Online classroom instruction is an exciting technology and continues to draw the attention of students, instructors and administrators working or studying in educational settings. Large numbers of faculty are currently involved in teaching online or hybrid courses within their educational institutions. At the present time, "very large" online classes are usually defined as 150 students and above. Many instructors are now experimenting with making online learning options available to even larger audiences and online class sizes are increasing rapidly. This paper presents guidelines for managing large online courses. Among key elements important in meeting the needs of the distant learner through large online course design are: effective communication, use of teaching assistants and multiple sections, teaching techniques successful in large online sections and professional practice in the online classroom. This paper will discuss these elements and corresponding suggestions for the instructors of large to very large online courses.
Background:The acute respiratory distress syndrome (ARDS) network low tidal-volume study comparing tidal volumes of 12 ml/kg versus 6 ml/kg was published in 2000. The study was stopped early as data revealed a 22% relative reduction in mortality rate when using 6 ml/ kg tidal volume. The current generation of critical care ventilators allows the tidal volume to be set during volume-targeted, assist/control (volume A/C); however, some ventilators include options that may prevent the tidal volume from being controlled. The purpose of this bench study was to evaluate the delivered tidal volume, when these options are active, in a spontaneously breathing lung model using an electronic breathing simulator. Methods: Four ventilators were evaluated: CareFusion AVEA (AVEA), Dräger Evita ® XL (Evita XL), Covidien Puritan Bennett ® 840 TM (PB 840), and Maquet SERVO-i (SERVO-i). Each ventilator was connected to the Hans Rudolph Electronic Breathing Simulator at an amplitude of 0 cm H 2 O and then 10 cm H 2 O. All four ventilators were set to deliver volume A/C, tidal volume 400 ml, respiratory rate 20 bpm, positive end-expiratory pressure 5 cm H 2 O, peak flowrate 60 L/ min. The displayed tidal volume was recorded for each ventilator at the above settings with additional options OFF and then ON. Results: The AVEA has two options in volume A/C: demand breaths and V-sync. When activated, these options allow the patient to exceed the set tidal volume. When using the Evita XL, the option AutoFlow can be turned ON or OFF, and when this option is ON, the tidal volume may vary. The PB 840 does not have any additional options that affect volume delivery, and it maintains the set tidal volume regardless of patient effort. The SERVO-i's demand valve allows additional flow if the patient's inspiratory flowrate exceeds the set flowrate, increasing the delivered tidal volume; this option can be turned OFF with the latest software upgrade. Conclusions: Modern ventilators have an increasing number of optional settings. These settings may increase the delivered tidal volume and disrupt a low tidal-volume strategy. Recognizing how each setting within a mode affects the type of breath delivered is critical when caring for ventilator-dependent patients.
The quantitative study presented here evaluates the effects of formative and summative assessment on student's connectedness, satisfaction, learning and academic performance within a university three-credit 400 level online healthcare course.Literature exploring the role that formative assessment plays within an online environment is currently lacking. Additionally, understanding how assessment practices can help support the goals of online healthcare education is vitally important given the rise in popularity of this delivery format.This study investigated student outcomes in the form of connectedness, satisfaction, learning and academic performance. Four cohorts of students were included in this study. Two cohorts were provided with formative assessment procedures while the other two cohorts were provided with primarily summative assessment. A survey-based tool was created and delivered to students' post-course completion which gathered information on a students' sense of connectedness, satisfaction, and learning, whereas academic performance equated to final course grade earned.A one-way ANOVA was performed utilizing SPSS to identify statistical differences between formative and summative assessment cohorts. Analysis results indicated that the formative cohorts were higher in all areas explored and statistically significantly higher in the areas of learning and academic performance. Additional discussion regarding the results as well as future research recommendations are provided at the conclusion of this quantitative study within chapter five.
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