A national qualitative investigation of the impact of service change on doctors' training during Covid-19

BACKGROUND

The Covid-19 crisis sparked service reconfigurations in healthcare systems worldwide. With postgraduate medical education sitting within these systems, service reconfigurations substantially impact trainees and their training environment. This study aims to provide an in-depth qualitative understanding of the impact of service reconfiguration on doctors' training during the pandemic, identifying opportunities for the future as well as factors that pose risks to education and training and how these might be mitigated.

METHODS

Qualitative parallel multi-centre case studies examined three Trusts/Health Boards in two countries in the United Kingdom. Data were collected from online focus groups and interviews with trainees and supervisors using semi-structured interview guides (September to December 2020). A socio-cultural model of workplace learning, the expansive-restrictive continuum, informed data gathering, analysis of focus groups and coding.

RESULTS

Sixty-six doctors participated, representing 25 specialties/subspecialties. Thirty-four participants were male, 26 were supervisors, 17 were specialty trainees and 23 were foundation doctors. Four themes described the impact of pandemic-related service reconfigurations on training: (1) Development of skills and job design, (2) Supervision and assessments, (3) Teamwork and communication, and (4) Workload and wellbeing. Service changes were found to both facilitate and hinder education and training, varying across sites, specialties, and trainees' grades. Trainees' jobs were redesigned extensively, and many trainees were redeployed to specialties requiring extra workforce during the pandemic.

CONCLUSIONS

The rapid and unplanned service reconfigurations during the pandemic caused unique challenges and opportunities to doctors' training. This impaired trainees' development in their specialty of interest, but also presented new opportunities such as cross-boundary working and networking.

Preservice Teacher Perceptions of Using Video Discussions to Foster a Community of Inquiry-Does the Learning Environment Matter?

The creation of an engaging online learning environment where students feel a sense of belonging is a challenge for all educators. With the rise of online courses, discussion forums are commonly used to connect students with course content, peers, and instructors. However, these discussions are often text-based in nature. The purpose of this quantitative study examined preservice teacher perceptions of Flipgrid in an introductory educational technology course. Statistically significant relationships between groups were found related to two of the three components of the Community of Inquiry framework. Specifically, the findings suggest those enrolled in a hybrid course perceived Flipgrid as a more effective platform to create cognitive and teaching presence than those online. Additionally, hybrid learners were significantly more likely to use Flipgrid in their own teaching practices. In this article, an analysis of findings will be discussed and provide suggestions for future research.

Impact of digital technologies upon teaching and learning in higher education in Latin America: an outlook on the reach, barriers, and bottlenecks

Digital technology and literacy can heighten the transformation of teaching and learning in higher education institutions (HEIs). This study uncovers the extent to which digital technologies have been used to advance the teaching and learning process in HEIs, and the barriers and bottlenecks to why it may not have been effectively implemented across the HEIs. The study used nine selected countries in Latin America (LATAM) based on the main focus of the educators, commercial, and financial investors; to show the level of impact/implications of computer technologies on the teaching and learning processes. We applied a two-step (mixed) methodology (through a quantitative and qualitative lens) for the research investigation, using data collected from survey we administered to faculty members in HEIs across the different countries in LATAM. In turn, we implemented a Text Mining technique (sentiment and emotional valence analysis) to analyze opinions (textual data) given by the participants to help determine challenges and obstacles to using the digital technologies for teaching and learning in the region. Quantitatively, we applied a Kruskal-Wallis H-test to analyze the collected multiple choice and ranked items in the questionnaire in order to identify prominent factors that consummately influence the reach, barriers, and bottlenecks, and where the differences may lie across the different LATAM countries. The results show that the users upheld the emphasis on lack of training, infrastructures and resources, access to internet and digital platforms, as the main challenges to the teaching-learning process. The study also empirically discussed and shed light on critical factors the HEIs, particularly in LATAM, should resolve and adopt in support of the decision-making strategies, operational policies and governance, financial investments, and policymaking, at a time when "digital technologies" have become an inevitable and indispensable part of education and learning.

Learning environments' influence on students' learning experience in an Australian Faculty of Business and Economics

We investigated how learning environments-involving their physical, pedagogical, and psychosocial dimensions-influence students learning experiences in an Australian Faculty of Business and Economics. Qualitative data collection involved observations of eight classrooms over a semester, four focus groups with 21 students and interviews with six educators. The study provided deeper understanding of the dynamic and complex intrinsic interrelations of learning environment dimensions over time, addressing previous gaps in research. It identified and analysed spaces and practices, educational activities, and students' subjective experiences in different learning environments to illustrate how these multiple elements intersect and influence on the students' experience. The mixed methods used in the research helped to uncover a broader view of the learning environment and its interdependent influences over time on students' learning experiences. One practical implication is that any strategies to support a more holistic student learning experience through more effective use of learning environments should be developed at an institutional level.

Patrony: A mobile application for pattern recognition learning

Pattern recognition is an important skill of Computational Thinking and is one of the most important competences for solving a problem that involves finding similarities or patterns in small problems to solve more complex ones. In this work, we present the mobile application software Patrony. The main contribution of this work is to promote the learning of Computational Thinking, especially pattern recognition, in specific sectors of education in Mexico through the simple use of a software application. To evaluate the effectiveness of the mobile application, tests were carried out in two elementary schools with a total of 43 students, which were divided into 2 groups: a control group and an experimental group. The results of the tests showed that the learning gain (M = 6.50 in postest compared to M = 4.94 on pretest) of the students who used our mobile application produces a significant difference with respect to students who learned using a traditional method of classroom teaching. The results also infer that computational thinking applications can be used as effective learning tools within some important Mathematics topics in public and private schools in Mexico.

Development and validation of Online Classroom Learning Environment Inventory (OCLEI): The case of Indonesia during the COVID-19 pandemic

This paper reports the development and validation of a new questionnaire to assess students' perceptions of the online learning environment in Indonesia during the COVID-19 pandemic. In total, 669 participants (454 women, 215 men) from various universities were recruited online to complete a 25-item questionnaire. Item factor analysis verified a five-factor model, while multidimensional Rasch analysis showed that all items fit this model and have good reliability. The factors of Access, Interaction, Lecturer Support, Equity, and Investigation formed the valid and reliable Online Classroom Learning Environment Inventory (OCLEI). All aspects of online learning readiness were related to the five factors of the OCLEI, therefore supporting convergent validity. With these results, we concluded that the OCLEI is a novel measure that can be used in future educational research in Indonesia. Limitations and implications are noted.

Systematic Literature Review of E-Learning Capabilities to Enhance Organizational Learning

E-learning systems are receiving ever increasing attention in academia, business and public administration. Major crises, like the pandemic, highlight the tremendous importance of the appropriate development of e-learning systems and its adoption and processes in organizations. Managers and employees who need efficient forms of training and learning flow within organizations do not have to gather in one place at the same time or to travel far away to attend courses. Contemporary affordances of e-learning systems allow users to perform different jobs or tasks for training courses according to their own scheduling, as well as to collaborate and share knowledge and experiences that result in rich learning flows within organizations. The purpose of this article is to provide a systematic review of empirical studies at the intersection of e-learning and organizational learning in order to summarize the current findings and guide future research. Forty-seven peer-reviewed articles were collected from a systematic literature search and analyzed based on a categorization of their main elements. This survey identifies five major directions of the research on the confluence of e-learning and organizational learning during the last decade. Future research should leverage big data produced from the platforms and investigate how the incorporation of advanced learning technologies (e.g., learning analytics, personalized learning) can help increase organizational value.

Effect of COVID-19 pandemic on academic accreditation

Background: Higher education quality is an essential measurement for any country’s development, since education is a significant source of new sciences and its applications. This importance works as one of the cornerstones toward public health. The sudden change from traditional classroom teaching and learning to online education and learning process did not give educators the time to adjust the teaching material or, for that matter, did not give the program administrators the time to prepare for the needed documents toward the accreditation. This situation creates a dilemma for all members involved in certification. This research is addressing this issue from the accreditation point of view.

Design: Brainstorming methodology is used to study the effect of COVID-19 pandemic on the academic/health accreditation.

Methods: Cause and effect diagram (Fishbone diagram) is used to present the ideas presented by institutional participants related to the effect of COVID-19 on the accreditations processes.

Conclusions: The study shows that COVID-19 pandemics have dramatic influence on accreditation processes, which may lead to change and/or adjust the rules and the requirements of the educational institutions due to changes in the fulfillment of the accreditation by the institutions during this period.

Transformation of the mathematics classroom with the internet

Growing use of the internet in educational contexts has been prominent in recent years. In this survey paper, we describe how the internet is transforming the mathematics classroom and mathematics teacher education. We use as references several reviews of use of the internet in mathematics education settings made in recent years to determine how the field has evolved. We identify three domains in which new approaches are being generated by mathematic educators: principles of design of new settings; social interaction and construction knowledge; and tools and resources. The papers in this issue reflect different perspectives developed in the last decade in these three domains, providing evidence of the advances in theoretical frameworks and support in the generation of new meanings for old constructs such as 'tool', 'resources' or 'learning setting'. We firstly highlight the different ways in which the use of digital technologies generates new ways of thinking about mathematics and the settings in which it is learnt, and how mathematics teacher educators frame the new initiatives of initial training and professional development. In this survey paper, we identify trends for future research regarding theoretical and methodological aspects, and recognise new opportunities requiring further engagement.

Flexible learning spaces reduce sedentary time in adolescents

OBJECTIVES

Many schools internationally are replacing traditional classrooms (TC) with innovative flexible learning spaces (FLS) to improve academic outcomes. Via a stealth approach, there may be additional unintended health benefits if students reduce their total and prolonged sitting. The aim of this study was to compare student sitting patterns between TC and FLS.

DESIGN

School-based cross-over trial.

METHODS

Students at nine secondary schools (n=191, M age=13.2±1.0years) wore activPAL accelerometers in both a traditionally furnished and arranged classroom (TC), and a FLS containing a variety of furniture and layout options, utilizing student-centered pedagogies, for the duration of one double classroom lesson (M=76min). The lesson content and teacher were consistent across both conditions. Data were analyzed using multilevel mixed-effects linear regression.

RESULTS

In FLS, students spent less class time sitting (mean=18%; 95% CI: -20.8, -15.0), and accumulated more breaks in sitting (2.1; 95% CI: 0.8, 3.5 per 60min), more bouts of intermittent (≤9min) sitting (2.2; 95% CI: 0.8, 3.6 per 60min), and fewer bouts of prolonged (≤30min) sitting (-0.2; 95% CI: -0.3, -0.1 per 60min), than in TC. Students also spent more class time standing (15%; 95% CI: 12.7, 18.0) and stepping (3%; 95% CI: 2.0, 3.1) in FLS than TC.

CONCLUSION

The results suggest that, by stealth, elements of FLS including a variety of furniture and resources, and greater use of student-centered pedagogies, facilitate improvements in adolescents' sedentary profiles during class time. This may translate into beneficial health impacts over a longer period given the health benefits of reducing total and breaking up prolonged sitting.

Grounded and embodied mathematical cognition: Promoting mathematical insight and proof using action and language

We develop a theory of grounded and embodied mathematical cognition (GEMC) that draws on action-cognition transduction for advancing understanding of how the body can support mathematical reasoning. GEMC proposes that participants' actions serve as inputs capable of driving the cognition-action system toward associated cognitive states. This occurs through a process of transduction that promotes valuable mathematical insights by eliciting dynamic depictive gestures that enact spatio-temporal properties of mathematical entities. Our focus here is on pre-college geometry proof production. GEMC suggests that action alone can foster insight but is insufficient for valid proof production if action is not coordinated with language systems for propositionalizing general properties of objects and space. GEMC guides the design of a video game-based learning environment intended to promote students' mathematical insights and informal proofs by eliciting dynamic gestures through in-game directed actions. GEMC generates several hypotheses that contribute to theories of embodied cognition and to the design of science, technology, engineering, and mathematics (STEM) education interventions. Pilot study results with a prototype video game tentatively support theory-based predictions regarding the role of dynamic gestures for fostering insight and proof-with-insight, and for the role of action coupled with language to promote proof-with-insight. But the pilot yields mixed results for deriving in-game interventions intended to elicit dynamic gesture production. Although our central purpose is an explication of GEMC theory and the role of action-cognition transduction, the theory-based video game design reveals the potential of GEMC to improve STEM education, and highlights the complex challenges of connecting embodiment research to education practices and learning environment design.

Swimming without the water: a critical perspective on mental health experience for adult nursing students

Adult nurses and adult field nursing students come into contact with a diverse range of other patient groups in their practice but perhaps none more so than those who have co-existing mental health issues. Consequently adult field student nurses must be equipped with the requisite knowledge and skills to competently care for their patients who also experience mental health problems. Given the pressure on placements many education providers have developed alternatives to direct mental health experiences. The authors review their own experience of some of the modalities that higher education institutes (HEI) use to instruct their students in this field. They argue that, ideally, there is no substitute for the practical experience of placements in the mental health sector, particularly if these include contact with mental health nursing. The paper concludes with some recommendations for nursing education and our professional body that could help equip adult field nursing students with the necessary experience and skills of mental health to support them into their future careers.

Understanding the science-learning environment: A genetically sensitive approach

Previous studies have shown that environmental influences on school science performance increase in importance from primary to secondary school. Here we assess for the first time the relationship between the science-learning environment and science performance using a genetically sensitive approach to investigate the aetiology of this link. 3000 pairs of 14-year-old twins from the UK Twins Early Development Study reported on their experiences of the science-learning environment and were assessed for their performance in science using a web-based test of scientific enquiry. Multivariate twin analyses were used to investigate the genetic and environmental links between environment and outcome. The most surprising result was that the science-learning environment was almost as heritable (43%) as performance on the science test (50%), and showed negligible shared environmental influence (3%). Genetic links explained most (56%) of the association between learning environment and science outcome, indicating gene–environment correlation.