Invented spelling intervention programmes: Comparing explicit and implicit instructions

This study aims to compare the effectiveness of two invented spelling intervention programs, one with explicit instruction of graph-phonetics matches and another based on questioning and reflection on the graph-phonetic correspondences (implicit instructions). Ninety pre-school children, whose invented spellings use conventional letters unconventionally to represent sounds, were allocated to three groups, two experimental and one control. All groups were equivalent in age, intelligence, letter knowledge, and phonological awareness. We manipulated the type of instructions (implicit vs. explicit) between the pre- and post-tests in two experimental groups where children participated in an intervention programme of invented spelling. Children who participated in the implicit intervention programme showed a significant improvement in the number of correct letters mobilized in their spelling and phonemic awareness compared with children of control and explicit instruction group. Children from explicit instruction group showed significant more improvements than the children from the control group. These results suggest that questioning and reflection applied to invented spelling programmes seems to enhance a more significant knowledge about the relations between the oral and written code.

An Account of Iranian Intermediate EFL Learners’ Vocabulary Retention and Recall Through Spaced and Massed Distribution Instructions

There has been an ongoing debate on the effectiveness of spaced and massed distribution instruction in second/foreign language learning. A number of studies in the literature have investigated the impacts of spacing effect on English as a Foreign Language (EFL) learners’ vocabulary acquisition. This study aims to expand the body of existing research by exploring the impact of spaced versus massed distribution instruction on EFL learners’ vocabulary recall and retention. To this end, the Oxford Quick Placement Test (OQPT) was administered to 120 Iranian EFL students to determine their level of English proficiency. Accordingly, 75 intermediate students were selected and randomly assigned to three equivalent groups: two experimental groups, namely spaced instruction ( n = 25) and massed instruction ( n = 25), and one control group ( n = 25). After administering a pretest, the participants in both experimental groups received two different modes of instruction. The massed instruction group attended one intensive session to learn each set of target vocabularies; the spaced instruction group, on the contrary, had three sessions at irregular time intervals to learn the same vocabularies. The control group studied the same vocabularies but received no vocabulary-focused instructions. Overall, 180 vocabularies were taught to the students during a 12-week period (15 vocabularies per week). The instructions in each group took 60 min each week. Using a pretest, posttest, and delayed posttest design, the students first took a receptive vocabulary pretest before the treatment. One week after the treatment, a receptive vocabulary posttest was administered. Finally, after a 4-week interval, the students took the delayed posttest. The results revealed that the spaced instruction group significantly outperformed the massed instruction group on both immediate and delayed posttests. The findings lend support to the modulation of spaced instruction into the curricula in instructional settings as a valuable vocabulary instruction technique to promote vocabulary learning in real classroom environments.

Flipping the Classroom to Optimize Clinical Decision-Making in the Didactic Setting

BackgroundDeliberate inclusion of clinical decision-making nursing skills in the didactic setting will assist students in potentially making better patient care decisions. This can be optimized through use of the flipped learning andragogy. Flipped learning promotes an interactive classroom environment. It fosters teamwork and collaboration. Direct content instruction is the responsibility of students.ObjectiveThis cohort pilot study investigated how the flipped and nonflipped approach to teaching impacted clinical decision-making and student participation.MethodsThe Clinical Decision-Making in Nursing Scale (CDMNS) was administered to the students in the flipped classroom and the nonflipped classroom on week 1 and week 6. A student participation checklist was used to observe class activities at three separate intervals (baseline, mid-semester, and end-semester). A repeated measures analysis of covariance was conducted with Instruction Group as the between subjects factor (Flipped and Nonflipped) and Time (preinstruction and postinstruction) as the within subjects factor, and covarying age. The Time by the Instruction group was significant. The Flipped group showed an increase in Clinical decision-making scores (p < .001) after instruction while the Nonflipped group did not (p = .40).ResultsThe Flipped group (n = 24) showed an increase in Clinical decision-making scores (p < .001) after instruction while the Nonflipped group (n = 23) did not (p = .40). The Flipped classroom showed 100% participation at baseline, mid-semester, and end of semester. The Nonflipped classroom showed overall lower levels of participation, with 42%, 33%, and 39% at each point respectively.Conclusion/Implications for NursingStudents who were taught using the flipped instruction were able to apply what they learned in relevant case studies, virtual simulations, and practice National Council Licensure Examination RN (NCLEX-RN) type questions. Through teamwork and collaboration, students had time to practice clinical decision-making skills. This was evident in the increased CDMNS scores and increased levels of participation over time in the flipped group when compared to the nonflipped group.

A non-inferiority randomised controlled trial comparing self-instruction with instructor-led method in training of layperson cardiopulmonary resuscitation

Our study aimed to compare the effect of self-instruction with manikin feedback to that of instructor-led method on cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skill performance. In our randomized non-inferiority trial, 64 non-healthcare providers were randomly allocated into self-instruction and instructor-led groups. Both groups watched a 27-min standardized teaching video. Participants in the self-instruction group then performed hands-on practice on the Resusci Anne QCPR with a device-driven feedback, while those in the instructor-led group practiced manikins; feedback was provided and student’s questions were answered by instructors. Outcomes were measured by blinded evaluators and SkillReporter software. The primary outcome was the pass rate. Secondary outcomes were scores of the knowledge test and items of individual skill performance. The baseline characteristics of the two groups were similar. The pass rates were 93.8% in both group (absolute difference 0%, p = 0.049 for noninferiority). The knowledge test scores were not significantly different. However, the self-instruction group performed better in some chest compression and ventilation skills, but performed worse in confirming environmental safety and checking normal breathing. There was no difference in AED skills between the two groups. Our results showed the self-instruction method is not inferior to the instructor-led method.

Effect of Instruction on Preventing Delayed Bleeding After Colorectal Polypectomy and Endoscopic Mucosal Resection

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6 – 2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding. Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection.Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of delayed post-polypectomy bleeding. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of patients before and after instruction were compared. Univariate analysis and forward stepwise logistic regression analysis were performed to test the influence of factors in association with delayed post-polypectomy bleeding.Results: A total of 3318 polyps in 1002 patients were evaluated. The before-instruction group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. Polyp size, pedunculated type, polyp location, and rate of cold snare polypectomy did not differ between before and after instruction. Clip placement was significantly more common after instruction (22.6%, 416/1839) than before (9.7%, 144/1479, P < 0.01). Delayed post-polypectomy bleeding occurred in 1.1% of cases before instruction, and 0.4% after instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Multivariate logistic regression analysis showed that hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for delayed post-polypectomy bleeding even after instruction.Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.

Advancing Multimedia Learning for STEM: Comparing the Effect of Virtual Versus Physical Embodied Learning Tools on Student Learning about Stereochemistry

Research suggests that embodied learning tools (ELTs), such as building and manipulating models, bolster student learning in STEM disciplines, especially for content relying on students’ spatial skills. However, studies addressing whether virtual ELTs are more or less effective than physical ones are limited. This study compares the effectiveness of online instruction using a virtual ELT, simulations, to a physical ELT, physical models, on organic chemistry students’ understanding of stereochemistry, a spatial STEM disciplinary concept. Furthermore, it examines whether physical or virtual ELTs promote the transfer and application of spatial STEM content to higher order concepts. To assess the magnitude of the effect of each tool, the simulation and physical model groups’ performance was compared to two control groups, a text-based instruction group and a no instruction group. Results revealed that the physical model group showed significant learning gains in stereochemistry understanding compared to the no instruction group, while the simulation group performed no differently than the no instruction group. When asked to apply their knowledge about stereochemistry to reasoning about reaction mechanisms, a higher order chemistry concept, the physical model group outperformed the simulation group and both control groups after receiving instruction about the concept. These results suggest that physical ELTs, compared to virtual ELTs, provide students with the scaffolding necessary to learn and retain spatially demanding STEM content and then apply that knowledge to more complex discipline-specific concepts. These findings have broad implications for online STEM pedagogy.

Comparing Classroom Instruction to Individual Instruction as an Approach to Teach Avatar-Based Patient Monitoring With Visual Patient: Simulation Study

Background Visual Patient is an avatar-based alternative to standard patient monitor displays that significantly improves the perception of vital signs. Implementation of this technology in larger organizations would require it to be teachable by brief class instruction to large groups of professionals. Therefore, our study aimed to investigate the efficacy of such a large-scale introduction to Visual Patient. Objective In this study, we aimed to compare 2 different educational methods, one-on-one instruction and class instruction, for training anesthesia providers in avatar-based patient monitoring. Methods We presented 42 anesthesia providers with 30 minutes of class instruction on Visual Patient (class instruction group). We further selected a historical sample of 16 participants from a previous study who each received individual instruction (individual instruction group). After the instruction, the participants were shown monitors with either conventional displays or Visual Patient displays and were asked to interpret vital signs. In the class instruction group, the participants were shown scenarios for either 3 or 10 seconds, and the numbers of correct perceptions with each technology were compared. Then, the teaching efficacy of the class instruction was compared with that of the individual instruction in the historical sample by 2-way mixed analysis of variance and mixed regression. Results In the class instruction group, when participants were presented with the 3-second scenario, there was a statistically significant median increase in the number of perceived vital signs when the participants were shown the Visual Patient compared to when they were shown the conventional display (3 vital signs, P<.001; effect size –0.55). No significant difference was found for the 10-second scenarios. There was a statistically significant interaction between the teaching intervention and display technology in the number of perceived vital signs (P=.04; partial η2=.076). The mixed logistic regression model for correct vital sign perception yielded an odds ratio (OR) of 1.88 (95% CI 1.41-2.52; P<.001) for individual instruction compared to class instruction as well as an OR of 3.03 (95% CI 2.50-3.70; P<.001) for the Visual Patient compared to conventional monitoring. Conclusions Although individual instruction on Visual Patient is slightly more effective, class instruction is a viable teaching method; thus, large-scale introduction of health care providers to this novel technology is feasible.

Differential contributions of implicit and explicit learning mechanisms to various contextual cues in dual adaptation

The ability to switch between different tasks accurately and efficiently is an invaluable feature to a flexible and adaptive human motor system. This can be examined in dual adaptation paradigms where the motor system is challenged to perform under randomly switching, opposing perturbations. Typically, dual adaptation doesn’t proceed unless each mapping is trained in association with a predictive cue. To investigate this, we first explored whether dual adaptation occurs under a variety of contextual cues including active follow-through movements, passive follow-through movements, active three-part lead-in movements, and static visual cues. In a final intervention, we provided our Instructed group with a compensatory strategy about the perturbations (30° CW/CCW rotations) and their relationships to each context (static visual cues). This allowed us to explore the extent by which dual learning is supported by both implicit and explicit mechanisms, regardless of whether or not they elicited dual adaptation across all the various cues. To this end, following perturbed training, participants from all experiments were asked to either use or ignore the strategy as they reached without visual feedback. This Process Dissociation Procedure teased apart the implicit and explicit contributions to dual adaptation. We found that active movement cues, but not passive ones, elicited dual adaptation. Expectedly, static visual cues didn’t elicit dual adaptation, but those in the Instruction group compensated by implementing aiming strategies. Critically, we found no implicit contributions in this Instruction group, but an effect of instruction, suggesting that explicit aiming strategies inhibit implicit mechanisms in dual adaptation. Thus, by implementing conscious strategies, dual adaptation can be easily facilitated even in cases where learning would not occur otherwise.

Comparing Classroom Instruction to Individual Instruction as an Approach to Teach Avatar-Based Patient Monitoring With Visual Patient: Simulation Study (Preprint)

BACKGROUND Visual Patient is an avatar-based alternative to standard patient monitor displays that significantly improves the perception of vital signs. Implementation of this technology in larger organizations would require it to be teachable by brief class instruction to large groups of professionals. Therefore, our study aimed to investigate the efficacy of such a large-scale introduction to Visual Patient. OBJECTIVE In this study, we aimed to compare 2 different educational methods, one-on-one instruction and class instruction, for training anesthesia providers in avatar-based patient monitoring. METHODS We presented 42 anesthesia providers with 30 minutes of class instruction on Visual Patient (class instruction group). We further selected a historical sample of 16 participants from a previous study who each received individual instruction (individual instruction group). After the instruction, the participants were shown monitors with either conventional displays or Visual Patient displays and were asked to interpret vital signs. In the class instruction group, the participants were shown scenarios for either 3 or 10 seconds, and the numbers of correct perceptions with each technology were compared. Then, the teaching efficacy of the class instruction was compared with that of the individual instruction in the historical sample by 2-way mixed analysis of variance and mixed regression. RESULTS In the class instruction group, when participants were presented with the 3-second scenario, there was a statistically significant median increase in the number of perceived vital signs when the participants were shown the Visual Patient compared to when they were shown the conventional display (3 vital signs, <i>P</i>&lt;.001; effect size –0.55). No significant difference was found for the 10-second scenarios. There was a statistically significant interaction between the teaching intervention and display technology in the number of perceived vital signs (<i>P</i>=.04; partial η²=.076). The mixed logistic regression model for correct vital sign perception yielded an odds ratio (OR) of 1.88 (95% CI 1.41-2.52; <i>P</i>&lt;.001) for individual instruction compared to class instruction as well as an OR of 3.03 (95% CI 2.50-3.70; <i>P</i>&lt;.001) for the Visual Patient compared to conventional monitoring. CONCLUSIONS Although individual instruction on Visual Patient is slightly more effective, class instruction is a viable teaching method; thus, large-scale introduction of health care providers to this novel technology is feasible.

Efektifitas Penerapan Model Pembelajaran Discovery Terhadap Kemampuan Argumentasi Siswa pada Materi Laju Reaksi di Kota Jambi

Penelitian ini bertujuan untuk melihat efektifitas penerapan model pembelajaran kooperatif discovery terhadap kemampuan argumentasi siswa pada materi laju reaksi kelas XI IPA SMAN 8 Kota Jambi. Efektifitas diselidiki dengan membandingkan kemampuan argumentasi siswa pada 3 kelas berbeda yaitu kelas Discovery Learning (eksperimen I), kelas Direct Instruction berbasis diskusi (eksperimen 2), dan kelas ceramah (kontrol). Posttest Only Group design telah digunakan dalam penelitian ini. Sebanyak 90 orang siswa telah dipilih secara random dan ditempatkan ke dalam 3 kelas tersebut. Data dikumpulkan menggunakan lembar observasi dan tes kemampuan argumentatif. Berdasarkan hasil analisis statistika menggunakan SPSS 23 diperoleh bahwa ketiga deret data berdistribusi normal (p>0.05) dan homogen (p>0.05) dengan nilai rata-rata tertinggi untuk discovery learning (eksperimen 1) sebesar 75.2, diikuti oleh direct instruction berbasis diskusi (eksperimen 2)sebesar 73.0, dan direct instruction ceramah (kontrol) sebesar 62.6. Hasil uji One Way Anova dengan metode Tukey menunjukkan bahwa tidak terdapat perbedaan kemampuan argumentsi antara kelas eksperimen 1 dan 2 (p>0.05) namun keduanya berbeda dengan kelas kontrol (p<0.05). Hasil uji tersebut parallel dengan hasil observasi yang menunjukkan bahwa kelas eksperimen 1 dan 2 melaksanakan pembelajaran dengan sangat baik (87,00%), dan baik (79,00%), sedangkan kelas kontrol melaksanakan pembelajaran dengan kualitas sedang (60%). Berdasarkan hasil penelitian dapat disimpulkan bahwa kemampuan argumentasi siswa dapat ditumbuhkan menggunakan model pembelajaran berkelompok namun tidak berhasil jika menggunakan model pembelajaran ceramah. Oleh karena itu, peneliti menyarankan agar guru menggunakan model pembelajaran berkelompok untuk melatih kemampuan argumentasi siswa dalam mata pelajaran kimia, termasuk IPA. This research aimed at investigating the effect of implementation of discovery learning on students’ argumentation skill in the subject of chemical reaction rate by students of XI IPA SMAN 8 in Jambi city. The effectiveness was investigated by comparing the students’ argumentation skill in three different groups; these were discovery learning (experiment 1), discussion-based direct instruction (experiment 2), and lecturing-based direct instruction (control group). Posttest Only Group design had been utilized in this study and some 90 students had been recruited randomly and allocated in the three groups. Data was collected using observational sheets and argumentation tests. Based on the statistical analyses using SPSS 23 it was seen that the data was normal (p>0.05) and homogeny (p>0.05) by the highest mean for the discovery learning group (experiment 1) at 75.2, followed by the discussion-based direct instruction group (experiment 2) at 73.0, and the lecturing-based direct instruction group (control) at 62.6. One way Anova test by Tukey HSD showed that there was no difference between the experiment groups (p>0.05) but both were significantly different with the control group (p<0.05). Such results were parallel with the observation results showing that the students in the both experiment groups conducted the learning process at the high and good quality (87% and 79%), meanwhile those in the control group conducted the learning process at the moderate quality (60%). It can be concluded, thus, that students’ argumentative skill can be successfully nurtured using the cooperative learning models but little success using more traditional strategies. This is why science teachers are strongly recommended to use the cooperative learning models to enhance students learning outcomes in chemistry, including in science subjects.