No abstract
Non-invasive ventilation (NIV) is known to improve quality of life and to prolong survival in amyotrophic lateral sclerosis (ALS) patients. However, little is known about the circumstances of dying in ventilated ALS patients. In the light of the debate on legalizing euthanasia it is important to provide empirical data about the process of dying in these patients. In a structured interview, 29 family caregivers of deceased ALS patients were asked about their own and the patient's attitude toward physician-assisted suicide (PAS) and euthanasia, circumstances of dying, and the use of palliative medication. Quantitative and qualitative content analysis was performed on the data. Non-recurring suicidal thoughts were reported by five patients. Three patients and seven relatives had thought about PAS. Seventeen caregivers described the patients' death as "peaceful", while choking was reported in six bulbar patients. In final stages of dying, the general practitioner (GP) was involved in the treatment of 10 patients, with palliative medication including sedatives and opiates being administered in eight cases. In conclusion, in contrast to the Netherlands, where 20% of terminal ALS patients die from PAS or euthanasia, only a small minority of our patients seems to have thought about PAS. The legal situation in Germany (where euthanasia is illegal), a bias due to the selection of NIV patients as well as a high percentage of religious patients and those with good levels of social support from family and friends, might account for this. Most of our patients died peacefully at home from carbon dioxide narcosis, but choking was described in some bulbar patients. Thus, palliative care, especially the use of opiates, anxiolytics and sedatives should be optimized, and the involvement of GP should be strongly encouraged, especially in bulbar patients.
Problem-based learning (PBL) is an internationally recognised pedagogical approach that is implemented within a number of disciplines. The relevance and uptake of PBL in psychology has to date, however, received very limited attention. The aim of this paper is therefore to review published accounts on how PBL is being used to deliver psychology curricula in higher education and to highlight psychological research that offers practical strategies for PBL theory and practice. The paper is divided into three sections. In the first, we discuss the principles of PBL and provide examples of how it can be used within psychology curricula alongside a consideration of its advantages and disadvantages. In the second section, we outline the results of a systematic literature review of published examples of PBL used within psychology undergraduate and postgraduate courses. Finally, in the third section, we examine some of the ways in which psychological research can provide practical guidance for PBL teaching practice. We conclude this paper with some recommendations for future research across all these areas, and call for the further development of PBL curricula in psychology higher education course provision. IntroductionProblem-based learning (PBL) is more than a pedagogical method (sometimes referred to as a didactic approach). It is an orientation to teaching and learning falling under the broad umbrella of student-centred, enquiry-based or active learning approaches (Barrett, 2005;Hmelo-Silver, 2004). PBL was pioneered in the 1960s in the Medical School at McMaster University, Canada (Barrows & Tamblyn, 1980) and has since then been developed at Aalborg University (Denmark), Maastricht University (Netherlands) and Newcastle University (Australia), as well as being implemented in a number of disciplines and universities worldwide. The fundamental principle of PBL is to equip students with an investigative approach and to develop a greater sense of responsibility for their learning. As the main processes of PBL are rooted in problem-solving, self-directed learning and group interaction, this places psychology very much at the centre of how PBL works and how it may be understood as a teaching and learning approach. Despite this, there is relatively little reporting of how PBL is used in psychology and how psychology informs PBL in published work (see for example, Dunsmuir & Frederickson, 2014;Kiernan, Murrell & Relf, 2008;Norman & Schmidt, 1992). In view of this, a main objective of this paper is to provide a systematic review of published accounts of the ways in which PBL is being used to deliver psychology curricula in higher education, with a second main objective to illustrate the ways in which psychological research can provide a range of principles and strategies that inform PBL practice. In so doing, our overall aim is to summarise the current developments in each of these areas and to stimulate a more robust engagement with PBL in psychology teaching and learning, and in psychological research. We will be...
2Undergraduates' Personal Circumstances, Expectations and Reasons for Attending University Undergraduate students are likely to have a range of reasons for attending university and expectations about their education. The current study aimed to determine the most prevalent reasons and expectations among students, and how these differed based on their personal circumstances. First-year undergraduate psychology students completed a questionnaire on reasons for attending university and expectations of university regarding assessment, teaching, learning and organisational resources. Improving career prospects was found to be the most important reason for attending university. The most important aspect of assessment was receiving feedback clarifying things they did not understand.Being good at explaining things was the most important teaching quality.Reasons and expectations were also found to differ depending on students' gender, age group, caring responsibilities, application route, fee status and whether English is their first language. Implications for educators are discussed in terms of bringing student experiences more in-line with their expectations.
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