This review examines how natural history museums (NHMs) can enhance learning and engagement in science, particularly for school-age students. First, we describe the learning potential of informal science learning institutions in general, then we focus on NHMs. We review the possible benefits of interactions between schools and NHMs, and the potential for NHMs to teach about challenging issues such as evolution and climate change and to use digital technologies to augment more traditional artefacts. We conclude that NHMs can provide students with new knowledge and perspectives, with impacts that can last for years. Through visits and their on-line presence, NHMs can help students see science in ways that the school classroom rarely can, with opportunities to meet scientists, explore whole topic exhibitions, engage with interactive displays and employ digital technologies both in situ and to support learning in the school science classroom. Although these interactions have the potential to foster positive cognitive, affective and social outcomes for students, there is a lack of reliable measures of the impact of NHM experiences for students. Opportunities to foster relationships between NHM staff and teachers through professional development can help articulate shared goals to support students’ learning and engagement.
Background: Previous studies have yielded conflicting results and substantial uncertainty about any independent association of Helicobacter pylori infection with dyspepsia, and about any benefits of antibiotic treatments for nonulcer or uninvestigated dyspepsia.
dergone hysterectomy showed evidence of better health than non-users on some dimensions. In the whole sample, however, there were no appreciable differences in social class and self reported health indicators between users and controls.
Objective -Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993 -4 Traditional audit is limited in achieving and showing overall service improvement in primary care.' 2 This is largely because audit tends to be topic based, retrospective, and usually involves few members of the primary healthcare teams.2 3 Total quality management seems to offer a more comprehensive approach to improvement, emphasising the need to set an overall strategy, concentrating on satisfying the needs of the customer or patient, developing improvement projects based on need, involving all members of the team, with the use of tools (only one of which is audit) to achieve improvement. In 1990 each of the 95 family health service authorities in England and Wales were required to establish a Medical Audit Advisory Group to support and monitor audit in the practices for which they were responsible.4 The groups usually appointed full or part time facilitators to work on audit with general practice teams. In 1993 the four Medical Audit Advisory Groups of the old Oxford Region together agreed to introduce and support a quality improvement programme for a group of practices, adapting total quality management methodology as appropriate for general practice. The programme was funded by the Department of Health, which required emphasis to be placed both on audit and Health of the nation topics.'The programme was based heavily on the approach to quality improvement developed by Deming,6 7 and adapted for health care by the Institute of Health Care Improvement in Boston, Massachusetts.8 The three key elements to quality improvement emphasised are: for the practice leaders to set the strategy taking into account needs of both patients and the practice; for the practice to establish a culture for quality improvement with emphasis on communication and team working; and then for small multidisciplinary teams to use specific tools to carry out quality improvement projects.We recommended that each participating practice establish a team of key people from each discipline (the quality executive) to manage the quality improvement programme. In consultation with the partners and practice members they were to agree strategy, select the projects, and arrange resources. For each project they set up and briefed a quality improvement team with at least one repesentative of each involved discipline, and supported and monitored the teams (fig 1).The approach recommended for the project was Juran's solution (the Juran journey, fig 2),89 by which each small multidisciplinary quality improvement team defined its problem, examined this problem in more detail and considered possible solutions to identify the best, introduced that solution , and evaluated the change. The aim was to enable practices to develop a focus on quality, committed 151 on 12 May 2018 by guest. Protected by copyright.
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