Journal articles on the topic 'Nursing Study and teaching Victoria Case studies'

The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.

This descriptive and exploratory study with a qualitative design aimed to describe and analyze discussions in online chats about mental disorders in a psychiatric nursing course as part of an undergraduate nursing program. The sample consisted of 32 undergraduate students who attended the course. Data analysis showed that the discussions through online chat sessions permeated the acquisition of knowledge, procedures, attitudes and values and promoted students' active participation. The results reaffirm the discussions' importance for students' learning and showed the potential of technology resources, such as real-time communication tools, to support and improve teaching possibilities in psychiatric nursing.

The purpose of this paper is to discuss the influence of applying Orem’s self-care framework practice methodology on the content and comprehensiveness of a case study about a woman who denied having self-care deficits. The discussion begins with presentation of the case as it might have been found in a classroom or health professions journal and contrasts this with application of Orem’s self-care framework practice methodology to illustrate how much more comprehensive the content of the case study is and how well it highlights the role of the primary care nurse practitioner in complex geriatric care. Through application of Orem’s practice methodology, the nurse practitioner is better able to address the high-level risk experienced by an older adult with complex comorbidities whose only initial complaint was “imbalance.”

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers’ perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers’ perception of culture and experience of teaching cultural competence. Semi-structured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark’s phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the transcripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be developed.

Objective: This study evaluated the effectiveness of an immersive teaching and learning approach for undergraduate nurses. Traditional classroom tutorials were combined with self-directed learning using LabTutor™, an online learning platform, and clinical nursing simulation using high fidelity manikins. Learning modules were designed to link the student’s knowledge and understanding of biosceince with clinical assessment and nursing management in order to develop clinical decision-making skills. It was anticipated that students’ learning experience would be enhanced by the higher level of realism that is possible using the sophisticated manikins and authentic patient clinical data and case notes provided in LabTutor™.Methods: The study took place in a New Zealand School of Nursing in 2014. Qualitative data was gathered using focus groups and an external facilitator. Quantitative data was gathered using an online survey.Results: Participants were second year undergraduate nursing students (N = 111): 71 (64%) interviewees, and 82 (73%) survey respondents. Qualitative data showed that the immersive learning process was effective. Quantitative data affirmed that immersive learning was liked, confidence improved, students enjoyed the process, and would recommend it to others. Using simulation and patient case studies were preferred teaching strategies. Performing experiments, and using digital LabTutor™ technology challenged many, but skills improved over the year.Conclusions: The immersive learning approach was effective. However, despite the high level of authenticity made possible by using high fidelity manikins, realism was hard to establish. An unexpected learning outcome occurred when intermittent technology malfunction prompted students to use problem-solving skills.

Purpose: This study investigated the impact of coronavirus disease 2019 (COVID-19) on women’s health nursing clinical practicums in undergraduate nursing schools in Korea during the spring 2020 semester. Methods: A cross-sectional online survey on clinical practicum teaching experiences in the spring 2020 semester was distributed to members of the Korean Society of Women Health Nursing (KSWHN) who taught undergraduate nursing. One faculty member from each of 203 institutions was requested to respond and there were no duplicate participants. Seventy-nine participants (38.9%) responded and 74 responses were analyzed. Descriptive statistics were presented for all survey items. Results: Fifty-two faculty members (70.3%) belonged to universities and 22 (29.7%) taught at colleges. Thirty-eight (51.4%) answered that their institutions had affiliated teaching hospitals. More than half (52.7%) conducted hospital-based clinical practicums either entirely (n=20) or partially (n=19), whereas the rest of them (47.3%) conducted clinical practicums at school or home via online teaching. The typical teaching methods for offline or online education were case conferences, tests or quizzes, scenario studies, nursing skill practicums, (virtual) nursing simulations, and simulated patient education. Most of faculties (93.2%) supported the development of an educational platform to share educational materials and resources, such as case scenarios. Conclusion: Nursing faculty members utilized various teaching methods to enhance clinical skills and mitigate limited clinical exposure during the early stage of the COVID-19 pandemic. The KSWHN should move forward to develop an education platform and modalities for members who face many challenges related to the accessibility and quality of nursing education contents.

Senior lecturers/lecturers in mental health nursing (11 in round one, nine in round two, and eight in the final round) participated in a three-round Delphi study into the teaching of health care ethics (HCE) to students of nursing. The participants were drawn from six (round one) and four (round three) UK universities. Information was gathered on the organization, methods used and content of HCE modules. Questionnaire responses were transcribed and the content analysed for patterns of interest and areas of convergence or divergence. Findings include: the majority (72.8%) of the sample believed that insufficient time was allocated to the teaching of HCE; case studies were considered a popular, although problematic, teaching method; the ‘four principles’ approach was less than dominant in the teaching of HCE; and virtue ethics was taught by only 36.4% of the participants. The Delphi technique proved adequate and worth while for the purposes of this study. Further empirical research could aim to replicate or contradict these findings, using a larger sample and recruiting more university departments. Reflection is required on several issues, including the depth and breadth to which ethics theory and, more controversially, meta-ethics, are taught to nursing students.

Objective: The purpose of this study was to understand the experiences of clinical instructors participating in a simulated experience teaching ethics.Background: Teaching ethics is an essential role of the clinical instructor. Limited information exists to guide instructors in the teaching of ethics in clinical settings. Clinical nursing instructors are often hired based on their experience as clinicians and are underprepared to teach ethics to nursing students during clinical instruction.Methods: A qualitative descriptive interpretive approach was used to understand the experiences of clinical faculty who participated in simulation based learning activities that explored ways to include ethics in clinical teaching. A video, case studies, and role-playing provided an opportunity to practice responding to teaching challenges and explored strategies for guiding ethical learning in clinical teaching.Results: Participants realized that ethics could be integrated into clinical teaching and seeking out ethical discussions with students is as important as teaching other nursing skills.Conclusions: Using simulation based education is a means to prepare faculty to include ethics in clinical instruction.

This research is a case study. The purpose of this study was to determine the process of implementing a flipped classroom for English course and analyse students’ perceptions of the implementation of the Flipped Classroom in teaching English for the nursing students of Nursing Academy of Kesdam Iskandar Muda Banda Aceh. The participant in this study were 50 students of Nursing Academy of Kesdam Iskandar Muda Banda Aceh in the academic year 2020/2021. They consist of 4 male students and 46 female students. Data collection methods in this study are lecturer’s observation checklist, teacher’s fieldnote and questionnaires. Lecturer's observation checklist in the form of a checklist for implementing the flipped classroom strategy at each meeting. Lecturer’s fieldnote is some notes that found while flipped classroom was implemented. Questionnaires are used to obtain results from student opinions and student experiences in Flipped Classroom. More than half of students felt that Flipped classroom aided their English studies. Most of the students enjoyed the flipped classroom learning and believed that this method can support their learning. This implies that the method is still useful for EFL classroom of ELT context. .

Abstract This presentation highlights the development, implementation, and results of an educational session with undergraduate nursing students about end-of-life decision making. The purpose of this qualitative thematic analysis study was to explore student perspectives of end-of-life decision making following an education session. The aims were to 1) develop themes from student feedback on end-of-life decision making and 2) refine educational strategies to teach end-of-life decision making to nursing students. The study was conducted with 72 junior level baccalaureate nursing students enrolled in an undergraduate gerontological nursing course. An interactive lecture was developed, following short philosophical ethics readings, which brought the students up to date on the history of end-of-life discussions, key cases, and different frameworks to approach a cluster of ethical issues associated with end-of-life care. A debate pedagogical model was employed as an engaging activity in which students directly applied recently learned concepts. In the debate activity, students were divided into two teams. Each team was assigned a position, which was a specific response to the case question: Should practitioners assist in their patient’s committing suicide? Should practitioners offer medical aid in dying? Each team conferred, presented their position, responded to the arguments or reasons from the opposing position. The session ended with a debrief by the course instructors. In the first semester, 31 nursing students completed four open-ended questions following the class. Results included increased student confidence discussing end-of-life issues and identification of two concepts commonly referred to in end-of-life care discussions and in bioethics, autonomy and dignity.

This descriptive study investigated the current status of ethics instruction in Turkish nursing education programs. The sample for this study comprised 39 nursing schools, which represented 51% of all nursing schools in Turkey. Data were collected through a postal questionnaire. The results revealed that 18 of these nursing schools incorporated an ethics course into undergraduate and three into graduate level programs. Most of the educators focused on the basic concepts of ethics, deontological theory, ethical principles, ethical problems in health care, patient rights and codes of ethics for nurses. More than half of the educators believed that students' theoretical knowledge of ethics is applied to their clinical experiences. The teaching methods used included discussion in class, lectures, case studies, small group discussion, dramatization and demonstration. Assessment was carried out by means of written essays and written examinations.

Spirituality and spiritual care in professional nursing are conceptualised and recognised as fundamental components of holistic healthcare. Despite the acceptance of and interest in spiritual care, a lack of education and clinical training on the subject limits nurses’ ability to meet patients’ spiritual needs. Consequently, the aim of this study was to analyse the effectiveness of a training programme designed to teach the specific knowledge, attitudes and competencies necessary to provide spiritual care in nursing practice. This study consisted of a one-group pre-post intervention design with two measurement times (baseline/pre-intervention and post-intervention). A teaching activity about spiritual care in nursing practice was designed and implemented (focal groups, open discussion, discussion groups and clinical case studies). The educational intervention was developed by the authors based on a literature review, research and feedback from the undergraduate students. A convenience sample of 369 nursing students at the University of Alicante (Spain) who were enrolled in the teaching subject of Psychology participated in this study. The effectiveness of the teaching activity was assessed through a self-administered 15-item questionnaire. The post-intervention results indicated that the programme was effective in improving knowledge, competencies and attitudes related to spiritual care. The implications of this study for teaching practice and future research are discussed

Background: While nursing ethics is becoming accepted as an independent subject in Japanese universities, there are many issues concerning the education. The purpose of this study was to anew investigate nursing ethics programs in university, to reveal the difficulties that nursing ethics educators in Japanese nursing bachelor’s degree programs faced and educational challenges, and to examine the best form of nursing ethics education.Methods: A self-administered questionnaire survey to nursing ethics educators in 235 nursing bachelor’s degree programs in Japan was conducted. The questionnaire mainly asked about an overview of nursing ethics programs, the difficulties educators experienced and educational challenges, and the association of ethics education with nursing practice.Results: The return rate of the questionnaire was 29.7%. Methods of group discussion based on case studies were common, and patients’ rights and analytical approaches to ethical issues were common topics. Many of the subjects faced difficulties in nursing ethics education: curriculum, students’ circumstances, students’ readiness and abilities, the characteristics of ethical problems, and educators’ abilities. The educators suggested that students should continue to learn nursing ethics over a few school years according to a curriculum built in a step-by-step, systematic manner.Conclusions: This survey indicated that discussions regarding what educational goals in what school year should be offered to students were needed at each university. Cooperation between educators and practical training instructors on the contents of education, and a clear definition of expertise necessary for teaching nursing ethics were challenges to be accomplished as well.

Background: Globally, the internet is becoming an increasingly indispensable tool in academic institutions and the workplace. Nursing students are required to use the computer and the internet to search for information and to use various software, for which computer and internet literacy are essential. Despite becoming an important tool for teaching and learning, literature reflects an under-utilization of the internet in academic and non-academic settings for a number of reasons. This article explores the general internet usage of undergraduate nursing students at a selected university in South Africa.Methods: A quantitative, non-experimental, exploratory descriptive design was used, with 115 undergraduate nursing students participating in the study. Data was collected using a questionnaire survey after obtaining ethical clearance from the university’s ethics committee and were analysed descriptively.Results: The findings revealed that the internet was used for various purposes including; academic (96.5%); communication (82.6%), pleasure (71.3%), and work-related activity (53.9%). Facebook (77.4%) was the most commonly used social network. Constraints encountered in using Barriers to the use of the internet include restriction of access to certain sites (62.6%), very slow internet connection (55.7%), little training on how to use internet facilities (38.3%), and a limited number of computers (37.4%).Conclusions: Contrary to other studies, this study shows that students do use the internet for a number of reasons, and recommend structured support on how to use if for academic purposes.

Learning outcomes This trio of cases is appropriate for upper-level undergraduate classes or for postgraduate programs in non-profit management, leadership and community development, international development, global studies, women’s and gender studies and social entrepreneurship. It allows the instructors and students to engage with classical leadership tenets and emerging social entrepreneurship literature. Upon completion of the case study discussion and assignments, students will be able to: identify diverse obstacles that African women face in starting social enterprises; understand the ways that African women leaders build a social dimension to their enterprise; and identify characteristics of women’s leadership and critique the value of women’s leadership for establishing sustainable social enterprises. Case overview/synopsis The case stories of the three African social enterprises portray how female leaders have fostered sustainable organisations through prioritising social, over economic and governance investments. Martha Letsoalo, a former domestic worker, founded the Heartfelt Project in South Africa, which now employs fifteen women, ships products all around the world and enriches the community of Makapanstad with its workshop, training and education centre. Victoria Nalongo Namusisi, daughter of a fisherman in rural Uganda, founded Bright Kids Uganda, a thriving care facility, school and community centre that educates vulnerable children, empowers victims of gender-based violence and distributes micro-loans to female entrepreneurs. Gertrude, abandoned in Lusaka, Zambia, founded Chikumbuso, a home of resilience and remembrance to educate children and offer women employment in a cooperative business. Each case documents the founding years of the social enterprise and outlines some of the shared women’s leadership approaches. The case dilemma focuses on why and how women start social enterprises in socially and economically difficult contexts. Complexity academic level This trio of cases is appropriate for undergraduate or graduate-level programs in non-profit management, leadership and community development, international development, global studies and social entrepreneurship. Supplementary materials Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes. Subject code CSS 3: Entrepreneurship. Supplementary materials Teaching notes are available for educators only.

The purpose of this article is to examine the disconnect happening in relation to family–centre partnerships. Developing partnerships with families is hotly debated and provides challenges for educators teaching in the early childhood sector. Using a comparative case study analysis, several research studies conducted in the states of New South Wales and Victoria, Australia, are examined to illustrate these disconnects. These issues are examined within Belonging, Being and Becoming: The Early Years Learning Framework for Australia, a national framework that is common to all programs across Australia, which identifies practice, principles and learning outcomes for young children. This disconnect is related to the language that is used by the early childhood staff and misunderstood by the parents, the ways communication occurs and its ineffectiveness. The article argues that there is a need to move beyond the current rhetoric of engaging in partnerships with families to a space that allows for transparency, reciprocity and new language.

Background The process of manually recording the consumption of medical materials can be time consuming and prone to omission owing to its detailed and complicated nature. Implementing an information system will better improve work performance. Objective The Information System Success Model was adopted as the theoretical foundation. The opinions of nursing staff were collected to verify the impact of the system intervention on their work performance. Methods This cross-sectional study was conducted at a regional teaching hospital. Nursing staff were invited to participate in the field survey. A total of 296 questionnaires were collected, and of these, 284 (95.9%) were valid and returned. Results The key findings showed that two critical factors (“subjective norm” and “system quality”) had significant positive effects (both P<.001) on user satisfaction (R2=0.709). The path of “service quality” to “user satisfaction” showed marginal significance (P=.08) under the 92% CI. Finally, the explanatory power of the model reached 68.9%. Conclusions Support from the top management, appointment of a nurse supervisor as the change agent, recruitment of seed members to establish a pioneer team, and promotion of the system through the influence of opinion leaders in small groups were critical success factors needed for implementing the system in the case hospital. The target system was proven to be able to improve work performance, and the time saved could be further used for patient care, thereby increasing the value of nursing work. The positive experiences gained from this study could lay the foundation for the further promotion of the new system, and this is for future studies to replicate. The example of the successful experience of the case hospital could also serve as a reference for other hospitals in developing countries like Taiwan with regard to the promotion of nursing informatization.

Background: The effectiveness of ethics education continues to be disputed. No studies exist on how nursing students perceive the effectiveness of nursing ethics education in Flanders, Belgium. Objectives: To develop a valid and reliable instrument, named the ‘Students’ Perceived Effectiveness of Ethics Education Scale’ (SPEEES), to measure students’ perceptions of the effectiveness of ethics education, and to conduct a pilot study in Flemish nursing students to investigate the perceived efficacy of nursing ethics education in Flanders. Research design: Content validity, comprehensibility and usability of the SPEEES were assessed. Reliability was assessed by means of a quantitative descriptive non-experimental pilot study. Participants and research context: 86 third-year baccalaureate nursing students of two purposefully selected university colleges answered the SPEEES. Ethical considerations: Formal approval was given by the ethics committee. Informed consent was obtained and anonymity was ensured for both colleges and their participating students. Findings: The scale content validity index/Ave scores for the subscales were 1.00, 1.00 and 0.86. The comprehensibility and user-friendliness were favourable. Cronbach’s alpha was 0.94 for general effectiveness, 0.89 for teaching methods and 0.85 for ethical content. Students perceived ‘case study’, ‘lecture’ and ‘instructional dialogue’ to be effective teaching methods and ‘general ethical concepts’ to contain effective content. ‘Reflecting critically on their own values’ was mentioned as the only ethical competence that, was promoted by the ethics courses. The study revealed rather large differences between both schools in students’ perceptions of the contribution of ethics education to other ethical competences. Discussion and conclusion: The study revealed that according to the students, ethics courses failed to meet some basic objectives of ethics education. Although the SPEEES proved to be a valid and reliable measure, the pilot study suggests that there is still space for improvement and a need for larger scale research. Additional insights will enable educators to improve current nursing ethics education.

Introduction Case-based learning (CBL) is a newer modality of teaching healthcare. In order to evaluate how CBL is currently used, a literature search and review was completed. Methods A literature search was completed using an OVID© database using PubMed as the data source, 1946-8/1/2015. Key words used were “Case-based learning” and “medical education”, and 360 articles were retrieved. Of these, 70 articles were selected to review for location, human health care related fields of study, number of students, topics, delivery methods, and student level. Results All major continents had studies on CBL. Education levels were 64% undergraduate and 34% graduate. Medicine was the most frequently represented field, with articles on nursing, occupational therapy, allied health, child development and dentistry. Mean number of students per study was 214 (7–3105). The top 3 most common methods of delivery were live presentation in 49%, followed by computer or web-based in 20% followed by mixed modalities in 19%. The top 3 outcome evaluations were: survey of participants, knowledge test, and test plus survey, with practice outcomes less frequent. Selected studies were reviewed in greater detail, highlighting advantages and disadvantages of CBL, comparisons to Problem-based learning, variety of fields in healthcare, variety in student experience, curriculum implementation, and finally impact on patient care. Conclusions CBL is a teaching tool used in a variety of medical fields using human cases to impart relevance and aid in connecting theory to practice. The impact of CBL can reach from simple knowledge gains to changing patient care outcomes.

Spiritual themes have long been a part of the vision of nursing and continue to be reflected in caring theories of nursing. Spirituality is best understood within the relational aspects of knowing the person and how they are responding to life events, often in the context of story. Nurses have a long and continuing tradition of using patient stories, calling them case studies, for teaching and learning about patients. Naturalistic research methods also make use of these ideas by capturing stories about the phenomena under study. The purpose of this paper is to describe aspects of spirituality as reflected in a representative story of one person’s experience with bone marrow transplantation (BMT). The story was selected from a larger phenomenological study describing the experiences and perspectives of persons who had a BMT at a comprehensive cancer center. Elements of the story illustrate characteristics of spiritual needs and evidence of resolution. The case illustration ends with a discussion of ways nurses can assess and provide interventions to address spirituality.

Introduction The COVID-19 pandemic affected nursing students dramatically when the clinical sites and the onsite classrooms closed to physical participation. This necessitated a move to virtual classrooms and virtual clinical experiences. Some nursing schools adopted telenursing to comply with their Board of Registered Nursing direct patient care requirements. Students value the hands-on nursing in a direct care facility and clinical instructors must replicate this in a virtual setting. This article discusses telenursing and Teach-Back processes with student active engagement that facilitates learning and meets the direct care requirement. The purpose is to share best practice ideas for clinical instructors to educate when clinical settings are unavailable. Methods This innovation includes examples from five clinical instructors when in-person clinicals were not available due to the COVID-19 pandemic. They used virtual teaching and telenursing for nursing students which complied with clinical requirements of preconference, clinical experience, and post-conference. Telenursing combines case studies or shared documents, student collaboration, and includes a patient or patient actor via telehealth. Clinical instructors present a patient history or case study and allow students time for preparation. Socratic questioning helps students focus on determining the correct questions to ask. Telenursing call to the patient and teach-back questioning validated patient learning. Following the call, the instructor leads a post-conference debrief and students independently document the call. Conclusion Five clinical instructors follow the process of pre-brief, case presentation, and debrief while students develop critical thinking, strong communication skills, documentation requirements, and utilize the nursing process of assessment, diagnosis, outcome, plan, interventions, and evaluation. Students will have future opportunities to develop hands-on skills as they return to the clinical setting.

Background Histology and Embryology and Pathology are two important basic medical morphology courses for studying human histological structures under healthy and pathological conditions, respectively. There is a natural succession between the two courses. At the beginning of 2020, the COVID-19 pandemic suddenly swept the world. During this unusual period, to ensure that medical students would understand and master basic medical knowledge and to lay a solid foundation for future medical bridge courses and professional courses, a web-based medical morphology teaching team, mainly including teachers of courses in Histology and Embryology and Pathology, was established. Objective This study aimed to explore a new teaching mode of Histology and Embryology and Pathology courses during the COVID-19 pandemic and to illustrate its feasibility and acceptability. Methods From March to July 2020, our team selected clinical medicine undergraduate students who started their studies in 2018 and 2019 as recipients of web-based teaching. Meanwhile, nursing undergraduate students who started their studies in 2019 and 2020 were selected for traditional offline teaching as the control group. For the web-based teaching, our team used the Xuexi Tong platform as the major platform to realize a new “seven-in-one” teaching method (ie, videos, materials, chapter tests, interactions, homework, live broadcasts, and case analysis/discussion). This new teaching mode involved diverse web-based teaching methods and contents, including flipped classroom, screen-to-screen experimental teaching, a drawing competition, and a writing activity on the theme of “What I Know About COVID-19.” When the teaching was about to end, a questionnaire was administered to obtain feedback regarding the teaching performance. In the meantime, the final written pathology examination results of the web-based teaching and traditional offline teaching groups were compared to examine the mastery of knowledge of the students. Results Using the Xuexi Tong platform as the major platform to conduct “seven-in-one” teaching is feasible and acceptable. With regard to the teaching performance of this new web-based teaching mode, students demonstrated a high degree of satisfaction, and the questionnaire showed that 71.3% or more of the students in different groups reported a greater degree of satisfaction or being very satisfied. In fact, more students achieved high scores (90-100) in the web-based learning group than in the offline learning control group (P=.02). Especially, the number of students with objective scores >60 in the web-based learning group was greater than that in the offline learning control group (P=.045). Conclusions This study showed that the web-based teaching mode was not inferior to the traditional offline teaching mode for medical morphology courses, proving the feasibility and acceptability of web-based teaching during the COVID-19 pandemic. Our findings lay a solid theoretical foundation for follow-up studies of medical students.

Purpose The purpose of this paper is to investigate the use of innovative teaching methods and share a four-step model, to promote the use of co-production in mental health practice. Design/methodology/approach The case study approach highlights three real-life examples of day to day experiences in mental health nurse education with innovative approaches to sharing and developing co-production skills and attitudes in mental health student nurses. Findings The case studies highlight three settings where undergraduate mental health nurses experience co-production through a world café event and dialogical community development. Common themes include setting the environment, developing a common aim and relationship building. Research limitations/implications A limitation of this paper is that only three case studies are provided, further examples would provide a greater pool of exemplars for others to draw on. However, by focusing upon student nurse education in learning environment, these examples are transferable to other settings. Practical implications The practical applications are summarised in a four-step model that can help develop co-productive teaching methods; enable educators to set the climate and generate an understanding of co-production that empowers students and service users. Social implications The emphasis and relevance of promoting co-productive working habits early on in nurses’ mental health nursing careers will enable them to raise awareness of future social implications for a range of client groups. Originality/value This paper focuses upon mental health student nurses whilst providing an innovative model to facilitate co-production experiences applicable in a range of settings.

Knowledge and skills for teachers to deliver course contents in an e-learning environment is essential. Information Communication Technology (ICT) is being increasingly used in tertiary education as it is flexible and offers many possibilities to meet the needs of a large number of learners. The implementation of e-learning platforms in Rwanda in 2012 for nursing and midwifery instruction has had a positive impact on the quality of nursing education. Educators' facilitation skills play an important role in motivating students in the computer-mediated learning environment. The aim of this paper is to explore the facilitation strategies used in e-learning by nurse educators in Rwanda. A non-experimental quantitative design was used, with 44 nurse educators from three campuses completing the research instruments. The results from this study indicated that the majority of the participants (84.1%) had the same vision of integrating ICT in teaching and learning as their colleagues, the institutional administration, and other staff. 97.7% used computers and/or the internet to prepare lesson and deliver instructions 95.5% reported using facilitation strategies of self-directed learning, 93.2% case studies, 88.6% group discussions, 81.8% small group activities, 72.7% formal lectures, 70.5% role play, 68.2% brainstorming, 63.6% situations of integration, and 63.6% videos. An average of 50% reported using research, and 43.2% workbooks. 27.3% used projects, 25% core lectures, and 11.4% Portfolio. E-learning requires a comprehensive approach of incorporating ICT in teaching and learning. The success of e-learning does not only depend on technological tools available, but also on the pedagogical design, with teachers being required to use innovative teaching approaches to deliver their course contents.

Background and objective: Research with Process Oriented Guided Inquiry Learning (POGIL), an interactive learning pedagogy, has shown improvement in grades and student satisfaction in science and nursing courses. POGIL is an active teaching strategy which utilizes small groups of students to analyze case studies. The student teams participate in groups of four to problem solve topics based on the material taught. POGIL can be additional to lecture and didactic teaching methods to help with the synthesis and analysis of content taught. The object of this study was to compare final course and national standardized exam grades between POGIL and comparison groups in both Fundamentals and Medical-Surgical II nursing courses.Methods: A quantitative, comparative design was used.Results: The Fundamentals POGIL group had significantly higher scores on a standardized national exam (p = .001) than a comparison group; no significant difference in final course grades was found. The Medical-Surgical Nursing II POGIL and comparison groups had no significant differences in standardized national exam or final course grades. Students in POGIL groups were given a satisfaction survey and indicated the experience was helpful to improving grades and understanding course content.Conclusions: In classes that used POGIL, there were higher scores on a standardized national exam scores but not final course grades for students in the Fundamentals course. Using POGIL in Medical Surgical Nursing II courses revealed no difference in final course grades or on national standardized exam scores. The use of POGIL for beginning nursing students may be more helpful as these students are in the process of determining which learning strategies are most helpful as they progress through the nursing curriculum. Introducing a new pedagogy to students in their last semester of the nursing program was not as helpful possibly because students have established successful strategies for learning prior to this last semester. Future research to further explore the impact of POGIL on grades and standardized tests scores in other nursing curriculum courses such as mental health or care of the emerging family is recommended. Exploring POGIL and the impact on the development of clinical thinking and clinical practice is another line of inquiry that could be explored.

Aim/Purpose: The objective of this study was to concept test a new instructional aid called Virtual Pathology Learning Resource (VPLR), which was used as a vehicle to communicate information and enhance teaching and learning of basic sciences (Anatomy, Physiology, and Pathology) to allied health science students at a South Australian university. Background: Pathology was traditionally taught using potted specimens to review disease manifestations independently. However, this approach was found inadequate and ineffective. VPLR is a new teaching platform comprising of digitised human normal and human pathology specimens (histology, histopathology), patient case studies, short answer and critical thinking questions, and self-assessment quizzes. Using authentic learning theory as an educational pedagogy, this learning resource was developed to enhance the teaching and learning of Pathology. Methodology: Cross-sectional study design was used. A survey, given at the end of the course, gathered qualitative and quantitative data concerning the perceptions and experiences of the students about VPLR and its components. The online tool SurveyMonkey was utilised so that students could respond anonymously to a web link that displayed the questionnaire. The perceived impact on students was assessed using an 18-item questionnaire seeking agreement or disagreement with statements about VPLR, multiple choice and open-ended questions querying the best things about VPLR, benefits to be derived, and areas for improvement. Descriptive and frequency analyses were performed. Contribution: The VPLR approach involved rich learning situations, contextualised content, and facilitated greater understanding of disease concepts and problems. Findings: In a sample of 103 Medical Radiation students, 42% of students (N=43) responded to the post-intervention survey. The majority of students reported highly positive effects for each component of the VPLR. The overall results indicated that this tool was a promising strategy in teaching Pathology as it assisted students’ gaining knowledge of the science, facilitated connections between sciences, and allowed students to make better links with professional practice and skills. Recommendations for Practitioners: As students found VPLR to be beneficial, it is recommended that the same approach is applied for the teaching of Pathology to other health science students, such as Nursing. Other universities might consider adopting the innovation for their courses. Recommendation for Researchers: Applying VPLR to teaching other allied health science students will be undertaken next. The innovation will be appropriate for other health science students with particular emphasis on case-based or problem-based learning and combined with clinical experiences. Impact on Society: In reshaping the way of teaching a science course, students are benefited with greater depth of understanding of content and increase motivation to study. These are important to keep students engaged and ready for practice. VPLR may impact on education and technology trends so that exploration and possibilities of initiatives are ongoing to help students become successful learners. Other impacts are the new forms of learning discovered, the renewed focus on group work and collaboration, and maximising the use of technology in innovation. Future Research: Future directions of this research would be to conduct a follow-up of this cohort of students to determine whether the impacts of the innovation were durable, meaning the change in perceptions and behaviour is sustained over time.

ABSTRACTObjective: to select methodological references that guide the accomplishment of the case studies. Method: This is a qualitative, reflexive type study. It refers to the analysis of two methodological references that guide the performance of case studies: the Galdeano, Rossi and Zago Instructional Guide and the Nursing Process. It is noteworthy that the construction of this reflection was based on the search for a strategy that would lead the student to a critical-reflexive professional practice. Results: During the reflexive analysis, a dialogue was observed between the stages of development of both methods. As the methodological approaches discussed complement each other, it was recommended the integration of these methods for the foundation of case studies in the caring process. Conclusion: it is concluded that the use of such referential leads academics to be protagonists in their formation, with the production of knowledge and practices, promoting critical-reflexive posture essential to future nurses for integral care to the health of the individual, the family, and the community. Descriptors: Case Reports; Nursing Diagnosis; Nursing; Nursing Process; Teaching; Education Nursing.RESUMO Objetivo: selecionar referenciais metodológicos que guiem a realização dos estudos de caso. Método: trata-se de um estudo qualitativo, do tipo reflexivo. Refere-se sobre a análise de dois referenciais metodológicos que norteiam a realização de estudos de casos: o Roteiro Instrucional de Galdeano, Rossi e Zago e o Processo de Enfermagem. Destaca-se que a construção desta reflexão se deu a partir da busca de uma estratégia que conduzisse o aluno a uma prática profissional crítico-reflexiva. Resultados: notou-se, durante a análise reflexiva, uma interlocução entre as etapas de desenvolvimento de ambos os métodos e, como as abordagens metodológicas discutidas se complementam, recomendou-se a integração destes métodos para a fundamentação de estudos de casos no processo de cuidar. Conclusão: conclui-se que a utilização de tais referenciais oportuniza, ao acadêmico, ser protagonista na sua formação, com a produção de saberes e práticas, promovendo uma postura crítico-reflexiva essencial aos futuros enfermeiros para a atenção integral à saúde do indivíduo, da família e da comunidade. Descritores: Estudos de Casos; Diagnóstico de Enfermagem; Enfermagem; Processo de Enfermagem; Ensino; Educação em Enfermagem.RESUMEN Objetivo: seleccionar referenciales metodológicos que guíen la realización de los estudios de caso. Método: se trata de un estudio cualitativo, del tipo reflexivo. Se refiere sobre el análisis de dos referenciale metodológicos que guían la realización de estudios de casos: La Guía de Instrucción de Galdeano, Rossi y Zago y el Proceso de Enfermería. Se destaca que la construcción de esta reflexión fue a partir de la búsqueda de una estrategia que condujera al aluno a una práctica profesional crítica-reflexiva. Resultados: se notó, durante el análisis reflexivo, una interlocución entre las etapas de desarrollo de ambos métodos y, como los enfoques metodológicos discutidos se complementan, se recomendó la integración de estos métodos para la fundamentación de estudios de casos en el proceso de cuidar. Conclusión: se concluye que la utilización de tales referenciales da la oportunidad al académico, de ser protagonista en su formación, con la producción de saberes y prácticas, promoviendo una postura crítico-reflexiva esencial a los futuros enfermeros para la atención integral a la salud del individuo, de la familia y de la comunidad. Descriptores: Informes de casos; Diagnóstico de Enfermería; Enfermería; Proceso de Enfermería; Enseñanz; Educación en Enfermería.

BackgroundDeliberate inclusion of clinical decision-making nursing skills in the didactic setting will assist students in potentially making better patient care decisions. This can be optimized through use of the flipped learning andragogy. Flipped learning promotes an interactive classroom environment. It fosters teamwork and collaboration. Direct content instruction is the responsibility of students.ObjectiveThis cohort pilot study investigated how the flipped and nonflipped approach to teaching impacted clinical decision-making and student participation.MethodsThe Clinical Decision-Making in Nursing Scale (CDMNS) was administered to the students in the flipped classroom and the nonflipped classroom on week 1 and week 6. A student participation checklist was used to observe class activities at three separate intervals (baseline, mid-semester, and end-semester). A repeated measures analysis of covariance was conducted with Instruction Group as the between subjects factor (Flipped and Nonflipped) and Time (preinstruction and postinstruction) as the within subjects factor, and covarying age. The Time by the Instruction group was significant. The Flipped group showed an increase in Clinical decision-making scores (p < .001) after instruction while the Nonflipped group did not (p = .40).ResultsThe Flipped group (n = 24) showed an increase in Clinical decision-making scores (p < .001) after instruction while the Nonflipped group (n = 23) did not (p = .40). The Flipped classroom showed 100% participation at baseline, mid-semester, and end of semester. The Nonflipped classroom showed overall lower levels of participation, with 42%, 33%, and 39% at each point respectively.Conclusion/Implications for NursingStudents who were taught using the flipped instruction were able to apply what they learned in relevant case studies, virtual simulations, and practice National Council Licensure Examination RN (NCLEX-RN) type questions. Through teamwork and collaboration, students had time to practice clinical decision-making skills. This was evident in the increased CDMNS scores and increased levels of participation over time in the flipped group when compared to the nonflipped group.

Introduction: Prior Canadian Emergency Department (ED) studies have demonstrated variable benefits of initial assessment physician (IAP) to rapidly assess and initiate care of ED patients after triage. These studies have been conducted primarily in academic teaching and large urban hospitals. It is not clear if such an IAP role could be beneficial in an small community hospital. Our pilot study hypothesized that instituting a supported IAP role can reduce physician intial assessment (PIA) time, total ED length of stay (LOS), and left-without-being-seen (LWBS) rates. Methods: This was a pre and post interrupted time series observational study at a community ED in Niagara Health Systems (Welland Ontario, 4 MD shifts, 36hrs total coverage, 30000 annual visits). In July 2017, an IAP ED shift (with separate assessment/treatment area) was re-purposed, with nursing support, to reduce initial time to MD assessment after triage. For lower acuity cases, the IAP MD generally completed full case management &amp; disposition. Higher acuity complex cases were initiated by IAP, and transferred into the main ED care areas for “inside” MD management. Administrative data was accessed for 6 months prior to intervention, and 4 months available post-intervention. Descriptive statistics were calculated for collected data. Results: A modest improvement in different administrative ED performance metrics was observed. The following changes were noted pre and post IAP intervention: PIA time reduced from 3.6hrs to 3.2hrs, total ED LOS reduced from 19.2hrs to 13.8hrs, and daily LWBS rate reduced from 4.2% to 3.7%. This pilot study demonstrated improvement trends in ED performance metrics, although there is insufficient data to show statistical significance. Aggregate data was not subgrouped based on CTAS categories. This pilot was not intended to collect patient or staff satisfaction data, adverse events, nor designed to demonstrate cost-effectiveness Conclusion: Introducing an IAP shift in a small community ED has shown improvement trends for various ED throughput measures pertaining to outcomes such as PIA time, total LOS and LWBS rates. Further research is required to determine statistical significance of time reductions, satisfaction (patients, staff), resource utilization impact and CTAS subgroup performance. This improvement demonstrates potential impact system-wide across Niagara region.

Education in Oceania continues to reflect the embedded implicit and explicit colonial practices and processes from the past. This paper conceptualises a cultural approach to education and leadership appropriate and relevant to the Republic of the Marshall Islands. As elementary school leaders, we highlight Kanne Lobal, a traditional Marshallese navigation practice based on indigenous language, values and practices. We conceptualise and develop Kanne Lobal in this paper as a framework for understanding the usefulness of our indigenous knowledge in leadership and educational practices within formal education. Through bwebwenato, a method of talk story, our key learnings and reflexivities were captured. We argue that realising the value of Marshallese indigenous knowledge and practices for school leaders requires purposeful training of the ways in which our knowledge can be made useful in our professional educational responsibilities. Drawing from our Marshallese knowledge is an intentional effort to inspire, empower and express what education and leadership partnership means for Marshallese people, as articulated by Marshallese themselves. Introduction As noted in the call for papers within the Waikato Journal of Education (WJE) for this special issue, bodies of knowledge and histories in Oceania have long sustained generations across geographic boundaries to ensure cultural survival. For Marshallese people, we cannot really know ourselves “until we know how we came to be where we are today” (Walsh, Heine, Bigler & Stege, 2012). Jitdam Kapeel is a popular Marshallese concept and ideal associated with inquiring into relationships within the family and community. In a similar way, the practice of relating is about connecting the present and future to the past. Education and leadership partnerships are linked and we look back to the past, our history, to make sense and feel inspired to transform practices that will benefit our people. In this paper and in light of our next generation, we reconnect with our navigation stories to inspire and empower education and leadership. Kanne lobal is part of our navigation stories, a conceptual framework centred on cultural practices, values, and concepts that embrace collective partnerships. Our link to this talanoa vā with others in the special issue is to attempt to make sense of connections given the global COVID-19 context by providing a Marshallese approach to address the physical and relational “distance” between education and leadership partnerships in Oceania. Like the majority of developing small island nations in Oceania, the Republic of the Marshall Islands (RMI) has had its share of educational challenges through colonial legacies of the past which continues to drive education systems in the region (Heine, 2002). The historical administration and education in the RMI is one of colonisation. Successive administrations by the Spanish, German, Japanese, and now the US, has resulted in education and learning that privileges western knowledge and forms of learning. This paper foregrounds understandings of education and learning as told by the voices of elementary school leaders from the RMI. The move to re-think education and leadership from Marshallese perspectives is an act of shifting the focus of bwebwenato or conversations that centres on Marshallese language and worldviews. The concept of jelalokjen was conceptualised as traditional education framed mainly within the community context. In the past, jelalokjen was practiced and transmitted to the younger generation for cultural continuity. During the arrival of colonial administrations into the RMI, jelalokjen was likened to the western notions of education and schooling (Kupferman, 2004). Today, the primary function of jelalokjen, as traditional and formal education, it is for “survival in a hostile [and challenging] environment” (Kupferman, 2004, p. 43). Because western approaches to learning in the RMI have not always resulted in positive outcomes for those engaged within the education system, as school leaders who value our cultural knowledge and practices, and aspire to maintain our language with the next generation, we turn to Kanne Lobal, a practice embedded in our navigation stories, collective aspirations, and leadership. The significance in the development of Kanne Lobal, as an appropriate framework for education and leadership, resulted in us coming together and working together. Not only were we able to share our leadership concerns, however, the engagement strengthened our connections with each other as school leaders, our communities, and the Public Schooling System (PSS). Prior to that, many of us were in competition for resources. Educational Leadership: IQBE and GCSL Leadership is a valued practice in the RMI. Before the IQBE programme started in 2018, the majority of the school leaders on the main island of Majuro had not engaged in collaborative partnerships with each other before. Our main educational purpose was to achieve accreditation from the Western Association of Schools and Colleges (WASC), an accreditation commission for schools in the United States. The WASC accreditation dictated our work and relationships and many school leaders on Majuro felt the pressure of competition against each other. We, the authors in this paper, share our collective bwebwenato, highlighting our school leadership experiences and how we gained strength from our own ancestral knowledge to empower “us”, to collaborate with each other, our teachers, communities, as well as with PSS; a collaborative partnership we had not realised in the past. The paucity of literature that captures Kajin Majol (Marshallese language) and education in general in the RMI is what we intend to fill by sharing our reflections and experiences. To move our educational practices forward we highlight Kanne Lobal, a cultural approach that focuses on our strengths, collective social responsibilities and wellbeing. For a long time, there was no formal training in place for elementary school leaders. School principals and vice principals were appointed primarily on their academic merit through having an undergraduate qualification. As part of the first cohort of fifteen school leaders, we engaged in the professional training programme, the Graduate Certificate in School Leadership (GCSL), refitted to our context after its initial development in the Solomon Islands. GCSL was coordinated by the Institute of Education (IOE) at the University of the South Pacific (USP). GCSL was seen as a relevant and appropriate training programme for school leaders in the RMI as part of an Asia Development Bank (ADB) funded programme which aimed at “Improving Quality Basic Education” (IQBE) in parts of the northern Pacific. GCSL was managed on Majuro, RMI’s main island, by the director at the time Dr Irene Taafaki, coordinator Yolanda McKay, and administrators at the University of the South Pacific’s (USP) RMI campus. Through the provision of GCSL, as school leaders we were encouraged to re-think and draw-from our own cultural repository and connect to our ancestral knowledge that have always provided strength for us. This kind of thinking and practice was encouraged by our educational leaders (Heine, 2002). We argue that a culturally-affirming and culturally-contextual framework that reflects the lived experiences of Marshallese people is much needed and enables the disruption of inherent colonial processes left behind by Western and Eastern administrations which have influenced our education system in the RMI (Heine, 2002). Kanne Lobal, an approach utilising a traditional navigation has warranted its need to provide solutions for today’s educational challenges for us in the RMI. Education in the Pacific Education in the Pacific cannot be understood without contextualising it in its history and culture. It is the same for us in the RMI (Heine, 2002; Walsh et al., 2012). The RMI is located in the Pacific Ocean and is part of Micronesia. It was named after a British captain, John Marshall in the 1700s. The atolls in the RMI were explored by the Spanish in the 16th century. Germany unsuccessfully attempted to colonize the islands in 1885. Japan took control in 1914, but after several battles during World War II, the US seized the RMI from them. In 1947, the United Nations made the island group, along with the Mariana and Caroline archipelagos, a U.S. trust territory (Walsh et al, 2012). Education in the RMI reflects the colonial administrations of Germany, Japan, and now the US. Before the turn of the century, formal education in the Pacific reflected western values, practices, and standards. Prior to that, education was informal and not binded to formal learning institutions (Thaman, 1997) and oral traditions was used as the medium for transmitting learning about customs and practices living with parents, grandparents, great grandparents. As alluded to by Jiba B. Kabua (2004), any “discussion about education is necessarily a discussion of culture, and any policy on education is also a policy of culture” (p. 181). It is impossible to promote one without the other, and it is not logical to understand one without the other. Re-thinking how education should look like, the pedagogical strategies that are relevant in our classrooms, the ways to engage with our parents and communities - such re-thinking sits within our cultural approaches and frameworks. Our collective attempts to provide a cultural framework that is relevant and appropriate for education in our context, sits within the political endeavour to decolonize. This means that what we are providing will not only be useful, but it can be used as a tool to question and identify whether things in place restrict and prevent our culture or whether they promote and foreground cultural ideas and concepts, a significant discussion of culture linked to education (Kabua, 2004). Donor funded development aid programmes were provided to support the challenges within education systems. Concerned with the persistent low educational outcomes of Pacific students, despite the prevalence of aid programmes in the region, in 2000 Pacific educators and leaders with support from New Zealand Aid (NZ Aid) decided to intervene (Heine, 2002; Taufe’ulungaki, 2014). In April 2001, a group of Pacific educators and leaders across the region were invited to a colloquium funded by the New Zealand Overseas Development Agency held in Suva Fiji at the University of the South Pacific. The main purpose of the colloquium was to enable “Pacific educators to re-think the values, assumptions and beliefs underlying [formal] schooling in Oceania” (Benson, 2002). Leadership, in general, is a valued practice in the RMI (Heine, 2002). Despite education leadership being identified as a significant factor in school improvement (Sanga & Chu, 2009), the limited formal training opportunities of school principals in the region was a persistent concern. As part of an Asia Development Bank (ADB) funded project, the Improve Quality Basic Education (IQBE) intervention was developed and implemented in the RMI in 2017. Mentoring is a process associated with the continuity and sustainability of leadership knowledge and practices (Sanga & Chu, 2009). It is a key aspect of building capacity and capabilities within human resources in education (ibid). Indigenous knowledges and education research According to Hilda Heine, the relationship between education and leadership is about understanding Marshallese history and culture (cited in Walsh et al., 2012). It is about sharing indigenous knowledge and histories that “details for future generations a story of survival and resilience and the pride we possess as a people” (Heine, cited in Walsh et al., 2012, p. v). This paper is fuelled by postcolonial aspirations yet is grounded in Pacific indigenous research. This means that our intentions are driven by postcolonial pursuits and discourses linked to challenging the colonial systems and schooling in the Pacific region that privileges western knowledge and learning and marginalises the education practices and processes of local people (Thiong’o, 1986). A point of difference and orientation from postcolonialism is a desire to foreground indigenous Pacific language, specifically Majin Majol, through Marshallese concepts. Our collective bwebwenato and conversation honours and values kautiej (respect), jouj eo mour eo (reciprocity), and jouj (kindness) (Taafaki & Fowler, 2019). Pacific leaders developed the Rethinking Pacific Education Initiative for and by Pacific People (RPEIPP) in 2002 to take control of the ways in which education research was conducted by donor funded organisations (Taufe’ulungaki, 2014). Our former president, Dr Hilda Heine was part of the group of leaders who sought to counter the ways in which our educational and leadership stories were controlled and told by non-Marshallese (Heine, 2002). As a former minister of education in the RMI, Hilda Heine continues to inspire and encourage the next generation of educators, school leaders, and researchers to re-think and de-construct the way learning and education is conceptualised for Marshallese people. The conceptualisation of Kanne Lobal acknowledges its origin, grounded in Marshallese navigation knowledge and practice. Our decision to unpack and deconstruct Kanne Lobal within the context of formal education and leadership responds to the need to not only draw from indigenous Marshallese ideas and practice but to consider that the next generation will continue to be educated using western processes and initiatives particularly from the US where we get a lot of our funding from. According to indigenous researchers Dawn Bessarab and Bridget Ng’andu (2010), doing research that considers “culturally appropriate processes to engage with indigenous groups and individuals is particularly pertinent in today’s research environment” (p. 37). Pacific indigenous educators and researchers have turned to their own ancestral knowledge and practices for inspiration and empowerment. Within western research contexts, the often stringent ideals and processes are not always encouraging of indigenous methods and practices. However, many were able to ground and articulate their use of indigenous methods as being relevant and appropriate to capturing the realities of their communities (Nabobo-Baba, 2008; Sualii-Sauni & Fulu-Aiolupotea, 2014; Thaman, 1997). At the same time, utilising Pacific indigenous methods and approaches enabled research engagement with their communities that honoured and respected them and their communities. For example, Tongan, Samoan, and Fijian researchers used the talanoa method as a way to capture the stories, lived realities, and worldviews of their communities within education in the diaspora (Fa’avae, Jones, & Manu’atu, 2016; Nabobo-Baba, 2008; Sualii-Sauni & Aiolupotea, 2014; Vaioleti, 2005). Tok stori was used by Solomon Islander educators and school leaders to highlight the unique circles of conversational practice and storytelling that leads to more positive engagement with their community members, capturing rich and meaningful narratives as a result (Sanga & Houma, 2004). The Indigenous Aborigine in Australia utilise yarning as a “relaxed discussion through which both the researcher and participant journey together visiting places and topics of interest relevant” (Bessarab & Ng’andu, 2010, p. 38). Despite the diverse forms of discussions and storytelling by indigenous peoples, of significance are the cultural protocols, ethics, and language for conducting and guiding the engagement (Bessarab & Ng’andu, 2010; Nabobo-Baba, 2008; Sualii-Sauni & Aiolupotea, 2014). Through the ethics, values, protocols, and language, these are what makes indigenous methods or frameworks unique compared to western methods like in-depth interviews or semi-structured interviews. This is why it is important for us as Marshallese educators to frame, ground, and articulate how our own methods and frameworks of learning could be realised in western education (Heine, 2002; Jetnil-Kijiner, 2014). In this paper, we utilise bwebwenato as an appropriate method linked to “talk story”, capturing our collective stories and experiences during GCSL and how we sought to build partnerships and collaboration with each other, our communities, and the PSS. Bwebwenato and drawing from Kajin Majel Legends and stories that reflect Marshallese society and its cultural values have survived through our oral traditions. The practice of weaving also holds knowledge about our “valuable and earliest sources of knowledge” (Taafaki & Fowler, 2019, p. 2). The skilful navigation of Marshallese wayfarers on the walap (large canoes) in the ocean is testament of their leadership and the value they place on ensuring the survival and continuity of Marshallese people (Taafaki & Fowler, 2019; Walsh et al., 2012). During her graduate study in 2014, Kathy Jetnil-Kijiner conceptualised bwebwenato as being the most “well-known form of Marshallese orality” (p. 38). The Marshallese-English dictionary defined bwebwenato as talk, conversation, story, history, article, episode, lore, myth, or tale (cited in Jetnil Kijiner, 2014). Three years later in 2017, bwebwenato was utilised in a doctoral project by Natalie Nimmer as a research method to gather “talk stories” about the experiences of 10 Marshallese experts in knowledge and skills ranging from sewing to linguistics, canoe-making and business. Our collective bwebwenato in this paper centres on Marshallese ideas and language. The philosophy of Marshallese knowledge is rooted in our “Kajin Majel”, or Marshallese language and is shared and transmitted through our oral traditions. For instance, through our historical stories and myths. Marshallese philosophy, that is, the knowledge systems inherent in our beliefs, values, customs, and practices are shared. They are inherently relational, meaning that knowledge systems and philosophies within our world are connected, in mind, body, and spirit (Jetnil-Kijiner, 2014; Nimmer, 2017). Although some Marshallese believe that our knowledge is disappearing as more and more elders pass away, it is therefore important work together, and learn from each other about the knowledges shared not only by the living but through their lamentations and stories of those who are no longer with us (Jetnil-Kijiner, 2014). As a Marshallese practice, weaving has been passed-down from generation to generation. Although the art of weaving is no longer as common as it used to be, the artefacts such as the “jaki-ed” (clothing mats) continue to embody significant Marshallese values and traditions. For our weavers, the jouj (check spelling) is the centre of the mat and it is where the weaving starts. When the jouj is correct and weaved well, the remainder and every other part of the mat will be right. The jouj is symbolic of the “heart” and if the heart is prepared well, trained well, then life or all other parts of the body will be well (Taafaki & Fowler, 2019). In that light, we have applied the same to this paper. Conceptualising and drawing from cultural practices that are close and dear to our hearts embodies a significant ontological attempt to prioritize our own knowledge and language, a sense of endearment to who we are and what we believe education to be like for us and the next generation. The application of the phrase “Majolizing '' was used by the Ministry of Education when Hilda Heine was minister, to weave cultural ideas and language into the way that teachers understand the curriculum, develop lesson plans and execute them in the classroom. Despite this, there were still concerns with the embedded colonized practices where teachers defaulted to eurocentric methods of doing things, like the strategies provided in the textbooks given to us. In some ways, our education was slow to adjust to the “Majolizing '' intention by our former minister. In this paper, we provide Kanne Lobal as a way to contribute to the “Majolizing intention” and perhaps speed up yet still be collectively responsible to all involved in education. Kajin Wa and Kanne Lobal “Wa” is the Marshallese concept for canoe. Kajin wa, as in canoe language, has a lot of symbolic meaning linked to deeply-held Marshallese values and practices. The canoe was the foundational practice that supported the livelihood of harsh atoll island living which reflects the Marshallese social world. The experts of Kajin wa often refer to “wa” as being the vessel of life, a means and source of sustaining life (Kelen, 2009, cited in Miller, 2010). “Jouj” means kindness and is the lower part of the main hull of the canoe. It is often referred to by some canoe builders in the RMI as the heart of the canoe and is linked to love. The jouj is one of the first parts of the canoe that is built and is “used to do all other measurements, and then the rest of the canoe is built on top of it” (Miller, 2010, p. 67). The significance of the jouj is that when the canoe is in the water, the jouj is the part of the hull that is underwater and ensures that all the cargo and passengers are safe. For Marshallese, jouj or kindness is what living is about and is associated with selflessly carrying the responsibility of keeping the family and community safe. The parts of the canoe reflect Marshallese culture, legend, family, lineage, and kinship. They embody social responsibilities that guide, direct, and sustain Marshallese families’ wellbeing, from atoll to atoll. For example, the rojak (boom), rojak maan (upper boom), rojak kōrā (lower boom), and they support the edges of the ujelā/ujele (sail) (see figure 1). The literal meaning of rojak maan is male boom and rojak kōrā means female boom which together strengthens the sail and ensures the canoe propels forward in a strong yet safe way. Figuratively, the rojak maan and rojak kōrā symbolise the mother and father relationship which when strong, through the jouj (kindness and love), it can strengthen families and sustain them into the future. Figure 1. Parts of the canoe Source: https://www.canoesmarshallislands.com/2014/09/names-of-canoe-parts/ From a socio-cultural, communal, and leadership view, the canoe (wa) provides understanding of the relationships required to inspire and sustain Marshallese peoples’ education and learning. We draw from Kajin wa because they provide cultural ideas and practices that enable understanding of education and leadership necessary for sustaining Marshallese people and realities in Oceania. When building a canoe, the women are tasked with the weaving of the ujelā/ujele (sail) and to ensure that it is strong enough to withstand long journeys and the fierce winds and waters of the ocean. The Kanne Lobal relates to the front part of the ujelā/ujele (sail) where the rojak maan and rojak kōrā meet and connect (see the red lines in figure 1). Kanne Lobal is linked to the strategic use of the ujelā/ujele by navigators, when there is no wind north wind to propel them forward, to find ways to capture the winds so that their journey can continue. As a proverbial saying, Kanne Lobal is used to ignite thinking and inspire and transform practice particularly when the journey is rough and tough. In this paper we draw from Kanne Lobal to ignite, inspire, and transform our educational and leadership practices, a move to explore what has always been meaningful to Marshallese people when we are faced with challenges. The Kanne Lobal utilises our language, and cultural practices and values by sourcing from the concepts of jouj (kindness, love), kautiej (respect), and jouj eo mour eo (reciprocity). A key Marshallese proverb, “Enra bwe jen lale rara”, is the cultural practice where families enact compassion through the sharing of food in all occurrences. The term “enra” is a small basket weaved from the coconut leaves, and often used by Marshallese as a plate to share and distribute food amongst each other. Bwe-jen-lale-rara is about noticing and providing for the needs of others, and “enra” the basket will help support and provide for all that are in need. “Enra-bwe-jen-lale-rara” is symbolic of cultural exchange and reciprocity and the cultural values associated with building and maintaining relationships, and constantly honouring each other. As a Marshallese practice, in this article we share our understanding and knowledge about the challenges as well as possible solutions for education concerns in our nation. In addition, we highlight another proverb, “wa kuk wa jimor”, which relates to having one canoe, and despite its capacity to feed and provide for the individual, but within the canoe all people can benefit from what it can provide. In the same way, we provide in this paper a cultural framework that will enable all educators to benefit from. It is a framework that is far-reaching and relevant to the lived realities of Marshallese people today. Kumit relates to people united to build strength, all co-operating and working together, living in peace, harmony, and good health. Kanne Lobal: conceptual framework for education and leadership An education framework is a conceptual structure that can be used to capture ideas and thinking related to aspects of learning. Kanne Lobal is conceptualised and framed in this paper as an educational framework. Kanne Lobal highlights the significance of education as a collective partnership whereby leadership is an important aspect. Kanne Lobal draws-from indigenous Marshallese concepts like kautiej (respect), jouj eo mour eo (reciprocity), and jouj (kindness, heart). The role of a leader, including an education leader, is to prioritise collective learning and partnerships that benefits Marshallese people and the continuity and survival of the next generation (Heine, 2002; Thaman, 1995). As described by Ejnar Aerōk, an expert canoe builder in the RMI, he stated: “jerbal ippān doon bwe en maron maan wa e” (cited in Miller, 2010, p. 69). His description emphasises the significance of partnerships and working together when navigating and journeying together in order to move the canoe forward. The kubaak, the outrigger of the wa (canoe) is about “partnerships”. For us as elementary school leaders on Majuro, kubaak encourages us to value collaborative partnerships with each other as well as our communities, PSS, and other stakeholders. Partnerships is an important part of the Kanne Lobal education and leadership framework. It requires ongoing bwebwenato – the inspiring as well as confronting and challenging conversations that should be mediated and negotiated if we and our education stakeholders are to journey together to ensure that the educational services we provide benefits our next generation of young people in the RMI. Navigating ahead the partnerships, mediation, and negotiation are the core values of jouj (kindness, love), kautiej (respect), and jouj eo mour eo (reciprocity). As an organic conceptual framework grounded in indigenous values, inspired through our lived experiences, Kanne Lobal provides ideas and concepts for re-thinking education and leadership practices that are conducive to learning and teaching in the schooling context in the RMI. By no means does it provide the solution to the education ills in our nation. However, we argue that Kanne Lobal is a more relevant approach which is much needed for the negatively stigmatised system as a consequence of the various colonial administrations that have and continue to shape and reframe our ideas about what education should be like for us in the RMI. Moreover, Kannel Lobal is our attempt to decolonize the framing of education and leadership, moving our bwebwenato to re-framing conversations of teaching and learning so that our cultural knowledge and values are foregrounded, appreciated, and realised within our education system. Bwebwenato: sharing our stories In this section, we use bwebwenato as a method of gathering and capturing our stories as data. Below we capture our stories and ongoing conversations about the richness in Marshallese cultural knowledge in the outer islands and on Majuro and the potentialities in Kanne Lobal. Danny Jim When I was in third grade (9-10 years of age), during my grandfather’s speech in Arno, an atoll near Majuro, during a time when a wa (canoe) was being blessed and ready to put the canoe into the ocean. My grandfather told me the canoe was a blessing for the family. “Without a canoe, a family cannot provide for them”, he said. The canoe allows for travelling between places to gather food and other sources to provide for the family. My grandfather’s stories about people’s roles within the canoe reminded me that everyone within the family has a responsibility to each other. Our women, mothers and daughters too have a significant responsibility in the journey, in fact, they hold us, care for us, and given strength to their husbands, brothers, and sons. The wise man or elder sits in the middle of the canoe, directing the young man who help to steer. The young man, he does all the work, directed by the older man. They take advice and seek the wisdom of the elder. In front of the canoe, a young boy is placed there and because of his strong and youthful vision, he is able to help the elder as well as the young man on the canoe. The story can be linked to the roles that school leaders, teachers, and students have in schooling. Without each person knowing intricately their role and responsibility, the sight and vision ahead for the collective aspirations of the school and the community is difficult to comprehend. For me, the canoe is symbolic of our educational journey within our education system. As the school leader, a central, trusted, and respected figure in the school, they provide support for teachers who are at the helm, pedagogically striving to provide for their students. For without strong direction from the school leaders and teachers at the helm, the students, like the young boy, cannot foresee their futures, or envisage how education can benefit them. This is why Kanne Lobal is a significant framework for us in the Marshall Islands because within the practice we are able to take heed and empower each other so that all benefit from the process. Kanne Lobal is linked to our culture, an essential part of who we are. We must rely on our own local approaches, rather than relying on others that are not relevant to what we know and how we live in today’s society. One of the things I can tell is that in Majuro, compared to the outer islands, it’s different. In the outer islands, parents bring children together and tell them legends and stories. The elders tell them about the legends and stories – the bwebwenato. Children from outer islands know a lot more about Marshallese legends compared to children from the Majuro atoll. They usually stay close to their parents, observe how to prepare food and all types of Marshallese skills. Loretta Joseph Case There is little Western influence in the outer islands. They grow up learning their own culture with their parents, not having tv. They are closely knit, making their own food, learning to weave. They use fire for cooking food. They are more connected because there are few of them, doing their own culture. For example, if they’re building a house, the ladies will come together and make food to take to the males that are building the house, encouraging them to keep on working - “jemjem maal” (sharpening tools i.e. axe, like encouraging workers to empower them). It’s when they bring food and entertainment. Rubon Rubon Togetherness, work together, sharing of food, these are important practices as a school leader. Jemjem maal – the whole village works together, men working and the women encourage them with food and entertainment. All the young children are involved in all of the cultural practices, cultural transmission is consistently part of their everyday life. These are stronger in the outer islands. Kanne Lobal has the potential to provide solutions using our own knowledge and practices. Connie Joel When new teachers become a teacher, they learn more about their culture in teaching. Teaching raises the question, who are we? A popular saying amongst our people, “Aelon kein ad ej aelon in manit”, means that “Our islands are cultural islands”. Therefore, when we are teaching, and managing the school, we must do this culturally. When we live and breathe, we must do this culturally. There is more socialising with family and extended family. Respect the elderly. When they’re doing things the ladies all get together, in groups and do it. Cut the breadfruit, and preserve the breadfruit and pandanus. They come together and do it. Same as fishing, building houses, building canoes. They use and speak the language often spoken by the older people. There are words that people in the outer islands use and understand language regularly applied by the elderly. Respect elderly and leaders more i.e., chiefs (iroj), commoners (alap), and the workers on the land (ri-jerbal) (social layer under the commoners). All the kids, they gather with their families, and go and visit the chiefs and alap, and take gifts from their land, first produce/food from the plantation (eojōk). Tommy Almet The people are more connected to the culture in the outer islands because they help one another. They don’t have to always buy things by themselves, everyone contributes to the occasion. For instance, for birthdays, boys go fishing, others contribute and all share with everyone. Kanne Lobal is a practice that can bring people together – leaders, teachers, stakeholders. We want our colleagues to keep strong and work together to fix problems like students and teachers’ absenteeism which is a big problem for us in schools. Demetria Malachi The culture in the outer islands are more accessible and exposed to children. In Majuro, there is a mixedness of cultures and knowledges, influenced by Western thinking and practices. Kanne Lobal is an idea that can enhance quality educational purposes for the RMI. We, the school leaders who did GCSL, we want to merge and use this idea because it will help benefit students’ learning and teachers’ teaching. Kanne Lobal will help students to learn and teachers to teach though traditional skills and knowledge. We want to revitalize our ways of life through teaching because it is slowly fading away. Also, we want to have our own Marshallese learning process because it is in our own language making it easier to use and understand. Essentially, we want to proudly use our own ways of teaching from our ancestors showing the appreciation and blessings given to us. Way Forward To think of ways forward is about reflecting on the past and current learnings. Instead of a traditional discussion within a research publication, we have opted to continue our bwebwenato by sharing what we have learnt through the Graduate Certificate in School Leadership (GCSL) programme. Our bwebwenato does not end in this article and this opportunity to collaborate and partner together in this piece of writing has been a meaningful experience to conceptualise and unpack the Kanne Lobal framework. Our collaborative bwebwenato has enabled us to dig deep into our own wise knowledges for guidance through mediating and negotiating the challenges in education and leadership (Sanga & Houma, 2004). For example, bwe-jen-lale-rara reminds us to inquire, pay attention, and focus on supporting the needs of others. Through enra-bwe-jen-lale-rara, it reminds us to value cultural exchange and reciprocity which will strengthen the development and maintaining of relationships based on ways we continue to honour each other (Nimmer, 2017). We not only continue to support each other, but also help mentor the next generation of school leaders within our education system (Heine, 2002). Education and leadership are all about collaborative partnerships (Sanga & Chu, 2009; Thaman, 1997). Developing partnerships through the GCSL was useful learning for us. It encouraged us to work together, share knowledge, respect each other, and be kind. The values of jouj (kindness, love), kautiej (respect), and jouj eo mour eo (reciprocity) are meaningful in being and becoming and educational leader in the RMI (Jetnil-Kijiner, 2014; Miller, 2010; Nimmer, 2017). These values are meaningful for us practice particularly given the drive by PSS for schools to become accredited. The workshops and meetings delivered during the GCSL in the RMI from 2018 to 2019 about Kanne Lobal has given us strength to share our stories and experiences from the meeting with the stakeholders. But before we met with the stakeholders, we were encouraged to share and speak in our language within our courses: EDP05 (Professional Development and Learning), EDP06 (School Leadership), EDP07 (School Management), EDP08 (Teaching and Learning), and EDP09 (Community Partnerships). In groups, we shared our presentations with our peers, the 15 school leaders in the GCSL programme. We also invited USP RMI staff. They liked the way we presented Kannel Lobal. They provided us with feedback, for example: how the use of the sail on the canoe, the parts and their functions can be conceptualised in education and how they are related to the way that we teach our own young people. Engaging stakeholders in the conceptualisation and design stages of Kanne Lobal strengthened our understanding of leadership and collaborative partnerships. Based on various meetings with the RMI Pacific Resources for Education and Learning (PREL) team, PSS general assembly, teachers from the outer islands, and the PSS executive committee, we were able to share and receive feedback on the Kanne Lobal framework. The coordinators of the PREL programme in the RMI were excited by the possibilities around using Kanne Lobal, as a way to teach culture in an inspirational way to Marshallese students. Our Marshallese knowledge, particularly through the proverbial meaning of Kanne Lobal provided so much inspiration and insight for the groups during the presentation which gave us hope and confidence to develop the framework. Kanne Lobal is an organic and indigenous approach, grounded in Marshallese ways of doing things (Heine, 2002; Taafaki & Fowler, 2019). Given the persistent presence of colonial processes within the education system and the constant reference to practices and initiatives from the US, Kanne Lobal for us provides a refreshing yet fulfilling experience and makes us feel warm inside because it is something that belongs to all Marshallese people. Conclusion Marshallese indigenous knowledge and practices provide meaningful educational and leadership understanding and learnings. They ignite, inspire, and transform thinking and practice. The Kanne Lobal conceptual framework emphasises key concepts and values necessary for collaborative partnerships within education and leadership practices in the RMI. The bwebwenato or talk stories have been insightful and have highlighted the strengths and benefits that our Marshallese ideas and practices possess when looking for appropriate and relevant ways to understand education and leadership. Acknowledgements We want to acknowledge our GCSL cohort of school leaders who have supported us in the development of Kanne Lobal as a conceptual framework. A huge kommol tata to our friends: Joana, Rosana, Loretta, Jellan, Alvin, Ellice, Rolando, Stephen, and Alan. References Benson, C. (2002). Preface. In F. Pene, A. M. Taufe’ulungaki, & C. Benson (Eds.), Tree of Opportunity: re-thinking Pacific Education (p. iv). Suva, Fiji: University of the South Pacific, Institute of Education. Bessarab, D., Ng’andu, B. (2010). Yarning about yarning as a legitimate method in indigenous research. International Journal of Critical Indigenous Studies, 3(1), 37-50. Fa’avae, D., Jones, A., & Manu’atu, L. (2016). Talanoa’i ‘a e talanoa - talking about talanoa: Some dilemmas of a novice researcher. AlterNative: An Indigenous Journal of Indigenous Peoples,12(2),138-150. Heine, H. C. (2002). A Marshall Islands perspective. In F. Pene, A. M. Taufe’ulungaki, & C. Benson (Eds.), Tree of Opportunity: re-thinking Pacific Education (pp. 84 – 90). Suva, Fiji: University of the South Pacific, Institute of Education. Infoplease Staff (2017, February 28). Marshall Islands, retrieved from https://www.infoplease.com/world/countries/marshall-islands Jetnil-Kijiner, K. (2014). Iep Jaltok: A history of Marshallese literature. (Unpublished masters’ thesis). Honolulu, HW: University of Hawaii. Kabua, J. B. (2004). We are the land, the land is us: The moral responsibility of our education and sustainability. In A.L. Loeak, V.C. Kiluwe and L. Crowl (Eds.), Life in the Republic of the Marshall Islands, pp. 180 – 191. Suva, Fiji: University of the South Pacific. Kupferman, D. (2004). Jelalokjen in flux: Pitfalls and prospects of contextualising teacher training programmes in the Marshall Islands. Directions: Journal of Educational Studies, 26(1), 42 – 54. http://directions.usp.ac.fj/collect/direct/index/assoc/D1175062.dir/doc.pdf Miller, R. L. (2010). Wa kuk wa jimor: Outrigger canoes, social change, and modern life in the Marshall Islands (Unpublished masters’ thesis). Honolulu, HW: University of Hawaii. Nabobo-Baba, U. (2008). Decolonising framings in Pacific research: Indigenous Fijian vanua research framework as an organic response. AlterNative: An Indigenous Journal of Indigenous Peoples, 4(2), 141-154. Nimmer, N. E. (2017). Documenting a Marshallese indigenous learning framework (Unpublished doctoral thesis). Honolulu, HW: University of Hawaii. Sanga, K., & Houma, S. (2004). Solomon Islands principalship: Roles perceived, performed, preferred, and expected. Directions: Journal of Educational Studies, 26(1), 55-69. Sanga, K., & Chu, C. (2009). Introduction. In K. Sanga & C. Chu (Eds.), Living and Leaving a Legacy of Hope: Stories by New Generation Pacific Leaders (pp. 10-12). NZ: He Parekereke & Victoria University of Wellington. Suaalii-Sauni, T., & Fulu-Aiolupotea, S. M. (2014). Decolonising Pacific research, building Pacific research communities, and developing Pacific research tools: The case of the talanoa and the faafaletui in Samoa. Asia Pacific Viewpoint, 55(3), 331-344. Taafaki, I., & Fowler, M. K. (2019). Clothing mats of the Marshall Islands: The history, the culture, and the weavers. US: Kindle Direct. Taufe’ulungaki, A. M. (2014). Look back to look forward: A reflective Pacific journey. In M. ‘Otunuku, U. Nabobo-Baba, S. Johansson Fua (Eds.), Of Waves, Winds, and Wonderful Things: A Decade of Rethinking Pacific Education (pp. 1-15). Fiji: USP Press. Thaman, K. H. (1995). Concepts of learning, knowledge and wisdom in Tonga, and their relevance to modern education. Prospects, 25(4), 723-733. Thaman, K. H. (1997). Reclaiming a place: Towards a Pacific concept of education for cultural development. The Journal of the Polynesian Society, 106(2), 119-130. Thiong’o, N. W. (1986). Decolonising the mind: The politics of language in African literature. Kenya: East African Educational Publishers. Vaioleti, T. (2006). Talanoa research methodology: A developing position on Pacific research. Waikato Journal of Education, 12, 21-34. Walsh, J. M., Heine, H. C., Bigler, C. M., & Stege, M. (2012). Etto nan raan kein: A Marshall Islands history (First Edition). China: Bess Press.

Remediation of nursing studies has been used to help improve progression and retention in nursing school. However, the format to remediate nursing students effectively is not well documented. Several studies have confirmed that case studies have helped to improve critical thinking skills in nursing students. Furthermore, studies have also concluded that remediation is effective to help improve test scores of nursing students. The purpose of this project was to determine if at-risk nursing students (grades less than 74%) placed on a performance improvement plan (PIP) that included case study analysis with weekly study sessions reviews would improve these students' test scores. In the junior level class, thirteen of the 29 students were not successfully succeeding in this class. These students were placed on the performance improvement plan. The students all completed the requirements of the PIP. The results of this project confirm that remediation with a case study results is an effective methodology to help improve test scores and success within a class. In this project, 50% of the at-risk students successfully completed the course as a result of participation in the PIP.

ABSTRACT Introduction The human-computer interaction is essential in simulated electronic systems associated with teaching-learning activities. Interactive clinical cases reinforce the diagnostic reasoning ability, a stage of the advanced Nursing Process. Purpose To build educational software, based on NANDA International, to improve the accuracy of nursing diagnoses. Method Methodological study in three stages: preparation and validation of case studies; construction; homologation and evaluation. Held between January / 2012 and December / 2013, in a university hospital in southern Brazil. Teachers, nurses, undergraduate students and graduate students in nursing and information technology participated. Approved by the Research Ethics Committee (130035). Results Construction of five case studies and two versions of the software: one simulates the reasoning process for establishing the diagnosis; another, aimed at teachers, makes it possible to edit/create cases. Conclusion The software helps in the teaching-learning process, generating accurate diagnoses, supporting more appropriate interventions.

“Calista” is a bilingual, bicultural Greek-Australian musician in Melbourne, Victoria who explores and enacts her bicultural identity by musicking (making music). This single case study explores the formation and development of hybridized identity which is a complex lifelong process that may generate tensions for an individual that changes across the lifespan. There are strengths and challenges for those traversing different cultures. This study focuses on a bicultural identity formed by personal, musical and cultural contexts. Calista enacts her bimusicality in different musical genres and in different modes of musical engagement. Data were collected by semi-structured interview and by reference to published materials. Data were analysed using Interpretative Phenomenological Analysis. The findings are reported under three themes that reflect different stages in Calista’s life: Becoming a Greek-Australian musician; Mature musicking; and Teaching and community work.

The need for the utilization of various teaching strategies by lecturers when facilitating learning cannot be overemphasized. The aim of this study was to establish if lecturers at a Nursing College in Mpumalanga were using teaching strategies that could facilitate the personal development of nursing learners. A quantitative approach was followed for this study. The participants of the study were all lecturers at a Nursing College in Mpumalanga. Data was gathered by means of a questionnaire. Descriptive statistics were used to describe and summarize data regarding the type of teaching strategies used and the recommendations that could enhance the utilization of various teaching strategies. The data revealed that the teaching strategies mostly utilized required active participation of the learners namely: formal/informal writing of assignments; learner-led class presentation; group sessions; clinical case studies; role-playing and clinical rounds. Inclusion of certain strategies such as problem-based learning, structured accompaniment and computer literacy for learners could enhance the personal development of nursing learners. Although lecturers did use some of the teaching strategies that could enhance the personal development of nursing learners, staff development regarding the utilization of various teaching strategies was highlighted as an important factor to be considered. Other findings revealed that lack of resources have a negative influence on the utilization of various teaching strategies.

Aim: This study aims to evaluate health students' perceptions toward pharmacology. Methodology: This study included a self-administered questionnaire that inquired concerning their perceptions about learning pharmacology. The survey was translated to Arabic language and after that it was validated and converted to online Google Form and then the link was sent to the students. Results: Most of the students was less than 22 years old (67.90%) in addition to that most of them were females (81.48%). About 38.27% of the respondents were pharmacy students. More than 90% of the respondents said that pharmacology is an interesting subject in the university courses. Most of the students agreed that there should be more emphasis on studying case studies not only theoretical teaching (88.89%). Conclusion: The study found that the perceptions of students regarding pharmacology were positive. It is important to add a practical training for pharmacology in the hospital not only teaching it theoretically. Moreover, it is important to integrate pharmacology horizontally with other related course such as pathophysiology and pharmacotherapy.

ABSTRACT Objective: to develop a mobile application to support nurses’ diagnostic reasoning in the care of surgical patients Method: this is applied research with technological production, carried out in a hospital in the metropolitan region of Espírito Santo, from September 2018 to December 2019. The study was divided into four stages: theoretical content elaboration through an integrative literature review of the main signs and symptoms observed in patients in the postoperative period of gastrointestinal, thoracic, head and neck surgeries, and cross-mapping between the signs and symptoms found in the literature review and NANDA International nursing diagnoses; development of 10 case studies that foster clinical and surgical situations elaborated according to nursing diagnoses mapped according to Lunney’s framework; assessment of case studies by experts using content validity index; and application construction in partnership with a graphic design expert by the User-Centered Design method. Results: the application CuidarTech®Cirúrgico presents four navigation options: 1) “Nursing Process” - displays theoretical contents; 2) “Nursing diagnoses and actions” - with nursing diagnoses and interventions to assist patients in the postoperative period of gastrointestinal, thoracic, head and neck surgeries; 3) “Case studies” - brings 10 validated studies to training clinical reasoning; and 4) “Credits” - executing team. Conclusion: the application is an unprecedented technology and constitutes an interactive support in the care and teaching of nurses’ Nursing Process and clinical reasoning.

ABSTRACT Objectives: to apply and analyze an educational strategy to develop management skills in nursing students to work in hospital practice. Methods: exploratory, intervention, qualitative study conducted from February 2020 to 2021. Fifty-four nursing students from a public higher education institution participated in this study, in which thirteen workshops were held to discuss management cases. Subsequently, semi-structured interviews were conducted using inductive thematic analysis. Results: the case studies addressed the management competencies of communication, decision making, leadership, and interpersonal relationships. After the intervention, the strategy was evaluated through interviews, identifying positive aspects regarding knowledge acquisition; and other limiting aspects, such as limited time to discuss the cases. Final Considerations: the workshops proved to be effective as teaching strategies for students, adding new management knowledge that should help their performance as future nurses, capable of reflection, and the subjects of knowledge construction for the professional practice of nursing.

An accelerating aging society and rise in serious illnesses has led to an increase in deaths and made the demand for palliative care even greater. An integrated review was conducted to identify the impact of interprofessional education (IPE) on palliative/end of life (EOL) care for unlicensed health care students with a multidisciplinary approach. The databases searched included MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), PsycINFO, and the Cochrane Library’s CENTRAL. Fifteen studies were included. Participants’ disciplines included medicine, nursing, pharmacy, physical therapy, occupational therapy, social work, chaplain, public health and psychology. Nine were pre-post design and others were post course evaluations. One research study was an interventional trial with a comparative group. The selected studies included a variety of teaching strategies such as simulation or role play, clinical experience, case study, and TOSCE training. The importance of an interprofessional approach to palliative/EOL care has been highlighted, and our review suggests that combined IPE and palliative/EOL interventions can potentially impact palliative/EOL patient outcomes. More studies are needed to clarify the effectiveness of interprofessional palliative/EOL educational interventions including facilitators, learning outcomes, variable methods or teaching strategy, and the level of students.

Abstract Background Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support final year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice. Methods This study aimed to evaluate a simulation-based education initiative from the perspectives of final year undergraduate nursing and midwifery students (N = 95). An online survey, using the validated Simulation Effectiveness Tool – Modified (SET-M), was distributed to final year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results The results of the study highlight final year nursing and midwifery students’ perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confidence and gain experience in preparation for real-life practice. Students reported feeling more confident in their assessment skills, in providing care and interventions in responding to changes in a person’s health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefing and debriefing sessions were highlighted as important aspects of the simulation which helped to increase student confidence and cultivate meaningful learning. Conclusion Simulation-based education is a valuable teaching and learning modality, particularly for final year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional.

ABSTRACT Objective to analyze diverse scientific evidence about educational materials related to intermittent urethral catheterization in children. Method a scoping review based on the method proposed by the Joana Briggs Institute and conducted in nine stages from July to December 2021, with the following guiding question: “Which is the available evidence about educational materials on intermittent urethral catheterization in children?”. Articles from the following databases were analyzed: National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online and SciVerse Scopus. Results six of the 3,323 articles retrieved were kept after applying the eligibility criteria and excluding the duplicates. The publication dates varied from 2009 to 2019; five were published in Brazil and one in the United States. Regarding the design, one was a cross-sectional study and there were two descriptive studies, two methodological studies and one case study. The data were presented considering the following variables: type of material, means of dissemination, target audience, and theoretical framework of the educational materials. Conclusion the studies analyzed in this review presented several educational materials, such as elaboration of educational software, a Telenursing manual, an educational video to guide parents and an online forum. Therefore, these materials are useful as teaching and learning strategies for caregivers of children undergoing intermittent urethral catheterization.

Objective: Clinical decision making is an essential part of nursing process and patient care plan adopted by nurses as a problem solving approach. This study aimed to evaluate the effect of case-based learning methods on self-confidence and anxiety of the students in clinical decision-making process in pediatric nursing lecture. Materials and Methods: This study was designed as quasi-experimental with two groups. While the first group was a case-based learning group (n=38), the second group was designed as simulation group in addition to case-based learning (n=47). Results: There was a similarity between the groups in the mean age, gender, income level of the students, area of residence, perception of the profession, their ability to use theoretical knowledge in practice, self-confidence in clinical decision-making before the lecture, anxiety total score, and the mean subscale scores (p>0.05). It was identified that there was an increase in the post-test mean scores of self-confidence for each group, and a decrease in the mean anxiety scores (p0.05). Conclusion: Enriched teaching methods with active participation such as case-based learning and case-based learning/simulation was determined to be effective on boosting self-confidence and reducing anxiety of pediatric nursing students and it was suggested that more studies would be done on the topic.

Gloves are worn to protect hands from contamination and microorganisms; this measurement tries to isolate the hands of the healthcare workers to ensure a better protection, with an aim of minimizing the risk of transmission of infectious agents to patients. This survey aims at assessing knowledge, attitudes, and practices towards disposable gloves use among nursing staff at Hassan II University Teaching Hospital in Fez. This is a cross-sectional prospective and evaluative study that covers a two-month period. Data were collected using an anonymous and self-administered questionnaire. The population studied was quite young with 76,5% aged between 20-30 years. The results have shown that 264 (85.99%) of participants had received training in disposable gloves mastering. Moreover, 161 (52.3%) claimed to change always disposable gloves while moving from one patient to another. In contrast, 231 (75.2%) emphasized the need to change gloves each time they have been in contact with blood or other body fluids. However, the Studies by self- administered questionnaires, as is the case for our investigation, inform about self-declared claims and are not always related to practical implications Inappropriate glove use was frequently declared in this study. This survey showed a misconception of the risk in several practice situations, some good results of wearing gloves reflect this engendered feeling of individual protection.

Abstract Objective The aim was to to establish core components of spiritual care training for healthcare professionals in Australia. Methods This study used the Delphi technique to undertake a consensus exercise with spiritual care experts in the field of healthcare. Participant opinion was sought on (i) the most important components of spiritual care training; (ii) preferred teaching methods; (iii) clinical scenarios to address in spiritual care training; and (iv) current spiritual assessment and referral procedures. Results Of the 107 participants who responded in the first round, 67 (62.6%) were female, 55 (51.4%) worked in pastoral care, and 84 (78.5%) selected Christian as their religious affiliation. The most highly ranked components of spiritual care training were “relationship between health and spirituality,” followed by “definitions of spirituality and spiritual care.” Consensus was not achieved on the item “comparative religions study/alternative spiritual beliefs.” Preferred teaching methods include case studies, group discussion, role-plays and/or simulated learning, videos of personal stories, and self-directed learning. The most highly ranked clinical scenario to be addressed in spiritual care training was “screening for spiritual concerns for any patient or resident.” When asked who should conduct an initial spiritual review with patients, consensus was achieved regarding all members of the healthcare team, with most nominating a chaplain or “whoever the patient feels comfortable with.” It was considered important for spiritual care training to address one's own spirituality and self-care. Consensus was not achieved on which spiritual care assessment tools to incorporate in training. Significance of results This Delphi study revealed that spiritual care training for Australian healthcare professionals should emphasize the understanding of the role of spirituality and spiritual care in healthcare, include a range of delivery methods, and focus upon the incorporation of spiritual screening. Further work is required to identify how spiritual care screening should be conducted within an Australian healthcare setting.

The purpose of the study was to compare the extent to which the different teaching approaches applied in the Baccalaureus Curationis programme adequately prepare graduating learners for professional competence. The research methodology was a quantitative approach, based on descriptive research, with a clinical competence development model to guide the data collection procedure. The target population of the study included a sample of 250 learners in the four-year B.Cur programme, that extended from first-to-fourth-year. Stratified random sampling was applied to select the sample learners for this research and data were collected by means of a five-point Likert scale questionnaire. Data were organised and managed using the SAS statistical software package. Descriptive statistics were gathered with measures of central tendency and dispersion included, and their findings were illustrated on descriptive tables. A correlation technique was applied to determine the effects of the independent variable on the dependent variable.The results of the study indicated that progression in competence did not occur as learners progressed through higher levels of their training, except during the third-year of study. However, the study’s results confirmed the strengths of the Case-based clinical reasoning approach to teaching and learning. This approach is able to combine the strengths of the traditional methods, which dealt with large class sizes and that had a focus on learner centred learning, with a focus on clinical practice. This approach provides realistic opportunities for learners to experiment with solutions to dilemmas encountered in real life situations, from the protected and safe environment of the classroom. The first-year learners who were observed in this study, who although novices, were exposed to Case-based teaching approaches and showed more self-perceived competence than learners in later years. This occurred in spite of the limited exposure of the first-year learners to real life clinical situations. The outcome of this study recommends that more studies are conducted, in the School of Nursing at the University of the Western Cape (UWC), to explore teaching and learning approaches that fully maximise the clinical and theoretical competencies of the learners. The outcome further recommends that learner-centred teaching approaches, such as Case-based method, are applied to all year levels of study in the B.Cur programme, due to its proven value when it was applied to first-year learners. The Case-based clinical reasoning approach to learning, that has been implemented at the school, promotes competence and self confidence in learners and has enhanced their sense of responsibility to be actively involved in their own learning.

Introduction : Mental disorders are individual behavior patterns associated with a symptom of suffering and weakness in one or more important functions of the human being, namely psychological, behavioral, biological functions, these disorders affect the relationship between themselves and society (Maramis, 2010). Objectives: The purpose of this study was to determine the appropriate nursing care and intervention in patients with social isolation. Method: The design in this study is a case study design using a nursing process approach. The sample in this study was Mrs. B. The sampling technique used was simple random sampling. The research was conducted at X Hospital in April 2021. Data was collected by means of interviews, observations, and documentation studies. The research instrument is the researcher himself with the assessment guide tool. The nursing process approach carried out by researchers includes the following stages: Assessment Researchers collect data, both from respondents/patients. Nursing diagnoses, make nursing interventions, implement and then carry out nursing evaluations. Result: Implementation strategy 1 (SP1): helping the client identify the causes of the client's social isolation, discussing with the client the advantages of interacting and the disadvantages of not interacting with others, teaching the client how to get to know one person and encouraging the client to include practice talking to people others into daily activities. Implementation Strategy 2 (SP2): evaluates the client's daily schedule of activities, provides opportunities for clients to practice how to get to know one person, and helps clients include talking to other people as one of their daily activities. Implementation Strategy 3 (SP3): evaluate the client's daily activity schedule, provide opportunities for the client to get acquainted with two or more people, and encourage the client to include it in the daily activity schedule Conclusion: Nursing care for Mrs. B found that the first priority nursing problem is social isolation

Welsh is the indigenous language of Wales, the Welsh Language (Wales) Measure (2011) means that English and Welsh have equal parity in Wales. Many nursing students are now embarking on their studies having completed their formal education throughout the medium of Welsh and thus feel more comfortable studying in their mother tongue. Therefore, Bangor University aims to teach Welsh speakers alongside English speakers and offers a choice to their students so they can study in their preferred language. This case study examines how a bilingual ethos can be incorporated to provide a dynamic approach to teaching using pre-recorded lectures and innovative group work. Presentations are recorded in two different languages and are supported by a gapped handbook, ensuring that students focus on the most important aspects of the lecture. The pre-recorded lecture capture is available for students to access after the lecture to reinforce the learning. Crossover group work (Mortiboys, 2010) was included to ensure that each member of the class contributed to discussions and fully understood the topic of managing pain in various scenarios.This resulted in a stimulating session which increased students' motivation and fostered ownership and interest in digital technology, but at the same time met the language and educational needs of a diverse population of students.

Well-developed clinical reasoning skills are central to the process of clinical judgement. However, the results of recent studies suggest that curricula and teaching approaches that support student nurses’ development of clinical reasoning skills have not yet been fully achieved. Cognitive apprenticeship offers a new approach to facilitate the development of complex thinking skills, for example, reasoning skills in making clinical decisions. This study examined the effect of an educational intervention utilizing principles of cognitive apprenticeship on students’ ability to apply clinical reasoning skills within the context of a purpose-built clinical vignette.A quasi-experimental, non-equivalent control-group design was used to evaluate the effect of the educational intervention on students’ accuracy, inaccuracy and self-confidence in clinical reasoning. Eighty-five undergraduate nursing students participated in the study. A purpose-built clinical vignette was utilised to collect data from study participants. Mixed-Design ANOVA with a significant level of p< 0.05 was employed. Both quantitative and qualitative data were collected. A statistically significant increase in students’ accuracy in clinical reasoning was found after the six-weeks educational intervention. Examination of the quantitative data at time 2 discovered a statistically significant higher accuracy in clinical reasoning score (p<0.00) of the intervention group as compared to the control group. Results from inaccuracy and self-confidence in clinical reasoning did not reach significance. Results from the qualitative data are reported separately. It is argued that interplay of small group discussion of domain specific case-scenarios and the provision of guided learning experience may play a role in achieving partially successful results. This study makes an important contribution to nursing education by providing evidence to understand how best to facilitate nursing students’ development of clinical reasoning.

This single and critical case study evaluated a faith-based natural family planning program's salient features using a framework on implementation fidelity. Multiple focus group discussions were conducted, with three groups of stakeholders (n=100), to gather qualitative data on their knowledge and experience of the program. Overall, the findings showed that the program primarily adhered to the essential elements of implementation fidelity, such as content, frequency, duration, and coverage prescribed by its designers. Three lessons were drawn to address some issues that have influenced the degree of fidelity in which the program was implemented. The first is the need to secure adequate and sustained human and financial resources. The second is the need to strengthen its partnership with government and non-government organizations that have provided them with much-needed assistance. Finally, there is also the need to provide extensive training, materials, and support to its service providers to preserve their morale and interest. Other faith-based organizations may hold this case as an indicator of how and why an NFP program works and the extent to which the need for family planning can be met adapted to their local conditions and needs. References Arbuckle, Gerald A. Refounding the Church: Dissent for Leadership. Quezon City: Claretian Publications. 1993. Arevalo, Marcos. "Expanding the Availability and improving the delivery of natural family planning services and fertility awareness education: providers' perspectives. Adv Contracept. Jun-Sep 1997; 13(2-3):275-81. Arévalo, Marcos, Victoria Jennings, and Irit Sinai. "Efficacy of a new method of family planning: the Standard Days Method." Contraception 65, no. 5 (2002): 333-338.Arévalo, Marcos, Irit Sinai, and Victoria Jennings. "A fixed formula to define the fertile window of the menstrual cycle as the basis of a simple method of natural family planning." Contraception 60, no. 6 (1999): 357-360. Atun, Jenna (2013). Religiosity and Contraceptive Use among Filipino Youth. Philippine Center for Population and Development. (2013) Accessed April 15, 2019, from http://www.pcpd.ph/.../religiosity-and-contraceptive-use- Authority, P. S. ICF Philippines national demographic and health survey 2017. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF, 2018. Authority, Philippine Statistics. "Philippine statistics authority." Accessed from Philippine Statistics Authority Web site: https://psa. gov. ph/vegetable-root-crops-main/tomato (2018). Authority, P. S. “Philippine statistics authority.” Accessed July 20, 2019, from Philippine Statistics Authority Web site: https://psa. gov. ph/vegetable-root-crops-main/tomato.(2016) Authority, P. S. “ICF Philippines national demographic and health survey.” Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF, 2017. Bamber, John, Stella Owens, Heino Schonfeld, Deborah Ghate, and Deirdre Fullerton. "Effective Community Development Programmes: a review of the international evidence base." (2010). Barden-O'Fallon, Janine. "Availability of family planning services and quality of counseling by faith-based organizations: a three-country comparative analysis." Reproductive health, 14, no. 1 (2017): 57. Baskarada, Sasa. "Qualitative case study guidelines." The Qualitative Report 19, no. 40 (2014): 1-25. Accessed July 25, 2019, from http://www.nova.edu/ssss/QR/QR19/baskarada24.pdf Beaubien, Louis, and Daphne Rixon. "Key performance indicators in co-operatives: directions and principles." Journal of Co-operative Studies 45, no. 2 (2012): 5-15. Booker, Victoria K., June Grube Robinson, Bonnie J. Kay, Lourdes Gutierrez Najera, and Genevieve Stewart. "Changes in empowerment: Effects of participation in a lay health promotion program." Health Education & Behavior 24, no. 4 (1997): 452-464. Breitenstein, Susan M., Deborah Gross, Christine A. Garvey, Carri Hill, Louis Fogg, and Barbara Resnick. "Implementation fidelity in community‐based interventions." Research in nursing & health 33, no. 2 (2010): 164-173. Carroll, Christopher, Malcolm Patterson, Stephen Wood, Andrew Booth, Jo Rick, and Shashi Balain. "A conceptual framework for implementation fidelity." Implementation Science 2, no. 1 (2007): 40. Casterline, J.B., A.E. Perez & A.E. Biddlecom. “Factors Affecting Unmet Need for FP in the Philippines," “Studies in Family Planning, (1997). (3):173-191. Accessed November 02, 2019, from http://www.jstor.org/stable/2137886. Catholic Bishops' Conference of the Philippines. (2011). Guiding Principles of Population Control. Accessed September 27, 2019, from www.cbcponline.net/ Catholic Church. Bishops' Conference of the Philippines. (1992). Acts and Decrees of the Second Plenary Council of the Philippines. Catholic Bishops' Conference of the Philippines. Catholic Bishops' Conference of the Philippines. (1990). A Pastoral Letter on the Population Control Activities of the Philippine Government and Planned Parenthood Association. Accessed November 24, 2019, from cbcponline.net/v2/?p=324. Cleland, John, and Kazuyo Machiyama. "Unmet need for family planning: past achievements and remaining challenges." In Seminars in reproductive medicine, vol. 33, no. 01, pp. 011-016. Thieme Medical Publishers, 2015. Costello, Marilou P., and John B. Casterline. "Fertility decline in the Philippines: current status, prospects." asdf (2009): 479. Creel, Liz C., Justine V. Sass, and Nancy V. Yinger. "Overview of quality of care in reproductive health: definitions and measurements of quality." New Perspectives on Quality of Care 1 (2002): 1-8. Cronin Jr, J. Joseph, Michael K. Brady, and G. Tomas M. Hult. "Assessing the effects of quality, value, and customer satisfaction on consumer behavioral intentions in service environments." Journal of retailing 76, no. 2 (2000): 193-218. Crous, M. "Quality service delivery through customer satisfaction." (2006). D’Arcy, Catherine, Ann Taket, and Lisa Hanna. "Implementing empowerment-based Lay Health Worker programs: a preliminary study." Health promotion international 34, no. 4 (2019): 726-734. Dane, Andrew V., and Barry H. Schneider. "Program integrity in primary and early secondary prevention: are implementation effects out of control?" Clinical psychology review 18, no. 1 (1998): 23-45. David, Clarissa C., and Jenna Mae L. Atun. "Factors affecting fertility desires in the Philippines." Social Science Diliman 10, no. 2 (2014).Accessed August 12, 2019, from jounals.upd.edu.ph/index.php/socialsciencediliman/article/viewFile/4407/3999. Ewerling, F., Victora, C. G., Raj, A., Coll, C. V., Hellwig, F., & Barros, A. J. (2018). Demand for family planning satisfied with modern methods among sexually active women in low-and middle-income countries: who is lagging? Reproductive health, 15(1). (2018): 42. Francisco, J.M. “Letting the Texts of RH Speak for themselves: (Dis) continuity andCounterpoint in CBCP Statements.” Philippine Studies: Historical and Ethnographic Viewpoints, 223. (2015). Accessed October 17, 2019, from www.philippinestudies.net. Franta, Benjamin, Hilly Ann Roa-Quiaoit, Dexter Lo, and Gemma Narisma. "Climate Disasters in the Philippines." (2016). Fehring, Richard Jerome, Mary Schneider, and Kathleen Raviele. "Pilot evaluation of an Internet‐based natural family planning education and service program." Journal of Obstetric, Gynecologic & Neonatal Nursing 40, no. 3 (2011): 281-291. Glickman, Norman J., and Lisa J. Servon. "More than bricks and sticks: Five components of community development corporation capacity." Housing Policy Debate 9, no. 3 (1998): 497-539. Gomez, Fausto, B., OP. “The Role of Priests in Natural Family Planning." Boletin Ecclesiastico de Filipinas, LXXII, (1996): 163. Gribble, James N. "The standard days' method of family planning: a response to Cairo." International family planning perspectives 29, no. 4 (2003): 188-191. Guida, Maurizio, Giovanni A. Tommaselli, Massimiliano Pellicano, Stefano Palomba, and Carmine Nappi. "An overview on the effectiveness of natural family planning." Gynecological Endocrinology 11, no. 3 (1997): 203-219.Hasson, Henna. "Systematic evaluation of implementation fidelity of complex interventions in health and social care." Implementation Science 5, no. 1 (2010): 67. Infantado, R. B. "Main-streaming NFP into the Philippines' Department of Health: opportunities and challenges." Advances in Contraception 13, no. 2-3 (1997): 249-254. Institute for Reproductive Health. Faith-based organizations as partners in family planning: Working together to improve family well-being. Washington, DC: Georgetown University. (2011). Accessed February 11, 2019, from http://www.ccih.org/FBOs_as_Partners_in_FP_Report.pdf. Ledesma, Antonio. J. “All-NFP: A Way Forward.” Philippine Daily Inquirer (2012). Accessed August 04, 2019, from https://opinion.inquirer.net/35848/all-nfp-a-way-forward#ixzz5zAroo0oo Ledesma, Antonio. J. “Al-Natural Family Planning: Going beyond the RH Bill.” Accessed April 15, 2019, from https://archcdo.wordpress.com/ Lundgren, Rebecka, Jeannette Cachan, and Victoria Jennings. "Engaging men in family planning services delivery: experiences introducing the Standard Days Method® in four countries." World health & population 14, no. 1 (2012): 44. Lundgren, Rebecka I., Mihira V. Karra, and Eileen A. Yam. "The role of the Standard Days Method in modern family planning services in developing countries." The European Journal of Contraception & Reproductive Health Care 17, no. 4 (2012): 254-259.Mikolajczyk, Rafael T., Joseph B. Stanford, and Martina Rauchfuss. "Factors influencing the choice to use modern natural family planning." Contraception 67, no. 4 (2003): 253-258. Orbeta, Aniceto., Jr. “Poverty, Fertility Preferences, and Family Planning Practice in the Philippines.” Philippine Journal of Development, 129. (2006). Accessed October 25, 2019, from https://ideas.repec.org/p/phd/dpaper/dp_2005-22.html.July Orbeta, Aniceto Jr. “Poverty, vulnerability, and family size: evidence from the Philippines (No. 68). (2005). Asian Development Bank. Orbeta Jr, Aniceto, and Ernesto M. Pernia. Population Growth and Economic Development in the Philippines: What Has Been the Experience and What Must Be Done? No. 1999-22. PIDS Discussion Paper Series, 1999. Rufo, Aries. “The church pays lip service to natural family planning.” Rappler (2011). Accessed October 01, 2019, from https://news.abs-cbn.com/-depth/12/04/11/church-pays-lip-service-natural-family-planning. Schivone, Gillian B., and Paul D. Blumenthal. "Contraception in the developing world: special considerations." In Seminars in reproductive medicine, vol. 34, no. 03, pp. 168-174. Thieme Medical Publishers, 2016. Seidman, M. "Requirements for NFP service delivery: an overview." Advances in Contraception 13, no. 2-3 (1997): 241-247. Selak, Anne. “What the Church Owes Families.” La Croix International (2020) Accessed October 24, 2020, from https://www.commonwealmagazine.org/what-church-owes-families. Sinai, Irit, Rebecka Lundgren, Marcos Arévalo, and Victoria Jennings. "Fertility awareness-based methods of family planning: predictors of correct use." International family planning perspectives (2006): 94-100. Smoley, Brian A., and Christa M. Robinson. "Natural family planning." American family physician 86, no. 10 (2012): 924-928. Stanford, Joseph B., Janis C. Lemaire, and Poppy B. Thurman. "Women's interest in natural family planning." Journal of Family Practice 46 (1998): 65-72. Tommaselli, G. A., M. Guida, S. Palomba, M. Pellicano, and C. Nappi. "The importance of user compliance on the effectiveness of natural family planning programs." Gynecological endocrinology 14, no. 2 (2000): 81-89. Van de Vusse, Leona, Lisa Hanson, Richard J. Fehring, Amy Newman, and Jaime Fox. "Couples' views on the effects of natural family planning on marital dynamics." Journal of Nursing Scholarship 35, no. 2 (2003): 171-176. Vidal, Avis C. “Faith-based organizations in Community Development. (2001) Accessed January 28, 2020, from www.huduser.org/publications/pdf/faith-based.pdf. Walker, Christopher, and Mark Weinheimer. "The performance of community development systems: A report to the National Community Development Initiative." Washington, DC: Urban Institute (1996). Weldon, Elizabeth, Karen A. Jehn, and Priti Pradhan. "Processes that mediate the relationship between a group goal and improved group performance." Journal of personality and social psychology 61, no. 4 (1991): 555. World Health Organization, "Family Planning Contraception Methods," June 22, 2020. Accessed August 08, 2020, from https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception. World Health Organization. "Building from common foundations: the World Health Organization and faith-based organizations in primary healthcare." (2008). World Health Organization. “Health topics: family planning.” (1988). Accessed September 24, 2020, from http://www.who.int/topics/family_planning/en/. World Health Organization. (1988). Natural family planning: a guide to the provision of services. Accessed August 27, 2019, from https://apps.who.int/iris/handle/10665/39322.Yin, Robert K. "Case study research: Design and methods 4th edition." In the United States: Library of Congress Cataloguing-in-Publication Data. 2009.

04–198Chandler-Olcott, Kelly and Mahar, Donna (Syracuse U., USA; Email: kpchandl@syr.edu). ‘Tech-savviness’ meets multiliteracies: exploring adolescent girls' technology-mediated literacy practices. Reading Research Quarterly (Newark, USA), 38, 3 (2003), 356–85.04–199Chung, Teresa Mihwa & Nation, Paul (Victoria U., New Zealand; Email: Paul.Nation@vuw.ac.nz). Identifying technical vocabulary. System (Oxford, UK), 32, 2 (2004), 251–63.04–200Ellis, Rod and Yuan, Fangyuan (U. of Auckland, New Zealand; Email: r.ellis@auckland.ac.nz). The effects of planning on fluency, complexity, and accuracy in L2 narrative writing. Studies in Second Language Acquisition (New York, USA) 26, 1 (2004), 59–84.04–201Gascoigne, Carolyn (U. of Nebraska-Omaha, USA). Examining the effect of feedback in beginning L2 composition. Foreign Language Annals (New York, USA), 37, 1 (2004) 71–76.04–202Hamston, J. and Love, K. Reading relationships: Parents, boys, and reading as cultural practice. Australian Journal of Language and Literacy (Adelaide, Australia), 26, 3 (2003), 44–57.04–203Hobbs, Renee and Frost, Richard (Babson College, USA). Measuring the acquisition of media-literacy skills. Reading Research Quarterly (Newark, USA), 38, 3 (2003), 330–55.04–204Huang, Jingzi (Monmouth University, USA; Email: jhuang@Monmouth.edu). Socialising ESL students into the discourse of school science through academic writing. Language and Education (Clevedon, UK), 18, 2 (2004), 97–123.04–205Johnston, Brenda (U. of Southampton, UK; Email: bhm@soton.ac.uk). Teaching and researching critical academic writing: scrutiny of an action research process. Educational Action Research (Oxford, UK), 11, 3 (2003), 365–87.04–206Kamler, B. (Deakin University, Australia). Relocating the writer's voice – from voice to story and beyond. English in Australia (Norwood, Australia), 138 (2003), 34–40.04–207Kim, Hae-Ri (Kyungil U., South Korea; Email: hrkimasu@hanmail.net). Dialogue journal writing through a literature-based approach in an EFL setting. English Teaching (Anseonggun, South Korea), 58, 4 (2003), 293–318.04–208Kim, Myonghee (Indiana University, USA; Email: mahn@indiana.edu). Literature discussions in adult L2 learning. Language and Education (Clevedon, UK), 18, 2 (2004), 145–66.04–209Lee, Icy (Hong Kong Baptist U., Hong Kong; Email: icylee@hkbu.edu.hk). L2 writing teachers' perspectives, practices and problems regarding error feedback. Assessing Writing (New York, USA), 8, 3 (2003), 216–37.04–210Lindgren, Eva (Email: eva.lindgren@engelska.umu.se) and Sullivan, Kirk P. H. Stimulated recall as a trigger for increasing noticing and language awareness in the L2 writing classroom: a case study of two young female writers. Language Awareness (Clevedon, UK), 12, 3&4 (2003), 172–86.04–211Luke, A. (U. of Queensland, Australia/National Institute of Education, Singapore). Making literacy policy and practice with a difference. Australian Journal of Language and Literacy. (Adelaide, Australia), 26, 3 (2003), 58–82.04–212Mission, R. (U. of Melbourne, Australia). Imagining the self: the individual imagination in the English classroom. English in Australia (Norwood, Australia) 138 (2003), 24–33.04–213Morris, Darrell, Bloodgood, Janet W., Lomax, Richard G. and Perney, Jan (Appalachian State U., USA). Developmental steps in learning to read: a longitudinal study in kindergarten and first grade. Reading Research Quarterly (Newark, USA), 38, 3 (2003), 302–28.04–214Ryu, Hoyeol (Hankyong National University, Korea; Email: hoyeol@hnu.hankyong.ac.kr). Process approach to writing in the post-process era: A case study of two college students' writing processes. English Teaching (Anseonggun, Korea), 58, 3 (2003), 123–42.04–215Shen, Helen H. (University of Iowa, USA; Email: Helen-shen@uiowa.edu). Level of cognitive processing: effects on character learning among non-native learners of Chinese as a foreign language. Language and Education (Clevedon, UK), 18, 2 (2004), 167–82.04–216Shi, Ling (U. of British Columbia, Canada). Textual borrowing in second-language writing. Written Communication (Thousand Oaks, California, USA), 21, 2 (2004), 171–200.04–217Spence, Lucy K. (Arizona State University, USA). Stepping out of the conversation: giving students a space to co-construct writing. Bilingual Research Journal (Arizona, USA), 27, 3 (2003), 523–32.