Aims: Prescribing medication is a complex process that, when done inappropriately, can lead to adverse drug events, resulting in patient harm and hospital admissions. Worldwide cost is estimated at 42 billion USD each year. Despite several efforts in the past years, medication-related harm has not declined. The aim was to determine whether a prescriber-focussed participatory action intervention, initiated by a multidisciplinary pharmacotherapy team, is able to reduce the number of in-hospital prescriptions containing ≥1 prescribing error (PE), by identifying and reducing challenges in appropriate prescribing. Methods: A prospective single-centre before- and after study was conducted in an academic hospital in the Netherlands. Twelve clinical wards (medical, surgical, mixed and paediatric) were recruited. Results: Overall, 321 patients with a total of 2978 prescriptions at baseline were compared with 201 patients with 2438 prescriptions postintervention. Of these, m456 prescriptions contained ≥1 PE (15.3%) at baseline and 357 prescriptions contained ≥1 PEs (14.6%) postintervention. PEs were determined in multidisciplinary consensus. On some study wards, a trend toward a decreasing number of PEs was observed. The intervention was associated with a nonsignificant difference in PEs (incidence rate ratio 0.96, 95% confidence interval 0.83–1.10), which was unaltered after correction. The most important identified challenges were insufficient knowledge beyond own expertise, unawareness of guidelines and a heavy workload. Conclusion: The tailored interventions developed with and implemented by stakeholders led to a statistically nonsignificant reduction in inappropriate in-hospital prescribing after a 6-month intervention period. Our prescriber-focussed participatory action intervention identified challenges in appropriate in-hospital prescribing on prescriber- and organizational level.
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This ‘Big Ideas’ paper will explore the relevance of the constraintsled approach (Davids et al., 2008) for nurse education, specifically when teaching nursing skills. The constraints-led approach is an applied theory, based on the ecological-dynamics framework, which explains that skill learning is a process of adjusting to the characteristics of a situation, instead of reproducing isolated, “ideal” movements out of context (Araújo et al., 2017; Seifert et al., 2017, 2019). During nurse education however, students often find themselves in isolated practice drills in which they practice a nursing skill based upon detailed protocols and/or explicit instructions by the lecturer. Following the ecological dynamics framework (Button et al., 2021), we argue that there is no single ideal way of executing a certain task. In clinical practice, there are often more than one appropriate task executions for a certain situation, and on the other hand, a certain task execution might be effective in one situation, but less effective in another. As all patients and contexts contain unique characteristics, students need to practice with representative characteristics from clinical practice, so that they learn attuning to contextual information, instead of simply following step-by-step instructions (Fajen et al., 2009; Pinder et al., 2011; Wulf and Lewthwaite, 2016).
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Over the last two decades, institutions for higher education such as universities and colleges have rapidly expanded and as a result have experienced profound changes in processes of research and organization. However, the rapid expansion and change has fuelled concerns about issues such as educators' technology professional development. Despite the educational value of emerging technologies in schools, the introduction has not yet enjoyed much success. Effective use of information and communication technologies requires a substantial change in pedagogical practice. Traditional training and learning approaches cannot cope with the rising demand on educators to make use of innovative technologies in their teaching. As a result, educational institutions as well as the public are more and more aware of the need for adequate technology professional development. The focus of this paper is to look at action research as a qualitative research methodology for studying technology professional development in HE in order to improve teaching and learning with ICTs at the tertiary level. The data discussed in this paper have been drawn from a cross institutional setting at Fontys University of Applied Sciences, The Netherlands. The data were collected and analysed according to a qualitative approach.
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More than 25!years after Moore’s first introduction of the public value concept in 995, the concept is now widely used, but its operationalization is still considered difficult. This paper presents the empirical results of a study analyzing the application of the public value concept in Higher Education Institutions, thereby focusing on how to account for public value. The paper shows how Dutch universities of applied sciences operationalize the concept ‘public value’, and how they report on the outcome achievements. The official strategy plans and annual reports for FY2016 through FY2018 of the ten largest institutions were used. While we find that all the institutions selected aim to deliver public value, they still use performance indicators that have a more narrow orientation, and are primarily focused on processes, outputs, and service delivery quality. However, we also observe that they use narratives to show the public value they created. In this way this paper contributes to the literature on public value accounting.
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Building on the Millennium Development Goals, Education for Sustainable Development (ESD) and Education for Sustainable Development Goals (ESDG) were established. Despite the willingness of many educational institutions worldwide to embrace the SDGs, given escalating sustainability challenges, this article questions whether ESDG is desirable as “an education for the future”. Many challenges outlined by the SDGs are supposed to be solved by “inclusive” or “sustainable” economic growth, assuming that economic growth can be conveniently decoupled from resource consumption. Yet, the current hegemony of the sustainability-through-growth paradigm has actually increased inequalities and pressure on natural resources, exacerbating biodiversity loss, climate change and resulting social tensions. With unreflective support for growth, far from challenging the status quo, the SDGs and consequently, the ESDGs, condone continuing environmental exploitation, depriving millions of species of their right to flourish, and impoverishing future generations. This article creates greater awareness of the paradoxes of sustainable development and encourages teaching for sustainability through various examples of alternative education that emphasizes planetary ethic and degrowth. The alternatives include Indigenous learning, ecopedagogy, ecocentric education, education for steady-state and circular economy, empowerment and liberation. “This is an Accepted Manuscript of an article published by Taylor & Francis in 'Journal of Environmental Education' on 01/20/20, available online: https://www.tandfonline.com/doi/full/10.1080/00958964.2019.1710444 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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This article focuses on improving the instructional quality of student teachers in elementary education. We developed a coaching approach involving classroom observation and appropriate lesson preparation and feedback templates. Using an untreated control group design with pre-test and posttest (n = 198), we answered the question ‘whether student teachers who learned to teach with the new coaching approach achieved a higher level of pedagogical and didactical teaching skills compared to student teachers who did not receive this approach’. The effect variable used was the observation instrument ICALT. We compared the average scores of the control group and the experimental group on the posttest (ANCOVA). The differences found on the posttest, after controlling for the confounding variables, were significant on all ICALT scales. These effect sizes are medium on the scales; ‘Safe climate’ and ‘Clear instruction’ and large on the scales; ‘Classroom management’ ‘Activating pupils’ ‘Adaptive teaching’ and ‘Teaching learning strategies’.
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Aims: In-hospital prescribing errors may result in patient harm, such as prolonged hospitalisation and hospital (re)admission, and may be an emotional burden for the prescribers and healthcare professionals involved. Despite efforts, in-hospital prescribing errors and related harm still occur, necessitating an innovative approach. We therefore propose a novel approach, in-hospital pharmacotherapeutic stewardship (IPS). The aim of this study was to reach consensus on a set of quality indicators (QIs) as a basis for IPS. Methods: A three-round modified Delphi procedure was performed. Potential QIs were retrieved from two systematic searches of the literature, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. In two written questionnaires and a focus meeting (held between the written questionnaire rounds), potential QIs were appraised by an international, multidisciplinary expert panel composed of members of the European Association for Clinical Pharmacology and Therapeutics (EACPT). Results: The expert panel rated 59 QIs and four general statements, of which 35 QIs were accepted with consensus rates ranging between 79% and 97%. These QIs describe the activities of an IPS programme, the team delivering IPS, the patients eligible for the programme and the outcome measures that should be used to evaluate the care delivered. Conclusions: A framework of 35 QIs for an IPS programme was systematically developed. These QIs can guide hospitals in setting up a pharmacotherapeutic stewardship programme to reduce in-hospital prescribing errors and improve in-hospital medication safety.
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The Ecocentric and Anthropocentric Attitudes toward the Sustainable Development (EAATSD) scale measures environmental concern in relation to sustainable development. This article will discuss how this scale was tested with three groups of Dutch higher education students. Findings demonstrate that anthropocentric and ecocentric values are independent of the students’ chosen course of study, suggesting that students attracted by the ‘sustainable development’ course title do not necessarily associate ‘sustainability’ with ecocentric aims. This article discusses why ecocentric values are beneficial to the objective of a sustainable society and proposes ways forward in which these values can be enhanced in learners. https://doi.org/10.3390/educsci7030069 https://www.linkedin.com/in/helenkopnina/
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Despite the willingness of many educational institutions worldwide to embrace Education for Sustainable Development and Education for Sustainable Development Goals, critical scholars have pointed out that the very enterprise of sustainable development is not without its contradictions. Therefore, any education that engages with sustainable development needs to be carefully reviewed, rather than supported, in its ambition to promote the supposedly universally desirable aims. The rhetoric of sustainable development as meeting the needs of present and future generations is largely anthropocentric in failing to take nonhuman species into account when setting up pragmatic and ethical objectives. Similarly to the Millennium Development Goals (MDGs) that have helped to raise living standards across the world, but have largely failed to address environmental sustainability challenges, the Sustainability Development Goals (SDGs) tend to prioritize “inclusive economic growth” at the expense of ecological integrity, which is very likely to negatively affect not only nonhuman species but also future generations and their quality of life. Thus, as this chapter will argue, universally applicable Education for Sustainable Development Goals (ESDGs) is problematic in the context of addressing the long-term sustainability for both human and nonhuman inhabitants of the planet. Given escalating climate change, biodiversity loss, pollution, and depletion of natural resources, this chapter questions whether ESDGs can qualify as a desirable “quality education”. The paradoxes of sustainable development and ways forward that seem a better alternative for ESDG include indigenous/traditional learning, ecopedagogy, ecocentric education, and education for degrowth, steady-state, and Cradle-to-Cradle and circular economy. Advantages of universal education are also highlighted, as any education that supports basic literacy, numeracy, and values attributed to the intrinsic rights of humans and nonhumans can help students to be equipped to deal with social and environmental challenges. https://doi.org/10.3390/books978-3-03897-893-0-1 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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Living Lab Environments (LLE) are a relative new phenomenon, especially in higher education. There is no unambiguous definition of LLE in the literature and several LLE are discussed. Where traditional education takes place in a classroom (a controlled internal environment), LLE experiments in a real-life environment with all kinds of stakeholder groups needed. For higher education, this research explores whether this form of education in practice is appropriate by mapping the success and failure factors. Interviews with coordinators of labs and their experience with these labs will provide clues for future research.
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