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- Feasibility of the Enhancing Participation In the Community by improving Wheelchair Skills (EPIC Wheels) program: study protocol for a randomized controlled trial. [Journal Article, Research Support, Non-U.S. Gov't]
- Trials 2013.:350.
Many older adults rely on a manual wheelchair for mobility but typically receive little, if any, training on how to use their wheelchair effectively and independently. Standardized skill training is an effective intervention, but limited access to clinician trainers is a substantive barrier. Enhancing Participation in the Community by Improving Wheelchair Skills (EPIC Wheels) is a 1-month monitored home training program for improving mobility skills in older novice manual wheelchair users, integrating principles from andragogy and social cognitive theory. The purpose of this study is to determine whether feasibility indicators and primary clinical outcome measures of the EPIC Wheels program are sufficiently robust to justify conducting a subsequent multi-site randomized controlled trial.A 2 × 2 factorial randomized controlled trial at two sites will compare improvement in wheelchair mobility skills between an EPIC Wheels treatment group and a computer-game control group, with additional wheelchair use introduced as a second factor. A total of 40 community-dwelling manual wheelchair users at least 55 years old and living in two Canadian metropolitan cities (n = 20 × 2) will be recruited. Feasibility indicators related to study process, resources, management, and treatment issues will be collected during data collection and at the end of the study period, and evaluated against proposed criteria. Clinical outcome measures will be collected at baseline (pre-randomization) and post-intervention. The primary clinical outcome measure is wheelchair skill capacity, as determined by the Wheelchair Skills Test, version 4.1. Secondary clinical outcome measures include wheelchair skill safety, satisfaction with performance, wheelchair confidence, life-space mobility, divided-attention, and health-related quality of life.The EPIC Wheels training program offers several innovative features. The convenient, portable, economical, and adaptable tablet-based, home program model for wheelchair skills training has great potential for clinical uptake and opportunity for future enhancements. Theory-driven design can foster learning and adherence for older adults. Establishing the feasibility of the study protocol and estimating effect size for the primary clinical outcome measure will be used to develop a multi-site randomized controlled trial to test the guiding hypotheses.Clinical Trials NCT01740635.
- Psychiatric rehabilitation education for physicians. [Journal Article]
- Psychiatr Rehabil J 2013 Jun; 36(2):126-7.
As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011).
- Athlete support personnel and anti-doping: Knowledge, attitudes, and ethical stance. [JOURNAL ARTICLE]
- Scand J Med Sci Sports 2013 May 22.
Athlete support personnel (ASP) failing to meet responsibilities under the World Anti-Doping Code risk sanction. It is unclear whether the poor knowledge of responsibilities seen in sports physicians and coaches applies to other ASP (e.g., administrators, chiropractors, family, nutritionists, physiotherapists, psychologists, and trainers). A purposive sample of Australian ASP (n = 292) responded to a survey on knowledge of anti-doping rules (35 true/false questions), ethical beliefs and practice, and attitudes toward performance enhancement. Some ASP declined to participate, claiming doping was irrelevant to their practice. Physicians were most knowledgeable (30.8/35), with family and trainers the least (26.0/35). ASP reported that improvements were needed to support anti-doping education (e.g., basis for anti-doping) and practice (e.g., rules). ASP also had a slightly negative attitude toward performance enhancement. Linear regression showed that being a sports physician, providing support at the elite level, and 15 years of experience influenced knowledge. The results confirm gaps in knowledge, suggesting that stronger engagement with ASP anti-doping education and practice is needed. Applying the principles of andragogy could help foster active engagement through emphasis on active inquiry, rather than passive reception of content. Future work on the context within which ASP experience anti-doping is needed, exploring acquisition and translation of knowledge into practice.
- Using modern teaching strategies to teach upper abdominal sonography to medical students. [Journal Article]
- J Chin Med Assoc 2013 Jul; 76(7):395-400.
Upper abdominal sonography can help physicians to confirm the diagnosis of various hepatobiliary diseases. Teaching sonography skills to medical students is important because it may enhance their level of knowledge and overall development during their gastroenterology section rotation. Sonographic imaging is abstract and students can be easily confused when scanning the abdominal structures from different sites and directions. We used several modern teaching strategies to facilitate the learning of sonography skills.The year five medical students beginning a gastroenterology section rotation for their first-year clerkship were taught abdominal sonography skills. Abstract sonographic images were related to concrete objects and the surrounding structures were further indicated. Each of the images was given a specific name and was sorted according to the scanning site. A mnemonics system was designed to help students to memorize the names of these images. A badge was created to recognize the achievement of being able to complete a basic upper abdominal sonography. Students were free (i.e., not obligated) to request a demonstration opportunity to show their skills within 2 weeks after receiving tutelage. We recorded the number of students who received training and were able to successfully complete the task; these individuals then received a badge to be pinned onto their white coats.Sixty-three of 68 students (92.6%) requested evaluation and all of them passed.We have greatly simplified the process of learning about upper abdominal sonography by using andragogy to enhance learning, mnemonics to help memory, and a pin-badge reward system to stimulate incentives.
- Gender matters in medical education. [Journal Article]
- Med Educ 2013 Jan; 47(1):59-70.
Women are in the majority in terms of entry to medical schools worldwide and will soon represent the majority of working doctors. This has been termed the 'feminising' of medicine. In medical education, such gender issues tend to be restricted to discussions of demographic changes and structural inequalities based on a biological reading of gender. However, in contemporary social sciences, gender theory has moved beyond both biology and demography to include cultural issues of gendered ways of thinking. Can contemporary feminist thought drawn from the social sciences help medical educators to widen their appreciation and understanding of the feminising of medicine?Post-structuralist feminist critique, drawn from the social sciences, focuses on cultural practices, such as language use, that support a dominant patriarchy. Such a critique is not exclusive to women, but may be described as supporting a tender-minded approach to practice that is shared by both women and men. The demographic feminising of medicine may have limited effect in terms of changing both medical culture and medical education practices without causing radical change to entrenched cultural habits that are best described as patriarchal. Medical education currently suffers from male biases, such as those imposed by 'andragogy', or adult learning theory, and these can be positively challenged through post-structuralist feminist critique.Women doctors entering the medical workforce can resist and reformulate the current dominant patriarchy rather than reproducing it, supported by male feminists. Such a feminising of medicine can extend to medical education, but will require an appropriate theoretical framework to make sense of the new territory. The feminising of medical education informed by post-structuralist frameworks may provide a platform for the democratisation of medical culture and practices, further informing authentic patient-centred practices of care.
- Student apathy for classroom learning and need of repositioning in present andragogy in Indian dental schools. [Journal Article]
- BMC Med Educ 2012.:118.
In the world of technology, when today's student is approaching the on-line /distance learning in the open universities and doing on-line self-assessment, the classroom learning is vanishing slowly. Globally, teachers are taking efforts to improve the pedagogy by implementing effective methods to retain the classroom teaching and student attendance. The present study aims at shedding some light on the need of changing the adult education strategies (andragogy), which can effectively improve the student attendance for lectures.It is an observational study, and the conceptual framework of it is based on beliefs, opinions and personal experiences of the respondents. Triangulation method is used for collecting the data. The data is achieved from three groups of concerned population who could provide valid results to support the study. It is collected by interviewing 10 senior faculty members who are/were the 'education experts' in the universities, while the main concerned groups of present educational stream, i.e. 'institution-teachers' and the 'students', were given questionnaires. 570 teacher respondents and 200 student respondents are the main participants of this study.As per data, it has been observed that senior faculty (90%) and students (93.25%) feel need of student motivation more than the institutional teachers (52.44%). P-values were obtained using Chi-Square test for testing the significance of difference between agreement and disagreement for a specific question.In India, Universities have already sensed the need of 'teacher development programmes'. But teachers in dental colleges, demand more efforts to be taken by universities and managements in this regard and expect better educational policies to give them accessibility to prove themselves.
- [Employees health education--challenges according to the educational level]. [English Abstract, Journal Article]
- Med Pr 2012; 63(1):55-71.
Article addresses the problem of increasing Polish employees health education effectiveness according to the differences in educational level.Research model assume that effective method of developing recommendations improving the health education will synthesise scientific findings regarding methodology of conducting such education and knowledge about needs of two target groups: low and high educated employees. Educational solutions were searched in publications related to: health education, andragogy, propaganda and direct marketing. The empirical material used to characterize two target groups came from four research (qualitative and quantitative) conducted by the National Centre for Workplace Health Promotion (Nofer Institute of Occupational Medicine) in 2007-2010.Low educated employees' health education should be focused on increasing responsibility for health and strengthening their self-confidence according to the introduction of healthy lifestyle changes. To achieve these goals, important issue is to build their motivation to develop knowledge about taking care of health. In providing such information we should avoid the methods associated with school. Another important issue is creating an appropriate infrastructure and conditions facilitating the change of harmful behaviors undertaken at home and in the workplace. According to high-educated employees a challenge is to support taking health behaviors--although they are convinced it is important for their health, such behaviors are perceived as a difficult and freedom restriction. Promoting behavior change techniques, avoiding prohibitions in the educational messages and creating favorable climate for taking care of health in groups they participate are needed.
- Medical students' perspective about role-plays as a teaching strategy in community medicine. [Comparative Study, Journal Article]
- J Coll Physicians Surg Pak 2012 Apr; 22(4):222-5.
To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine.A quasi-experimental study. PlACE AND DURATION OF STUDY: Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010.A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at < 0.05 as significant.Sixty-three students were selected as participants of this study in which 46 belonged to the fourth year MBBS class (73%) and 17 were third year MBBS students (27%). There were 13 male (20.6%) and 50 female (79.4%) students. Role-plays were identified as most effective method of teaching (n = 25, 37.9%) followed by lectures (n = 17, 25.8%, p = 0.054). Fifty-two students (78.5%) admitted that role-plays improved their knowledge of the subject, 55 (84.6%) said that it will help them in their clinical performance. Fifty-nine participants (89.4%) found role-plays interesting and 49 (74.2%) wanted to incorporate role-plays as a part of curriculum. Fifty-six of the participants (88.9%) agreed that role-plays improved their communication skills. Twenty-one participants (31.8%) believed that it helped them in making acquaintance with the local situation. Forty-six students (76.7%) identified role-plays as a feasible way of andragogy (p = 0.005) and 48 (76.2%) said that it provoked critical thinking about the subject (p = 0.038). Fifty-four students (85.7%) admitted that their attention span was better in role-plays as compared to lectures (p = 0.047).Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine.
- The good student is more than a listener - The 12+1 roles of the medical student. [Journal Article]
- Med Teach 2012; 34(1):e1-8.
The process of medical education, particularly in the fast evolving new era of medical metaschools, is a broad and complex issue. Harden & Crosby claimed that a good teacher is more than a lecturer, and identified 12 roles that certify a good and capable teacher. However, this is only half the truth: the good student is more than a listener. Teaching-and-learning is not simply a one-way process, and, as medical students are not children, the relationship between teacher and students involves andragogy rather than pedagogy. We therefore propose the 12+1 roles of the student. SUMMARY OF WORK: The Harden & Crosby paper was distributed in a class of 90 third year Ioannina University medical students, who were asked to think about the student's roles. A small discussion group brainstormed ideas, which were then refined further by the authors.12+1 roles of the good medical student were produced and grouped into six areas: information receiver, in lectures and clinical context; role model in learning, in class, with the added subarea of comparative choice of role models; teaching facilitator and teacher's mentor; teacher's assessor and curriculum evaluator; active participator and keeping-up with curriculum; resource consumer/co-creator and medical literature researcher. The ideal student should fulfil the majority if not all of these complementary roles.These 12+1 student's roles are complementary to the 12 roles of the teacher and help reshaping our understanding of today's medical education process.
- AM last page. Applying Knowles' andragogy to resident teaching. [Journal Article]
- Acad Med 2012 Jan; 87(1):129.