The foundation for future education, teaching, training, learning, and performing infrastructure - The open interoperability conceptual framework approach

The proliferation of Information and Communication Technologies (ICT) in Education, Teaching, Training, Learning, and the operational application (Performing) of acquired knowledge, skills, and competencies in contemporary social environments has directly influenced the transformation of early Networked Learning (NL) concepts into a Global Learning Infrastructure. Creating cooperative/collaborative stakeholders networks composed of learning subjects, objects, and competencies consumers, exposes the significant potential for gaining overall social progress. The main challenging obstacles of such globalization are: embedding semantics into the competence credentials carriers, trusted dissemination of verifiable competence tokens, the heterogeneous ontologies mapping, and sustainable service delivery infrastructure. The mainstream motivation of our research is the specification and development of a conceptual framework that fosters the interoperability of different stakeholders, whether individual or institutional, to declare, share and maintain the representative collections of information resources related to the particular Education, Learning, Teaching, Training, and Performing (Research, Development, Production, and Service) endeavors. In this article, we have specified an open, heterogeneous, interoperable conceptual framework capable of orchestrating past, current, and future paradigms to foster building the foundations for comparative analysis and evaluation of traditional and nontraditional competency-building processes, joined with students' portfolio creation, dissemination, and management. It is a starting specification that would serve for the future: open, heterogeneous, cooperative/collaborative, service-oriented software framework specification and development.

Use of theory to guide integration of virtual reality technology in nursing education: A scoping study

BACKGROUND

There is growing interest among academic nurse educators in using virtual reality (VR) environments as a pedagogical tool to enhance student learning.

PURPOSE

The aim of this scoping study was to identify the theories or conceptual models that informed the application of virtual reality technology in nursing education programs.

METHODS

A scoping study using the Arksey and O'Malley (2005) framework was conducted. A search strategy recommended and executed by a research librarian yielded 18 final articles for review.

FINDINGS

There is limited use of theory or a conceptual model, particularly of nursing origin, to guide the integration of VR technology for student learning.

DISCUSSION

More research is needed to define best practices for application of VR technology for specific curricular needs, and for theory development based on specific concepts and disciplinary perspectives of learning.

Frequently Used Conceptual Frameworks and Design Principles for Extended Reality in Health Professions Education

Health professions education (HPE) has witnessed a dramatic increase in the use of extended reality (XR), but there is limited evidence that conceptual frameworks are being effectively employed in the design and implementation of XR. This paper introduces commonly utilized conceptual frameworks that can support the integration of XR into the learning process and design principles that can be helpful for the development and evaluation of XR educational applications. Each framework and design principle is summarized briefly, followed by a description of its applicability to XR for HPE and an example of such application.

Investigating acceptability of a training programme in precision medicine for frontline healthcare professionals: a mixed methods study

BACKGROUND

Precision Medicine offers tailored prevention, diagnosis, treatment and management to patients that considers genomics, lifestyle and environmental factors. If implementation of Precision Medicine is to advance, effective, focused upskilling of frontline healthcare professionals through quality continuing professional development is needed. This study reports on an evidence-based approach to needs assessment to investigate the current level of knowledge of Precision Medicine, acceptable content for training, the perceived potential of a more precision approach to patient care and motivation to participate in a training programme among pharmacists, advanced practice nurses and general practitioners. Investigating perceived needs can avoid a top-down approach and support a design that is fit for purpose to targeted professions.

METHODS

This study reports on 2 focus groups (n = 12) delivered in French and German with equal professional participation of the targeted professions. The research objectives were investigated in two phases. During the first phase, a literature review and expert consultations were conducted to develop a definition of PM, patient cases and content for training. In a second phase, these investigations were further explored using focus groups to investigate acceptable learning objectives, the potential of PM to relevant professions and motivation of participants. Quantitative investigations using rating scales and visual analogues were incorporated. The focus groups were audio recorded, transcribed by intelligent verbatim and translated to English. NVivo was used for data analysis and interpretation following a hybrid approach using the Framework Method and thematic analysis. The analytical framework, Implementation Science, was applied to organise and present research data.

RESULTS

Precision Medicine is considered a new topic area, largely unfamiliar to frontline healthcare professionals.. There was acceptance of a more precision approach to care among all participants with perceived positive implications for patients. Valuable insight was gathered on acceptable content and form for training. All participants expressed concerns on readiness within their professions which included an insufficient system infrastructure, a lack of time to attend needed training, a lack of clarity for use in practice and the time needed to build a support network.

CONCLUSIONS

A precision approach to patient care is on the horizon for health care professionals not only in hospital settings but also at the community level. Our results conclude that an adaptable and flexible training programme in PM is timely, contextually relevant and conducive to the needs of targeted health professions for successful implementation. A training programme in PM will require support across sectors and stakeholders, supporting insurance models, educated patients and integrated care supported by innovative technology. Implementation Science outcomes are a useful strategy towards design of an effective training programme that can have measurable impact in practice.

Advancing the assessment of clinical reasoning across the health professions: Definitional and methodologic recommendations

The importance of clinical reasoning in patient care is well-recognized across all health professions. Validity evidence supporting high quality clinical reasoning assessment is essential to ensure health professional schools are graduating learners competent in this domain. However, through the course of a large scoping review, we encountered inconsistent terminology for clinical reasoning and inconsistent reporting of methodology, reflecting a somewhat fractured body of literature on clinical reasoning assessment. These inconsistencies impeded our ability to synthesize across studies and appropriately compare assessment tools. More specifically, we encountered: 1) a wide array of clinical reasoning-like terms that were rarely defined or informed by a conceptual framework, 2) limited details of assessment methodology, and 3) inconsistent reporting of the steps taken to establish validity evidence for clinical reasoning assessments. Consolidating our experience in conducting this review, we provide recommendations on key definitional and methodologic elements to better support the development, description, study, and reporting of clinical reasoning assessments.

A scoping review of theories and conceptual frameworks used to analyse health financing policy processes in sub-Saharan Africa

Health financing policies are critical policy instruments to achieve Universal Health Coverage, and they constitute a key area in policy analysis literature for the health policy and systems research (HPSR) field. Previous reviews have shown that analyses of policy change in low- and middle-income countries are under-theorised. This study aims to explore which theories and conceptual frameworks have been used in research on policy processes of health financing policy in sub-Saharan Africa and to identify challenges and lessons learned from their use. We conducted a scoping review of literature published in English and French between 2000 and 2017. We analysed 23 papers selected as studies of health financing policies in sub-Saharan African countries using policy process or health policy-related theory or conceptual framework ex ante. Theories and frameworks used alone were from political science (35%), economics (9%) and HPSR field (17%). Thirty-five per cent of authors adopted a 'do-it-yourself' (bricolage) approach combining theories and frameworks from within political science or between political science and HPSR. Kingdon's multiple streams theory (22%), Grindle and Thomas' arenas of conflict (26%) and Walt and Gilson's policy triangle (30%) were the most used. Authors select theories for their empirical relevance, methodological rational (e.g. comparison), availability of examples in literature, accessibility and consensus. Authors cite few operational and analytical challenges in using theory. The hybridisation, diversification and expansion of mid-range policy theories and conceptual frameworks used deductively in health financing policy reform research are issues for HPSR to consider. We make three recommendations for researchers in the HPSR field. Future research on health financing policy change processes in sub-Saharan Africa should include reflection on learning and challenges for using policy theories and frameworks in the context of HPSR.

Introduction: Autochthonous human adaptation to biodiversity change in the Anthropocene

Rapid biodiversity change that is already occurring across the globe is accelerating, with major and often negative consequences for human well-being. Biodiversity change is partly driven by climate change, but it has many other interacting drivers that are also driving human adaptation, including invasive species, land-use change, pollution and overexploitation. Humans are adapting to changes in well-being that are related with these biodiversity drivers and other forces and pressures. Adaptation, in turn, has feedbacks both for biodiversity change and human well-being; however, to date, these processes have received little science or policy attention. This Special Issue introduces human adaptation to biodiversity change as a science-policy issue. Research on human adaptation to biodiversity change requires new methods and tools as well as conceptual evolution, as social-ecological systems and environmental change adaptation approaches must be reconsidered when they are applied to different processes and contexts-where biodiversity change drivers are highly significant, where people are responding principally to changes in species, species communities and related ecosystem processes, and where adaptation entails changes in the management of biodiversity and related resource use regimes. The research was carried out in different marine and terrestrial environments across the globe. All of the studies consider adaptation among highly biodiversity-reliant populations, including Indigenous Peoples in the Americas and Europe, farmers in Asia and marine resource users in Europe and the Pacific. The concept of autochthonous adaptation is introduced to specifically address adaptation to environmental change in local systems, which also considers that local adaptation is conditioned by multi-scalar influences and occurs in synergy or conflict with adaptations of other non-local agents and actors who enable or constrain autochthonous adaptation options.

A systematic review of person-centered care interventions to improve quality of facility-based delivery

INTRODUCTION

We conducted a systematic review to summarize the global evidence on person-centered care (PCC) interventions in delivery facilities in order to: (1) map the PCC objectives of past interventions (2) to explore the impact of PCC objectives on PCC and clinical outcomes.

METHODS

We developed a search strategy based on a current definition of PCC. We searched for English-language, peer-reviewed and original research articles in multiple databases from 1990 to 2016 and conducted hand searches of the Cochrane library and gray literature. We used systematic review methodology that enabled us to extract and synthesize quantitative and qualitative data. We categorized interventions according to their primary and secondary PCC objectives. We categorized outcomes into person-centered and clinical (labor and delivery, perinatal, maternal mental health).

RESULTS

Our initial search strategy yielded 9378 abstracts; we conducted full-text reviews of 32 quantitative, 6 qualitative, 2 mixed-methods studies, and 7 systematic reviews (N = 47). Past interventions pursued these primary PCC objectives: autonomy, supportive care, social support, the health facility environment, and dignity. An intervention's primary and secondary PCC objectives frequently did not align with the measured person-centered outcomes. Generally, PCC interventions either improved or made no difference to person-centered outcomes. There was no clear relationship between PCC objectives and clinical outcomes.

CONCLUSIONS

This systematic review presents a comprehensive analysis of facility-based delivery interventions using a current definition of person-centered care. Current definitions of PCC propose new domains of inquiry but may leave out previous domains.

A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study

BACKGROUND

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.

METHODS

The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the mapping of implementation strategies to EPIS stages, articulation of research questions, and selection, content, and timing of measurement protocols. Among other key developments, the project led to a reconceptualization of its governing implementation science framework into cyclical form as the EPIS Wheel. The EPIS Wheel is more consistent with rapid-cycle testing principles and permits researchers to track both progressive and recursive movement through EPIS. Moreover, because this randomized controlled trial was predicated on a bundled strategy method, JJ-TRIALS was designed to rigorously test progress through the EPIS stages as promoted by facilitation of data-driven decision making principles. The project extended EPIS by (1) elucidating the role and nature of recursive activity in promoting change (yielding the circular EPIS Wheel), (2) by expanding the applicability of the EPIS framework beyond a single evidence-based practice (EBP) to address varying process improvement efforts (representing varying EBPs), and (3) by disentangling outcome measures of progression through EPIS stages from the a priori established study timeline.

DISCUSSION

The utilization of EPIS in JJ-TRIALS provides a model for practical and applied use of implementation frameworks in real-world settings that span outer service system and inner organizational contexts in improving care for vulnerable populations.

TRIAL REGISTRATION

NCT02672150 . Retrospectively registered on 22 January 2016.

Understanding the role of conceptual frameworks: Reading the ecosystem service cascade

The aim of this paper is to identify the role of conceptual frameworks in operationalising and mainstreaming the idea of ecosystem services. It builds on some initial discussions from IPBES, which suggested that conceptual frameworks could be used to: 'simplify thinking', 'structure work', 'clarify issues', and 'provide a common reference point'. The analysis uses the cascade model as a focus and looks at the way it has been used in recent published material and across a set of case studies from the EU-funded OpenNESS Project as a device for conceptual framing. It found that there are examples in the literature that show the cascade model indeed being used as an 'organising framework', a tool for 're-framing' perspectives, an 'analytical template', and as an 'application framework'. Although the published materials on the cascade are rich, these accounts lack insights into the process by which the different versions of the model were created, and so we turned to the set of OpenNESS case studies to examine how they read the cascade. We found that the cascade was able to provide a common reference for a diverse set of studies, and that it was sufficiently flexible for it to be developed and elaborated in ways that were meaningful for the different place-based studies. The case studies showed that generalised models like the cascade can have an important 'awareness-raising' role. However, we found that using models of this kind it was more difficult for case studies to link their work to broader societal issues such as human well-being, sustainable ecosystem management, governance, and competitiveness, than to their own concerns. We therefore conclude that to be used effectively, conceptual models like the cascade may need to be supported by other materials that help users read it in different, outward looking ways. We also need to find mechanisms for capturing this experience so that it can be shared with others.

Integrating design thinking with sustainability science: a Research through Design approach

Design disciplines have a long history of creating well-integrated solutions to challenges which are complex, uncertain and contested by multiple stakeholders. Society faces similar challenges in implementing the Sustainable Development Goals, so design methods hold much potential. While principles of good design are well established, there has been limited integration of design thinking with sustainability science. To advance this integration, we examine the process of designing MetaMAP: an interactive graphic tool for collaborating to understand social-ecological systems and design well-integrated solutions. MetaMAP was created using Research through Design methods which integrate creative and scientific thinking. By applying design thinking, researchers and practitioners from different backgrounds undertook multiple cycles of problem framing, solution development, testing and reflection. The testing was highly collaborative involving over 150 people from diverse disciplines in workshops, case studies, interviews and critique. Reflecting on this process, we discuss design principles and opportunities for integrating design thinking with sustainability science to help achieve Sustainable Development Goals.

Applied immuno-epidemiological research: an approach for integrating existing knowledge into the statistical analysis of multiple immune markers

Background

Immunologists often measure several correlated immunological markers, such as concentrations of different cytokines produced by different immune cells and/or measured under different conditions, to draw insights from complex immunological mechanisms. Although there have been recent methodological efforts to improve the statistical analysis of immunological data, a framework is still needed for the simultaneous analysis of multiple, often correlated, immune markers. This framework would allow the immunologists’ hypotheses about the underlying biological mechanisms to be integrated.

Results

We present an analytical approach for statistical analysis of correlated immune markers, such as those commonly collected in modern immuno-epidemiological studies. We demonstrate i) how to deal with interdependencies among multiple measurements of the same immune marker, ii) how to analyse association patterns among different markers, iii) how to aggregate different measures and/or markers to immunological summary scores, iv) how to model the inter-relationships among these scores, and v) how to use these scores in epidemiological association analyses. We illustrate the application of our approach to multiple cytokine measurements from 818 children enrolled in a large immuno-epidemiological study (SCAALA Salvador), which aimed to quantify the major immunological mechanisms underlying atopic diseases or asthma. We demonstrate how to aggregate systematically the information captured in multiple cytokine measurements to immunological summary scores aimed at reflecting the presumed underlying immunological mechanisms (Th1/Th2 balance and immune regulatory network). We show how these aggregated immune scores can be used as predictors in regression models with outcomes of immunological studies (e.g. specific IgE) and compare the results to those obtained by a traditional multivariate regression approach.

Conclusion

The proposed analytical approach may be especially useful to quantify complex immune responses in immuno-epidemiological studies, where investigators examine the relationship among epidemiological patterns, immune response, and disease outcomes.

Electronic supplementary material

The online version of this article (doi:10.1186/s12865-016-0149-9) contains supplementary material, which is available to authorized users.