Unpacking the Homeostasis Core Concept in Physiology: An Australian Perspective

Australia-wide consensus was reached on seven core concepts of physiology, which included Homeostasis, a fundamental concept for students to understand as they develop their basic knowledge of physiological regulatory mechanisms. The term homeostasis is most commonly used to describe how the internal environment of mammalian systems maintains relative constancy. The descriptor 'the internal environment of the organism is actively regulated by the responses of cells, tissues, and organs through feedback systems', was unpacked by a team of three Australian Physiology educators into five themes and 18 sub-themes arranged in a hierarchy. Using a 5-point Likert scale, the unpacked concept was rated by 24 physiology educators from 24 Australian Universities for level of importance and level of difficulty for students. Survey data was analyzed using a one-way ANOVA to compare between and within concept themes and sub-themes. There were no differences in main themes for level of importance, with all ratings between essential or important. The first theme, 'The organism has regulatory mechanisms to maintain a relatively stable internal environment, a process known as homeostasis' was almost unanimously rated as essential. Difficulty ratings for unpacked concept themes averaged between slightly difficult and moderately difficult. The Australian team concurred with published literature that there are inconsistencies in the way the critical components of homeostatic systems are represented and interpreted. We aimed to simplify the components of the concept so that undergraduates would be able to easily identify the language used and build on their knowledge.

Should the concepts chosen to guide concept-based curricula be threshold concepts?

In this paper we propose that the concepts guiding concept-based curricula should be threshold knowledge concepts. We briefly discuss some of the hurdles of current concept-based curricular designs and describe how the concepts themselves, paradoxically, might perpetuate the continued emphasis on content in nursing courses. Until now, threshold concept theory has not been part of the mainstream conversation about concept-based curricula. Threshold concepts act as portals to professional identity development and are recognized by their troublesome and transformative potential to enhance knowledge acquisition and change worldviews. This feature differentiates them from the core concepts often described within concept-based curriculum literature. The identification of threshold concepts in existing nursing courses might help structure curricular revision with the goal of enhancing transfer of learning and decreasing faculty resistance to the concept-based curricular approach.

Defining core conceptual knowledge: Why pharmacy education needs a new, evidence-based approach

INTRODUCTION

No pharmacy program, however well-resourced, has sufficient time or resources to teach students all current, practice-relevant knowledge. And while the volume of potential pharmacy education curriculum content increases exponentially each year, available time for direct instruction continues to decline. Given these constraints, pharmacy curricula must focus on promoting deep learning of the most critical, fundamental, broadly applicable, and lasting knowledge. Yet, in terms of didactic knowledge, pharmacy education currently has no agreed upon, evidence-based criteria for determining which foundational concepts are most important to teach nor any research-based assessment tools to demonstrate how well students have learned those core concepts.

PERSPECTIVE

This lack of consensus regarding core conceptual knowledge makes disparities in learning outcomes both more likely to occur and less likely to be detected or addressed. Over the past 30 years, several scientific disciplines undergirding pharmacy have developed research-based lists of core concepts and related concept inventories, demonstrating their transformative educational potential. Core concepts are big, fundamental ideas that experts agree are critical for all students in their discipline to learn, remember, understand, and apply. Concept inventories are research-based, psychometrically validated, multiple-choice tests designed to uncover learners' prior knowledge and potential misconceptions and determine their depth of understanding of disciplinary core concepts.

IMPLICATIONS

This commentary proposes adapting and applying this evidence-based core concepts approach to enhance pharmacy education's overall effectiveness and efficiency and outlines an ongoing, multinational research initiative to identify and define essential pharmacy concepts to be taught, learned, and assessed.

Mathematization of nature: how it is done

Natural phenomena can be quantitatively described by means of mathematics, which is actually the only way of doing so. Physics is a convincing example of the mathematization of nature. This paper gives an answer to the question of how mathematization of nature is done and illustrates the answer. Here nature is to be taken in a wide sense, being a substantial object of study in, among others, large domains of biology, such as epidemiology and neurobiology, chemistry, and physics, the most outspoken example. It is argued that mathematization of natural phenomena needs appropriate core concepts that are intimately connected with the phenomena one wants to describe and explain mathematically. Second, there is a scale on and not beyond which a specific description holds. Different scales allow for different conceptual and mathematical descriptions. This is the scaling hypothesis, which has meanwhile been confirmed on many occasions. Furthermore, a mathematical description can, as in physics, but need not be universally valid, as in biology. Finally, the history of science shows that only an intensive gauging of theory, i.e., mathematical description, by experiment leads to progress. That is, appropriate core concepts and appropriate scales are a necessary condition for mathematizing nature, and so is its verification by experiment.

Implementation of the norwegian 'Starting right' child health service innovation: implementation adjustments, adoption, and acceptability

BACKGROUND

An increased and/or stable proportion of the child and adolescent population reports symptoms of impaired health, and the symptoms can be identified early. Therefore, structured child- and parent-reported outcome measures need to be implemented in child and school health services for decision support and identification of children at risk. We aimed to (a) qualitatively examine adjustments of active implementation from the pilot implementation of the Norwegian 'Starting Right' health service innovation including an online child health assessment tool and practical routines, and (b) measure practitioners´ adoption and parental acceptability.

METHODS

We used a mixed-methods design to qualitatively examine adjustments from working notes and meeting memoranda, and quantitatively assess adoption and acceptability from user rates provided by the systems log. Twenty-one child and school health nurses (CSHNs) from two child health centers participated in the implementation pilot of online health assessments in children aged 2-, 4- and 6-year. We used a deductive and narrative analysis approach using Fixsen et al.´s core implementation components to code and sort adjustments.

RESULTS

Core implementation components were adjusted throughout the pilot implementation. Researchers´ increased their availability in reciprocity with staff evaluation to integrate active implementation adjustments. We launched a project for improved data systems integration. The overall CSHNs adoption rate was satisfactory and higher in center A, where a medical secretary supported the nurses through the entire pilot phase, than in center B (96 vs. 55 %). Parental acceptability rate was overall high (77 %) with increased rates among parents of 6-year-old children (98 %) compared with younger ones (78-85 %), and in cases where both parents received the questionnaires.

CONCLUSIONS

The 'Starting Right' health service innovation implementation was actively adjusted by integration of core implementation components mainly based on staff evaluation. The CSHNs adopted the innovation which was also acceptable to parents.

Developing a framework for successful research partnerships in global health

BACKGROUND

The Centre for Global Health, Trinity College Dublin has as one of its goals, strengthening health systems in developing countries. In realising this goal we work across more than 40 countries with third-level, civil society, government, private sector and UN partners. Each of these requires that different relationships be established. Good principles must guide all global health research partnerships. An exploratory research project was undertaken with research partners of, and staff within, the Centre for Global Health. The aim was to build an evidence-based framework.

METHODS

An inductive exploratory research process was undertaken using a grounded theory approach in three consecutive phases: Phase I: An open-ended questionnaire was sent via email to all identified partners. Phase II: A series of consultative meetings were held with the staff of the Centre for Global Health. Phase III: Data sets from Phases I and II were applied to the development of a unifying framework. Data was analysed using grounded theory three stage thematic analysis - open, axial and selective coding.

RESULTS

Relational and operational aspects of partnership were highlighted as being relevant across every partnership. Seven equally important core concepts emerged (focus, values, equity, benefit, leadership, communication and resolution), and are described and discussed here. Of these, two (leadership and resolution) are less often considered in existing literature on partnerships.

CONCLUSIONS

Large complex partnerships can work well if all parties are agreed in advance to a common minimum programme, have been involved from the design stage, and have adequate resources specifically allocated. Based on this research, a framework for partnerships has been developed and is shared.