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Experiential & High Impact Learning as Catalysts for Change: Exploring the Historical Inquiry Process and Experiences of High School and College History Educators
Full text linkABSTRACT
This study explores how high school and college history instructors’ perspectives of experiential learning opportunities and high-impact practices influence their epistemic beliefs as history teachers. The research considers educators’ pedagogical practices to align inquiry and historical thinking with experiential learning opportunities and high-impact practices (HIPs). This study promotes the American Association of Colleges and Universities (AAC&U) notion that college success is not determined by earning a degree but by becoming a civic-minded, engaged graduate. Kuh (2008a) and the AAC&U created the HIPs framework to transform higher education and prepare students to meet the challenges of a changing global world. Kuh (2008a) states that although high-impact practices will differ, each approach supports experiential learning. Experiential learning couples activities and experiences to facilitate learning by doing; hands-on learning is the source of knowledge and is a lifelong process (Kolb, 2015).
This explanatory sequential mixed methods (QUANT → qual) study investigated the extent to which experiential learning opportunities and high-impact practices (HIPs) (Kuh, 2008a) were instrumental in the educational experiences of current high school and college history instructors. Experiential learning and high-impact practices create opportunities to facilitate various approaches to learning. This study examined experiential learning and high-impact practices via a criterialist orientation to historical inquiry in high school and college history courses to propose a theory of change model supporting professional practice and targeted outcomes. The study developed a purposeful sample of 5,195 current Missouri and Illinois high school and college history instructors who were invited to participate in the survey via email. I analyzed 183 surveys and interviewed ten educators.
Study results revealed strong, positive relationships between current high school and college history instructors’ formative experiences with experiential learning (Kolb, 2015) and high-impact practices (HIPs) (Kuh, 2008a) and (1) their views of themselves as history learners, (2) their use of a criterialist approach to historical inquiry (Maggioni et al., 2009), and (3) their professional commitments to using experiential learning and HIPs in their classrooms. An analysis of the qualitative interviews identified four themes: (a) history instructors’ formative learning experiences, (b) history instructors’ experiential learning and HIPs, (c) fostering a criterialist orientation to historical inquiry, and (d) developing learners through positive educator relationships and the value of history. During the interviews, instructors revealed a deep love of history education, a passion for teaching, and an emphasis on building relationships via compassion, empowering students, and supporting student efficacy, motivation, collaboration, and engagement. Taken together, this research found a connection between instructors who express a professional commitment to using experiential learning and HIPs in their classroom and their use of a criterialist approach to historical inquiry.
These findings provide initial verification for a theory of change model that undergirded this research, i.e., A Conceptual Model Exploring History Instructor Formative Experiences, Epistemological and Pedagogical Beliefs, and Professional Commitments, which integrates the criterialist approach to historical inquiry with experiential learning and high-impact practices in high school and college history courses as a pathway to transforming student learning experiences. This model is a tool for current and future history educators to advance the epistemological foundation of experiential learning, HIPs, and the criterialist approach to historical inquiry
Implementation of Intentional Hourly Rounding at Pediatric Hospital
Full text linkProblem: Intentional hourly rounding improves patient safety and can impact patient fall rates. At a pediatric hospital in suburban Missouri, the fall rate is 25%. This quality improvement project worked to implement a standardized intentional hourly rounding process at a pediatric hospital to bolster their fall prevention program.
Methods: This quality improvement project was conducted using a descriptive, observational design utilizing patient chart review and hospital quality department records. The setting was a 60-bed pediatric hospital in the Midwest with 2 inpatient units that specializes in chronic, complex care. The sample was a convenience sample of 92 male and female patients ages 0-23 years of age admitted at the time of project implementation. The project focused on implementing intentional hourly rounding on two inpatient units. The 5 P’s (pain, position, potty, possessions, and pathways) was the chosen standardization. The project ran for 12-weeks from January to March. Fall rates were tracked as well as the safety metric of safe bed heights to analyze how intentional hourly rounding impacted patient safety.
Results: The fall rate prior to implementation was 25%. After the twelve-week project, the fall rate was 19.5%. The p-value was 0.45. Of inpatient beds, 87.9% were found at a safe height which was almost 5% more than prior to implementation.
Implications for Practice: Future quality improvement projects should be done to continue evaluating for patient safety improvement and fall rate reduction. A longer project time would allow for a larger sample size and greater information to analyze
The Impact of Hourly Safety Rounding on Pediatric Fall Rates
Full text linkThe Impact of Hourly Safety Rounding on Pediatric Fall Rates
Abstract
Problem: Falls are a common adverse event in the inpatient pediatric setting and are a significant risk to patient safety. Environmental factors, such as unclear pathways, bed rails down, beds in high position, and call lights out of reach, are considered avoidable causes of patient falls. The site’s fall data in a 12-month period from January 2023 to January 2024 showed (n=9) patient falls occurred with (n=5, 55.6%) due to environmental factors. The purpose of this Quality Improvement (QI) pilot project was to assess the impact of hourly safety rounding on pediatric fall rates. The study question was: In pediatric inpatients aged 8-14 years on a renal/endocrine floor, how does implementation of hourly safety rounding compared to no intervention implementation affect fall rates over 12 weeks?
Methods: The QI pilot project’s design was a descriptive cohort study with a pre-and post-intervention comparison. A retrospective data review was performed and the post-intervention period was completed over a 12-week timeframe. This project utilized a convenience sampling. Participants were inpatients on the renal/endocrine floor aged 8-14 years. The exclusion criteria was patients who were not in the 8–14-year age range and not on the renal/endocrine floor.
Results: There were (N=107) patients who met criteria for this project. The number of patients in the pre-implementation phase from July through September of 2023 was (n=71) with (n=2) patient falls occurring and (n=1) caused by environmental factors. In the post-implementation phase from February through April 2024, there were (n=36) patients, with zero patient falls occurring (FET p= .549). Hourly safety rounding was completed on (n=24, 66.7%) patients and interventions were completed during rounds on (n=20, 83.3%) patients.
Implications for Practice: The implementation of hourly safety rounding with interventions completed within a fall prevention bundle could be a vital step to decreasing the rate of falls caused by avoidable environmental factors which has an impact on healthcare costs and patient safety
Restraint Reduction Using the Brøset Violence Checklist
Full text linkAbstract
Problem: Patient aggression, restraint usage and assaults against healthcare workers have numerous negative health outcomes. Patient aggression and restraint usage on inpatient psychiatric units can be identified early with imminent violence predicative tools such as the Brøset Violence Checklist (BVC), where patient de-escalation interventions can subsequently occur.
Methods: This quality improvement project was conducted using a cohort design with a retrospective and prospective chart review. The IHI PDSA model was used for this project. The BVC was administered to male and female patients ages 18 to 64 years old on the adult inpatient psychiatric unit during the implementation period. Data collection included the patient demographics, BVC scores, number of interventions, and restraint type, patient restraint injuries, patient to patient assaults, and staff assault injuries.
Results: During the pre-implementation period, a total of 329 patients were admitted, 12 patients were restrained, and 40 restraint episodes occurred. Post-implementation 317 patients were admitted, 18 restrained and 55 restraint episodes occurred. Total restraints increased by 2%, chemical restraints increased by 6%, manual holds increased by 2%, lock seclusion increased by 7% and 4-point restraints decreased by 17%. Patient-restraint injuries decreased by 6%, patient-to-patient assaults decreased by 1% and staff injuries increased by 2%.
Implications for Practice: Patients at-risk for aggression were identified by the BVC. Further research is needed into the use of the BVC and restraint reduction
Improving Nurse Response to Seizure Events in a Pediatric Epilepsy Monitoring Unit with Use of a Standardized Process
Full text linkProblem: Nurses responding to seizure events in the pediatric epilepsy monitoring unit (EMU) should initiate a neurological exam in addition to managing seizure activity. When nurses respond to these events, however, there can be significant variability, which can result in diagnostic inaccuracy and adverse patient outcomes. The purpose of this project is to implement a nursing response checklist and neurological assessment guide to standardize the process of response to seizure events in the pediatric EMU.
Methods: This quality improvement (QI) project utilized a cohort study design. Standardized tools were placed in an accessible area outside patient rooms. Education was provided to nursing staff on how to use the tools. Nurses also received an emailed survey to assess confidence in the ability to respond to seizure events both before and after implementation of the tools. The primary outcome measure was nursing compliance with utilizing the tools, with secondary outcomes of medication administration times and nursing confidence in responding to seizures. Data was collected through review of patient charts, review of video EEGs obtained, and answers to survey questions.
Results: Nursing compliance in utilizing the tools during seizure events was 26.7%. The mean medication administration time for the post-intervention sample was 17.5 minutes compared to 20.7 minutes for the pre-intervention sample; however, this difference was not statistically significant. Additionally, there was no significant difference between self-reported nursing confidence between the pre- and post-implementation samples.
Implications and Recommendations: Future studies should focus on generating data from larger samples to determine the effect of standardized seizure response protocols on nursing response to seizure events and confidence in caring for patients with epilepsy
Management of Post-Extubation Dysphagia using the Yale Swallow Protocol
Full text linkAbstract
Problem: Post extubation dysphagia (PED) increases the patient’s risk for long term complications contributing to increased healthcare cost. Intensive care settings rarely use standardized swallow screening assessments for patients post extubation leading to variation in the evaluation of PED. Variation in the assessment of swallowing post extubation can lead to the missed diagnosis of patients with dysphagia.
Methods: This quality improvement (QI) project was a prospective cohort study implementing an evidence-based swallow screening protocol, the Yale Swallow Protocol (YSP), in an intensive care unit. This study was conducted over four months, which included a pre survey, education, implementation, and post survey. Qualitative and quantitative data was collected from the electronic medical record on the patient responses to the screening. The surveys were distributed via QR code on a flyer and recorded in an Excel sheet via Google Forms.
Results: The total number of YSP screenings was 24 (11 passed (46%), 9 failed (37%), and 4 (17%) were excluded). Seven (78%) of the failed screenings were validated with a fiberoptic endoscopic evaluation of swallowing test (FEES) or modified barium swallow study (MBS) showing mild to moderate dysphagia (n=5, 72%), aspiration (n=1, 14%), and laryngeal edema (n=1, 14%).
Implications for Practice: The YSP provides clinical settings with a swallow screen that identifies extubated patients with an increased risk for dysphagia
Deconstructing Diagnostic Criteria for ADHD
Full text linkAttention deficit hyperactivity disorder (ADHD) is a highly prevalent disorder across development. Early detection is a critical first step to early intervention but the average age of diagnosis is 7. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) includes 18 symptoms for ADHD. The purpose of this project is to determine how these 18 symptoms individually map onto effortful control, surgency, and negative affect (measured via the Child Behavior Questionnaire) in 3-6 year olds. A better understanding of how ADHD symptoms manifest in this age range has the potential to move the average age of diagnosis and help connect children with resources earlier
Afterlight: Game Design and the Power of Narrative
Full text linkIn the last few decades we as a society have watched the evolution of games as a storytelling medium. From Candyland to The Last of Us, all games use some form of narrative to bring players into the world of the game. Over the course of the last six months, I’ve been developing a tabletop card game with the working title of Afterlight. In this presentation, I will be explaining my process as I’ve worked on designing and refining this game. I will also talk about why I feel game design can be an effective way to engage people with difficult topics and the broader uses of game design in helping people deal with and process difficult narratives in the real world. The core of this is centered around the “magic circle” players create when they choose to play a game, and the fantasy of empowerment and disempowerment players willingly accept in taking on their role as a “player”
Preserving Sacred Memory: The Effort to Create the United States Holocaust Memorial Museum
Full text linkThis poster attempts to provide insight on how the American government remembers the Holocaust through its formation of the United States Holocaust Memorial Museum in Washington, D.C. Topics include the physical structure of the museum, the history of the museum, and the relationship between original museum chairman Elie Wiesel and U.S. presidents Jimmy Carter and Ronald Reagan
Comparative Genomics Supports Ecologically Induced Selection as a Putative Driver of Banded Penguin Diversification
Full text linkThe relative importance of genetic drift and local adaptation in facilitating speciation remains unclear. This is particularly true for seabirds, which can disperse over large geographic distances, providing opportunities for intermittent gene flow among distant colonies that span the temperature and salinity gradients of the oceans. Here, we delve into the genomic basis of adaptation and speciation of banded penguins, Galápagos (Spheniscus mendiculus), Humboldt (Spheniscus humboldti), Magellanic (Spheniscus magellanicus), and African penguins (Spheniscus demersus), by analyzing 114 genomes from the main 16 breeding colonies. We aim to identify the molecular mechanism and genomic adaptive traits that have facilitated their diversifications. Through positive selection and gene family expansion analyses, we identified candidate genes that may be related to reproductive isolation processes mediated by ecological thermal niche divergence. We recover signals of positive selection on key loci associated with spermatogenesis, especially during the recent peripatric divergence of the Galápagos penguin from the Humboldt penguin. High temperatures in tropical habitats may have favored selection on loci associated with spermatogenesis to maintain sperm viability, leading to reproductive isolation among young species. Our results suggest that genome-wide selection on loci associated with molecular pathways that underpin thermoregulation, osmoregulation, hypoxia, and social behavior appears to have been crucial in local adaptation of banded penguins. Overall, these results contribute to our understanding of how the complexity of biotic, but especially abiotic, factors, along with the high dispersal capabilities of these marine species, may promote both neutral and adaptive lineage divergence even in the presence of gene flow