Traditional teacher-centered methods of lectures and PowerPoint presentations are commonly used when teaching secondary social studies, yet these methods continually prove to be boring for most high school students and neglect to teach critical thinking skills. Student-centered methods are different than teacher-centered methods because these methods incorporate several learning styles, cooperative activities, and even technology in order to engage the student and promote critical thinking skills. Critical thinking is important for students to master because it gives them the skills to move past the obvious and make individual connections with the text. The intent of this thesis was to explore the effectiveness of integrating student-centered methods in high school social studies classrooms as a means of promoting critical thinking skills. All students were given the same pretest and posttests. Students were divided into three groups: one was taught using student-centered methods, one was taught using teacher-centered methods, and one was the control group and was not directly taught by anyone. Based on analyzing students' posttest scores compared to their pre-test scores, student-centered teaching produced a higher average score increase, though all methods had students who scored higher, and students whose scores remained constant. Evidence and student feedback showed that continued future research should be conducted to see if student-centered methods should be used throughout all secondary social studies classrooms to promote critical thinking.

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For many minority children, the classroom is a space in which language and culture often awkwardly and harmfully collides. Schools often maintain a culture that is misaligned with the culture of their students, which is seen as an incompatibility between home and school, and is often used by educators to justify this mismatch within the classroom. This incompatibility is clearly displayed by the misinterpreted interactions that often occur within the classroom between teachers and students, often surrounding the differing assumptions about appropriate ways of using language within the classroom (Villegas, 1988, p.4). The purpose of this paper is to explore the intersections of language and culture for African-American children within education. I begin by outlining what we currently know about language development and how it manifests itself in the classroom setting. Secondly I provide a short overview of the history of language in education and its relationship to cultural perceptions of standard versus non-standard English and identity formation. Lastly, I offer African-Centered and Culturally Relevant education as responses to the current challenges that surround language and culture within many traditional classrooms and as a means of reform. / Urban Education

Acknowledgements First and foremost, I am very grateful to my supervisor, Dr. Kerstin de Wit, for her mentorship and guidance throughout my time as a graduate student. It has been a pleasure to work with someone so innovative and passionate about clinical research. Her ability to bridge thrombosis and emergency medicine research to improve and change clinical practice is inspiring. I am grateful to my supervisory committee members, Dr. Teresa Chan, Dr. Lori-Ann Linkins, and Dr. Mathew Mercuri, for their continuous support throughout this process. Our scientific discussions were always insightful, and motivated me to push myself as a researcher. I am very thankful to the entire EMeRGE Research Group for creating such a helpful and friendly environment. Their diligence and commitment to conducting high-quality research motivated me to do the same, and greatly expanded my knowledge on clinical research. Working with this team made my experience as a graduate student very memorable. I would like to thank my family and friends for all of the support they gave me throughout this entire process. Their constant encouragement and emotional support helped me overcome challenges and persevere, for which I am infinitely grateful. / Background: There is an evidence-practice gap between guidelines for diagnosing pulmonary embolism (PE) and emergency physician practice. This is concerning because computed tomography (CT) scanning is being overused to exclude PE in the emergency department (ED). It is possible that the answer behind this lies within the physician-patient relationship. Past research on shared decision-making strategies have shown to decrease use of hospital resources, and improve patient outcomes. Objective: The aim of this three-part MSc thesis was to achieve a patient-centered approach to the testing of PE in the ED. Method: 1) A systematic review on existing shared decision-making models used for testing and/or treatment of medical decisions in the ED was conducted. 2) Qualitative interviews with ED patients being tested for PE identified patient-specific values and preferences which may present as barriers to patient-centered care in the ED. 3) Both the systematic review and patient interviews informed the development of a new shared information tool to be used in the ED. Results: The systematic review found that shared decision-making interventions in ED patients tested for acute coronary syndrome and clinically-important traumatic brain injuries can potentially reduce hospital admissions and increase discharge rates without negatively affecting health outcomes. The qualitative interviews highlighted four major themes: 1) patient satisfaction comes from addressing their primary concern; 2) preference for imaging over clinical examination; 3) patients expect 100% certainty when given a diagnosis; and 4) patients expect individualized care throughout their entire ED visit. This data led to the formation of a shared information sheet which ensures that testing decisions for low-risk PE patients align with patient-specific values. Conclusion: By placing the focus on patient-centered care, this study incorporates evidence-based medicine with patient priorities in order to improve patient outcomes in the ED. / Thesis / Master of Science (MSc) / Pulmonary embolism occurs when blood clots form in veins of the legs, and travel to the lungs, causing chest pain and shortness of breath. There are well-established, evidence-based guidelines on how to diagnose pulmonary embolism. Diagnostic tools such as the Wells score and D-dimer have been proven to be safe and effective in ruling out pulmonary embolism in low risk patients preventing the need for a CT scan. However, CT scans are still being overused to diagnose pulmonary embolism in low risk patients. Unnecessary testing in the emergency department (ED) exposes patients to the harms associated with CT scanning: such as increased risk of cancer, and diagnosing blood clots that are not actually there, resulting in unnecessary treatment. It is possible that the answer behind the over-testing of PE in the ED lies within the physician-patient relationship. This three-part study first reviewed all prior studies on shared decision-making strategies, which are techniques used to help physician align medical decisions with patient-specific values, in the ED. Second, we employed qualitative methods to identify patient-specific values and preferences on PE testing in the ED. Finally, both of these aims informed the development of a patient-centered shared information tool to overcome barriers to patient-centered care. Ultimately, the goal of this study is to achieve a patient-centered approach to the testing of pulmonary embolism in the ED.

Henrico County Public Schools (HCPS) deployed laptop computers to over 23,000 middle and high school students in the division. Access to the computer network was through a wireless system that provided convenient and unlimited classroom arrangements without the restrictions required with cabled computer systems. Because each student was assigned a computer and assisted in obtaining low cost Internet service at home, this initiative also provided 24-hour access to digital information. This program was called the Teaching and Learning Initiative (TLI). Division leaders were striving to utilize this initiative not only to provide its students and teachers with 21st-century technologies that included access to the latest digital information, but also to change pedagogical practices in HCPS to a student-centered model. The purpose of this study was to determine the perceptions of students about the influence that this initiative has had on their classroom experiences. Secondary purposes included student perceptions of pedagogical changes in instruction, information acquisition, and recommendations that students would have for improving the TLI. Literature on computer use in schools is reviewed as it related to the HCPS' laptop initiative, as well as the importance of giving students a voice in change processes. Through a qualitative analysis of interviews with student focus groups from six of the 11 middle schools in the division, middle school students' perceptions of their experiences in the TLI were obtained. Analysis of focus group interviews, classroom observations, and students' logs of classroom activities provided triangulation. Data were analyzed inductively and results emerged organized by subcategories, categories, and themes. Results were reported in narrative form and explanatory tables, with an emphasis on findings related to the research questions of this study focusing on students' experiences in the TLI. Conclusions derived from this study were: Middle school students were keenly aware of their educational experiences and clearly articulated their thoughts; students' educational experiences changed during the TLI; some elements of constructivist classrooms were supported by laptop use, but not collaborative work; students obtained information from the Internet and websites, using textbooks less; computer reliability was a concern; cost to students for repairs raised equity issues; and benefits of the TLI went beyond the classroom. / Ed. D.

Bakgrund: Patientnära rond är ett teamarbete mellan framförallt patient, sjuksköterska och läkare. Ett bra samarbete förbättrar relationen dem emellan. Dessutom har en framgångsrik rond mellan patient och sjukvårdspersonal stor betydelse för att patienten ska kunna få en säker och personcentrerad vård. Därför är det viktigt att få en djupare förståelse för hur patienter och sjukvårdpersonal upplever patientnära rond samt för betydelsen av teamarbetet vid patientnära rond. Syfte: Att belysa vilka effekter patientnära rond har på vårdteam samt att undersöka upplevelsen av patientnära rond utifrån perspektiven från både patienter och sjukvårdspersonal (sjuksköterskor, läkare och medicinstudenter). Metod: En litteraturstudie baserad på 14 vetenskapliga originalartiklar. Databaser som användes i studien var PubMed, Cochrane Library, Cinahl, SBU och SveMed. Resultat: Resultatet av denna studie indikerar att både patienter och sjukvårdspersonal upplever en ökad tillfredsställelse vid patientnära rond. Vidare visar resultatet att patientnära rond bidrar till att sjukvårdpersonal kan ge patienter en proaktiv omvårdnad, att samarbetet sjukvårdpersonal emellan blir mer effektivt och att patientnära rond gynnar medicinstudenters utveckling samt ökar studenters tillfredsställelse med sin utbildning. En utmaning som sjuksköterskor upplever i samband med patientnära rond är tidsbegränsning – framför allt upplever de att det tar tid för sjuksköterskor och läkare att synkronisera och koordinera mötet mellan patient och vårdpersonal samt att tid för dokumentation är bristande. Läkare upplever dessutom att deras autonomi minskas i samband med patientnära rond. Slutsats: Överlag kan patientnära rond vara ett effektivt sätt att främja personcentrerad vård. Patientnära rond har en positiv inverkan på teamarbete sjukvårdpersonal emellan samt bidrar till ökad tillfredsställelse hos både patienter och sjukvårdspersonal. Det finns dock behov av ytterligare forskning om patienters upplevelse av patientnära rond och vilka specifika åtgärder som kan vidtas för att sjukvårdpersonalen ska kunna samarbeta på ett mer effektivt sätt. / Background: The ward round is a team collaboration mainly between patient, nurse and physician. A good collaboration enhances the relationship between them. In addition, a successful round between the patient and the medical personnel is of great significance for the patient to have a safe and person-centered care. Therefore it is important to gain a deeper understanding of how patients and medical staff experience ward rounds, as well as of the importance of team work during the ward rounds. Aim: To shed light upon the effects of ward rounding on healthcare teams and to explore the experience of ward rounds from the perspectives of both patients and medical staff (nurses, physicians and medical students). Method: A literature study based on 14 scientific articles. Databases used in the study were PubMed, Cochrane Library, CINAHL, SBU and SveMed. Results: The results of this study indicate that both patients and medical personnel experience an increased satisfaction during ward rounds. Furthermore, the results show that ward rounds contribute in making medical personnel provide a proactive care to their patients, that cooperation between medical staff becomes more efficient, and that ward rounding benefits medical students’ development and increases students’ satisfaction with their education. A challenge that nurses experience during ward rounds is time limitation – mainly they experience that it takes time for nurses and physicians to synchronize and coordinate the meeting between patient and medical personnel, and also that the time for documentation is inadequate. Physicians also experience that their autonomy is reduced in relation to ward rounds. Conclusion: Overall, ward rounding can be an effective way to promote person-centered care. Ward rounds have a positive impact on teamwork between medical personnel and contribute to increased satisfaction among both patients and medical staff. However, there is need for further research on patients' perception of ward rounding and which specific measures that can be taken for the medical staff to be able to collaborate more efficiently.

Although in the past 50 years significant advances based on research of brain-computer interface (BCI) technology have occurred, there is a scarcity of BCI assistive technology devices at the consumer level. This multiple case study explored user-centered clinical BCI device design strategies used by computer scientists designing BCI assistive technologies to meet patient-centered outcomes. The population for the study encompassed computer scientists experienced with clinical BCI assistive technology design located in the midwestern, northeastern, and southern regions of the United States, as well as western Europe. The multi-motive information systems continuance model was the conceptual framework for the study. Interview data were collected from 7 computer scientists and 28 archival documents. Guided by the concepts of user-centered design and patient-centered outcomes, thematic analysis was used to identify codes and themes related to computer science and the design of BCI assistive technology devices. Notable themes included customization of clinical BCI devices, consideration of patient/caregiver interaction, collective data management, and evolving technology. Implications for social change based on the findings from this research include focus on meeting individualized patient-centered outcomes; enhancing collaboration between researchers, caregivers, and patients in BCI device development; and reducing the possibility of abandonment or disuse of clinical BCI assistive technology devices.

The patient centered care (PCC) model is recommended by the Institute of Medicine for individuals with intellectual and developmental disabilities. The problem identified in this quality improvement (QI) project was that PCC practices had not been included in the training curriculum within the organization. Framed within the plan-do-study-act model of QI, the purpose of this project was to develop an educational initiative on PCC that included a curriculum plan, a pretest/posttest, a protocol, a revision of the training policy, and an implementation and evaluation plan. Drawing upon the evidence-based literature and using a team approach, a curriculum plan on PCC practices was developed which included a pretest/posttest to evaluate staff knowledge on the curriculum before and after the training. Three content experts from the committee approved the curriculum and validated the pretest/posttest items. The content validation index was 0.99 showing that each item reflected the content and objectives of the curriculum. As well, a training protocol was developed which identified the steps for provision of the curriculum to maintain consistency for all users. The training policy was revised to set expectations for all staff for the incorporation of the PCC practices into the organization. This initiative will be implemented into the organization using Kurt Lewin’s model of change to guide PCC practices. A recommendation was made to add a small section on “people’s first language” to the training to preserve patients’ dignity and respect during communication. This project contributes to social change by promoting PCC practices among healthcare workers thus limiting healthcare disparities and improving access for persons with intellectual developmental disabilities.

Thesis (M.A.)--University of North Carolina at Wilmington, 2006. / Includes bibliographical references (leaves: [72]-74)

A reliance on a teacher-centered model of instruction presented the foundation for my research. I chose to investigate constructivist theory and to implement constructivist teaching practices within my art education classroom to determine if constructivist teaching practices would facilitate a shift to a more student-centered learning environment, and to determine if constructivist strategies positively impact student learning. I collected my raw data using autoethnographic recording, documenting my results over a two month period in January and February of 2007 from my experiences as an art educator at a public, Metro-Atlanta elementary school. A positive impact on student learning was observed and the constructivist teaching strategies did produce student-centered learning environments. Based on my experiences constructivist teaching strategies may be beneficial to the creation of student-centered learning environments and assist in broadening student inquiry and investment with lessons.