Disentangling the Therapist Effect: Clustering Therapists by Using Different Treatment Outcomes

Previous studies have shown that therapists' performance varies, known as therapist effects, and have indicated that therapists who excel in one treatment outcome may not necessarily be effective in other outcomes. This observational naturalistic study aimed to enhance our understanding of therapist effects and the assessment of therapists' performance in different areas. The study included 68 therapists and 5,582 clients from a large mental health facility. Information about their learning activities was available for a subsample of 49 therapists. Separate multilevel analyses were conducted for treatment outcomes, including case mix-corrected OQ-45 change scores, dropout rates, referrals to other facilities, treatment duration, and client satisfaction ratings. A hierarchical cluster analysis was performed to identify groups of therapists based on their performance across various treatment outcomes. Additionally, differences in therapist characteristics among the clusters identified were examined. Therapist effects varied across different outcomes, ranging from small (2.6% for OQ-45 change) to moderate (6.5% for number of sessions). The cluster analysis revealed four distinct clusters of therapists with specific profiles. They had performance differences in certain areas but not in others. This exploratory study supports the notion that therapists exhibit diverse profiles regarding treatment outcomes. These findings are significant for future investigations of therapist effects that aim to identify the characteristics of effective therapists and in the context of personalizing treatment for clients.

Five-year changes of social activity and incident long-term care needs among depressed older adults: A 15-year follow up

OBJECTIVES

To examine the effects of changes in individual/multiple social activities between 65 and 70 years of age on incident long-term care (LTC) needs between 70 and 80 in older adults with depressive symptoms.

METHODS

Participants were recruited from the New Integrated Suburban Seniority Investigation Project, an ongoing prospective cohort study. A total of 525 older adults with depressive symptoms were included. The validated 15-item Geriatric Depression Scale was used to assess depressive symptoms. A self-report questionnaire was used to measure social activities (social-related, learning, and personal). LTC needs was defined according to Japan's Long-term Care Insurance System. A competing risk model and a Laplace regression model were used to estimate the hazard ratios of LTC needs incidence and the 25th percentile difference in LTC-needs-free survival time and their 95% confidence intervals.

RESULTS

Out of 4314 person-years of mild LTC needs, 108 individuals developed it. Participants who increased their frequency of learning activities have a lower risk of developing mild LTC needs. Increasing the frequency could also prolong LTC-needs-free survival time by approximately 2.61 years. Out of 4535 person-years for severe LTC needs, 54 individuals developed it. Participants with a continuous regular frequency of learning activities had a lower risk of developing severe LTC needs. However, the association between this frequency and LTC-needs-free survival time for severe LTC needs was insignificant in the multivariable models.

CONCLUSIONS

Increased frequency of learning activities reduced the risk of LTC needs among older adults with depressive symptoms and prolonged their LTC-needs-free survival time.

Activities to promote empathy for patients among pharmacy learners: A scoping review

BACKGROUND

Provider empathy has been shown to be directly linked to improved patient outcomes. The objective of this scoping review of the literature was to identify and describe learning activities that promote empathy for patients among pharmacy learners.

METHODS

This scoping review was conducted using the following inclusion criteria: publication in English, activities conducted in any academic pharmacy training program (professional degree program, experiential, residency, or fellowship), description of the learning activity(ies) provided, and focus on the experience of empathy/caring/compassion for patients, either human or animal. Articles were excluded if they focused only on skills such as empathic responding or if they did not describe the learning experience. All study designs other than reviews were included.

RESULTS

The scoping review revealed 89 full-text articles that met the inclusion criteria. Included studies demonstrated a wide variety of approaches to the design of learning experiences as well as methods of measurement of empathy. Various types of learning modalities have been used to develop empathy in pharmacy learners, with reflection being the most common. A large proportion of studies that assessed empathy development used quasi-experimental or qualitative designs and did not report tests of statistical significance, which would make it difficult to compare the effectiveness of the different learning activities.

IMPLICATIONS

A variety of approaches have been used among pharmacy learners to develop empathy for patients. Due to the high level of variability in approaches, more rigorous studies are needed to assess the effectiveness of these learning activities.

Energy justice in education sector: The impact of student demographics on elementary and secondary school energy consumption

Reducing school energy costs has become an important issue, while the energy saving should consider different school systems and student backgrounds. This study investigated the impact of student demographics on energy consumption in elementary and secondary schools and explores the difference of energy consumption in different types and levels of school systems. Data were collected from 3672 schools (including 3108 elementary and 564 secondary schools, respectively) in Ontario, Canada. The number of students whose first language is not English, the number of students who receive special education services, the number of school-aged children who live in low-income households, and student learning ability are all inversely proportional to energy consumption; student learning ability has the largest negative impact. The partial correlation between student enrollment and energy consumption has a trend of gradually increasing as the grade levels increase in Catholic elementary schools, Catholic secondary schools, and public secondary schools; however, the correlation shows a gradually decreasing trend with the increase in grade levels in public elementary schools. This study is helpful for policy-makers to clarify the energy implications of various student backgrounds and the energy consumption difference in different types and levels of school systems to facilitate their formulation of effective policies.

Professional learning activities in the higher education institution of Ethiopia

Ample studies have evidenced that the professional development of teachers significantly increases the quality of teaching and improves educational institutions. Nevertheless, adequate studies have not been carried out on the professional development of higher education teachers. Most studies focus on school teachers. Hence, this study investigated the professional learning activities of university teachers in Ethiopia. A case study design was used in which twenty-four teachers participated in the study. A semi-structured interview was used to explore the learning activities used by the participants. The findings demonstrate that various learning activities are utilised, each driven by a different form of inspiration. The learning motives largely depend on incentives and are motivated by outside factors. University instructors' professional learning practices seem to require more advanced learning methodologies to maintain their learning that is underpinned by self-motivated learning.

Academic library spaces and student activities during the COVID-19 pandemic

A library in higher education plays a primary role in students' learning on campus. In addition to individually-focused studying, students come to a library for various purposes, such as group learning, collaborating, and socializing. To support students' different types of learning, appropriate physical and functional environments of the spaces must be provided. However, the environmental effects of learning spaces have not been explored extensively. Additionally, the COVID-19 pandemic has forced students to remain and study at home for extended periods, and it is expected that the pandemic experience has affected students' space use patterns. This study aims to examine the effect of the pandemic on students' library usage and to investigate the necessary environments to effectively support students' learning activities. Data was collected via interviews with 12 students. One of the main findings is that, even though students used the library less during the pandemic, they expected to use it as much as pre-pandemic or even more after the pandemic. Furthermore, both physical and functional environments were associated with the study performance and wellbeing of the students. Therefore, understanding students' learning activities and preferred environments in a library is critical to providing appropriate spaces supporting students' learning performance and wellbeing.

Learning Outcome After Different Combinations of Seven Learning Activities in Basic Life Support on Laypersons in Workplaces: a Cluster Randomised, Controlled Trial

BACKGROUND

The goal for laypersons after training in basic life support (BLS) is to act effectively in an out-of-hospital cardiac arrest situation. However, it is still unclear whether BLS training targeting laypersons at workplaces is optimal or whether other effective learning activities are possible.

AIM

The primary aim was to evaluate whether there were other modes of BLS training that improved learning outcome as compared with a control group, i.e. standard BLS training, six months after training, and secondarily directly after training.

METHODS

In this multi-arm trial, lay participants (n = 2623) from workplaces were cluster randomised into 16 different BLS interventions, of which one, instructor-led and film-based BLS training, was classified as control and standard, with which the other 15 were compared. The learning outcome was the total score for practical skills in BLS calculated using the modified Cardiff Test.

RESULTS

Four different training modes showed a significantly higher total score compared with standard (mean difference 2.3-2.9). The highest score was for the BLS intervention including a preparatory web-based education, instructor-led training, film-based instructions, reflective questions and a chest compression feedback device (95% CI for difference 0.9-5.0), 6 months after training.

CONCLUSION

BLS training adding several different combinations of a preparatory web-based education, reflective questions and chest compression feedback to instructor-led training and film-based instructions obtained higher modified Cardiff Test total scores 6 months after training compared with standard BLS training alone. The differences were small in magnitude and the clinical relevance of our findings needs to be further explored.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03618888. Registered August 07, 2018-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03618888.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-020-01160-3.

Nursing students' perception on transferring experiences in palliative care simulation to practice

BACKGROUND

Learning palliative care is challenging for nursing students. Simulation is recommended as a learning approach. Whether experiences from simulation transfer into clinical practice must be investigated.

OBJECTIVE

The aim of this study was to explore nursing students' experiences of participating in palliative care simulation and examine how they describe the perceived transfer of knowledge, skills, and competence into clinical practise.

METHOD

This prospective, qualitative study was comprised of 11 in-depth interviews with second-year bachelor nursing students. Content analysis was performed to analyse the answers to open-ended questions.

RESULTS

From this sample, simulation is a preferred method to gather knowledge, skills, and attitudes towards palliative care. Realistic cases stimulated senses and feelings. Courage grew through active participation and debriefing and influenced the students' self-confidence. Debriefing seemed to alter the situation from one of chaos to control.

CONCLUSIONS

Experiences from the simulation were perceived to transfer to practice, serve as a sound basis for clinical judgement, and enable communication with patients and their relatives. Continuity in learning through simulation combined with practice is highlighted.

Experiences of nursing students and educators during the co-construction of clinical nursing leadership learning activities: A qualitative research and development study

BACKGROUND

Student voice posits that students' unique perspectives on teaching and learning can be used in conjunction with those of educators to create meaningful educational activities.

OBJECTIVE

The study aimed to describe nursing students' and educators' experiences during the co-construction of educational activities involving clinical nursing leadership.

DESIGN

Qualitative research and development model.

SETTING

The study was conducted at a French-Canadian nursing faculty that provides a 3-year undergraduate program.

PARTICIPANTS

Five undergraduate nursing students, four nursing educators, and the principal investigator formed the co-construction team.

METHODS

Data collected included all documents (written and audio) related to the co-construction process: three 2-hour team meetings, PI's fieldnotes and a focus group discussion that occurred once the co-construction process was completed. Thematic analysis was performed guided by Paillé and Muchielli's (2010) method.

RESULTS

Data analysis revealed two interrelated themes: (1) unique, purposeful collaboration and (2) change that makes a difference. A space described as safe, without hierarchy and that included the "right" people helped the team achieve their objective of creating new educational activities on clinical nursing leadership. The two new learning activities developed by the team were perceived as useful for future nursing students. At the individual level, team members appreciated how co-construction helped them understand teaching and learning from new perspectives.

CONCLUSIONS

A structured, efficient co-construction process contributed to positive changes in the nursing program and participants. Additional research is required to enhance understanding of the factors that facilitate and hinder student-educator collaboration outside the classroom.

Surgical learning activities for house officers: do they improve the surgical experience?

OBJECTIVE

To ascertain whether house officers (HOs) attain a more satisfactory surgical rotation experience when they perform basic surgical learning activities. We also sought to establish how many and which learning activities HOs achieve and the effect on their surgical experience.

METHODOLOGY

A questionnaire listing 20 learning activities and questions regarding satisfaction with an overall experience was disseminated to HOs in the UK and Ireland who had completed ≥3 months of surgical rotations. Satisfaction with surgical experience was dichotomised in order to perform logistic regression using R Studio software v0.98.

RESULTS

The survey was completed by 150 respondents, with 26 % completing at least 10 basic surgical learning activities during their surgical rotation. On multivariate analysis, the completion of these learning activities was significantly associated with a satisfactory rotation experience (p < 0.001). Furthermore, the use of a checklist of surgical activities provided to HOs was associated with a significant increase in the performance of learning activities (p = 0.003).

CONCLUSION

Surgical HOs who were informed about potential basic surgical learning activities that can be performed during their rotations performed significantly more of these activities. And these activities were associated with a significantly greater satisfaction with surgical rotations. Therefore, we recommend facilitating HOs completion of these activities as this will ensure that basic surgical competencies are achieved and that HOs will be more satisfied with their surgical experience.

Participation in formal learning activities of older Europeans in poor and good health

Little attention has been given to the involvement in formal learning activities (FLA) in the older population when considering different health statuses. The aim of this study is to explore the extent to which possible predictors (derived from previous research as well as a conceptual model) of FLA differ for older people in poor and good health. Data are used from SHARE 2010/2011 for the 50+ populations in 16 European countries. Poor health is defined as self-report of having two or more chronic diseases assessed by a medical doctor, i.e. multimorbidity. Possible predictors of learning activities represent individual characteristics: functional limitations, demography (age, gender, marital status and household size), human capital (achieved level of education), employment, income and participation in other social activities. To assess the predictors of FLA, logistic regression models are used and average marginal estimates are compared across groups. In addition to multimorbidity, labour market activity is used as a grouping variable. The average participation of individuals in the group with multimorbidity was nearly 50 % lower than that in the group in good health (6.5 vs. 13.3 %). Regardless of multimorbidity, human capital proved to be significant predictors of FLA, especially in those active on the labour market. However, the associations were weaker in the multimorbidity group. Also, significant associations were observed of other types of social activities, in particular cultural and leisure activity and volunteering, with FLA. This study suggests that similar factors are predictors of FLA in older people with and without multimorbidity.

Motives and activities for continuing professional development: An exploration of their relationships by integrating literature and interview data

BACKGROUND

To effectively enhance professional development, it is important to understand the motivational factors behind nurses' engagement in particular types of learning activities. Nurses have various motives for professional development and utilise different learning activities. Not much is known about how these relate.

OBJECTIVES

The aim of this study was to explore the relationship between nurses' motives and activities for continuing professional development, by examining in which types of learning activities nurses engage, with which motives, and whether certain motives are associated with certain learning activities.

DESIGN

A qualitative study using semi-structured interviews.

SETTINGS AND PARTICIPANTS

Twenty-one nurses in academic and general Dutch hospitals participated.

METHODS

Interview data on nurses' learning biographies were analysed using a literature-based framework on motives and learning activities for continuing professional development. As recent classifications of nurses' motives for professional development were absent, the literature was reviewed for motives, using three databases. The interview transcripts were analysed for motives, learning activities and their relationships.

RESULTS

Nine motives and four categories of learning activities for continuing professional development were delineated. Increasing competence was the primary motive that stimulated nurses to engage in self-directed learning during work, and in formal learning activities. To comply with requirements, they engaged in mandatory courses. To deepen knowledge, they registered for conferences. To develop their careers, they enrolled in postgraduate education. Five other motives were not mentioned as frequently.

CONCLUSIONS

Specific motives were found to be related to engagement in particular learning activities. Nurses could use these findings to increase their awareness of why and how they develop professionally, and managers and human resource development professionals could develop approaches that would better suit nurses' needs.

Students' and experts' perspectives on three learning and teaching activities

Nursing is a profession that closely related to human life, and nurses are required to demonstrate critical thinking and creativity in providing health care services. However, traditional teaching approaches usually limit students' autonomy and freedom of expressing their thoughts and feelings. In order to develop the corresponding competence of nursing students, I adopted three teaching innovations, namely writing poems, composing songs, and using role plays in a nursing problem-based learning class in a university in Hong Kong. According to students' reflective notes and comments from two international expert reviewers, participating in these activities is a valuable experience and students were able to develop clinical reasoning, empathy, team spirit, motivation to learn, creativity, and ability to summarise and reconstruct knowledge. It is hoped that more innovative learning activities will be implemented, to prepare professional and ethical nurses in the future. It is also hoped that this study could provide other PBL educators some insights in innovative problem-based learning activities.