| 1. |
- Lederman, Judith, et al.
(author)
-
An international collaborative investigation of beginning seventh grade students' understandings of scientific inquiry : Establishing a baseline
- 2019
-
In: Journal of Research in Science Teaching. - : Wiley. - 0022-4308 .- 1098-2736. ; 56:4, s. 486-515
-
Journal article (peer-reviewed)abstract
- Although understandings of scientific inquiry (as opposed to conducting inquiry) are included in science education reform documents around the world, little is known about what students have learned about inquiry during their elementary school years. This is partially due to the lack of any assessment instrument to measure understandings about scientific inquiry. However, a valid and reliable assessment has recently been developed and published, Views About Scientific Inquiry (VASI; Lederman et al. [2014], Journal of Research in Science Teaching, 51, 65-83). The purpose of this large-scale international project was to collect the first baseline data on what beginning middle school students have learned about scientific inquiry during their elementary school years. Eighteen countries/regions spanning six continents including 2,634 students participated in the study. The participating countries/regions were: Australia, Brazil, Chile, Egypt, England, Finland, France, Germany, Israel, Mainland China, New Zealand, Nigeria, South Africa, Spain, Sweden, Taiwan, Turkey, and the United States. In many countries, science is not formally taught until middle school, which is the rationale for choosing seventh grade students for this investigation. This baseline data will simultaneously provide information on what, if anything, students learn about inquiry in elementary school, as well as their beginning knowledge as they enter secondary school. It is important to note that collecting data from all of the approximately 200 countries globally was not humanly possible, and it was also not possible to collect data from every region of each country. The results overwhelmingly show that students around the world at the beginning of grade seven have very little understandings about scientific inquiry. Some countries do show reasonable understandings in certain aspects but the overall picture of understandings of scientific inquiry is not what is hoped for after completing 6 years of elementary education in any country.
|
|
| 2. |
- Lederman, J. S., et al.
(author)
-
International collaborative follow-up investigation of graduating high school students' understandings of the nature of scientific inquiry : is progress Being made?
- 2021
-
In: International Journal of Science Education. - : Informa UK Limited. - 0950-0693 .- 1464-5289. ; 43:7, s. 991-1016
-
Journal article (peer-reviewed)abstract
- Understandings of the nature of scientific inquiry (NOSI), as opposed to engaging students in inquiry learning experiences, are included in science education reform documents around the world. However, little is known about what students have learned about NOSI during their pre-college school years. The purpose of this large-scale follow-up international project (i.e. 32 countries and regions, spanning six continents and including 3917 students for the high school sample) was to collect data on what exiting high school students have learned about NOSI. Additionally, the study investigated changes in 12th grade students' NOSI understandings compared to seventh grade (i.e. 20 countries and regions) students' understandings from a prior investigation [Lederman et al. (2019). An international collaborative investigation of beginning seventh grade students' understandings of scientific inquiry: Establishing a baseline. Journal of Research in Science Teaching, 56(4), 486-515. ]. This study documents and discusses graduating high school students' understandings and compares their understandings to seventh grade students' understandings of the same aspects of scientific inquiry for each country. It is important to note that collecting data from each of the 130+ countries globally was not feasible. Similarly, it was not possible to collect data from every region of each country. A concerted effort was made, however, to provide a relatively representative picture of each country and the world.
|
|
| 3. |
- von Gyllenpalm, Jakob, 1979-, et al.
(author)
-
Views About Scientific Inquiry : A Study of Students’ Understanding of Scientific Inquiry in Grade 7 and 12 in Sweden
- 2022
-
In: Scandinavian Journal of Educational Research. - : Informa UK Limited. - 0031-3831 .- 1470-1170. ; 66:2, s. 336-354
-
Journal article (peer-reviewed)abstract
- This paper analyses data from the Swedish sample of the international VASI (Views about scientific inquiry) study (Lederman et al. [2019]. An international collaborative investigation of beginning seventh grade students’ understandings of scientific inquiry: Establishing a baseline. Journal of Research in Science Teaching. Published online. https://doi.org/10.1002/tea.21512). Understandings about scientific inquiry involve knowledge about the processes of inquiry, and are not the same as being able to do inquiry although these are related domains. This paper focuses on what students know about scientific inquiry and what impact school science may have on this knowledge. Data were collected using the VASI instrument developed previously and was administered to 126 students at the beginning of year seven and 145 students at the end of year 12 in a cross-sectional design. Results indicate that the majority of students do not have an informed understanding of key aspects of scientific inquiry in either grade. Although students in year 12 are more informed, the average is still less than 50% as measured by the VASI and with a large spread.
|
|
| 4. |
- Lederman, Jakob, et al.
(author)
-
A phenomenological interview study with patients being non-conveyed in the ambulance service
- 2023
-
In: BMC Emergency Medicine. - : BioMed Central (BMC). - 1471-227X. ; 23:1
-
Journal article (peer-reviewed)abstract
- BackgroundNon-conveyed patients (i.e. patients who are not transported to a hospital after being assessed by ambulance clinicians) represent a significantly increasing proportion of all patients seeking ambulance care. Scientific knowledge about patients' non-conveyance experiences is sparse. This study describes the lived experiences of non-conveyed patients in an ambulance care context.MethodsA reflective lifeworld research (RLR) approach founded on phenomenology is used. Data is derived from nine in-depth interviews with patients not conveyed by the ambulance service in a major Swedish region.ResultsPatients' lived experiences of becoming acutely ill or injured and not conveyed by ambulance to a hospital are characterised by several dynamic movements: losing and regaining situational and bodily control, dependence and autonomy, external competence and inner knowledge, handing over and regaining responsibility, and fear and security.ConclusionsPatients' lived experiences of non-conveyance are complex and versatile. Although non-conveyed patients initially experience strong fear and the loss of situational and bodily control, they gradually feel more secure when experiencing confirmation and trust, which evolves into insecurity and uncertainty. The non-conveyance situation's complexity from a patient's perspective implies the need for ambulance organisations to take measures to prevent further suffering. Non-conveyed patients must be taken seriously in their unique situations, requiring ambulance clinicians to reflect and act with a conscious ethical perspective before, during and after their visit.
|
|
| 5. |
|
|
| 6. |
- Lederman, Jakob, et al.
(author)
-
Assessing non-conveyed patients in the ambulance service : a phenomenological interview study with Swedish ambulance clinicians
- 2019
-
In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:9, s. 1-8
-
Journal article (peer-reviewed)abstract
- Objectives To combat overcrowding in emergency departments, ambulance clinicians (ACs) are being encouraged to make on-site assessments regarding patients' need for conveyance to hospital, and this is creating new and challenging demands for ACs. This study aimed to describe ACs' experiences of assessing non-conveyed patients. Design A phenomenological interview study based on a reflective lifeworld research approach. Setting The target area for the study was Stockholm, Sweden, which has a population of approximately 2.3 million inhabitants. In this area, 73 ambulances perform approximately just over 200000 ambulance assignments annually, and approximately 25000 patients are non-conveyed each year. Informants 11 ACs. Methods In-depth open-ended interviews. Results ACs experience uncertainty regarding the accuracy of their assessments of non-conveyed patients. In particular, they fear conducting erroneous assessments that could harm patients. Avoiding hasty decisions is important for conducting safe patient assessments. Several challenging paradoxes were identified that complicate the non-conveyance situation, namely; responsibility, education and feedback paradoxes. The core of the responsibility paradox is that the increased responsibility associated with non-conveyance assessments is not accompanied with appropriate organisational support. Thus, frustration is experienced. The education paradox involves limited and inadequate non-conveyance education. This, in combination with limited support from non-conveyance guidelines, causes the clinical reality to be perceived as challenging and problematic. Finally, the feedback paradox relates to the obstruction of professional development as a result of an absence of learning possibilities after assessments. Additionally, ACs also described loneliness during non-conveyance situations. Conclusions This study suggests that, for ACs, performing non-conveyance assessments means experiencing a paradoxical professional existence. Despite these aggravating paradoxes, however, complex non-conveyance assessments continue to be performed and accompanied with limited organisational support. To create more favourable circumstances and, hopefully, safer assessments, further studies that focus on these paradoxes and non-conveyance are needed.
|
|
| 7. |
- Lederman, Jakob, et al.
(author)
-
Non-conveyance in the ambulance service : a population-based cohort study in Stockholm, Sweden
- 2020
-
In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:7
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: Non-conveyed patients represent a significant proportion of all patients cared for by ambulance services in the western world. However, scientific knowledge on non-conveyance is sparse. Therefore, the aim of this study was to describe the prevalence of non-conveyance, investigate associations and compare patients' characteristics, drug administration, initial problems and vital signs between non-conveyed and conveyed patients.DESIGN: A population-based retrospective cohort study.SETTING: The study setting area, Stockholm, Sweden, has a population of 2.3 million inhabitants, with seven emergency hospitals. Annually, approximately 210 000 assignments are performed by 73 ambulances. All ambulance assignments performed from 1 January to 31 December 2015 were included.RESULTS: In total, 23 603 ambulance assignments ended in non-conveyance-13.8% of all ambulance assignments performed in 2015. Compared with conveyed patients, non-conveyed patients were younger and more often female (median age 50.1 years for non-conveyed vs 61.7 years for conveyed; female=52 %, both p values <0.001). Approximately half of all ambulance assignments ending in non-conveyance were initially prioritised and dispatched as the highest priority. Non-conveyed patients were more often assessed by ambulance clinicians as presenting non-specific symptoms or symptoms related to psychiatric problems. Low blood glucose levels were highly associated with non-conveyance (adjusted OR (AOR): 15; 95 % CI 11.18 to 20.13), although non-conveyed patients presented abnormal vital signs across all categories of vital signs. Moreover, drugs were more often administered to younger non-conveyed patients. Older patients were more often conveyed and administered drugs once conveyed (AOR: 1.29; 95 % CI 1.07 to 1.56).CONCLUSIONS: This study shows that non-conveyed patients represent a non-negligible proportion of all patients in contact with ambulance services. In general, most cases of non-conveyance occur at the highest dispatch level, to a large extent involve younger patients, and features problems assessed by ambulance clinicians as non-specific or related to psychiatric symptoms.
|
|
| 8. |
- Lederman, Jakob, et al.
(author)
-
Non-conveyance of older adult patients and association with subsequent clinical and adverse events after initial assessment by ambulance clinicians : a cohort analysis
- 2021
-
In: BMC Emergency Medicine. - : BioMed Central. - 1471-227X. ; 21:1
-
Journal article (peer-reviewed)abstract
- BackgroundOlder adults (age >= 65 years) represent a significant proportion of all patients who are not transported to hospital after assessment by ambulance clinicians (non-conveyed patients). This study aimed to fill the knowledge gap in the understanding of the prevalence of older adult non-conveyed patients and investigate their characteristics and risk factors for subsequent and adverse events with those of younger non-conveyed patients comparatively.MethodsThis population-based retrospective cohort study included all adult non-conveyed patients who availed the ambulance service of Region Stockholm, Sweden in 2015; they were age-stratified into two groups: 18-64 and >= 65 years. Inter-group differences in short-term outcomes (i.e. emergency department visits, hospitalisations, and mortality within 7 days following non-conveyance) were assessed using multivariate regression analyses.ResultsOlder adult patients comprised 48% of the 17,809 non-conveyed patients. Dispatch priority levels were generally lower among older non-conveyed patients than among younger patients. Non-conveyance among older patients occurred more often during daytime, and they were more frequently assessed by ambulance clinicians with nonspecific presenting symptoms. Approximately one in five older adults was hospitalised within 7 days following non-conveyance. Patients presenting with infectious symptoms had the highest mortality risk following non-conveyance. Oxygen saturation level < 95% or systolic blood pressure > 160 mmHg had significantly higher associations with hospitalisation within 7 days following non-conveyance in older adult patients.ConclusionsOlder adult patients have an increased risk for adverse events following non-conveyance. In combination with a complex and variating presentation of symptoms and vital signs proved difficult for dispatch operators and ambulance clinicians to identify and assess, the identified risks raise questions on the patient safety of older adult non-conveyed patients. The results indicate a system failure that need to be managed within the ambulance service organisation to achieve higher levels of patient safety for older non-conveyed patients.
|
|
| 9. |
- Lederman, Jakob
(author)
-
Non-conveyed patients : a thesis on epidemiology, and patients' and ambulance clinicians' experiences
- 2020
-
Doctoral thesis (other academic/artistic)abstract
- BACKGROUND: As a consequence of the increased overall number of ambulance assignments in combination with an increase in patients assessed as having non-urgent complaints, new demands are being placed on the ambulance service and the ambulance clinicians (ACs) regarding patient assessments and decisions. Alternative care pathways – excluding emergency departments (EDs) – such as non-conveyance, have increased over the last decade. However, knowledge regarding non-conveyance is limited. Increased knowledge from an epidemiological and qualitative research perspective is needed to enhance patient safety. AIM: The overall aim was to explore situations in which patients were non-conveyed. Furthermore, it was intended to describe ACs and patients’ lived experiences of non-conveyance. METHODS: Four sub-studies were performed. Study I was an observational population-based study with the aim of describing the prevalence of non-conveyance, investigating associations and comparing patients’ characteristics, drug administration, initial problems, and vital signs between non-conveyed and conveyed patients. Patient data were retrieved from ambulance medical records (CAK-net, Region Stockholm). Study II was a retrospective cohort study with the aim of increasing the understanding of elderly non-conveyed patients. The primary objective of this study was to present the prevalence of older adult non-conveyed patients and their characteristics – in comparison with younger non-conveyed patients – and identify and describe the risk factors associated with ED visits, hospitalisations, and mortality up to 7 days following non-conveyance. The secondary objective was to investigate the probable associations between abnormal vital signs and ED visits, hospitalisations, and mortality up to 7 days after non-conveyance among older adult non-conveyed patients. Patient data were retrieved from the ambulance medical records, and follow-up data were retrieved from The Regional Health Care Data Warehouse (VAL). Study III was an interview study of ACs conducted using a reflective lifeworld research (RLR) approach based on phenomenology. The aim was to describe ACs experiences of assessing non-conveyed patients. Study IV was also an interview study conducted using an RLR approach. The aim was to describe experiences of becoming acutely ill and not accompanying the ambulance to a hospital from a non-conveyed patient perspective. RESULTS: The results show that non-conveyance situations represent a non-negligible proportion of all ambulance assignments performed annually. Non-conveyance constitutes a complex caring encounter involving a great diversity of patients with variating characteristics and complaints. Ambulance assignments ending in non-conveyance were often dispatched as the highest priority – involving overall younger individuals – and patients’ medical complaints were often assessed as non-specific or related to psychiatric problems (Study I). Older non-conveyed adults represent a risk group for adverse events that need to be met with adequate measures to ensure patient safety. The observed increased risk of hospitalisation and mortality among older adult patients compared to younger adult non-conveyed patients raises questions pertinent to patient safety (Study II). Furthermore, insufficient organisational support, a lack of non-conveyance education, and an absence of clinical performance feedback complicate ACs ability to perform accurate and person-centred non-conveyance assessments (Study III). Patients’ experiences of non-conveyance showed it to be a complex and versatile phenomenon in which patients need to be met with an ethical mindset in the creation of a caring encounter. Patients that are non-conveyed experience an existential fear and loss of bodily control that need to be met with confirmation, listening, and the establishment of a partnership (Study IV). CONCLUSIONS: Several conclusions with clinical implications stem from this thesis, including increased awareness and knowledge regarding the large group of patients with varying characteristics, complaints, and symptoms that are non-conveyed annually. Older adults that are non-conveyed were identified as a risk group for adverse events that need to be met with adequate measures to ensure patient safety. Performing non-conveyance assessments is complicated by several paradoxes that need to be met with sufficient organisational support, educational efforts, and the introduction of clinical performance feedback in order to perform person-centred care, ensure patient safety, and enhance professional development among ACs. Non-conveyance encounters are complex care meetings in which several existential aspects deemed important for non-conveyed patients need to be met in order to establish caring encounters based on person-centred care.
|
|
| 10. |
|
|
