Background:Postoperative complications and readmissions to hospital are factors known to negatively influence the short- and long-term quality of life of patients with gastrointestinal cancer. Active family involvement in activities, such as fundamental care activities, has the potential to improve the quality of health care. However, there is a lack of evidence regarding the relationship between active family involvement and outcomes in patients with gastrointestinal cancer after surgery.Objective:This protocol aims to evaluate the effect of a family involvement program (FIP) on unplanned readmissions of adult patients undergoing surgery for malignant gastrointestinal tumors. Furthermore, the study aims to evaluate the effect of the FIP on family caregiver (FC) burden and their well-being and the fidelity of the FIP.Methods:This cohort study will be conducted in 2 academic hospitals in the Netherlands. The FIP will be offered to adult patients and their FCs. Patients are scheduled for oncological gastrointestinal surgery and have an expected hospital stay of at least 5 days after surgery. FCs must be willing to participate in fundamental care activities during hospitalization and after discharge. Consenting patients and their families will choose to either participate in the FIP or be included in the usual care group. According to the power calculation, we will recruit 150 patients and families in the FIP group and 150 in the usual care group. The intervention group will receive the FIP that consists of information, shared goal setting, task-oriented training, participation in fundamental care, presence of FCs during ward rounds, and rooming-in for at least 8 hours a day. Patients in the comparison group will receive usual postoperative care. The primary outcome measure is the number of unplanned readmissions up to 30 days after surgery. Several secondary outcomes will be collected, that is, total number of complications (sensitive to fundamental care activities) at 30 and 90 days after surgery, emergency department visits, intensive care unit admissions up to 30 and 90 days after surgery, hospital length of stay, patients’ quality of life, and the amount of home care needed after discharge. FC outcomes are caregiver burden and well-being up to 90 days after participating in the FIP. To evaluate fidelity, we will check whether the FIP is executed as intended. Univariable regression and multivariable regression analyses will be conducted.Results:The first participant was enrolled in April 2019. The follow-up period of the last participant ended in May 2022. The study was funded by an unrestricted grant of the University hospital in 2018. We aim to publish the results in 2023.Conclusions:This study will provide evidence on outcomes from a FIP and will provide health care professionals practical tools for family involvement in the oncological surgical care setting.
A primary teacher needs mathematical problem solving ability. That is why Dutch student teachers have to show this ability in a nationwide mathematics test that contains many non-routine problems. Most student teachers prepare for this test by working on their own solving test-like problems. To what extent does these individual problem solving activities really contribute to their mathematical problem solving ability? Developing mathematical problem solving ability requires reflective mathematical behaviour. Student teachers need to mathematize and generalize problems and problem approaches, and evaluate heuristics and problem solving processes. This demands self-confidence, motivation, cognition and metacognition. To what extent do student teachers show reflective behaviour during mathematical self-study and how can we explain their study behaviour? In this study 97 student teachers from seven different teacher education institutes worked on ten non-routine problems. They were motivated because the test-like problems gave them an impression of the test and enabled them to investigate whether they were already prepared well enough. This study also shows that student teachers preparing for the test were not focused on developing their mathematical problem solving ability. They did not know that this was the goal to strive for and how to aim for it. They lacked self-confidence and knowledge to mathematize problems and problem approaches, and to evaluate the problem solving process. These results indicate that student teachers do hardly develop their mathematical problem solving ability in self-study situations. This leaves a question for future research: What do student teachers need to improve their mathematical self-study behaviour? EAPRIL Proceedings, November 29 – December 1, 2017, Hämeenlinna, Finland
In this study, we aimed to identify how the learning activities elicited in a lesson study project contributed to self-perceived change in supervisors’ pedagogical content knowledge (PCK). Lesson study is a method which combines both professional and educational development. During a lesson study project, teachers collaborate in a team and develop, teach, evaluate, and redesign a research lesson. During the 4-month lesson study project described here, four supervisors designed a protocol for research supervision meetings aimed at enhancing undergraduate students’ learning. During the project, they experimented with open questioning and giving positive feedback instead of giving instruction and explanations. A mixed-methods design was used in this study. Data on the supervisors’ learning activities and PCK were gathered using learner reports, video-recordings of meetings, and exit interviews. The analyses of these data showed that the lesson study project contributed to the development of the supervisors’ PCK on instructional strategies and student understanding. The learning activity that contributed most to these changes was reflecting on their own practice and that of their students.
