Improving the Academic Performance of Non‐native English‐Speaking Students: the Contribution of Pre‐sessional English Language Programmes

There is an established, if weak, inverse relationship between levels of English language proficiency and academic performance in higher education. In response, higher education institutions (HEIs) insist upon minimum entry requirements concerning language for international applicants. Many HEIs now also offer pre‐sessional English courses to bring applicants up to the designated language requirement. This paper revisits the research into language proficiency and academic performance using data on all full‐time students (17,925) attending a major UK HEI in the academic year 2011–2012, 4,342 of whom were non‐native English speakers. The findings confirm that while higher International English Language Testing System (IELTS) marks at entry translate into higher grade point averages (GPAs), students who undertake pre‐sessional courses do notably worse in GPA terms than students who arrive with acceptable (for the course) IELTS scores. These findings suggest HEIs (and, by extension, international students) could benefit from a review regarding the appropriateness of current pre‐sessional English language proficiency programmes.     

An Experimental Test of Medical Disclosure and Consent Documentation: Assessing Patient Comprehension,Self-Efficacy,and Uncertainty

Effectively conveying risks and hazards in medical disclosure and informed consent documentation is a crucial type of communication. However, existing protocols typically do not meet the needs of patients or practitioners. In the present study, we advance a reconceptualization of obtaining written informed consent by analyzing it as a process of uncertainty management rather than a matter of document readability and recall. Results of this randomized trial indicated that patients who reviewed a simplified consent document reported greater comprehension of medico-legal terminology and lower uncertainty about the document, although they did not evince greater self-efficacy. Health literacy was a significant moderator of the relationship between consent form version and comprehension.     

A strategic approach to developing e-learning capability for healthcare

Objectives: This article examines a strategic approach to developing e‐learning capability to enhance learning opportunities for the workforce of a healthcare organization. Emphasis is given to the procurement of a bespoke Managed Learning Environment (MLE). Strategic organizational issues impacting on future e‐learning developments are considered. Methods: The 2‐year implementation plan was evaluated through a two phase external research project. The first phase focused on the effectiveness of a training programme designed to build capacity for e‐learning within the Northern area and also included a virtual learning environment usability study which informed the MLE specification. The second phase evaluation is ongoing during 2005 and interim findings are presented. Results: The MLE has been piloted and on‐line learning packages have been acquired. There has been a phased take‐up of e‐learning opportunities and e‐tutor training. Some virtual Communities of Practice have been established. Key organizational issues have been identified and ongoing findings are informing strategic planning. Conclusions: The healthcare MLE is offering enhanced learning opportunities and assisting area healthcare providers in training their dispersed workforces. Blended learning strategies are most successful. The need for protected time for e‐learning is a key issue, financial savings are available. Progress has been slowed by identified organizational constraints—the MLE's benefits are widely recognized.     

The effects of response cost and species-typical behaviors on a daily time–place learning task

Two theories that have been hypothesized to mediate acquisition in daily time–place learning (TPL) tasks were investigated in a free operant daily TPL task: the response cost hypothesis and the species-typical behavior hypothesis. One lever at the end of one of the choice arms of a T-maze provided food in the morning, and 6 h later, a lever in the other choice arm provided food. Four groups were used to assess the effect of two possible sources of response cost: physical effort of the task and costs associated with foraging ecology. One group was used to assess the effect of explicitly allowing for species-typical behaviors. If only first arm choice data were considered, there was little evidence of learning. However, both first press and percentage of presses on the correct lever prior to the first reinforcement revealed evidence of TPL in most rats tested. Unexpectedly, the high response cost groups for both of the proposed sources did not perform better than the low response cost groups. The groups that allowed animals to display species-typical behaviors performed the worst. Skip session probe trials confirmed that the majority of the rats that acquired the task were using a circadian timing strategy. The results from the present study suggest that learning in free operant daily TPL tasks might not be dependent on response cost.     

The impact of computer-mediated interaction on distance learning

Distance‐learning courses were classified with regard to their use of computer‐mediated interaction and the degree to which such interaction was integrated into the curriculum and the assessment regime. This produced four groups of courses varying according to their use of interaction and integration. The impact of interaction and integration was investigated in terms of their effects on students' performance, their perceptions of academic quality and their approaches to studying. In all three respects, variations within the groups of courses proved to be more important than variations between the groups. Interpretation of these results suggests that the adoption of interactive environments within computer‐mediated learning may not be enough in itself to lead to positive learning outcomes. We found no evidence for this assumption in terms of students' completion rates, pass rates, grades, perceptions of the quality of their courses or approaches to studying. Large variations in the measured indicators were found between courses, and these appeared to be largely independent of the effects of interaction and integration. Courses may differ markedly with regard to how they make use of computer‐mediated interaction and how this is integrated into the curriculum and the assessment regime. A case study approach is suggested as being more likely to identify the impact of specific designs based on computer‐mediated interaction and to bring together the diverse student responses arising from the use of such interaction in their studies.     

Facilitation skills: the catalyst for increased effectiveness in consultant practice and clinical systems leadership

Consultant practitioner is the pinnacle of the clinical career ladder for all health care disciplines in the United Kingdom. Consultant nurse, midwife and health visitor roles build on the clinical credibility and expertise characteristic of advanced level practice, but also possess expertise in: clinical systems leadership and the facilitation of culture change, learning and development; advanced consultancy approaches, and research and evaluation to prioritise person-centred, safe and effective care across patient pathways.

This project aimed to help new and emerging consultants to become more effective in their role through a programme of support to develop their expertise.

Emancipatory action research, supported by claims, concerns and issues tool, derived from Stakeholder Evaluation, and other methods (active learning, action learning, collaborative workshops and individual tools e.g. qualitative 360 degree feedback and reflective reviews) comprised the supportive intervention which enabled participants to research their own practice.

The programme’s methodology and methods helped participants to: research their own practice; theorise from practice; grow the facilitation skills needed to develop and demonstrate their own effectiveness; foster the effectiveness of others and; transform practice culture. Greater effectiveness in their multiple roles was demonstrated, as was the impact of this on others, services and organisations.

The study concludes that the support programme augmented by the methodology, facilitation skills and the 10 principles derived from a concept analysis of work-based learning is central to achieving improved effectiveness and transformation of others, services and organisations. Theoretical insights at collective/community levels also resulted. Key recommendations are identified for commissioners, higher education and research.