A Guide to Innovation in the Adoption of Alternative Digital Credentials

This chapter provides a guidance to universities that desire to adopt quality standards and effective procedures for the issuance of alternative digital credentials (ADCs). Its underlying message is that universities must become involved in issuing ADCs if they are to continue to serve the public in relevant ways. It lists the strong reasons for the institutional adoption of ADCs, the barriers to adoption, and then provides advice on how to design an institutional icon (badge), criteria for the issuance of ADCs, the standardization of ADC metadata, choosing an ADC platform, establishing governance and oversight, and establishing an administrative structure. This chapter argues strongly for the adoption of competency-based assessments in contrast to assessments focused only on learning achievement assessments. This comprehensive guide is based on the experience of three universities which have successfully implemented comprehensive ADC issuance programs.

Examining the Experiences of Campus Safety among International Students

Although international students comprise a significant percentage of the college population, limited attention is directed to their safety needs. This study measured the experiences and perceptions of campus safety among international college students in the United States. The researchers sampled participants from institutions around the country, who self-identified as international students. A researcher-developed 53-item Likert scale questionnaire, the International College Students’ Safety Questionnaire (ICSSQ), was administered to the sample. Findings from the exploratory factor analysis provided preliminary evidence for a four-factor solution for the 26-item ICSSQ with adequate internal consistency. Salient demographic variables, such as, nationality, college status and perceived proficiency in English, were found to be significantly linked to derived factor scores. Implications for institutional adoption of this instrument, along with limitations and directions for future research are included.

Applications of Learning Analytics in High Schools: A Systematic Literature Review

Learning analytics aims to analyze data from students and learning environments to support learning at different levels. Although learning analytics is a recent field, it reached a high level of maturity, especially in its applications for higher education. However, little of the research in learning analytics targets other educational levels, such as high school. This paper reports the results of a systematic literature review (SLR) focused on the adoption of learning analytics in high schools. More specifically, the SLR followed four steps: the search, selection of relevant studies, critical assessment, and the extraction of the relevant field, which included the main goals, approaches, techniques, and challenges of adopting learning analytics in high school. The results show that, in this context, learning analytics applications are focused on small-scale initiatives rather than institutional adoption. Based on the findings of this study, in combination with the literature, this paper proposes future directions of research and development in order to scale up learning analytics applications in high schools.

Developing an Ecological Approach to the Strategic Implementation of UDL in Higher Education

This paper argues that, as Canadian Higher Education campuses embark on large scale Universal Design for Learning (UDL) implementation, it is essential for them to take the time to strategically consider inherent institutional challenges before pushing ahead. As a result, it is argued that ecological theory will represent a unique and powerful lens in this process of implementation. The first section of the paper examines two inherent dangers being perpetuated in current UDL drives on the vast majority of Canadian campuses that have embarked on this adventure: (i) overreliance on disability service providers, and (ii) a conceptualization of UDL work in silos. The second half of the paper focuses on solutions, and on the idea of developing a strategic approach to UDL integration framed around ecological theory. The paper draws on an analysis of phenomenological data emerging from the author’s own lived experience as a consultant responding regularly to the needs of post-secondary campuses with regards to the institutional adoption of UDL.

Assessment of the Implementation of AUC Dosing and Monitoring Practices With Vancomycin at Hospitals Across the United States

Introduction: The latest vancomycin therapeutic drug monitoring guidelines for serious MRSA infections have made a pivotal change in dosing, switching from targeting trough levels to AUC dosing. Because of these new recommendations, antimicrobial stewardship programs across the country are tasked with implementing AUC based dosing. Objectives: To assess plans for institutional adoption of vancomycin AUC dosing programs and perceptions of currently used programs in hospitals across the US. Methods: An electronic survey was distributed to members of the American College of Clinical Pharmacy IDprn Listserv and American Society of Health-System Pharmacists between May and June 2020 to assess current institutional vancomycin dosing. Institutional program use and multiple software user parameters were analyzed using descriptive statistics. Results: Two hundred two pharmacists responded to the survey with the majority practicing in institutions with 251-500 beds. Most respondents have yet to implement AUC dosing (142/202, 70.3%) with many of them planning to do so in the next year (81/142, 57.0%). Of those that already implemented AUC dosing programs, purchased Bayesian software (23/60, 38.3%) and homemade software (21/60, 35.0%) were the 2 methods most frequently utilized. Purchased Bayesian software users were more likely to recommend their software to other institutions and ranked user friendliness higher compared to non-purchased software. Conclusion: Most respondents have not made the switch to vancomycin AUC dosing, but there is a growing interest with many institutions looking to adopt a program within the next year.

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a “roadmap” for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.

Institutional Adoption of Blended Learning: Analysis of an Initiative in Action

This instrumental case study explored some preliminary impacts of a 7-year blended learning initiative (BLI) at a medium sized Canadian university on student learning. Building on the Community of Inquiry (CoI) framework, two research questions directed the investigation: (1) What are the preliminary impacts of a BLI on student learning? (2) What are the actual lived experiences of students, professors, and administrators in a university-wide BLI? Preliminary impacts reveal that student retention appears to be greater in blended courses as opposed to traditional ones, and no significant differences were observed for student grades in the campus-wide roster of courses. Both students and instructors shared that an intentional synergy of in-class instructional practices and online activities added value to a course and had a positive impact on student learning. The viewpoints of the three key stakeholders were very different concerning themes such as motivating factors and mechanisms for support; these themes need to be taken into account and weighted carefully.

Barriers to Development of an App for Improving Staff-Family Communication at Israeli Geriatric Facilities

Family caregivers (FCs) of institutionalized noncommunicative older persons reported multiple unmet communication needs focusing on the need to receive reliable and regular updates on the patient’s condition. We have developed a mobile app for improving communication between FCs and healthcare professionals (HPs), based on 152 interviews with FCs and 13 discussion groups with HPs from four Israeli geriatric facilities. Both parties participated in app planning, tailoring it to their needs and abilities. App use implementation encountered major obstacles including the bureaucratic process concerning signing contracts between the university and software development firms, which hindered the process for a full year; data security department required disproportionate security levels that interfered with user experience and delayed the development process; the study’s definition varied across different ethics/Helsinki committees (Institutional Review Boards; IRBs), which led to different demands, e.g., insurance for medical clinical trials although no drugs or medical device were involved; lack of cooperation by mid-level staff members despite the institutional adoption of the app project; low utilization by HPs resulted in FCs not receiving timely responses. Despite these and other obstacles, we tested app use for 15 months in one facility in a pre-post-design with intervention and control groups, and we have since begun testing it in another facility. FCs who had used the app had positive feedback and wished to continue using it. App use optimization requires implementation planning, assimilating changes in each facility’s work procedures and HP’s engagement and motivation and thus depends on institutional procedures and politics.

Challenges of Screening Prospective Stool Donors for Fecal Microbiota Transplantation

Despite high efficacy rates, significant costs and logistical challenges associated with procuring stool from healthy donors for fecal microbiota transplantation (FMT) have presented barriers to broader institutional adoption and limited the availability of this life-saving treatment. Published outcomes for donor screening programs report donor deferral rates between 90% and 96%. Due to the paucity of FMT donor screening data, a secondary analysis on a cohort of previously screened donors (n = 7,968) was conducted to provide a synopsis of the observed trends and rationales for prospective stool donor deferrals. Upon completion of the evaluation, 1.7% of prospective donors (n = 134) qualified for stool donation. Over 50% of donors who completed the online pre-screen were deferred, primarily for a body mass index of 30 kg/m2 or greater (n = 1,516, 37.0%), logistics (n = 841, 20.5%), and travel history (n = 638, 15.5%). Despite pre-screening, 569 donors (72.8%) who completed the in-person clinical assessment were ultimately deferred due primarily to potentially microbiome-mediated diseases (n = 187, 32.9%). A notably small portion of donors (n = 46, 25.6%) were deferred during the laboratory assessment process suggesting the clinical assessment was effective at deferring donors at higher risk for transmissible diseases. Donors lost to follow-up throughout the screening process presented a significant challenge and contributed to a notable (n = 3,117; 39.1%) portion of donor attrition. Findings were used to support recommendations for improving prospective stool donor screening programs and to provide suggestions for future research.