Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were obtained for this project. The purpose of this project was to explore barriers to SMBG and to use a literature search to identify strategies for improving compliance with SMBG. The health belief model was the framework used to guide the project. Secondary data obtained from the QIP (n = 19) were analyzed and coded. Results indicated that patients' financial concerns, social support, emotional needs, and lack of diabetes education were the main barriers to daily SMBG. Recommendations to the providers were to consider each barrier before ordering the use and frequency of SMBG and to consider an appropriate strategy for promoting SMBG adherence. Addressing low compliance with SMBG may promote positive social change through improved T2DM management, self-care, adherence to daily SMBG and treatment, and improved patient quality of life.

In this study, I aimed to build on a line of research focused on using technology-based, self-management interventions for students experiencing behavioral difficulties in a classroom setting. I analyzed the effects of an iPad application (app) called SCORE IT (Bruhn, Goin, &Hasselbring, 2014) on the behavior of three 5th grade students with, or at risk of an emotional and behavioral disorder (EBD) who were exhibiting low rates of academic engagement in a general education environment. I also aspired to gain an in-depth understanding of a teacher’s perceptions of the feasibility and value of the intervention, SCORE IT. This study was conducted using an embedded, experimental mixed methods design. Quantitative data using direct observation of student behavior was graphed and analyzed to determine if a functional relation existed between SCORE IT and student behavior (academic engagement). Qualitative data, consisting of teacher interviews and electronic journal entries, were merged with quantitative data from the Intervention Rating Profile 15 (IRP-15) and analyzed to assess the extent to which the teacher perceived the intervention to be practical and valuable. Overall, the SCORE IT intervention resulted in significant improvements in academic engagement and teacher perceptions of the feasibility and worth of the intervention were reported as highly favorable. Study limitations and future directions for research are discussed.

Obesity in America has grown widespread over the past decade and is a significant social issue that affects many families. Identifying interventions that are not only effective in the natural environment but are easy to implement are ideal for helping individuals engage in more fitness related activities. The purpose of this study was to evaluate the effectiveness of the NikeTM FuelBand for increasing physical activity in 3 adults. Additionally, a goal setting procedure was used to test if it enhanced the effects of the NikeTM FuelBand. Three measures were collected as part of the study, NikeTM Fuel, daily steps, and caloric expenditure. The NikeTM FuelBand was found to be effective at increasing all participants NikeTM Fuel score, daily steps, and caloric expenditure daily average from baseline to intervention phase. The goal setting procedure was found to be effective at increasing NikeTM Fuel point score, daily steps, and caloric expenditure daily average scores for two of three participants.

Many people in the United States do not engage in the recommended levels of physical activity. Self-management strategies, including self-monitoring and goal setting, are among the interventions that have been used to increase physical activity in adults. Visual feedback has also been incorporated into interventions to increase physical activity. Minimal research has focused on increasing swimming behavior. The current study investigated the effectiveness of self-management strategies to increase swimming activity in adults. An automated recording device (watch) was used to collect data on participants’ swimming behavior. The effect of self-monitoring in the form of a self-graphing intervention to increase swimming activity was evaluated. If self-graphing alone was not effective, goal setting was added to the intervention. Three participants showed an increase in swimming activity when self-graphing was implemented. Two participants showed little or no change in activity across all phases. This study did not include any reinforcement contingencies for engaging in an increase in swimming activity. Future research directions are discussed.

Researchers have successfully increased physical activity with self-monitoring, goal setting, and feedback. Goal attainment is a crucial part of what makes goal setting successful; however, it is often unreported in the literature or implied that goals were not reached consistently. A potential way to achieve this consistency is to create an action plan, or a detailed account of exactly how and when the individual will engage in the desired physical activity to reach his or her goal. This study evaluated whether making a detailed action plan would allow individuals to reach their physical activity goals more consistently than when using goal setting and self-monitoring alone. Action planning increased goal attainment for all participants but only resulted in increased physical activity for 2 of 3 participants. Future research should replicate this study to validate these findings and further explore methods for improving the success of goal setting as an intervention.

Children diagnosed with autism spectrum disorder (ASD) characteristically exhibit social communication and language deficits. Natural environment teaching (NET) is an intervention proven effective at improving social communication and language skills. Treatment fidelity is critical for an intervention to be effective. Research shows that training alone is often not sufficient to ensure proper implementation. Self-monitoring has shown to increase treatment fidelity, but performance feedback may be necessary to further improve the fidelity of individuals implementing interventions. Using a nonconcurrent multiple baseline design across participants with an ABC sequence, this study evaluated the impact of self-monitoring and video feedback on behavior therapist implementation of NET procedures and maintenance of the skills during fading. Results indicated that self-monitoring slightly improved fidelity of implementation. Fidelity improved further with the addition of video feedback. The results also indicated that implementation of NET with fidelity by the therapists led to improvement in participating children's verbal language skills.

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.

This research examined Facebook friendships between college/university instructors and students. Based on the development of instructor-student dual relationships, this study described instructors’ Facebook use with students. This included explanations for allowing/not allowing students, communication with students, and ethical concerns. Rooted in the theories of impression management, self-monitoring and role conflict, plus the concept of ambient awareness, hypotheses predicted relationships between instructors’ individual differences and Facebook use: (1) self-monitoring would be positively related to role conflict; and (2) self-monitoring, (3) role conflict, and (4) ambient awareness would be positively related to instructors’ self-presentation, impression management behaviors, and privacy management. Emails were sent to faculty at 270 colleges/universities throughout the U.S. and 331 instructors completed the online survey. Of these, 56.2% allowed students as friends. Open-ended answers revealed that instructors allowed students as friends to communicate, to facilitate learning about each other, and because it was difficult to decline requests. Some instructors did not allow certain students (e.g., problematic students, undergraduates). They communicated by commenting on and liking posts on students’ pages, and had ethical concerns about negative consequences. Open-ended answers revealed that instructors did not allow students as friends to maintain the professional divide and avoid favoritism, which explained their ethical concerns. Hierarchical regression analyses tested the predicted relationships. Results revealed that self-monitoring approached significance as having a positive relationship with role conflict and a negative relationship with privacy management, but was not related to self-presentation or impression management behaviors. Role conflict was not related to impression management. Awareness of students was positively related to self-presentation and impression management behaviors, but unexpectedly, perception of students’ awareness of instructors was negatively related to privacy management. A partial correlation analysis tested high/low self-monitors separately and not only replicated the results, but also revealed that high self-monitors’ perception of students’ awareness was positively correlated with self-presentation and impression management behaviors. These findings indicate that ambient awareness is related to online communication and should be studied further. This is especially intriguing since the two types of ambient awareness related differently to the three types of impression management studied in this research.

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.

Bakgrund och problem: Det finns mycket litteratur skrivet kring styrning i privat verksamhet, dock glöms den offentliga sektorn ofta bort, trots att styrning krävs även i dessa verksamheter. I denna studie kommer att fokuseras kring styrning i den offentliga sektorn och närmare bestämt i den akademiska världen. Anställda inom akademin värderar ofta friheten att själva kunna organisera sitt arbete högt, vilken kan hämmas av de finansiella begränsningar som dessa organisationer innehar. Här har strategin en viktig uppgift i att visa för de anställda i vilken riktning de ska sträva och få dem att fokusera på rätt saker. Vi ser att de finansiella begränsningarna kan hämma de anställdas frihet och på så vis påverka motivationen negativt. Frågan är då hur de chefer som arbetar närmast de anställda ska kunna styra dem att fortsätta arbeta med bibehållen motivation och samtidigt hålla sig inom de finansiella ramarna. Syfte: Syftet med studien är att undersöka hur första linjens chefer vid Linköpings Universitet styr de anställda att agera i enlighet med den strategi som finns och hur styrningen uppfattas av de anställda. Metod: För att besvara uppsatsens syfte har en fallstudie vid Linköpings Universitet genomförts. Fallstudien har genomförts kvalitativt genom 15 intervjuer på tre utvalda institutioner på den filosofiska fakulteten. Intervjuer har valts för att få en djupare förståelse för ämnet. Slutsats: Vi kan konstatera att chefer och anställda har en relativt lika syn i de flesta frågeställningar vi berört. Vi kan även konstatera att första linjens chefer vid Linköpings Universitet inte behöver styra sina underordnade i någon hög utsträckning då de anställda innehar ett brinnande intresse för sitt ämne och är självstyrande. Inom akademin innehar anställda en stark individualism och självständighet, vilket vi ser tyder på att de anställda inte behöver några tydliga mål för vad de ska uppnå. / Background and problem: There is much literature written on management control in private businesses but the public sector is often forgotten, despite the fact that management is also required in these businesses. This study will focus on management control in the public sector and more specifically in the academia. Employees of the academia often value the freedom to have the possibility to organize their work, which can be inhibited by financial constraints that these organizations hold. Here the strategy has an important role in demonstrating to the employees in which direction to pursue and get them to focus their efforts on the right things. We see that the financial limitations may inhibit employees' freedom and thereby affect their motivation negatively. The question then is how the managers who work most closely with the staff are able to steer them to continue working with the same motivation, while staying within the financial framework. Aim: The purpose of this study is to investigate how the first-line managers at Linköping University control the employees to act in accordance with the strategy and how this control is perceived by employees. Methodology: To answer the purpose for this thesis we have chosen to do a case study of Linköping University. The case study has been carried out qualitatively by 15 interviews in three selected departments at the Faculty of Arts & Sciences. Interviews were chosen to obtain a deeper understanding of the topic. Conclusion: We can say that managers and employees have a relatively similar view of most issues in the thesis. We can also observe that first-line managers at Linköping University don´t need to direct their subordinates to any great extent because the employees have a passion for their subject and are self-monitored. Within the university, staff have a strong individualism and independence, which we see imply that employees don’t need any clear objectives for what they should achieve.