ethics rationale. Surgical placebos might be most appropriate when there is poor evidence for the efficacy of the procedure and a justified concern that results of a trial would be associated with a high risk of bias, particularly because of the placebo effect. CONCLUSIONS The use of placebo controls is justified in randomised controlled trials of surgical interventions provided that there is a strong scientific and ethics rationale. Feasibility work is recommended to optimise the design and implementation of randomised controlled trials. An outline for best practice was produced in the form of the Applying Surgical Placebo in Randomised Evaluations (ASPIRE) guidelines for those considering the use of a placebo control in a surgical randomised controlled trial. LIMITATIONS Although the workshop participants involved international members, the majority of participants were from the UK. Therefore, although every attempt was made to make the recommendations applicable to all health systems, the guidelines may, unconsciously, be particularly applicable to clinical practice in the UK NHS. FUTURE WORK Future work should evaluate the use of the ASPIRE guidelines in making decisions about the use of a placebo-controlled surgical trial. In addition, further work is required on the appropriate nomenclature to adopt in this space. FUNDING Funded by the Medical Research Council UK and the National Institute for Health Research as part of the Medical Research Council-National Institute for Health Research Methodology Research programme