Evaluating the merits of interdisciplinary education

This article describes interdisciplinary education initiatives developed at Columbia University in the USA and cites the difficulties encountered in implementing such a programme. The author also discusses problems in evaluating such initiatives, and some of the administrative, educational and professional factors involved. She argues that while there may be some resistance among educators to formal interdisciplinary collaboration, students appear more open to the idea. The author concludes that the changing health care environment makes it increasingly important to find successful methods of delivering such programmes.

Congruence or conflict? Challenges in implementing problem-based learning across nursing cultures

Using the "real-life" situation of delivering an Australian nursing curriculum in the Maldives, this paper argues that successful offshore delivery requires far more than simply implementing an existing programme on a different site. In health education, cultural and contextual circumstances necessitate a critical appraisal of the needs of the community and the corresponding attributes of those who provide health-care services. This means designing programmes that are process oriented and easily adapted to different circumstances, and a commitment to maintaining effective communication systems. Although it would seem that problem-based learning (PBL) provides the framework for a process-oriented, learner-centred curriculum, the paper raises questions about how universally relevant the processes embedded in PBL are and describes concerns about the intent and purpose of nominating PBL as the preferred instructional strategy for cross-cultural projects.

Addressing self-selection bias in quasi-experimental evaluations of whole-school reform. A comparison of methods

This article discusses potential sources of self-selection bias in quasi-experimental evaluations of whole-school reform models and considers how individual student-level data might be used to provide valid impact estimates. Although repeated pretreatment and posttreatment measures of student performance can provide unbiased estimates under relatively weak assumptions, such data are difficult to obtain. The article develops an instrumental variable strategy that can be used to improve on common value-added estimators when only posttreatment measures of performance are available. Using data from New York City, the author shows that the instrumental variable strategy can provide estimates of model impacts similar to those provided by a difference-in-differences estimator provided that appropriate instruments are used.

Schools alone are not enough: after-school programs and education reform in Boston

Boston's efforts to expand after-school programs and build their capacity to support the standards-based education reforms of the city's public schools are explored.

Graduate students with marginal abilities in communication sciences and disorders: prevalence, profiles, and solutions

This paper addresses the special challenges encountered when working with graduate students whose academic and/or clinical performance is marginal or less than satisfactory. From a variety of perspectives including instructional, professional, financial, ethical, and legal, among others, working effectively with marginal students deserves serious and systematic consideration. The purpose of this paper is to present the results of a national survey that explore the prevalence, profiles, and documented impact of marginal students on professional training programs in speech-language pathology and audiology. Current strategies for prevention and intervention, factors inhibiting implementation of such strategies, and implications for the student and the program are discussed.

LEARNING OUTCOMES

(1) To learn the prevalence, profiles, and documented impact of marginal students on professional preparation programs in communication sciences and disorders. (2) To become familiar with current strategies for prevention and intervention with marginal students, factors inhibiting implementation of such strategies, and implications for the student and the program. (3) To understand professional preparation as a system of academic, clinical, and supervisory instruction, including evaluation and due process; namely, a student's right, a program's responsibility. (4) To identify critical questions generated by this study that must be addressed by the professions and individual programs.

Senior residents in psychiatry: views on training in developmental disabilities

OBJECTIVES

To determine the proportion of senior residents who believed their education in the field of developmental disabilities was adequate and to collect suggestions for improvements.

METHOD

We distributed a self-administered questionnaire to senior residents prior to an annual voluntary preparatory exam. Their views on training in developmental disabilities and ideas about improving curricula were solicited in detail, and their feedback results were analyzed.

RESULTS

Of the 89 senior residents who attended the exam, 60 (67.4%) completed the survey. This represents 29% of the national complement. Most (85%) of the one-half who reported receiving undergraduate training in developmental disabilities felt the quantity was inadequate. Almost 90% of those who did not receive training felt they should have. Of respondents, 85% received residency training in dual diagnosis, but most (59%) felt more curriculum time was needed.

CONCLUSIONS

Senior residents also desire curricular enhancements that experts in developmental disabilities have long recommended.

Military trauma training performed in a civilian trauma center

BACKGROUND

In 1996, Congress passed legislation requiring the Department of Defense to conduct trauma training in civilian hospitals. In September of 1998 an Army team composed of surgeons, nurses, emergency medical technicians (EMTs), and operating room technicians (OR techs) trained in a civilian level 1 trauma center. This study analyzes the quality of the training.

METHODS

The training period was 30 days. Before and after training all members completed a questionnaire of their individual and team ability to perform at their home station, at the civilian hospital, and in the combat setting. Surgeons maintained an operative log, which was compared with their prior year's experience. Primary trauma cases (PTCs) met Residency Review Committee criteria as defined category cases and were done acutely. Other personnel tracked the percentage of supporting soldier tasks (SSTs) they performed or were exposed to during the training period.

RESULTS

Review of the questionnaires revealed a significant increase in confidence levels in all areas tested (P < 0.005). The three general surgeons performed a total of 42 PTCs during the 28 call periods, or 1.5 PTCs per call period. During the prior year, the same three general surgeons performed 20 PTCs during 114 call periods for 0.175 cases per call period (P = 0.003). The maximum number of PTCs performed during one call period at the civilian center was 4, compared with 5 PTCs performed by one Army surgeon during the Somalia 1993 mass casualty event. Performance of or exposure to SSTs was 71% for the EMTs, 94% for the nurses, and 79% for the OR techs.

CONCLUSIONS

A 1-month training experience at a civilian trauma center provided military general surgeons with a greater trauma experience than they receive in 1 year at their home station. Other personnel on the team benefited by performing or being exposed to their SSTs. Further training of military teams in civilian trauma centers should be investigated.

MSWs with and without long-term substance abuse training: agency, community, and personal outcomes

Behavioral outcomes in agency, community, and personal arenas were examined for 81 social workers with Masters degrees (MSWs) who completed a clinical postgraduate substance abuse (SA) training program (trainees) and a matched group of 78 MSWs not enrolled in such a program (comparison subjects). Subject self-report data was collected via telephone interviews of 30-40 min. With little or limited prior SA training, trainees took this clinical training to a broader level: they were significantly more likely than comparison subjects to provide agency SA training, receive SA training and supervision outside the agency, engage in SA community service, present SA papers at conferences, and intervene with their SA-troubled significant others. With more MSW students now receiving SA training in their graduate programs, the impact of such postgraduate education is likely to be even greater.

[Excellent faculties and superior education in countries in transition]

Respectable international schools established in lots of the counties in transition offer first-class graduate and postgraduate studies. We have not elite faculties and frim that reason we are lagging behind the west. Talented students in our universities have been obviously neglected so far. It is high time to pay attention to the best students and to use their talent. Best students are mostly deprived by poor possibilities to schools a faculty they want while western students are in a position to choose the best faculties that have an inducing intellectual milieu. The present situation is in our favour for we have a possibility to get a financial support from International Community, to establish prestige faculties in Tuzla University and in Bosnia and Herzegovina.

Training costs and investment payback of implementing molecular diagnostics for identification of vancomycin resistant enterococci in a clinical microbiology laboratory

Molecular diagnostics may be a more efficient method to manage resources; but most Microbiology laboratories have not introduced them into routine use due to the specialized training required. Using vancomycin resistant enterococci (VRE) screening during a comparison of a multiplex PCR (MPCR) and conventional biochemical testing (CBT) we studied 3 objectives: 1) to develop a molecular diagnostics in-house training program, 2) to assess the training program outcomes for competency and confidence, and 3) to determine laboratory payback. A training program for 14 technologists using multiple adult learning methods was implemented. Methods to minimize technical errors were introduced and included: use of a calibrated loop to deliver sample; prealiquotting reagents; increasing volume of specimen; addition of gel loading dye directly into reaction tubes; and establishment of an equivocal zone. In our laboratory MPCR costs $7.06 less than CBT, therefore the payback period for training and implementation would be approximately 3 years.

Overcoming inequality in schooling: a call to action for community psychology

Community psychology, indeed psychology as a discipline, has been largely absent from the table of school reform. Schools are critical socializing forces in society and serve as the one institution through which the full diversity of our child population passes. At the start of the 21st century, despite successive waves of legislation, the goals of the civil rights struggle for equality in educational opportunity have yet to be achieved. Negative self-fulfilling prophecies, reflected at individual, interpersonal, institutional, and societal levels, play a critical role in creating and perpetuating unequal opportunities to learn. Such effects as well as pathways for preventive intervention are best understood through ecological lenses. Our field must commit a greater share of resources to collaborative and systemic change for a broader learning so that all children, regardless of their differences, have continuing and nonstigmatized opportunities to develop into competent adults.

Whose education counts? The added impact of adult-child education on physical functioning of older taiwanese

OBJECTIVES

Research has implicated education as an important predictor of physical functioning in old age. Older adults in Taiwan tend to experience tight familial integration and high rates of adult-child coresidency-much more so than is typical in Western cultures-which might imply additional influences stemming from the education of children. This could arise in a number of ways; for instance, through the sharing of health-related information between child and parent, the quality of caregiving efforts, monetary assistance for medical and other services, or other psychosocial avenues. Despite this probable association, such hypotheses have rarely been tested. In this study, a nationally representative survey of older Taiwanese was used to examine these concurrent effects.

METHODS

Outcome variables include the existence of any functional limitations (dichotomously measured) and the severity of functional disorders (ordinally measured). Dichotomous and ordinal logistic models were used.

RESULTS

Results suggest that, after adjusting for age, sex, and other factors, both child and respondent education associate with the existence of limitations, but the child's education is more important than the parent's when predicting severity of limitations.

DISCUSSION

This implies that models ignoring social network characteristics in determining health outcomes of older adults may be misspecified, at least in some non-Western societies, and calls for further testing in other societies as well.

Schooling and traditional collaborative social organization of problem solving by Mayan mothers and children

Traditional indigenous social organization in the Americas has been characterized as involving horizontal multiparty engagements, in contrast with schooling, which often relies on hierarchy and division of labor. This study examined whether the social organization of problem solving of Guatemalan Mayan indigenous mothers and children varied with the mothers' extent of experience with school. We observed 47 mothers as they constructed a puzzle with 3 children (ages 6-12 years). Mayan mothers with little schooling (0-2 grades) were involved more in horizontal, multiparty engagements, whereas Mayan mothers with extensive experience with schooling (12 or more grades) were involved more in hierarchical, division-of-labor engagements with the children. The results suggest that Western formal schooling contributes to the reshaping of traditional collaborative social organization among indigenous Mayan people.

Training programs for healthcare professionals in domestic violence

Although women who experience domestic violence seek healthcare services frequently, screening and counseling rates remain low, and healthcare professionals report feeling inadequately trained to care for abused women. The English language literature from 1989 to 1999 was searched to identify and evaluate published assessments of the education of healthcare providers in domestic violence toward women. Major deficiencies in program evaluation were found. They included the use of a historical comparison group, lack of an experimental design, selection of nonstandardized outcomes without clinical performance measures, short-term follow-up, limited documentation of course content and theory, and lack of focus on the impact of programs on abused women. Educational programs generally consisted of a single session of limited duration (1-3 hours). Based on published reports, it appears that few rigorously designed evaluations have been conducted of training programs for healthcare providers in the detection and treatment of women affected by domestic violence.

Building capacity for health disparity research at minority institutions

The science and technology enterprise of the United States has consistently produced seminal work and cutting-edge technologies. It has responded promptly to both new opportunities and urgent crises. The success of this enterprise derives largely from the diversity of the types of institutions doing the work and from the many sources of public and private funding available to accomplish it. To those who argue that public-sector funds should support only the best science at the premier research institutions on the nation's East and West coasts, Dr. Rita Colwell, the director of the National Science Foundation (NSF) eloquently responds, "No one region, no one group of institutions, and no special communities have a corner on the market of good and great ideas, smart people, or outstanding researchers. Great ideas can come from just about anywhere."

Building capacity for health disparity research at minority institutions

The science and technology enterprise of the United States has consistently produced seminal work and cutting-edge technologies. It has responded promptly to both new opportunities and urgent crises. The success of this enterprise derives largely from the diversity of the types of institutions doing the work and from the many sources of public and private funding available to accomplish it. To those who argue that public-sector funds should support only the best science at the premier research institutions on the nation's East and West coasts, Dr. Rita Colwell, the director of the National Science Foundation (NSF) eloquently responds, "No one region, no one group of institutions, and no special communities have a corner on the market of good and great ideas, smart people, or outstanding researchers. Great ideas can come from just about anywhere."

[Study of higher schooling load effect on the health status of schoolchildren]

Higher schooling load, non-observance of school routine, inactivity, etc. have a negative impact on health. The purpose of the study was to determine the impact of intensive training on the health status of schoolchildren. An intensive training college, a physico-mathematical school, a private school-gymnasia were chosen as objects of studies. A general educational school was matched as a control object. In each educational establishment, 180-320 schoolchildren from the 8th-10th forms were examined. The examination ascertained that the schooling load at new-type schools was greater than the standards established. Before going to new-type schools, schoolchildren had a better health status than did the general educational school children of their age; during schooling, worse health was, however, more noticeable in new-type school children than in the matched schoolchildren. A higher schooling load also affects the performance of schoolchildren unfavorably.

Integration of children with visual impairment in regular preschools

The current practice in Germany is to integrate children who are blind or partially sighted into regular preschools providing they exhibit no further severe impairments. The present study asked 72 regular preschool teachers about their experiences in integrating 24 children who were blind and 16 who were partially sighted. Results showed that integration seemed to be unproblematic except for greater emotional difficulties in children who are partially sighted. According to preschool teachers, integrating children who are blind is far more complex and difficult than integrating the partially sighted. One fifth of the blind exhibited marked to serious problems in 10 out of 28 preschool activities surveyed. Most of these difficulties involved manual, cognitive, interactive and daily living skills. When asked about difficulties that had not been anticipated before integration commenced, preschool teachers emphasized four domains: the increase in their own workload; the children's problems with concentration and motivation; fixation on one preschool teacher; and difficulties in the fine- and gross-motor domain as well as in daily living skills. Findings indicate the need for improved preparations and support when integrating the blind into regular preschool.