Technology is being increasingly integrated into teaching environments in view of enhancing students' engagement and motivation. In particular, game-based student response systems have been found to foster students' engagement, enhance classroom dynamics and improve overall students' learning experience. This article presents outcomes of research that examined students' experience using a game-based student response system, Kahoot!, in an Information Systems Strategy and Governance course at a research-intensive teaching university in New Zealand. We conducted semi-structured interviews with students to learn about the extent to which Kahoot! influence classroom dynamics, motivation and students' learning process. Key findings revealed that Kahoot! enriched the quality of student learning in the classroom, with the highest influence reported on classroom dynamics, engagement, motivation and improved learning experience. Our findings also suggest that the use of educational games in the classroom is likely to minimise distractions, thereby improving the quality of teaching and learning beyond what is provided in conventional classrooms. Other factors that contributed to students' enhanced learning included the creation and integration of appropriate content in Kahoot!, providing students with timely feedback, and game-play (gamification) strategies.
About 87 000 neonates die annually in Ethiopia, with slower progress than for child deaths and 85% of births are at home. As part of a multi-country, standardized economic evaluation, we examine the incremental benefit and costs of providing management of possible serious bacterial infection (PSBI) for newborns at health posts in Ethiopia by Health Extension Workers (HEWs), linked to improved implementation of existing policy for community-based newborn care (Health Extension Programme). The government, with Save the Children/Saving Newborn Lives and John Snow, Inc., undertook a cluster randomized trial. Both trial arms involved improved implementation of the Health Extension Programme. The intervention arm received additional equipment, support and supervision for HEWs to identify and treat PSBI. In 2012, ∼95% of mothers in the study area received at least one pregnancy or postnatal visit in each arm, an average of 5.2 contacts per mother in the intervention arm (4.9 in control). Of all visits, 79% were conducted by volunteer community health workers. HEWs spent around 9% of their time on the programme. The financial cost per mother and newborn was $34 (in 2015 USD) in the intervention arm ($27 in control), economic costs of $37 and $30, respectively. Adding PSBI management at community level was estimated to reduce neonatal mortality after day 1 by 17%, translating to a cost per DALY averted of $223 or 47% of the GDP per capita, a highly cost-effective intervention by WHO thresholds. In a routine situation, the intervention programme cost would represent 0.3% of public health expenditure per capita and 0.5% with additional monthly supervision meetings. A platform wide approach to improved supervision including a dedicated transport budget may be more sustainable than a programme-specific approach. In this context, strengthening the existing HEW package is cost-effective and also avoids costly transfers to health centres/hospitals.
BackgroundCountdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies to explore factors contributing to progress (or lack of progress) in reproductive, maternal, newborn and child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, and Tanzania. This paper aims to identify cross-cutting themes on how and why these countries achieved or did not achieve MDG progress.MethodsApplying a standard evaluation framework, analyses of impact, coverage and equity were undertaken, including a mixed methods analysis of how these were influenced by national context and coverage determinants (including health systems, policies and financing).ResultsThe majority (7/10) of case study countries met MDG-4 with over two-thirds reduction in child mortality, but none met MDG-5a for 75 % reduction in maternal mortality, although six countries achieved >75 % of this target. None achieved MDG-5b regarding reproductive health. Rates of reduction in neonatal mortality were half or less that for post-neonatal child mortality. Coverage increased most for interventions administered at lower levels of the health system (e.g., immunisation, insecticide treated nets), and these experienced substantial political and financial support. These interventions were associated with ~30–40 % of child lives saved in 2012 compared to 2000, in Ethiopia, Malawi, Peru and Tanzania. Intrapartum care for mothers and newborns -- which require higher-level health workers, more infrastructure, and increased community engagement -- showed variable increases in coverage, and persistent equity gaps. Countries have explored different approaches to address these problems, including shifting interventions to the community setting and tasks to lower-level health workers.ConclusionsThese Countdown case studies underline the importance of consistent national investment and global attention for achieving improvements in RMNCH. Interventions with major global investments achieved higher levels of coverage, reduced equity gaps and improvements in associated health outcomes. Given many competing priorities for the Sustainable Development Goals era, it is essential to maintain attention to the unfinished RMNCH agenda, particularly health systems improvements for maternal and neonatal outcomes where progress has been slower, and to invest in data collection for monitoring progress and for rigorous analyses of how progress is achieved in different contexts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3401-6) contains supplementary material, which is available to authorized users.
Individuals that combine features of both genders–gender blends–are sometimes appealing and sometimes not. Heretofore, this difference was explained entirely in terms of sexual selection. In contrast, we propose that part of individuals’ preference for gender blends is due to the cognitive effort required to classify them, and that such effort depends on the context in which a blend is judged. In two studies, participants judged the attractiveness of male-female morphs. Participants did so after classifying each face in terms of its gender, which was selectively more effortful for gender blends, or classifying faces on a gender-irrelevant dimension, which was equally effortful for gender blends. In both studies, gender blends were disliked when, and only when, the faces were first classified by gender, despite an overall preference for feminine features in all conditions. Critically, the preferences were mediated by the effort of stimulus classification. The results suggest that the variation in attractiveness of gender-ambiguous faces may derive from context-dependent requirements to determine gender membership. More generally, the results show that the difficulty of resolving social category membership–not just attitudes toward a social category–feed into perceivers’ overall evaluations toward category members.
Objective: The primary aim of this overview was to synthesise results from studies including digital education and its effect on knowledge or learning outcomes, student satisfaction, student enrolment, attendance rate, course completion rate, clinical practice, health outcomes for patients and cost-effectiveness in health-care education. A secondary aim was to report on successful instructional design strategies, and barriers or contextual factors influencing the effectiveness of online learning course delivery in healthcare education. Method: We conducted an overview of systematic reviews (SRs) for digital education interventions delivered to health-care students and practitioners. Results: We scanned 848 titles, reviewed 247 abstracts and assessed 49 full-text articles against pre-determined inclusion and exclusion criteria. This overview includes data collected from 31,730 participants across 16 SRs. The quality of evidence included in the SRs ranged from very low ( n = 2), low ( n = 6) to moderate ( n = 8). The best available SRs were of moderate quality (7.4 of 11 AMSTAR). SR authors did not report other teaching methods as being superior to digital learning. In most cases ( n = 9), digital education when used in addition to traditional methods augmented knowledge acquisition. Other SRs ( n = 7) did not show statistically significant differences across interventions including digital education as a replacement, or additive resource to traditional intervention. Conclusion: Student enrolment, attendance rates, course completion rates, cost-effectiveness and changes in clinical outcomes for patients are underreported in the existing evidence. Although the quality and quantity of data are limited, evidence-based instructional design for digital education is becoming more possible, especially as educators establish learning activities that track to learning objectives for knowledge acquisition in health care.
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