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1.  Using a Systematic Conceptual Model for a Process Evaluation of a Middle School Obesity Risk-Reduction Nutrition Curriculum Intervention: Choice, Control & Change 
Objective
To use and review a conceptual model of process evaluation and to examine the implementation of a nutrition education curriculum, Choice, Control & Change, designed to promote dietary and physical activity behaviors that reduce obesity risk.
Design
A process evaluation study based on a systematic conceptual model.
Setting
Five middle schools in New York City.
Participants
562 students in 20 classes and their science teachers (n=8).
Main Outcome Measures
Based on the model, teacher professional development, teacher implementation, and student reception were evaluated. Also measured were teacher characteristics, teachers’ curriculum evaluation, and satisfaction with teaching the curriculum.
Analysis
Descriptive statistics and Spearman’s Rho Correlation for quantitative analysis and content analysis for qualitative data were used.
Results
Mean score of the teacher professional development evaluation was 4.75 on a 5-point scale. Average teacher implementation rate was 73%, and student reception rate was 69%. Ongoing teacher support was highly valued by teachers. Teachers’ satisfaction with teaching the curriculum was highly correlated with students’ satisfaction (p <.05). Teachers’ perception of amount of student work was negatively correlated with implementation and with student satisfaction (p<.05).
Conclusions and implications
Use of a systematic conceptual model and comprehensive process measures improves understanding of the implementation process and helps educators to better implement interventions as designed.
doi:10.1016/j.jneb.2012.07.002
PMCID: PMC3595367  PMID: 23321021
process evaluation; obesity risk-reduction; middle schools; nutrition education curriculum
2.  Clinical teachers as humanistic caregivers and educators: perceptions of senior clerks and second-year residents 
BACKGROUND: The acquisition and nurturing of humanistic skills and attitudes constitute an important aim of medical education. In order to assess how conducive the physician-learning environment is to the acquisition of these skills, the authors determined the extent to which clinical teachers are perceived by their trainees as humanistic with patients and students, and they explored whether undergraduate and graduate students share the same perceptions. METHODS: A mail survey was conducted in 1994/95 of all senior clerks and second-year residents at Laval University, University of Montreal and University of Sherbrooke medical schools. Of 774 trainees, 259 senior clerks and 238 second-year residents returned the questionnaire, for an overall response rate of 64%. Students' perceptions of their teachers were measured on a 6-point Likert scale applied to statements about teachers' attitudes toward the patient (5 items) and toward the student (5 items). RESULTS: On average, only 46% of the senior clerks agreed that their teachers displayed the humanistic characteristics of interest. They were especially critical of their teachers' apparent lack of sensitivity, with as many as 3 out of 4 declaring that their teachers seemed to be unconcerned about how patients adapt psychologically to their illnesses (75% of clerks) and that their teachers did not try to understand students' difficulties (78%) or to support students who have difficulties (77%). Compared with the clerks, the second-year residents were significantly less critical, those with negative perceptions varying from 27% to 58%, 40% on average. Except for this difference, their pattern of responses from one item to another was similar. INTERPRETATION: This study suggests the existence of a substantial gap between what medical trainees are expected to learn and what they actually experience over the course of their training. Because such a gap could represent a significant barrier to the acquisition of important skills, more and urgent research is needed to understand better the factors influencing students' perceptions.
PMCID: PMC1232732  PMID: 9805021
3.  Five teacher profiles in student-centred curricula based on their conceptions of learning and teaching 
BMC Medical Education  2014;14(1):220.
Background
Teachers’ conceptions of learning and teaching are partly unconscious. However, they are critical for the delivery of education and affect students’ learning outcomes. Lasting changes in teaching behaviour can only be realized if conceptions of teachers have been changed accordingly. Previously we constructed a questionnaire named COLT to measure conceptions. In the present study, we investigated if different teacher profiles could be assessed which are based on the teachers’ conceptions. These teacher profiles might have implications for individual teachers, for faculty development activities and for institutes. Our research questions were: (1) Can we identify teacher profiles based on the COLT? (2) If so, how are these teacher profiles associated with other teacher characteristics?
Methods
The COLT questionnaire was sent electronically to all teachers in the first three years of the undergraduate curriculum of Medicine in two medical schools in the Netherlands with student-centred education. The COLT (18 items, 5 point Likert scales) comprises three scales: ‘teacher centredness’, ‘appreciation of active learning’ and ‘orientation to professional practice’. We also collected personal information about the participants and their occupational characteristics. Teacher profiles were studied using a K-means cluster analysis and calculating Chi squares.
Results
The response rate was 49.4% (N = 319/646). A five-cluster solution fitted the data best, resulting in five teacher profiles based on their conceptions as measured by the COLT. We named the teacher profiles: Transmitters (most traditional), Organizers, Intermediates, Facilitators and Conceptual Change Agents (most modern). The teacher profiles differed from each other in personal and occupational characteristics.
Conclusions
Based on teachers’ conceptions of learning and teaching, five teacher profiles were found in student-centred education. We offered suggestions how insight into these teacher profiles might be useful for individual teachers, for faculty development activities and for institutes and departments, especially if involved in a curriculum reform towards student-centred education.
doi:10.1186/1472-6920-14-220
PMCID: PMC4287471  PMID: 25324193
Conceptions of learning and teaching; Teachers; Reflection; Faculty development
4.  Association of Medical Students' Reports of Interactions with the Pharmaceutical and Medical Device Industries and Medical School Policies and Characteristics: A Cross-Sectional Study 
PLoS Medicine  2014;11(10):e1001743.
Aaron Kesselheim and colleagues compared US medical students' survey responses regarding pharmaceutical company interactions with the schools' AMSA PharmFree scorecard and Institute on Medicine as a Profession's (IMAP) scores.
Please see later in the article for the Editors' Summary
Background
Professional societies use metrics to evaluate medical schools' policies regarding interactions of students and faculty with the pharmaceutical and medical device industries. We compared these metrics and determined which US medical schools' industry interaction policies were associated with student behaviors.
Methods and Findings
Using survey responses from a national sample of 1,610 US medical students, we compared their reported industry interactions with their schools' American Medical Student Association (AMSA) PharmFree Scorecard and average Institute on Medicine as a Profession (IMAP) Conflicts of Interest Policy Database score. We used hierarchical logistic regression models to determine the association between policies and students' gift acceptance, interactions with marketing representatives, and perceived adequacy of faculty–industry separation. We adjusted for year in training, medical school size, and level of US National Institutes of Health (NIH) funding. We used LASSO regression models to identify specific policies associated with the outcomes. We found that IMAP and AMSA scores had similar median values (1.75 [interquartile range 1.50–2.00] versus 1.77 [1.50–2.18], adjusted to compare scores on the same scale). Scores on AMSA and IMAP shared policy dimensions were not closely correlated (gift policies, r = 0.28, 95% CI 0.11–0.44; marketing representative access policies, r = 0.51, 95% CI 0.36–0.63). Students from schools with the most stringent industry interaction policies were less likely to report receiving gifts (AMSA score, odds ratio [OR]: 0.37, 95% CI 0.19–0.72; IMAP score, OR 0.45, 95% CI 0.19–1.04) and less likely to interact with marketing representatives (AMSA score, OR 0.33, 95% CI 0.15–0.69; IMAP score, OR 0.37, 95% CI 0.14–0.95) than students from schools with the lowest ranked policy scores. The association became nonsignificant when fully adjusted for NIH funding level, whereas adjusting for year of education, size of school, and publicly versus privately funded school did not alter the association. Policies limiting gifts, meals, and speaking bureaus were associated with students reporting having not received gifts and having not interacted with marketing representatives. Policy dimensions reflecting the regulation of industry involvement in educational activities (e.g., continuing medical education, travel compensation, and scholarships) were associated with perceived separation between faculty and industry. The study is limited by potential for recall bias and the cross-sectional nature of the survey, as school curricula and industry interaction policies may have changed since the time of the survey administration and study analysis.
Conclusions
As medical schools review policies regulating medical students' industry interactions, limitations on receipt of gifts and meals and participation of faculty in speaking bureaus should be emphasized, and policy makers should pay greater attention to less research-intensive institutions.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Making and selling prescription drugs and medical devices is big business. To promote their products, pharmaceutical and medical device companies build relationships with physicians by providing information on new drugs, by organizing educational meetings and sponsored events, and by giving gifts. Financial relationships begin early in physicians' careers, with companies providing textbooks and other gifts to first-year medical students. In medical school settings, manufacturers may help to inform trainees and physicians about developments in health care, but they also create the potential for harm to patients and health care systems. These interactions may, for example, reduce trainees' and trained physicians' skepticism about potentially misleading promotional claims and may encourage physicians to prescribe new medications, which are often more expensive than similar unbranded (generic) drugs and more likely to be recalled for safety reasons than older drugs. To address these and other concerns about the potential career-long effects of interactions between medical trainees and industry, many teaching hospitals and medical schools have introduced policies to limit such interactions. The development of these policies has been supported by expert professional groups and medical societies, some of which have created scales to evaluate the strength of the implemented industry interaction policies.
Why Was This Study Done?
The impact of policies designed to limit interactions between students and industry on student behavior is unclear, and it is not known which aspects of the policies are most predictive of student behavior. This information is needed to ensure that the policies are working and to identify ways to improve them. Here, the researchers investigate which medical school characteristics and which aspects of industry interaction policies are most predictive of students' reported behaviors and beliefs by comparing information collected in a national survey of US medical students with the strength of their schools' industry interaction policies measured on two scales—the American Medical Student Association (AMSA) PharmFree Scorecard and the Institute on Medicine as a Profession (IMAP) Conflicts of Interest Policy Database.
What Did the Researchers Do and Find?
The researchers compared information about reported gift acceptance, interactions with marketing representatives, and the perceived adequacy of faculty–industry separation collected from 1,610 medical students at 121 US medical schools with AMSA and IMAP scores for the schools evaluated a year earlier. Students at schools with the highest ranked interaction policies based on the AMSA score were 63% less likely to accept gifts as students at the lowest ranked schools. Students at the highest ranked schools based on the IMAP score were about half as likely to accept gifts as students at the lowest ranked schools, although this finding was not statistically significant (it could be a chance finding). Similarly, students at the highest ranked schools were 70% less likely to interact with sales representatives as students at the lowest ranked schools. These associations became statistically nonsignificant after controlling for the amount of research funding each school received from the US National Institutes of Health (NIH). Policies limiting gifts, meals, and being a part of speaking bureaus (where companies pay speakers to present information about the drugs for dinners and other events) were associated with students' reports of receiving no gifts and of non-interaction with sales representatives. Finally, policies regulating industry involvement in educational activities were associated with the perceived separation between faculty and industry, which was regarded as adequate by most of the students at schools with such policies.
What Do These Findings Mean?
These findings suggest that policies designed to limit industry interactions with medical students need to address multiple aspects of these interactions to achieve changes in the behavior and attitudes of trainees, but that policies limiting gifts, meals, and speaking bureaus may be particularly important. These findings also suggest that the level of NIH funding plays an important role in students' self-reported behaviors and their perceptions of industry, possibly because institutions with greater NIH funding have the resources needed to implement effective policies. The accuracy of these findings may be limited by recall bias (students may have reported their experiences inaccurately), and by the possibility that industry interaction policies may have changed in the year that elapsed between policy grading and the student survey. Nevertheless, these findings suggest that limitations on gifts should be emphasized when academic medical centers refine their policies on interactions between medical students and industry and that particular attention should be paid to the design and implementation of policies that regulate industry interactions in institutions with lower levels of NIH funding.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001743.
The UK General Medical Council provides guidance on financial and commercial arrangements and conflicts of interest as part of its good medical practice document, which describes what is required of all registered doctors in the UK
Information about the American Medical Student Association (AMSA) Just Medicine campaign (formerly the PharmFree campaign) and about the AMSA Scorecard is available
Information about the Institute on Medicine as a Profession (IMAP) and about its Conflicts of Interest Policy Database is also available
“Understanding and Responding to Pharmaceutical Promotion: A Practical Guide” is a manual prepared by Health Action International and the World Health Organization that medical schools can use to train students how to recognize and respond to pharmaceutical promotion
The US Institute of Medicine's report “Conflict of Interest in Medical Research, Education, and Practice” recommends steps to identify, limit, and manage conflicts of interest
The ALOSA Foundation provides evidence-based, non-industry-funded education about treating common conditions and using prescription drugs
doi:10.1371/journal.pmed.1001743
PMCID: PMC4196737  PMID: 25314155
5.  Increasing participation and improving the quality of discussions in seventh-grade social studies classes 
An experiment was conducted to evaluate procedures to improve classroom discussions in seventh-grade social studies classes. An increased number of students participated in discussions when rules were stated for discussions, students were praised for their contributions, the teacher restated or paraphrased students' contributions aloud or on the blackboard, the teacher planned an outline of discussion questions, student contributions to discussions were recorded and were used to determine part of the students' grades for the class, and discussion grades were publicly posted.
The second part of the study focused on procedures designed to improve quality of classroom discussions. Students were taught to participate in discussions by providing reasons for their statements, comparisons between different points, or examples supporting their statements. As each type of contribution was taught, recorded, and counted toward part of the students' classroom grades, each type of contribution increased. Ratings of discussions by outside judges consisting of junior high school teachers, junior high school students, and persons experienced in conducting discussions, indicated that the training increased the overall quality of the discussions. Use of the quality training procedures, however, resulted in decreased levels of overall participation in discussion, a decrease that was reversed by the use of a group contingency for participation. Finally, the discussions after training seemed to be preferred by both the teacher and the students.
doi:10.1901/jaba.1982.15-97
PMCID: PMC1308250  PMID: 16795657
academic behavior; discussion skills; contingencies; teacher behavior; junior high students
6.  Preventing conduct problems and improving school readiness: evaluation of the Incredible Years Teacher and Child Training Programs in high-risk schools 
Background
School readiness, conceptualized as three components including emotional self-regulation, social competence, and family/school involvement, as well as absence of conduct problems play a key role in young children’s future interpersonal adjustment and academic success. Unfortunately, exposure to multiple poverty-related risks increases the odds that children will demonstrate increased emotional dysregulation, fewer social skills, less teacher/parent involvement and more conduct problems. Consequently intervention offered to socio-economically disadvantaged populations that includes a social and emotional school curriculum and trains teachers in effective classroom management skills and in promotion of parent—school involvement would seem to be a strategic strategy for improving young children’s school readiness, leading to later academic success and prevention of the development of conduct disorders.
Methods
This randomized trial evaluated the Incredible Years (IY) Teacher Classroom Management and Child Social and Emotion curriculum (Dinosaur School) as a universal prevention program for children enrolled in Head Start, kindergarten, or first grade classrooms in schools selected because of high rates of poverty. Trained teachers offered the Dinosaur School curriculum to all their students in bi-weekly lessons throughout the year. They sent home weekly dinosaur homewrok to encourage parents’ involvement. Part of the curriculum involved promotion of lesson objectives through the teachers’ continual use of positive classroom management skills focused on building social competence and emotional self-regulation skills as well as decreasing conduct problems. Matched pairs of schools were randomly assigned to intervention or control conditions.
Results
Results from multi-level models on a total of 153 teachers and 1,768 students are presented. Children and teachers were observed in the classrooms by blinded observers at the begining and the end of the school year. Results indicated that intervention teachers used more positive classroom management strategies and their students showed more social competence and emotional self-regulation and fewer conduct problems than control teachers and students. Intervention teachers reported more involvement with parents than control teachers. Satisfaction with the program was very high regardless of grade levels.
Conclusions
These findings provide support for the efficacy of this universal preventive curriculum for enhancing school protective factors and reducing child and classroom risk factors faced by socio-economically disadvantaged children.
doi:10.1111/j.1469-7610.2007.01861.x
PMCID: PMC2735210  PMID: 18221346
Aggression; behavior problem; prevention; school; teacher; school readiness
7.  Peer assessments of normative and individual teacher–student support predict social acceptance and engagement among low-achieving children 
Journal of school psychology  2006;43(6):447-463.
This study used hierarchical linear modeling to predict first grade students' peer acceptance, classroom engagement, and sense of school belonging from measures of normative classroom teacher–student support and individual teacher–student support. Participants were 509 (54.4% male) ethnically diverse, first grade children attending one of three Texas School districts (1 urban, 2 small city) who scored below their school district median on a measure of literacy administered at the beginning of first grade. Peer nominations from 5147 classmates were used to assess both normative and individual levels of teacher support. Normative classroom teacher–student support predicted children's peer acceptance and classroom engagement, above the effects of child gender, ethnic minority status, and individual teacher–student support. Results are discussed in terms of implications for teacher preparation and professional development.
doi:10.1016/j.jsp.2005.10.002
PMCID: PMC2857331  PMID: 20411044
Teacher–student relations; Teacher warmth; Peer acceptance; Engagement; School belonging; Elementary students
8.  Remediation of at-risk medical students: theory in action 
BMC Medical Education  2013;13:132.
Background
Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives revealed that remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry. This community needs expert teachers capable of performing a unique combination of roles (facilitator, nurturing mentor, disciplinarian, diagnostician and role model), with high levels of teaching presence and practical wisdom. Yet, despite participants’ convergent opinions on the elements of effective remediation, significant differences were found between outcomes of students working with experienced and inexperienced teachers. The current study explores the actual practice of teachers on this remediation course, aiming to exemplify elements of our theory of remediation and explore differences between teachers.
Methods
Since it is in the classroom context that the interactions that constitute the complex process of remediation emerge, this practice-based research has focused on direct observation of classroom teaching. Nineteen hours of small group sessions were recorded and transcribed. Drawing on ethnography and sociocultural discourse analysis, selected samples of talk-in-context demonstrate how the various elements of remediation play out in practice, highlighting aspects that are most effective, and identifying differences between experienced and novice teachers.
Results
Long-term student outcomes are strongly correlated to teacher experience (r, 0.81). Compared to inexperienced teachers, experienced teachers provide more challenging, disruptive facilitation, and take a dialogic stance that encourages more collaborative group dynamics. They are more expert at diagnosing cognitive errors, provide frequent metacognitive time-outs and make explicit links across the curriculum.
Conclusions
Remediation is effective in small groups where dialogue is used for collaborative knowledge construction and social regulation. This requires facilitation by experienced teachers who attend to details of both content and process, and use timely interventions to foster curiosity and the will to learn. These teachers should actively challenge students’ language use, logical inconsistencies and uncertainties, problematize their assumptions, and provide a metacognitive regulatory voice that can generate attitudinal shifts and nurture the development of independent critical thinkers.
doi:10.1186/1472-6920-13-132
PMCID: PMC3851205  PMID: 24070196
At-risk students; Remediation; Small group teaching; Classroom discourse; Facilitation skills; Teaching experience; Pedagogical context knowledge
9.  Providing Undergraduate Science Partners for Elementary Teachers: Benefits and Challenges 
CBE Life Sciences Education  2009;8(3):239-251.
Undergraduate college “science partners” provided content knowledge and a supportive atmosphere for K–5 teachers in a university–school professional development partnership program in science instruction. The Elementary Science Education Partners program, a Local Systemic Change initiative supported by the National Science Foundation, was composed of four major elements: 1) a cadre of mentor teachers trained to provide district-wide teacher professional development; 2) a recruitment and training effort to place college students in classrooms as science partners in semester-long partnerships with teachers; 3) a teacher empowerment effort termed “participatory reform”; and 4) an inquiry-based curriculum with a kit distribution and refurbishment center. The main goals of the program were to provide college science students with an intensive teaching experience and to enhance teachers' skills in inquiry-based science instruction. Here, we describe some of the program's successes and challenges, focusing primarily on the impact on the classroom teachers and their science partners. Qualitative analyses of data collected from participants indicate that 1) teachers expressed greater self-confidence about teaching science than before the program and they spent more class time on the subject; and 2) the college students modified deficit-model negative assumptions about the children's science learning abilities to express more mature, positive views.
doi:10.1187/cbe.08-07-0041
PMCID: PMC2736027  PMID: 19723818
10.  Engaging Rural Youth in Physical Activity Promotion Research in an After-School Setting 
Preventing Chronic Disease  2005;2(Spec No):A15.
Background
West Virginia, the second most rural state in the nation, has a higher than average prevalence of chronic diseases, especially those related to physical inactivity and obesity. Innovative educational approaches are needed to increase physical activity among adults and youth in rural areas and reduce rural health disparities. This paper describes West Virginia's Health Sciences and Technology Academy (HSTA) Education and Outreach on Healthy Weight and Physical Activity. The project involved teachers and underserved high school students in social science research aimed at increasing physical activity among student and community participants.
Context
The HSTA is an ongoing initiative of university–school–community partnerships in West Virginia that offers academic enrichment to high-school students in after-school clubs. For this project, six HSTA clubs were awarded grants to conduct research on physical activity promotion during the 2003–2004 school year. The project was funded by the Centers for Disease Control and Prevention.
Methods
Focus groups, workshops, and targeted technical assistance were used to assist teachers and students with developing, implementing, and evaluating their research projects. Each club completed one project, and students reported on their research at the annual HSTA symposium held in the spring. Teachers documented their experience with the projects in process journals before and during implementation.
Consequences
Data from the teachers' process journals revealed that they believed this research experience increased their students' interest in health and health science careers and increased their students' understanding of social science research methods. Challenges included lack of time after school to complete all activities, competing student activities, limited social science research experience of both teachers and students, and delays that resulted from a lengthy human subjects approval process.
Interpretation
The entire process was too ambitious to be achieved in one school year. Recommendations for future implementation include offering training modules on social science research methods for both teachers and students. These modules could be offered as a graduate course for teachers and as an in-school elective within the curriculum or as a summer institute for students. This preparatory training might alleviate some of the time management issues experienced by all the projects and could result in more skilled teacher and student researchers.
PMCID: PMC1459460  PMID: 16263048
11.  Impacting the Science Community through Teacher Development: Utilizing Virtual Learning 
Commitment to the STEM (science, technology, engineering, math) pipeline is slowly declining despite the need for professionals in the medical field. Addressing this, the John A. Burns School of Medicine developed a summer teacher-training program with a supplemental technology-learning component to improve science teachers’ knowledge and skills of Molecular Biology. Subsequently, students’ skills, techniques, and application of molecular biology are impacted. Science teachers require training that will prepare them for educating future professionals and foster interest in the medical field. After participation in the program and full access to the virtual material, twelve high school science teachers completed a final written reflective statement to evaluate their experiences. Using thematic analysis, knowledge and classroom application were investigated in this study. Results were two-fold: teachers identified difference areas of gained knowledge from the teacher-training program and teachers’ reporting various benefits in relation to curricula development after participating in the program. It is concluded that participation in the program and access to the virtual material will impact the science community by updating teacher knowledge and positively influencing students’ experience with science.
PMCID: PMC3995534  PMID: 24765214
Virtual Learning; Teacher Training; High School Science
12.  The Effects of the SUN Project on Teacher Knowledge and Self-Efficacy Regarding Biological Energy Transfer Are Significant and Long-Lasting: Results of a Randomized Controlled Trial 
CBE Life Sciences Education  2013;12(2):287-305.
The Students Understanding eNergy (SUN) Project reports significant long-term effects on biology teacher knowledge and self-efficacy regarding biological energy transfer. Teachers use a hydrogen fuel cell and manipulatives to develop a model of energy transfer based on electrons moving in thermodynamically spontaneous reactions.
Biological energy flow has been notoriously difficult to teach. Our approach to this topic relies on abiotic and biotic examples of the energy released by moving electrons in thermodynamically spontaneous reactions. A series of analogical model-building experiences was supported with common language and representations including manipulatives. These materials were designed to help learners understand why electrons move in a hydrogen explosion and hydrogen fuel cell, so they could ultimately understand the rationale for energy transfer in the mitochondrion and the chloroplast. High school biology teachers attended a 2-wk Students Understanding eNergy (SUN) workshop during a randomized controlled trial. These treatment group teachers then took hydrogen fuel cells, manipulatives, and other materials into their regular biology classrooms. In this paper, we report significant gains in teacher knowledge and self-efficacy regarding biological energy transfer in the treatment group versus randomized controls. Significant effects on treatment group teacher knowledge and self-efficacy were found not only post–SUN workshop but even 1 yr later. Teacher knowledge was measured with both a multiple-choice exam and a drawing with a written explanation. Teacher confidence in their ability to teach biological energy transfer was measured by a modified form of the Science Teaching Efficacy Belief Instrument, In-Service A. Professional development implications regarding this topic are discussed.
doi:10.1187/cbe.12-09-0155
PMCID: PMC3671655  PMID: 23737635
13.  Neuroscience in Middle Schools: A Professional Development and Resource Program That Models Inquiry-based Strategies and Engages Teachers in Classroom Implementation 
CBE— Life Sciences Education  2006;5(2):144-157.
The Department of Neuroscience at the University of Minnesota and the Science Museum of Minnesota have developed and implemented a successful program for middle school (grades 5–8) science teachers and their students, called Brain Science on the Move. The overall goals have been to bring neuroscience education to underserved schools, excite students about science, improve their understanding of neuroscience, and foster partnerships between scientists and educators. The program includes BrainU, a teacher professional development institute; Explain Your Brain Assembly and Exhibit Stations, multimedia large-group presentation and hands-on activities designed to stimulate student thinking about the brain; Class Activities, in-depth inquiry-based investigations; and Brain Trunks, materials and resources related to class activities. Formal evaluation of the program indicated that teacher neuroscience knowledge, self-confidence, and use of inquiry-based strategies and neuroscience in their classrooms have increased. Participating teachers increased the time spent teaching neuroscience and devoted more time to “inquiry-based” teaching versus “lecture-based teaching.” Teachers appreciated in-depth discussions of pedagogy and science and opportunities for collegial interactions with world-class researchers. Student interest in the brain and in science increased. Since attending BrainU, participating teachers have reported increased enthusiasm about teaching and have become local neuroscience experts within their school communities.
doi:10.1187/cbe.05-08-0109
PMCID: PMC1618517  PMID: 17012205
14.  Qualities of an effective teacher: what do medical teachers think? 
BMC Medical Education  2013;13:128.
Background
Effective teaching in medicine is essential to produce good quality doctors. A number of studies have attempted to identify the characteristics of an effective teacher. However, most of literature regarding an effective medical teacher includes student ratings or expert opinions. Furthermore, interdisciplinary studies for the same are even fewer. We did a cross-sectional study of the characteristics of effective teachers from their own perspective across medicine and dentistry disciplines.
Methods
A questionnaire comprising of 24 statements relating to perceived qualities of effective teachers was prepared and used. The study population included the faculty of medicine and dentistry at the institution. Respondents were asked to mark their response to each statement based on a 5-point Likert scale ranging from strongly disagree to strongly agree. These statements were grouped these into four main subgroups, viz. Class room behaviour/instructional delivery, interaction with students, personal qualities and professional development, and analysed with respect to discipline, cultural background, gender and teaching experience using SPSS v 13.0. For bivariate analysis, t-test and one way ANOVA were used. Multiple linear regression for multivariate analysis was used to control confounding variables.
Results
The top three desirable qualities of an effective teacher in our study were knowledge of subject, enthusiasm and communication skills. Faculty with longer teaching experienced ranked classroom behaviour/instructional delivery higher than their less experienced counterparts. There was no difference of perspectives based on cultural background, gender or discipline (medicine and dentistry).
Conclusion
This study found that the faculty perspectives were similar, regardless of the discipline, gender and cultural background. Furthermore, on review of literature similar findings are seen in studies done in allied medical and non-medical fields. These findings support common teacher training programs for the teachers of all disciplines, rather than having separate training programs exclusively for medical teachers. Logistically, this would make it much easier to arrange such programs in universities or colleges with different faculties or disciplines.
doi:10.1186/1472-6920-13-128
PMCID: PMC3848658  PMID: 24044727
Medical teacher; Medical education; Effective teacher; Teacher perspectives
15.  Fostering Critical Thinking, Reasoning, and Argumentation Skills through Bioethics Education 
PLoS ONE  2012;7(5):e36791.
Developing a position on a socio-scientific issue and defending it using a well-reasoned justification involves complex cognitive skills that are challenging to both teach and assess. Our work centers on instructional strategies for fostering critical thinking skills in high school students using bioethical case studies, decision-making frameworks, and structured analysis tools to scaffold student argumentation. In this study, we examined the effects of our teacher professional development and curricular materials on the ability of high school students to analyze a bioethical case study and develop a strong position. We focused on student ability to identify an ethical question, consider stakeholders and their values, incorporate relevant scientific facts and content, address ethical principles, and consider the strengths and weaknesses of alternate solutions. 431 students and 12 teachers participated in a research study using teacher cohorts for comparison purposes. The first cohort received professional development and used the curriculum with their students; the second did not receive professional development until after their participation in the study and did not use the curriculum. In order to assess the acquisition of higher-order justification skills, students were asked to analyze a case study and develop a well-reasoned written position. We evaluated statements using a scoring rubric and found highly significant differences (p<0.001) between students exposed to the curriculum strategies and those who were not. Students also showed highly significant gains (p<0.001) in self-reported interest in science content, ability to analyze socio-scientific issues, awareness of ethical issues, ability to listen to and discuss viewpoints different from their own, and understanding of the relationship between science and society. Our results demonstrate that incorporating ethical dilemmas into the classroom is one strategy for increasing student motivation and engagement with science content, while promoting reasoning and justification skills that help prepare an informed citizenry.
doi:10.1371/journal.pone.0036791
PMCID: PMC3350470  PMID: 22615814
16.  Job Burnout among Iranian Elementary School Teachers of Students with Autism: a Comparative Study 
Iranian Journal of Psychiatry  2013;8(1):20-27.
Objective
Teachers often experience burnout and challenges during their active career. Different studies have shown that those directly involved with teaching children with special needs are more subject to burnout. Due to advance screening tools, more children with autism are now diagnosed and involved in special education. The aim of the present study was to investigate the professional burnout in teachers of children with autism compared to teachers of other children with special needs.
Methods
Casual Comparative study design was used for this research. Three self-reported measures (Maslach Burnout Inventory, Job Descriptive Index, and General Health Questionnaire) were distributed; clustered sampling selection was conducted to select participants. Ninety three female teachers (32 teachers of children with autism, 30 teachers in schools for deaf and 31 for teachers of children with mental retardation) from 12 schools located in 4 districts of Tehran were selected. Pearson's and Spearman's correlation statistical tests, analysis of variances and regression were used to analyze the results.
Results
Results of the current study revealed a significant difference in criterion validity between the three groups of teachers The three groups were different in terms of general health (p=0.010), emotional exhaustion (p=0.005) and depersonalization (p<0.001); however considering other variables no significant differences were observed. Comparison between groups showed that the average scores of teachers of children with autism were significantly higher than teachers of deaf and hard of hearing and mentally retarded children in general health, fatigue, and depersonalization variables. No significant differences were observed in average scores of teachers for mentally retarded and deaf children.
Conclusions
Female teachers’ of children with autism are experiencing significantly higher levels of burnout and general mental health problems compared to teachers of children with other disabilities requiring special education.
PMCID: PMC3655226  PMID: 23682248
Autism; job burnout; job satisfaction; teachers of special education
17.  Bioinformatics Education in High School: Implications for Promoting Science, Technology, Engineering, and Mathematics Careers 
CBE Life Sciences Education  2013;12(3):441-459.
We report the effects of our Bio-ITEST teacher professional development model and bioinformatics curricula on cognitive traits (awareness, engagement, self-efficacy, and relevance) in high school teachers and students that are known to accompany a developing interest in STEM (science, technology, engineering, and mathematics) careers.
We investigated the effects of our Bio-ITEST teacher professional development model and bioinformatics curricula on cognitive traits (awareness, engagement, self-efficacy, and relevance) in high school teachers and students that are known to accompany a developing interest in science, technology, engineering, and mathematics (STEM) careers. The program included best practices in adult education and diverse resources to empower teachers to integrate STEM career information into their classrooms. The introductory unit, Using Bioinformatics: Genetic Testing, uses bioinformatics to teach basic concepts in genetics and molecular biology, and the advanced unit, Using Bioinformatics: Genetic Research, utilizes bioinformatics to study evolution and support student research with DNA barcoding. Pre–post surveys demonstrated significant growth (n = 24) among teachers in their preparation to teach the curricula and infuse career awareness into their classes, and these gains were sustained through the end of the academic year. Introductory unit students (n = 289) showed significant gains in awareness, relevance, and self-efficacy. While these students did not show significant gains in engagement, advanced unit students (n = 41) showed gains in all four cognitive areas. Lessons learned during Bio-ITEST are explored in the context of recommendations for other programs that wish to increase student interest in STEM careers.
doi:10.1187/cbe.12-11-0193
PMCID: PMC3763012  PMID: 24006393
18.  Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity 
Background
Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured.
Methods
This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness.
Results
Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness).
Conclusion
Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as selecting programs with features that minimize complexity while maximizing flexibility. Time constraints in the classroom should be considered when choosing a program. Student behavior also influences program delivery, so schools should train teachers in the use of classroom management skills. This project involved comprehensive program monitoring and technical assistance that likely facilitated the identification and resolution of problems and contributed to the overall high quality of implementation. Schools should recognize the importance of training and technical assistance to ensure quality program delivery.
doi:10.1186/1748-5908-3-5
PMCID: PMC2265741  PMID: 18205919
19.  High Concordance of Parent and Teacher Attention-Deficit/Hyperactivity Disorder Ratings in Medicated and Unmedicated Children with Autism Spectrum Disorders 
Abstract
Objective
Parent and teacher ratings of core attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as behavioral and emotional problems commonly comorbid with ADHD, were compared in children with autism spectrum disorders (ASD).
Method
Participants were 86 children (66 boys; mean: age=9.3 years, intelligence quotient [IQ]=84) who met American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for an ASD on the Autism Diagnostic Interview–Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). Parent and teacher behavioral ratings were compared on the Conners' Parent and Teacher Rating Scales (CPRS-R; CTRS-R). The degree to which age, ASD subtype, severity of autistic symptomatology, and medication status mediated this relationship was also examined.
Results
Significant positive correlations between parent and teacher ratings suggest that a child's core ADHD symptoms—as well as closely related externalizing symptoms—are perceived similarly by parents and teachers. With the exception of oppositional behavior, there was no significant effect of age, gender, ASD subtype, or autism severity on the relationship between parent and teacher ratings. In general, parents rated children as having more severe symptomatology than did teachers. Patterns of parent and teacher ratings were highly correlated, both for children who were receiving medication, and for children who were not.
Conclusions
Parents and teachers perceived core symptoms of ADHD and closely-related externalizing problems in a similar manner, but there is less agreement on ratings of internalizing problems (e.g., anxiety). The clinical implication of these findings is that both parents and teachers provide important behavioral information about children with ASD. However, when a clinician is unable to access teacher ratings (e.g., during school vacations), parent ratings can provide a reasonable estimate of the child's functioning in these domains in school. As such, parent ratings can be reliably used to make initial diagnostic and treatment decisions (e.g., medication treatment) regarding ADHD symptoms in children with ASDs.
doi:10.1089/cap.2011.0067
PMCID: PMC3422050  PMID: 22849541
20.  Reducing corruption in a Mexican medical school: impact assessment across two cross-sectional surveys 
BMC Health Services Research  2011;11(Suppl 2):S13.
Background
Corruption pervades educational and other institutions worldwide and medical schools are not exempt. Empirical evidence about levels and types of corruption in medical schools is sparse. We conducted surveys in 2000 and 2007 in the medical school of the Autonomous University of Guerrero in Mexico to document student perceptions and experience of corruption and to support the medical school to take actions to tackle corruption.
Methods
In both 2000 and 2007 medical students completed a self-administered questionnaire in the classroom without the teacher present. The questionnaire asked about unofficial payments for admission to medical school, for passing an examination and for administrative procedures. We examined factors related to the experience of corruption in multivariate analysis. Focus groups of students discussed the quantitative findings.
Results
In 2000, 6% of 725 responding students had paid unofficially to obtain entry into the medical school; this proportion fell to 1.6% of the 436 respondents in 2007. In 2000, 15% of students reported having paid a bribe to pass an examination, not significantly different from the 18% who reported this in 2007. In 2007, students were significantly more likely to have bribed a teacher to pass an examination if they were in the fourth year, if they had been subjected to sexual harassment or political pressure, and if they had been in the university for five years or more. Students resented the need to make unofficial payments and suggested tackling the problem by disciplining corrupt teachers. The university administration made several changes to the system of admissions and examinations in the medical school, based on the findings of the 2000 survey.
Conclusion
The fall in the rate of bribery to enter the medical school was probably the result of the new admissions system instituted after the first survey. Further actions will be necessary to tackle the continuing presence of bribery to pass examinations and for administrative procedures. The social audit helped to draw attention to corruption and to stimulate actions to tackle it.
doi:10.1186/1472-6963-11-S2-S13
PMCID: PMC3332557  PMID: 22376281
21.  Helping students make meaning of authentic investigations: findings from a student–teacher–scientist partnership 
As student–teacher–scientist partnerships become more widespread, there is a need for research to understand the roles assumed by scientists and teachers as they interact with students in general and in inquiry learning environments in particular. Although teacher roles during inquiry learning have been studied, there is a paucity of research about the roles that scientists assume in their interactions with students. Socio-cultural perspectives on learning emphasize social interaction as a means for students to make meaning of scientific ideas. Thus, this naturalistic study of classroom discourse aims to explore the ways scientists and teachers help high school students make meaning during authentic inquiry investigations. Conversational analysis is conducted of video recordings of discussions between students and teachers and students and scientists from two instances of a student–teacher–scientist partnership program. A social semiotic analytic framework is used to interpret the actions of scientists and teachers. The results indicate a range of common and distinct roles for scientists and teachers with respect to the conceptual, social, pedagogical, and epistemological aspects of meaning making. While scientists provided conceptual and epistemological support related to their scientific expertise, such as explaining scientific phenomena or aspects of the nature of science, teachers played a critical role in ensuring students' access to this knowledge. The results have implications for managing the division of labor between scientists and teachers in partnership programs.
doi:10.1007/s11422-012-9385-3
PMCID: PMC3698873  PMID: 23828722
Meaning making; Inquiry; High school; Scientists; Social semiotics
22.  Understanding influences on teachers’ uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial 
BMC Public Health  2015;15:119.
Background
The ‘Supporting Teachers And childRen in Schools’ (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8–12 teachers. The STARS trial will investigate whether TCM can improve children’s behaviour, attainment and wellbeing, reduce teachers’ stress and improve their self-efficacy. This protocol describes the methodology of the process evaluation embedded within the main trial, which aims to examine the uptake and implementation of TCM strategies within the classroom plus the wider school environment and improve the understanding of outcomes.
Methods/design
The STARS trial will work with eighty teachers of children aged 4–9 years from eighty schools. Teachers will be randomised to attend the TCM course (intervention arm) or to “teach as normal” (control arm) and attend the course a year later. The process evaluation will use quantitative and qualitative approaches to assess fidelity to model, as well as explore headteachers’ and teachers’ experiences of TCM and investigate school factors that influence the translation of skills learnt to practice. Four of the eight groups of teachers (n = 40) will be invited to participate in focus groups within one month of completing the TCM course, and again a year later, while 45 of the 80 headteachers will be invited to take part in telephone interviews. Standardised checklists will be completed by group leaders and each training session will be videotaped to assess fidelity to model. Teachers will also complete standardised session evaluations.
Discussion
This study will provide important information about whether the Teacher Classroom Management course influences child and teacher mental health and well-being in both the short and long term. The process evaluation will provide valuable insights into factors that may facilitate or impede any impact.
Trial registration
The trial has been registered with ISCTRN (Controlled Trials Ltd) and assigned an ISRCTN number ISRCTN84130388. Date assigned: 15 May 2012.
doi:10.1186/s12889-015-1486-y
PMCID: PMC4336516
Process evaluation; Public health trial; Classroom behaviour management; Qualitative methods; Protocol
23.  Supportive relationship: Experiences of Iranian students and teachers concerning student-teacher relationship in clinical nursing education 
Background:
Student-teacher relationship is a salient issue in nursing education and has long-lasting implication in professional development of nursing students. Nowadays, this relationship in clinical settings is different from the past due to changing in nursing education paradigm. The purpose of this qualitative study was to explore the experiences of students and teachers about student-teacher relationship in the context of clinical nursing education in Iran.
Materials and Methods:
In this qualitative study that has been carried out adopting conventional qualitative content analysis approach, six bachelor nursing students and six clinical teachers in school of Nursing and Midwifery, were selected through purposive sampling. Semi-structured interview and participant observation were used for data collection. Interviews transcribed verbatim and analyzed using conventional content analysis through the process of data reduction and condensation, coding and also generating the categories and themes.
Results:
Results of the study showed the existence of a type of relationship in clinical education in which supportive actions of clinical teachers were prominent. These supportive actions appeared as three major categories including educational support, emotional support and social support which emerged from data.
Conclusion:
The results of this study explicit the ways that support could be provided for students in their relationship with clinical teachers. It also determines the teachers’ need to know more about the influence of their supportive relationship on students’ learning and the best possible outcomes of their education in clinical settings.
PMCID: PMC3917130  PMID: 24554945
Clinical clerkship; education; interpersonal relations; Iran; nursing; qualitative study
24.  Student apathy for classroom learning and need of repositioning in present andragogy in Indian dental schools 
BMC Medical Education  2012;12:118.
Background
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.
Methods
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.
Results
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.
Conclusions
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.
doi:10.1186/1472-6920-12-118
PMCID: PMC3536713  PMID: 23176285
Contemporary education; Student psychology; Teacher development; Classroom teaching; Distance learning; Andragogy; Dental education
25.  Utility of Teacher-Report Assessments of Autistic Severity in Japanese School Children 
Autism Research and Treatment  2013;2013:373240.
Recent studies suggest that many children with milder autism spectrum disorder (ASD) are undiagnosed, untreated, and being educated in mainstream classes without support and that school teachers might be the best persons to identify a child's social deviance. At present, only a few screening measures using teacher ratings of ASD have been validated. The aim of this study was to examine the utility of teacher ratings on the Social Responsiveness Scale (SRS), a quantitative measure of ASD. We recruited 130 participants aged 4 to 17 years from local schools or local pediatric outpatient clinics specializing in neurodevelopmental disorders that included 70 children with ASD. We found that the teacher-report SRS can be reliably and validly applied to children as a screening tool or for other research purposes, and it also has cross-cultural comparability. Although parent-teacher agreement was satisfactory overall, a discrepancy existed for children with ASD, especially for girls with ASD. To improve sensitivity in children at higher risk, especially girls, we cannot overstate the importance of using standardized norms specific to gender, informant, and culture.
doi:10.1155/2013/373240
PMCID: PMC3874348  PMID: 24392224

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