The laboratory test utilization management toolbox

Efficiently managing laboratory test utilization requires both ensuring adequate utilization of needed tests in some patients and discouraging superfluous tests in other patients. After the difficult clinical decision is made to define the patients that do and do not need a test, a wealth of interventions are available to the clinician and laboratorian to help guide appropriate utilization. These interventions are collectively referred to here as the utilization management toolbox. Experience has shown that some tools in the toolbox are weak and other are strong, and that tools are most effective when many are used simultaneously. While the outcomes of utilization management studies are not always as concrete as may be desired, what data is available in the literature indicate that strong utilization management interventions are safe and effective measures to improve patient health and reduce waste in an era of increasing financial pressure.     

Designing Large-Scale Multisite and Cluster-Randomized Studies of Professional Development

We develop a theoretical and empirical basis for the design of teacher professional development studies. We build on previous work by (a) developing estimates of intraclass correlation coefficients for teacher outcomes using two- and three-level data structures, (b) developing estimates of the variance explained by covariates, and (c) modifying the conventional optimal design framework to include differential covariate costs so as to capture the point at which the cost of collecting a covariate overtakes the reduction in variance it supplies. We illustrate the use of these estimates to explore the absolute and relative sensitivity of multilevel designs in teacher professional development studies. The results from these analyses are intended to guide researchers in making more-informed decisions about the tradeoffs and considerations involved in selecting study designs for assessing the impacts of professional development programs.     

Integrative assessment: reframing assessment practice for current and future learning

The requirement to provide timely formative tasks that are designed to facilitate student learning and autonomy has provoked a wider examination of the role of assessment in higher education and encouraged further investigation of the alignment of learning, teaching and assessment in curriculum design frameworks. Many current authors have proposed that the primary purpose of assessment is to enhance current and future learning and that current practice tends to overemphasise the importance of assessment for progression and certification purposes. This paper proposes that a clearer distinction be made between assessment tasks designed to facilitate and test current learning through the use of formative and summative assessments, and those tasks primarily designed to enhance future learning, which could be better termed integrative assessments. This distinction would allow students and teachers to have greater clarity around the proposed outcomes and reward mechanisms associated with assessment tasks and feedback. This paper proposes that teachers should strive to incorporate four different types of assessment tasks throughout a programme of study, namely diagnostic, formative, integrative and summative tasks, and that the outcomes and reward mechanisms for different assessment types be explained more clearly to students.     

Low‐fee private schools in England and in less economically developed countries. What can be learnt from a comparison?

There has been a growing amount of research on low‐fee private schools in less economically developed countries, but much less on low‐fee private schools in developed countries. Yet, low‐fee private schools have also been a recent feature of the educational landscape in countries such as Canada, the USA, Australia and Great Britain. This paper draws together some of my previously published work on such schools in England and considers the similarities between low‐fee private schools in developed and less economically developed countries. In particular, it examines sponsors' motivations for starting such schools and the motivations of parents for using such schools for their children.     

Social Interactions of Retarded Children: Generalization from Mainstream to Special School

Seven IH children attending a special school were integrated into a mainstream school on a part‐time basis over a period of 18 weeks. Effects were evaluated using behavioural measures of activity participation and social interactions during class time and free‐play periods in both the mainstream school and the special school which the children continued to attend. Compared to IH children who remained in the special school, the integrated children showed larger increases in Associative play in the special school free‐play period, but no differential change in classroom behaviour. In the mainstream school, social interactions between IH and non‐handicapped children occurred at high levels in both class and playground periods.