Basic psychological needs satisfaction as a mediator between clinical learning climate, self-regulated learning and perceived learning in the nursing education context

PURPOSE

Self-regulated learning (SRL) can enhance students' learning process. Students need support to effectively regulate their learning. However, the effect of learning climate on SRL behavior, its ultimate effect on learning and the underlying mechanisms have not yet been established. We explored these relationships using self-determination theory.

MATERIALS AND METHODS

Nursing students (N = 244) filled in questionnaires about SRL behavior, perceived learning, perceived pedagogical atmosphere and Basic Psychological Needs (BPN) satisfaction after their clinical placement. Structural equation modelling was used to test a model in which perceived pedagogical atmosphere affects SRL behavior and subsequent perceived learning through BPN satisfaction.

RESULTS

The tested model had an adequate fit (RMSEA = 0.080, SRMR = 0.051; CFI = 0.972; TLI = 0.950). A positively perceived pedagogical atmosphere contributed to SRL behavior, which was fully explained by BPN satisfaction. SRL partially mediated the contribution of pedagogical atmosphere/BPN to perceived learning.

CONCLUSIONS

A learning climate that satisfies students' BPN contributes to their SRL behavior. SRL behavior plays a positive but modest role in the relationship between climate and perceived learning. Without a culture that is supportive of learning, implementation of tools to apply SRL behavior may not be effective. Study limitations include reliance on self-report scales and the inclusion of a single discipline.

"Being a Person of Color in This Institution Is Exhausting": Defining and Optimizing the Learning Climate to Support Diversity, Equity, and Inclusion at the University of Washington School of Public Health

Learning climate greatly affects student achievement. This qualitative study aimed to understand community definitions of climate; share lived experiences of students, faculty, and staff; and define priority areas of improvement in the University of Washington School of Public Health (UWSPH). Between March-May 2019, 17 focus group discussions were conducted–stratified by role and self-identified race/ethnicity, gender and sexual orientation–among 28 faculty/staff and 36 students. Topics included: assessing the current climate, recounting experiences related to roles and identities, and recommending improvements. Transcripts were coded using deductive and inductive approaches. Race/ethnicity, gender, and sexual orientation appeared to affect perceptions of the climate, with nearly all respondents from underrepresented or minoritized groups recounting negative experiences related to their identity. Persons of color, women, and other respondents who identified as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual (LGBTQIA) frequently perceived the climate as “uncomfortable.” Most felt that UWSPH operates within a structural hierarchy that perpetuates white, male, and/or class privilege and “protects those in power” while leaving underrepresented or minoritized groups feeling like “the way to move up… is to conform” in order to not be seen as “someone pushing against the system.” Improvement priorities included: increasing community responsiveness to diversity, equity, and inclusion; intentionally diversifying faculty/staff and student populations; designing inclusive curricula; and supporting underrepresented or minoritized groups academically, professionally, and psychologically.

Aprendizaje en línea durante la pandemia de COVID-19: aplicación de la teoría de la autodeterminación en la ‘nueva normalidad’

La pandemia de COVID-19 ha introducido la noción de la ‘nueva normalidad’ en la vida diaria al influir profundamente en la forma en que solíamos vivir, estudiar y trabajar. Durante estos tiempos sin precedentes, la rápida transición del aprendizaje presencial tradicional al aprendizaje digital se observa como un cambio de paradigma en la educación superior. Inspirándose en el marco teórico de la autodeterminación, este estudio tiene como objetivo examinar el impacto del aprendizaje digital en la motivación de los estudiantes. También plantea la hipótesis del papel mediador, de las necesidades psicológicas básicas, en el nexo entre el aprendizaje digital y la motivación de los estudiantes. 689 estudiantes que asistieron a clases digitales en diez universidades (cinco públicas y cinco privadas) de Pakistán respondieron a la encuesta preparada en la web. Los resultados de esta investigación no confirman la relación directa entre el aprendizaje digital y la motivación de los estudiantes, sin embargo, esta relación sí está mediatizada por las percepciones de los estudiantes sobre el grado en que sus necesidades psicológicas básicas estaban satisfechas / insatisfechas. Este estudio contribuye teórica y empíricamente a la literatura tanto de la psicología como de la educación superior, perteneciente al campo en desarrollo del aprendizaje digital. Las implicaciones prácticas de este estudio informan a los responsables de la formulación de políticas en el ámbito académico para que reflexionen sobre las necesidades psicológicas de los estudiantes dentro del entorno de la enseñanza virtual.

The Relationship between Teachers and Peers' Motivational Climates, Needs Satisfaction, and Physical Education Grades: An AGT and SDT Approach

Grounded in achievement goal theory and self-determination theory, this study aimed to examine the associations of students’ perception of learning- and performance-oriented climates created by teachers and peers on basic psychological needs satisfaction, and consequently their relationships with physical education grades. This study had a cross-sectional design, and 589 students aged between 10 and 18 years (M = 12.93; SD = 1.49) were recruited for analysis. Participants completed a multisection survey assessing motivational climates and basic psychological needs, and physical education grades were provided by the physical education teacher. Students’ perception of learning-oriented climates created by teachers and peers was positively and significantly associated with basic psychological needs satisfaction. Additionally, these learning-oriented climates presented a significant indirect association with physical education grades. On the other hand, the performance-oriented climate created by teachers had a negative and significant relationship with basic psychological needs satisfaction and displayed a negative indirect relationship with physical education grades. The performance-oriented climate created by peers had a positive and significant relationship with basic psychological needs satisfaction and displayed a positive indirect relationship with physical education grades. The perception of performance-oriented climates created by peers could represent a boost within the students in physical education features. Teachers have the responsibility of promoting task and learning environments in which students experience positive outcomes, not only on a motivational level but also on a cognitive level.

School learning climate in the lens of parental involvement and school leadership: lessons for inclusiveness among public schools

Prior literature has shown that school learning climate is critical in helping individual learners meet their educational objectives. In this paper, the role of parental involvement in shaping the school learning climate is explored within a multilevel and hierarchical modeling framework using data from the 2015 PISA round.

As the schools’ social and relational character, we find that reducing learning barriers is a critical challenge for school leadership. A welcoming environment for parents, as well as the effective design of effective forms of two-way communications, are positively associated with a substantial reduction in the barriers to improving teacher management’s learning climate.

We also find that public schools facing social and educational inclusiveness challenges can dramatically enhance their learning environment by activating specific parental involvement mechanisms. Similarly, principal’s leadership in framing and communicating goals and curricular development to the school is also found to be significant for inclusiveness.

However, parental involvement is also found to have potential tensions with school management. The worsening of the learning climate may arise due to pressures brought about by laws requiring parental involvement in schools. Because the learning climate is composed of a wide variety of relationships between and within schools, this work demonstrates that parental involvement is an integral part of school leadership and the school improvement process. Further research attention is encouraged to understand the tensions between teacher roles, principal leadership, and parental involvement through employing other quantitative or qualitative research designs.

Evaluating the educational environment in a residency programme in Singapore: can we help reduce burnout rates?

INTRODUCTION

The educational environment (EE) reflects the quality of a residency programme and has an association with burnout. Studying the EE allows for interventions to target specific weaknesses. We aimed to measure the EE of an internal medicine residency programme in Singapore, compare the perceptions between genders, residency grades and levels of work experience, and identify specific areas of weaknesses for intervention in hopes of reducing residency burnout rates in Singapore.

METHODS

This study took place between October and December 2017. We adopted a mixed methods approach, quantitatively using the Postgraduate Hospital Educational Environment Measure (PHEEM), and qualitative exploration using semi-structured focus group discussion.

RESULTS

A total of 136 (88.9%) out of 153 residents responded. Our total PHEEM scores (112.23 ± 16.71), along with the scores for all three subscales, were higher than those of institutions in previous studies. There were no differences in overall PHEEM and subscale scores between genders, residency grades or levels of work experience. However, there were differences for individual questions, which were explored in the focus group discussion. Senior residents juggling heavier workloads, responsibilities and examinations appeared to be most prone to burnout. We identified three recurring themes that contributed to a poor EE in our programme: excessive workload, poor faculty relationships and differing unmet needs.

CONCLUSION

Although our programme had a good EE, there were also areas of weaknesses revealed by specific questions, possibly contributing to burnout. We hope to implement interventions to these areas and subsequently assess for longitudinal changes in EE and burnout rates.

The Dutch residency educational climate test: construct and concurrent validation in Spanish language

OBJECTIVES

To translate the 35-item version of the Dutch Residency Educational Climate Test (D-RECT), and assess its reliability, construct validity and concurrent validity in the Spanish language.

METHODS

For this validation study, the D-RECT was translated using international recommendations. A total of 220 paper-based resident evaluations covering two Colombian universities were cross-sectionally collected in 2015. A Confirmatory Factor Analysis (CFA) was used to assess the internal validity of the instrument using the Comparative fit index (CFI), Tucker-Lewis index (TLI), Standardized root mean square residual (SRMSR), and Root mean square error of approximation (RMSA). Cronbach's α was used to assess reliability. The concurrent validity was investigated through Pearson correlations with the Spanish version of the Postgraduate Hospital Educational Environment Measure (PHEEM).

RESULTS

The original 9-factor structure showed an appropriate fit for the Spanish version of the instrument (CFI = 0.84, TLI = 0.82, SRMSR = 0.06, and RMSA = 0.06). The reliability coefficients were satisfactory (>0.70). The mean total scores of the D-RECT and the PHEEM showed a significant correlation (r = 0.7, p<0.01).

CONCLUSIONS

This study confirms the validity and reliability of the Spanish version of the Dutch Residency Educational Climate Test, indicating that the instrument is suitable for the evaluation of departments' learning climate in the Spanish context. Future research is needed to confirm these findings in other Spanish speaking countries.

Learning Climate Perceptions as a Determinant of Employability: An Empirical Study Among European ICT Professionals

This study investigated the role of age in the relationship between perceptions of learning climate and self- and supervisor-rated employability among European Information and Communication Technology (ICT) professionals. The psychological climate for learning was operationalized by three indicators, namely the perceptions that employees have of the learning value of their job, supervisor support for learning, and the organizational support for learning. As hypothesized, a Structural Equation Model demonstrated that the relationship between age and perceptions of learning climate was negative. The model also showed a strong positive relationship between learning climate and self-reported and supervisor-rated employability. Furthermore, learning climate perceptions appeared important for employability irrespective of life or career stage. An explorative bootstrapping-based test suggested that older workers with managerial responsibilities profit less from psychological learning climate for self-reported and supervisor-rated employability than older workers at non-managerial levels. These findings have important implications for human resource practices that aim to increase lifelong employability.

The Healer's Art: Remembering Our Professional Lineage in Community through the Cultivation of Individual Core Values

This article was migrated. The article was marked as recommended. Introduction: There is both patient and provider dissatisfaction with the climate of healthcare delivery. Upon review, this is found to be at least in part attributable to the mechanization of health care, which often involves more computer interaction than hands-on care. Despite rising costs, the physical exam is replaced by lab tests and radiologic studies, generating more cost. The time-honored respect for a carefully obtained history from the patient is replaced by a computer check-box template. The humanity of both physician and patient are marginalized, with increased potential for both diagnostic and therapeutic compromise. Though access to medical information about disease is possible with bioinformatics, artificial intelligence cannot substitute for analysis by an informed, attentive, and properly educated physician. The process of healing must begin with the first patient visit - and the presence of an informed, compassionate, and fully attentive physician. Objective: To describe the history of medical educators' grappling with this problem through 3 landmark articles over a 100-year period. To illustrate the challenges of the climate of medical education. To offer some educational strategies (with examples of successful programs) to teach physicians using the Humanities. To illustrate that the art and science of medicine are synergistic, not dichotomous. Methods: Two educational theories ripe for use: Chickering and the Discovery Model, and Osler's recommended bedside reading list, exemplary programs that are being used currently (and over the last 25-plus years) to emphasize the importance of both the science and the practice of medicine in an effort to optimize the medical climate. Conclusion: The problem of physician burnout and patient dissatisfaction is being addressed in the medical literature, by regulatory societies devoted to physician wellness and by medical educators. This is nevertheless a challenge given the current electronic climate (with bioinformatics and artificial intelligence) and revenue-focused agendas of practice management business people. Results: With an awareness of the need for emphasis on the humanities coupled with an historical perspective over the last 100 years, a spirit of hope can be provided to both physician and patient from the lineage of the medical profession, which also is a legacy for our medical students.

Leadership rounds to reduce health care-associated infections

BACKGROUND

Evidence-based guidelines exist to reduce health care-associated infections (HAIs). Leadership rounds are one tool leaders can use to ensure compliance with guidelines, but have not been studied specifically for the reduction of HAIs. This study examines HAI leadership rounds at one facility.

METHODS

We explored unit-based HAI leadership rounds led by 2 hospital leaders at a large academic hospital. Leadership rounds were observed on 19 units, recorded, and coded to identify themes. Themes were linked to the Consolidated Framework for Implementation Research and used to guide interviews with frontline staff members.

RESULTS

Staff members disclosed unit-specific problems and readily engaged in problem-solving with top hospital leaders. These themes appeared over 350 times within 22 rounds. Findings revealed that leaders used words that demonstrated fallibility and modeled curiosity, 2 factors associated with learning climate and psychologic safety. These 2 themes appeared 115 and 142 times, respectively. The flexible nature of the rounds appeared to be conducive for reflection and evaluation, which was coded 161 times.

CONCLUSIONS

Each interaction between leaders and frontline staff can foster psychologic safety, which can lead to open problem-solving to reduce barriers to implementation. Discovering specific communication and structural factors that contribute to psychologic safety may be powerful in reducing HAIs.

A Pilot Study

This paper will explore if and how psychological strain plays a mediator role between the learning climate and job performance in a group of health workers. Although the relationship between learning climate and job performance has already been explored in the international literature, the role of psychological strain, which may hamper or deepen this relationship, has yet to be investigated. The research hypothesis is that psychological strain mediates the relationship between the climate toward learning (including also the error avoidance climate) and job performance. Data were gathered in a Public hospital in Italy. Participants (N = 61) were health professionals (nurses and obstetricians). Considering the relatively small sample size, a mediation analysis with the aid of the SPSS macro PROCESS was performed. The results show that the relationship between the learning climate (specifically its dimension of organizational appreciation toward learning) and job performance is mediated by psychological strain. The future research agenda and practical implications are discussed in the paper.

A multicenter study: how do medical students perceive clinical learning climate?

BACKGROUND

The relationship between students and instructors is of crucial importance for the development of a positive learning climate. Learning climate is a multifaceted concept, and its measurement is a complicated process. The aim of this cross-sectional study was to determine medical students' perceptions about the clinical learning climate and to investigate differences in their perceptions in terms of various variables.

METHODS

Medical students studying at six medical schools in Turkey were recruited for the study. All students who completed clinical rotations, which lasted for 3 or more weeks, were included in the study (n=3,097). Data were collected using the Clinical Learning Climate Scale (CLCS). The CLCS (36 items) includes three subscales: clinical environment, emotion, and motivation. Each item is scored using a 5-point Likert scale (1: strongly disagree to 5: strongly agree).

RESULTS

The response rate for the trainees was 69.67% (n=1,519), and for the interns it was 51.47% (n=917). The mean total CLCS score was 117.20±17.19. The rotation during which the clinical learning climate was perceived most favorably was the Physical Therapy and Rehabilitation rotation (mean score: 137.77). The most negatively perceived rotation was the General Internal Medicine rotation (mean score: 104.31). There were significant differences between mean total scores in terms of trainee/intern characteristics, internal medicine/surgical medicine rotations, and perception of success.

CONCLUSION

The results of this study drew attention to certain aspects of the clinical learning climate in medical schools. Clinical teacher/instructor/supervisor, clinical training programs, students' interactions in clinical settings, self-realization, mood, students' intrinsic motivation, and institutional commitment are important components of the clinical learning climate. For this reason, the aforementioned components should be taken into consideration in studies aiming to improve clinical learning climate.

The Questionnaire D-RECT German: Adaptation and testtheoretical properties of an instrument for evaluation of the learning climate in medical specialist training

AIM

Boor et al developed and validated the questionnaire D-RECT (Dutch Residency Educational Climate Test ) to measure the clinical learning environment within the medical specialist training. In this study, a German version of this questionnaire (D-RECT German) is analyzed regarding testtheoretical properties.

PROBLEM

Are the results of Boor et al replicable as a proof for validity of the questionnaire D-RECT?

MATERIAL & METHODS

The study was performed as online survey using the questionnaire D-RECT German (50 items in 11 subscales). To determine item characteristics and internal consistency (Cronbach's α), item- and reliability analyses were performed. Furthermore, a confirmatory factor analysis was performed using a model for maximum-likelihood estimation to evaluate validity.

RESULTS

This replication study on the psychometric properties of the D-RECT with 255 residents at 17 German hospitals revealed heterogeneous discriminatory power for all items and an internal consistency of Cronbach's α between 0.57 and 0.85. Within the confirmatory factor analysis, 6 items showed standardized regression coeffizients <0.5, two of them in the subscale "Attendings role". Furthermore, strong interdependencies (>0.7) were found between the subscales "Supervision", "Coaching" and "Attendings role".

CONCLUSION

The present replication study with the D-RECT German showed structural differences with respect to factorial validity underpinning the need of further validation studies.

What motivates young physicians? - a qualitative analysis of the learning climate in specialist medical training

BACKGROUND

Not least the much-invoked shortage of physicians in the current and the next generation has resulted in a wide range of efforts to improve postgraduate medical training. This is also in the focus of the current healthcare policy debate. Furthermore, quality and scope of available postgraduate training are important locational advantages in the competition for medical doctors. This study investigates the preferences and concerns that German house officers (HOs) have about their current postgraduate training. It also highlights how HOs evaluate the quality of their current postgraduate training and the learning environment.

METHODS

HOs were asked to answer the question: "Which things are of capital importance to you personally in your medical training?", using a free text format. The survey was conducted web based (Lime survey) and all data was anonymized. Summarizing qualitative analyses were performed using the software tool MaxQDA.

RESULTS

A total of 255 HOs participated in this study (female: n = 129/50.6 %; male: n = 126/49.4 %; age: 32 + 6 years) associated with 17 different German hospitals and from four medical specialties. Ten categories were generated from a total of 366 free text answers: 1. methodology of learning (n = 66), 2. supervision (n = 66), 3. learning structure (n = 61), 4. teaching competence (n = 37), 5. dedication (n = 34), 6. work climate (n = 29), 7. feedback/communication (n = 22), 8. challenge/patient safety (n = 21), 9. time/resources (n = 17), 10. personal security/safety (n = 13).

CONCLUSIONS

HOs want a reliable and curriculum-guided learning structure. Different studying techniques should be used with sufficient (time) resources available in a trusting and communicative learning environment. Competent and dedicated instructors are expected to give individual and specific feedback to the HOs on individual strengths and deficits. Instructors should develop educational concepts in cooperation with the HOs and at the same time avoid excessive demands on HOs or hazards to patients.

The effects of formalized and trained non-reciprocal peer teaching on psychosocial, behavioral, pedagogical, and motor learning outcomes in physical education

Peer teaching is recognized as a powerful instructional method; however, there is a paucity of studies that have evaluated the outcomes experienced by peer-teachers and their student recipients in the context of trained, non-reciprocal, high school physical education (PE). Accordingly, the effectiveness of a formalized and trained non-reciprocal peer teaching (T-PT) program upon psychosocial, behavioral, pedagogical, and student learning outcomes within high school PE classes was investigated. Students from eight intact classes (106 males, 94 females, Mage = 12.46, SD = 0.59) were randomly assigned to either a T-PT intervention group (taught by a volunteer peer-teacher who was trained in line with a tactical games approach) or untrained group (U-PT; where volunteer peer-teachers received no formal training, but did receive guidance on the game concepts to teach). Data were collected over 10 lessons in a 5-week soccer unit. Mixed-model ANOVAs/MANOVAs revealed that, in comparison to U-PT, the T-PT program significantly enhanced in-game performance actions and academic learning time among student recipients. Those in the T-PT also provided greater levels of feedback and structured learning time, as well as reporting more positive feelings about peer teaching and fewer perceived barriers to accessing learning outcomes. These findings show that non-reciprocal peer-teachers who receive formalized support through training and tactical games approach-based teaching resources can enhance behavioral, pedagogical, and motor performance outcomes in PE.

Exercise, character strengths, well-being, and learning climate in the prediction of performance over a 6-month period at a call center

Background: Performance monitoring might have an adverse influence on call center agents' well-being. We investigate how performance, over a 6-month period, is related to agents' perceptions of their learning climate, character strengths, well-being (subjective and psychological), and physical activity.

Method: Agents (N = 135) self-reported perception of the learning climate (Learning Climate Questionnaire), character strengths (Values In Action Inventory Short Version), well-being (Positive Affect, Negative Affect Schedule, Satisfaction With Life Scale, Psychological Well-Being Scales Short Version), and how often/intensively they engaged in physical activity. Performance, “time on the phone,” was monitored for 6 consecutive months by the same system handling the calls.

Results: Performance was positively related to having opportunities to develop, the character strengths clusters of Wisdom and Knowledge (e.g., curiosity for learning, perspective) and Temperance (e.g., having self-control, being prudent, humble, and modest), and exercise frequency. Performance was negatively related to the sense of autonomy and responsibility, contentedness, the character strengths clusters of Humanity and Love (e.g., helping others, cooperation) and Justice (e.g., affiliation, fairness, leadership), positive affect, life satisfaction and exercise Intensity.

Conclusion: Call centers may need to create opportunities to develop to increase agents' performance and focus on individual differences in the recruitment and selection of agents to prevent future shortcomings or worker dissatisfaction. Nevertheless, performance measurement in call centers may need to include other aspects that are more attuned with different character strengths. After all, allowing individuals to put their strengths at work should empower the individual and at the end the organization itself. Finally, physical activity enhancement programs might offer considerable positive work outcomes.

Cognitive milieu therapy and physical activity: experiences of mastery and learning among patients with dual diagnosis

During the last decade, there has been a growing interest in implementing cognitive milieu therapy (CMT) in psychiatric institutions. However, there is a lack of systematic evaluations from patients' point of view. The aim of this study was to explore and describe patient perceptions of essential experiences of mastery, learning alternative ways of thinking, and acquiring new skills through CMT and physical activity in an inpatient setting. Qualitative interviews were carried out with 20 patients with dual diagnosis. A hermeneutic - phenomenological approach was used in the data collection and analysis. The results showed that the learning climate in the unit was important. This included a proactive attitude from the staff, focusing on cooperation on equal terms between patients and staff, and a professional methodological approach through CMT. The optimal balance between staff-induced activities and patient initiatives was not easy to obtain. Patients appreciated both the education provided by the staff and learning from other patients. The cognitive method was sometimes experienced as too theoretical and difficult to understand. Physical activity, however, was experienced as 'concrete' and providing practical knowledge. It motivated patients to establish new habits and provided opportunities for the development of mastery together with other patients.

Treating and precepting with RESPECT: a relational model addressing race, ethnicity, and culture in medical training

BACKGROUND

In 2000 a diverse group of clinicians/educators at an inner-city safety-net hospital identified relational skills to reduce disparities at the point of care.

DESCRIPTION

The resulting interviewing and precepting model helps build trust with patients as well as with learners. RESPECT adds attention to the relational dimension, addressing documented disparities in respect, empathy, power-sharing, and trust while incorporating prior cross-cultural models. Specific behavioral descriptions for each component make RESPECT a concrete, practical, integrated model for teaching patient care.

CONCLUSIONS

Precepting with RESPECT fosters a safe climate for residents to partner with faculty, address challenges with patients at risk, and improve outcomes.