scholarly journals Quality and Value-Focused Decision Making in Heparin-Induced Thrombocytopenia: The Impact of the American Society of Hematology's Choosing Wisely Initiative

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2342-2342
Author(s):  
Anmol Baranwal ◽  
Sindhu Joseph
Keyword(s):  
Platelet Count ◽  
Scoring System ◽  
Pretest Probability ◽  
Choosing Wisely ◽  
Chi Square ◽  
Heparin Administration ◽  
Student’S T ◽  
American Society ◽  
The Impact ◽  
4T Score

Abstract Introduction: For patients admitted to hospital, the use of heparin and its analogs is very common. Heparin administration can result in heparin-induced thrombocytopenia (HIT). Development of HIT is independent of the dose of heparin administration. Presence of HIT is determined by platelet antibody assays and confirmed by serotonin release assay. However, hospitalized patients have many comorbidities and are on several medications, both of which may be responsible for thrombocytopenia. The 4T scoring system was developed in 2006 to determine the pretest probability of HIT. Scores of 0-3, 4-5, and 6-8 are considered to correspond to a low, intermediate, and high probability of HIT, respectively. The 4T score was validated by a meta-analysis published in 2012 which reported that the negative predictive value of a low 4T score is close to 100% (Blood 2012;120(20):4160-4167). Inappropriate testing for thrombocytopenia can lead to inadvertent use of the platelet factor 4 assays, halting heparin administration unnecessarily and the over-treatment of patients with alternative anticoagulants. The American Society of Hematology (ASH) highlighted this in its 2014 Choosing Wisely guidelines (Blood 2014;124(24):3524-3528). The Choosing Wisely recommendations include using the 4T scoring system to assess the pretest probability of HIT. ASH recommends against testing and treating patients who have low pretest probability of HIT. We wanted to assess the impact of ASH Choosing Wisely recommendations on the appropriateness of checking for HIT. Methods: All the patients, admitted between January 2013 to March 2016, who had a HIT test done (CPT code 86022), were extracted from the hospital database. Of these patients, 140 were randomly selected before and after the publication of ASH Choosing Wisely guidelines. The immediately previous platelet count before ordering a HIT test was used to calculate the platelet nadir. The percentage in platelet count fall was determined by the difference between the immediately previous platelet count before ordering HIT test and the maximum platelet count documented on current admission. Timing of platelet count fall was determined as the number of days from HIT testing ordered to when patient received the first dose of heparin, or from the date of the immediately previous platelet count before ordering HIT test to the maximum platelet count, whichever is less. Patients were considered to have suspected thrombosis if an ultrasound doppler lower extremity or CT chest was ordered, but the results were not available at the time of ordering the HIT test. 4T scores were calculated for the first HIT test ordered to determine if the patients were a low-risk or intermediate- to high-risk for HIT. We did a chi-square test without Yate's correction to check if there has been a proportionate increase in HIT testing for patients with 4T score greater than 3, after the Choosing Wisely recommendations were published in 2014. Student's t-test was used to determine if there has been a decrease in the number of HIT tests ordered per patient after the release of Choosing Wisely guidelines. Patients who were not fit to be calculated for 4T score were excluded. Results: A total of 280 patient charts were reviewed. 23 patients were excluded as they received recent heparin and had platelet count fall within less than 4 days. Of the 129 patients admitted in 2013-2014, 31 (24%) were considered high/intermediate risk 4T score category. Of the 128 patients admitted from January 2015 to March 2016, 26 (20.3%) were considered high/intermediate risk 4T score category. The chi-square test did not show any difference between the two groups (chi-score 0.515 with 1 degrees of freedom, P = 0.47). However, the Student's t-test showed that the number of HIT tests ordered per patient declined significantly after the release of the Choosing Wisely guidelines (t = 2.09, P = 0.038). Conclusions: Physician adherence to 4T scoring system has not yet changed after the release of ASH Choosing Wisely guidelines. However, repeated testing for HIT has declined significantly after the guideline release. More efforts need to be taken to improve the quality of care in this population. Disclosures Baranwal: MacNeal Hospital: Employment.

Thrombocytopenia Is a Strong Adverse Feature in Transplant-Eligible Patients with Myelofibrosis: Utility for an Improved CBC-Based Scoring System.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2584-2584
Author(s):  
David Dingli ◽  
Susan M. Schwager ◽  
Ruben A. Mesa ◽  
Chin-Yang Li ◽  
Ayalew Tefferi
Keyword(s):  
Multivariate Analysis ◽  
Platelet Count ◽  
High Risk ◽  
Scoring System ◽  
High Risk Patient ◽  
Risk Patient ◽  
Poor Survival ◽  
Hematopoietic Stem ◽  
Myeloid Metaplasia ◽  
The Impact

Abstract Background: Allogeneic hematopoietic stem cell transplantation is potentially curative in agnogenic myeloid metaplasia (AMM) but is associated with substantial mortality and morbidity that necessitates accurate identification of patients in whom benefit outweighs risk. The current single institutional study investigates prognostic variables in transplant-eligible patients with AMM with the main objective of improved discrimination between intermediate- and high-risk patient categories. Methods: Patients diagnosed with AMM before the age of 60 years and seen at Mayo Clinic were identified and the diagnosis confirmed. Relevant demographic, clinical and laboratory characteristics were abstracted and the impact of various parameters on overall survival was evaluated with univariate and multivariate analysis. Results: A cohort of 159 patients (median age 52 years, range 18–60; 89 males) with AMM is described. Median follow-up from initial diagnosis was 63 months (range 0–300). During this period, 102 patients have died; overall median survival 79 months. Multivariate analysis of parameters measured in all study patients at diagnosis identified thrombocytopenia (platelet count < 100 x 109/L) as the strongest predictor of inferior survival (p=0.002). In addition, a hemoglobin level of <10 g/dL (p=0.003), white blood cell count of either <4 or >30 x 109/L (p=0.03), and older age (p=0.02) were also found to be independent indicators of poor prognosis. However, when the analysis included parameters that were measured in variable proportion of the study population, the independent prognostic factors for poor survival were thrombocytopenia (p=0.0001), anemia (p=0.01), and the presence of unfavorable cytogenetic abnormalities (0.001). Based on the above findings, we constructed a new complete blood count (CBC)-based prognostic scoring system (Figure 1) that performed better than the Dupriez scoring system in discriminating intermediate- from high-risk patient categories(Figure 2). Figure Figure Conclusions: Thrombocytopenia is a strong predictor of poor survival in transplant-eligible patients with AMM. The incorporation of platelet count into the Dupriez prognostic scoring system might allow the construction of an improved, CBC-based scoring system that can accurately identify high-risk as well as intermediate-risk patients with AMM.

scholarly journals Does a previous surgical experience interfere on psychic stress in patients submitted to major surgery?

2014 ◽  
Vol 41 (1) ◽  
pp. 043-048 ◽  
Author(s):  
Luiz Ronaldo Alberti ◽  
Márcia Rodrigues Daian ◽  
Andy Petroianu
Keyword(s):  
Emotional Disorders ◽  
Psychological Symptoms ◽  
Major Surgery ◽  
Chi Square ◽  
Stress Symptoms ◽  
Chi Square Test ◽  
Group 2 ◽  
Postoperative Stress ◽  
Student’S T ◽  
The Impact

OBJECTIVE: to evaluate the impact of stress in patients undergoing major surgeries under general anesthesia, relating their physical and psychic reactions to the different stages of stress. METHODS: we studied 100 adult patients of both genders, who were divided into two groups: Group 1 - 22 patients without experience with surgery; Group 2 - 78 patients previously submitted to medium and major surgery. To investigate the stress, we used the Inventory of Stress Symptoms for Adults, developed by Lipp, the day before the procedure and two days and seven days after the operation. The comparison of groups with respect to gender, pain, and percentage of stress were performed using the Chi-square test, and for the age variable the Student's t test was used. Differences were considered significant at p<0.05. RESULTS: the groups were not homogeneous as for the overall percentage of stress on the three measurements. G1 had decreased postoperative stress, whilst in G2 it increased. Psychological symptoms of stress prevailed in both groups. CONCLUSION: previous surgery reduced preoperative stress but did not affect postoperative emotional disorders.

scholarly journals Utilizing the Predictive Value of the 4T Scoring System to Reduce Unnecessary HIT Panel Costs in the Community Hospital Setting

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5001-5001 ◽  
Author(s):  
Rashmika Potdar ◽  
Sorab Gupta ◽  
Jia Hwei Ng ◽  
Schoepe Robert ◽  
Andrew Berson ◽  
...  
Keyword(s):  
Scoring System ◽  
Community Hospital ◽  
Conflicts Of Interest ◽  
Hospital Setting ◽  
Immunological Response ◽  
Retrospective Chart Review ◽  
Turnaround Time ◽  
Study Objective ◽  
Heparin Administration ◽  
4T Score

Abstract Abstract Study Objective-Heparin Induced Thrombocytopenia (HIT) is a life-threatening immunological response to heparin. The objectives for this study were to determine if the 4T scoring system was being utilized as a tool for predicting HIT, and to look at the costs associated with HIT panels. Methods-This was a retrospective chart review of patients greater than 18 years of age who had HIT panels performed between January 2013 and June 2014 in a community hospital. Any duplicate HIT panels sent during the same admission period were excluded. Study investigators were trained in two 30-minute intervals in the area of data collection and retrospective calculation of 4T score. Results- Of the 154 patients studied, 73 (47.4%) were male, and 81 (52.6%)were female. All patients had a 4T score calculated by study investigators during data analysis, and 1.29% (n=2) had a 4T score calculated before a HIT panel was sent by the team taking care of the patient. 62.3% (n=96) of patients had a low 4T score and 37. 7%( n=58) had an intermediate to high 4T score. Hematology was consulted on 57.7% (n=89) and anticoagulant administration was stopped on 74 % (n=114), while in 26 % ( 40/ 154) heparin was continued despite sending HIT. 25.4%(29/114) were started on alternate anti- coagulants after stopping heparin . Throughout the course of the study, 20 patients died, with only 1 of these patients being HIT positive. If 100 unnecessary HIT panels were performed in a year, the hospital would be charged more than $20,000 by the diagnostic lab. Additional costs include the halting of Heparin administration and starting an alternate anticoagulant such as Argatroban. 24 hour administration of Argatroban costed $1,000 for continuous infusion. HIT panels have a turnaround time of 4-5 days, resulting in the additional charge of $5,000 just for Argatroban administration. A lengthened stay in the hospital due to HIT panel turnaround time is also a source of increased costs. Combined, the ordering of a HIT panel, alternate anticoagulant administration, and bed charges could amount to $40,000 over the course of four days. This time and money could be put to better use treating the underlying disease of the patient, instead of focusing on the testing for HIT. Conclusion-Management of HIT in community hospital was sub-optimal. Lack of utilization of the 4T scoring system led to unnecessary ordering of HIT panels. This increased duration of hospital stay, elevated the cost of treatment, and resulted in the holding of prophylactic anticoagulants. Disclosures No relevant conflicts of interest to declare.

Admitting Service and Outcome for Small Bowel Obstruction

2021 ◽  
pp. 000313482110540
Author(s):  
Christopher Thacker ◽  
Claire Lauer ◽  
Kathleen Nealon ◽  
Charles Walker ◽  
Matthew Factor
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Multivariable Analysis ◽  
Admission Diagnosis ◽  
Chi Square ◽  
Surgical Services ◽  
Multivariable Regression ◽  
Student’S T ◽  
The Impact

Introduction Small bowel obstruction (SBO) is a common admission diagnosis. Prior research has shown improved length of stay and time to operation for SBO patients on surgical services (SS) compared to medical services (MS). This study evaluates the impact of admitting service on readmission and mortality. Methods A 12-year retrospective cohort study of patients ≥18 years old, admitted with SBO to either a MS or SS within one health care system was performed. Clinicodemographic characteristics and admission details were extracted and reviewed. Statistical analyses performed included the Student’s t-test, chi-square, and multivariable regression. Results The study included 7921 patients, of which 3862 (48.8%) were admitted to a SS. No significant clinicodemographic differences existed between the groups except SS patients were more likely to have cancer (23.3% vs 15.2%, P < .0001) and to be within a 30-day post-operative period (9.4% vs 1.8%, P < .0001). On multivariable analysis, admission to a SS was associated with a decreased admission mortality (OR .70), 30-day mortality (OR .42), and 180-day mortality (OR .42). 30-day readmissions (OR .54) and 180-day readmission (OR .43) were also significantly decreased for SS patients. In patients requiring a procedure during admission, there was significantly decreased admission mortality (OR .684), 30-day mortality (OR .470), 180-day mortality (OR .431), 30-day readmission (OR .63), and 180-day readmission (OR .50). Conclusion In patients with SBO, admission to a SS confers decreased odds of readmission and mortality compared to MS. Future studies are needed to understand the management decisions potentially underlying these differences. These findings may help better define admission pathways and improve outcomes.

scholarly journals Behavior and development of Tetranychus ludeni Zacher, 1913 (Acari: Tetranychidae) and physiological stress in genetically modified cotton expressing Cry1F and Cry1Ac proteins

2020 ◽  
Author(s):  
N. R. Valadares ◽  
M. A. Soares ◽  
E. A. Ferreira ◽  
V. G. Mendes-Sá ◽  
A. M. Azevedo ◽  
...  
Keyword(s):  
Physiological Stress ◽  
Genetically Modified ◽  
Oviposition Preference ◽  
Photosynthetic Parameters ◽  
Bt Cotton ◽  
Chi Square ◽  
Genetically Modified Cotton ◽  
Randomized Design ◽  
Student’S T ◽  
The Impact

Abstract Genetically modified plants are one of the tactics used in integrated pest management - IPM. There is great concern about the impact of these plants on non-target organisms. On the other hand, there is little information in the literature on the effects of transgenics (Bacillus thuringiensis) Bt on populations of phytophagous mites, and the physiological responses that this attack promotes on plants. The objective of this work was to evaluate the biology of the T. ludeni mite in Bt cotton, expressing the Cry1F and Cry1Ac proteins. To evaluate the behavior of food and oviposition preference of the T. ludeni with Bt cotton and isohybrid. Verify if the physiological stress caused by T. ludeni’s attack is differentiated in Bt cotton. The mites were reared in Bt cotton and isohybrid, in a total of 40 replicates in the completely randomized design and the biological cycle was evaluated. The food preference and oviposition analysis were done with 10 replicates, with choice. The physiological stress was evaluated through chlorophyll fluorescence, under greenhouse conditions. The data of the T. ludeni biology were analyzed by Student's t-test, for food and oviposition preference the chi-square test was performed. Regression models were fitted for the fluorescence parameters. The model identity test was used to evaluate the differences between Bt and isohybrid treatments. Cry1F and Cry1Ac proteins have not affected the biology of T. ludeni. The photosynthetic parameters in Bt cotton plants were less influenced by T. ludeni infestation.

scholarly journals 175. Assessment of Institutional Uptake of Vancomycin AUC Monitoring One-Year Post Guideline Publication in Hospitals Across the United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S196-S197
Author(s):  
Nicole Bradley ◽  
Yuman Lee ◽  
Ariel E Francis ◽  
Duchess Iregbulem
Keyword(s):  
Phase 1 ◽  
The United States ◽  
Research Network ◽  
Therapeutic Monitoring ◽  
Phase 2 ◽  
Chi Square ◽  
Initial Survey ◽  
American Society ◽  
One Year ◽  
The Impact

Abstract Background A new therapeutic monitoring of vancomycin for serious methicillin resistant Staphylococcus aureus infections guideline was published in March 2020. The guideline recommends a change in monitoring from trough to AUC/MIC based to improve patient outcomes. The purpose of this study was to determine institutional uptake of vancomycin AUC monitoring 1-year post guideline publication in hospitals across the U.S. Methods An electronic survey was created to assess vancomycin AUC monitoring practices and distributed to the American College of Clinical Pharmacy Infections Diseases Practice and Research Network (ACCP IDprn) and American Society of Health System Pharmacists (ASHP). Initial survey distribution (phase 1) occurred May-June 2020 and aimed to serve as baseline data. The survey was re-distributed (phase 2) to the ACCP IDprn and ASHP one year later, May-June 2021. Prior to re-distribution the survey was updated to assess the impact of COVID-19 on uptake. Results were analyzed and reported using descriptive statistics. Chi-Square tests were used to compare categorical data. Results A total of 202 responses to phase 1 and 138 responses to phase 2 were recorded. Significantly more respondents implemented AUC monitoring 1-year post guideline than at baseline (42.8% vs 29.8%, p= 0.013). In both phases, 57% of those who had not implemented AUC monitoring had plans to do so over the next year. Additionally, 46.2% phase 2 respondents reported COVID-19 impacted their ability to transition to AUC monitoring citing issues such as lack of time and inadequate resources. The most common AUC monitoring programs utilized at baseline and 1-year post guideline were purchased Bayesian software (38.3% vs. 35.6%) and homemade software (26.1% vs 23.7%). Perceived challenges to implementing AUC monitoring included cost, difficult use and integration. Conclusion Increased uptake of vancomycin AUC monitoring occurred from baseline to 1-year post guideline publication. However, less than half of hospitals implemented this recommendation. Although COVID-19 impacted a large portion respondents’ ability to implement AUC monitoring, majority plan to transition to vancomycin AUC monitoring over the next year. AUC monitoring should be adapted by all hospitals to optimize vancomycin efficacy and safety. Disclosures All Authors: No reported disclosures

scholarly journals Effect of intensive training in improving older women's knowledge and support for infant vaccination in Nigerian urban slums: a before-and-after intervention study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Folusho Mubowale Balogun ◽  
Olayinka Samson Bamidele ◽  
Eniola Adetola Bamgboye
Keyword(s):  
Child Care ◽  
Older Women ◽  
Urban Slum ◽  
Chi Square ◽  
Intensive Training ◽  
Participatory Learning ◽  
Infant Vaccination ◽  
Before And After ◽  
Student’S T ◽  
The Impact

Abstract Background One of the strategies for improving vaccination uptake is to make communities understand the importance of immunization and this is expected to drive the demand for vaccines. Building the capacity of older women who supervise child care in Africa may improve infant vaccination in underserved communities. This study determined the impact of training of older women on their knowledge and support for infant vaccination in selected urban slum communities in Ibadan, Nigeria. Methods This was a before-and-after study that enrolled women aged ≥35 years. They were trained with a manual and short video using participatory learning methods over an 8 month period. The content of their training includes importance of immunization timeliness and completion, how vaccines work and how to be advocates and supporters of infant vaccination. Their knowledge and support for infant vaccination at baseline were compared with post training values using Student’s t test and Chi square test with the level of significance set at 5%. Results There were 109 women with mean age 55.8 ± 11.6. they had a mean of 5.7 ± 2.1 training sessions. At the end of the training, their knowledge about infant vaccination and the support they give to it increased from 4.8 ± 3.8 to 10.7 ± 0.6, and 3.1 ± 3.5 to 8.1 ± 1.7 respectively. Those with good knowledge about infant vaccination increased significantly from 37(33.9%) to 82(82.8%), while those with good support for the same increased from 31(28.4%) to 85(85.9%). Women who were ≤ 64 years significantly had improved knowledge after the training compared to the older ones. Those with post secondary education had better knowledge and greater support for infant vaccination at baseline. However, there was no difference in the knowledge and support for infant vaccination among the women across the different educational levels after the training. Conclusions Participatory learning improved the knowledge about, and support for infant vaccination among older women supervising child care in these urban slum communities. Similar training may be extended to comparable settings in order to improve demand for infant vaccination.

Pupillometry-guided Intraoperative Remifentanil Administration versus Standard Practice Influences Opioid Use

2017 ◽  
Vol 127 (2) ◽  
pp. 284-292 ◽  
Author(s):  
Nada Sabourdin ◽  
Jérôme Barrois ◽  
Nicolas Louvet ◽  
Agnès Rigouzzo ◽  
Marie-Laurence Guye ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Randomized Study ◽  
Gynecologic Surgery ◽  
Standard Group ◽  
Opioid Use ◽  
Chi Square ◽  
American Society ◽  
Postoperative Morphine ◽  
American Society Of Anesthesiologists ◽  
The Impact

Abstract Background Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. Methods After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study. General anesthesia was standardized with propofol–remifentanil target-controlled infusion. Patients were randomly assigned into two groups. In the pupillometry group, remifentanil administration was guided by pupillary diameter changes. In the standard group, remifentanil administration was left to the discretion of the anesthesiologist. The primary outcome was intraoperative remifentanil consumption. Results Fifty-five patients were analyzed. Remifentanil consumption was markedly decreased in the pupillometry group (3.8 [3.4 to 4.8 µg · kg–1 · h–1] vs. 7.9 µg · kg–1 · h–1 [6.5 to 9.0 µg · kg–1 · h–1] in the standard group; difference = 4.2 µg · kg–1 · h–1 [95% CI, 3.0 to 5.3 µg · kg–1 · h–1]; P &lt; 0.001). Cumulative 0- to 12-h morphine consumption was reduced in the pupillometry group (two-way repeated measures ANOVA 0.3 ± 0.1 vs. 0.4 ± 0.2 mg/kg; P = 0.048). A telephone survey 3 months after surgery revealed that 15 of 29 patients in the standard group still experienced procedure-related pain versus 3 of 23 in the pupillometry group (chi-square P = 0.037). No adverse events associated with pupillometry were observed during the study. Conclusions The use of pupillometry to guide intraoperative analgesia reduced intraoperative remifentanil consumption and postoperative morphine requirements. The possible consequences of decreasing intraoperative remifentanil in terms of chronic pain require further investigation.

scholarly journals Shorter Length of Gonadotropin Stimulation is Associated with Adverse IV F outcomes: A Retrospective Analysis

2018 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Ovarian Reserve ◽  
Chi Square ◽  
Cycle Number ◽  
Oocyte Yield ◽  
Gonadotropin Stimulation ◽  
Secondary Outcomes ◽  
Student’S T ◽  
The Impact ◽  
Student’S T Test ◽  
Hcg Trigger

Background: The impact of the length of gonadotropin stimulation (LOS) on IVF outcome has been studied by several groups. Results so far have been conflicting. The primary aim was to evaluate the impact of LOS on pregnancy rates and oocyte yield. Secondary outcomes included comparison of outcome based on LOS separately in gonadotropinreleasing hormone (GnRH) agonist (GnRH-a) and antagonist (GnRH-ant) cycles. Methods: Retrospective review of IVF cycles managed by a single provider in a private clinic. Data was collected for demographic, stimulation, embryology and clinical outcome parameters. Oocyte yield (the ability to obtain an oocyte from a proper sized follicle) was calculated for each cycle (number of oocytes retrieved/ follicles >14 mm at last scan). LOS was divided into short (≤8 days), normal (9-12 days), and prolonged (≥13 days). Student’s t-test, ANOVA, and Chi-Square tests were used. Results: Outcome based on 295 IVF cycles (GnRH-a: 94 and GnRH-ant: 201) were analyzed. Overall pregnancy rate (PR) was 36.3%. Age, ovarian reserve, number of available and transferred embryos didn’t differ in the three groups. Shorter cycles compared unfavorably to normal and prolonged stimulations regarding oocyte yield (1.2 vs 1.5 vs 1.9, P<0.05) and PR (17.6% vs 40.9% vs 28.7%, P<0.05). Oocyte yield was significantly lower in cycles ≤8 days in both the GnRH-a and GnRH-ant groups when compared to longer stimulation. Conclusions: Quicker response to gonadotropin stimulation may suggest diminished ovarian reserve but could indicate inadequate time for oocyte/ endometrial maturation to occur. LOS should be considered prior to hCG trigger administration.

scholarly journals Impacto del método “Instrucción por pares” con el apoyo de “clickers” en el aprendizaje de Matemáticas Básicas / Impact ot the “Peer Instruction Method” supported by “Clickers” on Basic Maths Learning

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Rafael Enrique Escudero
Keyword(s):  
Equal Treatment ◽  
Peer Instruction ◽  
Summer Period ◽  
Joint Research ◽  
Chi Square ◽  
Before And After ◽  
Post Test ◽  
Good Learning ◽  
Student’S T ◽  
The Impact

ABSTRACTThis study was intended to promote greater interaction between students and focusing your attention on the under-lying concepts studied in the course basic math, in exchangefor the material in sequence presented in textbooks and class notes. The study was conducted during the first half of 2012 (2012-10) and the 2012 summer period (2012 20), through a process of joint research quantitatively and qualitatively. The number of students treated in 2012 (10) was 249 and 10in the summer period. Of the 249 randomly took a course of 37 students which was a pretest at the start of the course without having received treatment. In the last week, was applied a posttestwhen the student had received the Peer Instruction Meth-od. Equal treatment is made with the summer course. The samples came from normal distributions, which found using the Shapiro-Wilk and Chi square statistical. Found significant differences between the averages of the posttest and pretest in both courses, for which was applied a test for paired as a study before and after samples student's t. For the Group of 37 students t = 5.87212 with p = 0.0000296539 < 0.05. The Group of 10 students t = 4.39678 with p = 0.00172844 < 0.05. The confidence level was of 95%. Surveys were conducted to measure the impact qualitatively, Likert type to all students, in which stood a high favorability (more than 80%) of the method in terms of more dynamic classes, greater motivation, good learning environment, greater participation, sufficient time to answer questions and improvement in learning.RESUMENEste estudio tuvo como propósito promover una mayor interacción entre los estudiantes y enfocar su atención en los conceptos subyacentes estudiados en la asignatura Matemáticas Básicas, a cambio de presentar el material en secuencia como en los libros de textos y las notas de clase. El estudio se realizó durante el primer semestre del 2012 (2012 10) y el periodo intersemestral del 2012 (2012 20), mediante un proceso de investigación mixta cuantitativa y cualitativamente. El número de estudiantes tratado en 2012 (10) fue de 249 y en el intersemestral de 10. De los 249 se tomó aleatoriamente un curso de 37 estudiantes a los que se les aplicó un pre test al inicio del curso sin haber recibido el tratamiento del método y en la última semana, se aplicó un post test. Igual tratamiento se hizo con el curso intersemestral. Las muestras provinieron de distribuciones normales, lo que se comprobó usando los estadísticos Chi Cuadrado y Shapiro-Wilk. Se encontraron diferencias significativas entre las medias de los post test y pre test, en ambos cursos, para lo cual se aplicó una prueba t de student para muestras pareadas, por ser un estudio antes y después. Para el grupo de 37 estudiantes t = 5.87212 con un p = 0.0000296539 < 0.05. En el grupo de 10 estudiantes t = 4.39678 con un p = 0.00172844 < 0.05. En ambos casos a un nivel de confiabilidad de 95%. Para medir el impacto cualitativamente, se realizaron encuestas tipo Likert a la totalidad de estu-diantes, en las que se destacaron una alta favorabilidad (más del 80%) del método en cuanto a clases más dinámicas, mayor motivación, buen ambiente de aprendizaje, mayor participación, tiempo suficiente para responder las preguntas y mejora-miento en el aprendizaje.

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