sample abstract for educational research

Writing an Abstract for Your Research Paper

Definition and Purpose of Abstracts

An abstract is a short summary of your (published or unpublished) research paper, usually about a paragraph (c. 6-7 sentences, 150-250 words) long. A well-written abstract serves multiple purposes:

• an abstract lets readers get the gist or essence of your paper or article quickly, in order to decide whether to read the full paper;
• an abstract prepares readers to follow the detailed information, analyses, and arguments in your full paper;
• and, later, an abstract helps readers remember key points from your paper.

It’s also worth remembering that search engines and bibliographic databases use abstracts, as well as the title, to identify key terms for indexing your published paper. So what you include in your abstract and in your title are crucial for helping other researchers find your paper or article.

If you are writing an abstract for a course paper, your professor may give you specific guidelines for what to include and how to organize your abstract. Similarly, academic journals often have specific requirements for abstracts. So in addition to following the advice on this page, you should be sure to look for and follow any guidelines from the course or journal you’re writing for.

The Contents of an Abstract

Abstracts contain most of the following kinds of information in brief form. The body of your paper will, of course, develop and explain these ideas much more fully. As you will see in the samples below, the proportion of your abstract that you devote to each kind of information—and the sequence of that information—will vary, depending on the nature and genre of the paper that you are summarizing in your abstract. And in some cases, some of this information is implied, rather than stated explicitly. The Publication Manual of the American Psychological Association , which is widely used in the social sciences, gives specific guidelines for what to include in the abstract for different kinds of papers—for empirical studies, literature reviews or meta-analyses, theoretical papers, methodological papers, and case studies.

Here are the typical kinds of information found in most abstracts:

• the context or background information for your research; the general topic under study; the specific topic of your research
• the central questions or statement of the problem your research addresses
• what’s already known about this question, what previous research has done or shown
• the main reason(s) , the exigency, the rationale , the goals for your research—Why is it important to address these questions? Are you, for example, examining a new topic? Why is that topic worth examining? Are you filling a gap in previous research? Applying new methods to take a fresh look at existing ideas or data? Resolving a dispute within the literature in your field? . . .
• your research and/or analytical methods
• your main findings , results , or arguments
• the significance or implications of your findings or arguments.

Your abstract should be intelligible on its own, without a reader’s having to read your entire paper. And in an abstract, you usually do not cite references—most of your abstract will describe what you have studied in your research and what you have found and what you argue in your paper. In the body of your paper, you will cite the specific literature that informs your research.

When to Write Your Abstract

Although you might be tempted to write your abstract first because it will appear as the very first part of your paper, it’s a good idea to wait to write your abstract until after you’ve drafted your full paper, so that you know what you’re summarizing.

What follows are some sample abstracts in published papers or articles, all written by faculty at UW-Madison who come from a variety of disciplines. We have annotated these samples to help you see the work that these authors are doing within their abstracts.

Choosing Verb Tenses within Your Abstract

The social science sample (Sample 1) below uses the present tense to describe general facts and interpretations that have been and are currently true, including the prevailing explanation for the social phenomenon under study. That abstract also uses the present tense to describe the methods, the findings, the arguments, and the implications of the findings from their new research study. The authors use the past tense to describe previous research.

The humanities sample (Sample 2) below uses the past tense to describe completed events in the past (the texts created in the pulp fiction industry in the 1970s and 80s) and uses the present tense to describe what is happening in those texts, to explain the significance or meaning of those texts, and to describe the arguments presented in the article.

The science samples (Samples 3 and 4) below use the past tense to describe what previous research studies have done and the research the authors have conducted, the methods they have followed, and what they have found. In their rationale or justification for their research (what remains to be done), they use the present tense. They also use the present tense to introduce their study (in Sample 3, “Here we report . . .”) and to explain the significance of their study (In Sample 3, This reprogramming . . . “provides a scalable cell source for. . .”).

Sample Abstract 1

From the social sciences.

Reporting new findings about the reasons for increasing economic homogamy among spouses

Gonalons-Pons, Pilar, and Christine R. Schwartz. “Trends in Economic Homogamy: Changes in Assortative Mating or the Division of Labor in Marriage?” Demography , vol. 54, no. 3, 2017, pp. 985-1005.

Sample Abstract 2

From the humanities.

Analyzing underground pulp fiction publications in Tanzania, this article makes an argument about the cultural significance of those publications

Emily Callaci. “Street Textuality: Socialism, Masculinity, and Urban Belonging in Tanzania’s Pulp Fiction Publishing Industry, 1975-1985.” Comparative Studies in Society and History , vol. 59, no. 1, 2017, pp. 183-210.

Sample Abstract/Summary 3

From the sciences.

Reporting a new method for reprogramming adult mouse fibroblasts into induced cardiac progenitor cells

Lalit, Pratik A., Max R. Salick, Daryl O. Nelson, Jayne M. Squirrell, Christina M. Shafer, Neel G. Patel, Imaan Saeed, Eric G. Schmuck, Yogananda S. Markandeya, Rachel Wong, Martin R. Lea, Kevin W. Eliceiri, Timothy A. Hacker, Wendy C. Crone, Michael Kyba, Daniel J. Garry, Ron Stewart, James A. Thomson, Karen M. Downs, Gary E. Lyons, and Timothy J. Kamp. “Lineage Reprogramming of Fibroblasts into Proliferative Induced Cardiac Progenitor Cells by Defined Factors.” Cell Stem Cell , vol. 18, 2016, pp. 354-367.

Sample Abstract 4, a Structured Abstract

Reporting results about the effectiveness of antibiotic therapy in managing acute bacterial sinusitis, from a rigorously controlled study

Note: This journal requires authors to organize their abstract into four specific sections, with strict word limits. Because the headings for this structured abstract are self-explanatory, we have chosen not to add annotations to this sample abstract.

Wald, Ellen R., David Nash, and Jens Eickhoff. “Effectiveness of Amoxicillin/Clavulanate Potassium in the Treatment of Acute Bacterial Sinusitis in Children.” Pediatrics , vol. 124, no. 1, 2009, pp. 9-15.

“OBJECTIVE: The role of antibiotic therapy in managing acute bacterial sinusitis (ABS) in children is controversial. The purpose of this study was to determine the effectiveness of high-dose amoxicillin/potassium clavulanate in the treatment of children diagnosed with ABS.

METHODS : This was a randomized, double-blind, placebo-controlled study. Children 1 to 10 years of age with a clinical presentation compatible with ABS were eligible for participation. Patients were stratified according to age (<6 or ≥6 years) and clinical severity and randomly assigned to receive either amoxicillin (90 mg/kg) with potassium clavulanate (6.4 mg/kg) or placebo. A symptom survey was performed on days 0, 1, 2, 3, 5, 7, 10, 20, and 30. Patients were examined on day 14. Children’s conditions were rated as cured, improved, or failed according to scoring rules.

RESULTS: Two thousand one hundred thirty-five children with respiratory complaints were screened for enrollment; 139 (6.5%) had ABS. Fifty-eight patients were enrolled, and 56 were randomly assigned. The mean age was 6630 months. Fifty (89%) patients presented with persistent symptoms, and 6 (11%) presented with nonpersistent symptoms. In 24 (43%) children, the illness was classified as mild, whereas in the remaining 32 (57%) children it was severe. Of the 28 children who received the antibiotic, 14 (50%) were cured, 4 (14%) were improved, 4(14%) experienced treatment failure, and 6 (21%) withdrew. Of the 28children who received placebo, 4 (14%) were cured, 5 (18%) improved, and 19 (68%) experienced treatment failure. Children receiving the antibiotic were more likely to be cured (50% vs 14%) and less likely to have treatment failure (14% vs 68%) than children receiving the placebo.

CONCLUSIONS : ABS is a common complication of viral upper respiratory infections. Amoxicillin/potassium clavulanate results in significantly more cures and fewer failures than placebo, according to parental report of time to resolution.” (9)

Some Excellent Advice about Writing Abstracts for Basic Science Research Papers, by Professor Adriano Aguzzi from the Institute of Neuropathology at the University of Zurich:

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Writing for Publication: Abstracts

An abstract is "a brief, comprehensive summary of the contents of the paper" (American Psychological Association [APA], 2020, p. 38). This summary is intended to share the topic, argument, and conclusions of a research study or course paper, similar to the text on the back cover of a book. When submitting your work for publication, an abstract is often the first piece of your writing a reviewer will encounter. An abstract may not be required for course papers.

Read on for more tips on making a good first impression with a successful abstract.

An abstract is a single paragraph preceded by the heading " Abstract ," centered and in bold font. The abstract does not begin with an indented line. APA (2020) recommends that abstracts should generally be less than 250 words, though many journals have their own word limits; it is always a good idea to check journal-specific requirements before submitting. The Writing Center's APA templates are great resources for visual examples of abstracts.

Abstracts use the present tense to describe currently applicable results (e.g., "Results indicate...") and the past tense to describe research steps (e.g., "The survey measured..."), and they do not typically include citations.

Key terms are sometimes included at the end of the abstract and should be chosen by considering the words or phrases that a reader might use to search for your article.

An abstract should include information such as

• The problem or central argument of your article
• A brief exposition of research design, methods, and procedures.
• A brief summary of your findings
• A brief summary of the implications of the research on practice and theory

It is also appropriate, depending on the type of article you are writing, to include information such as:

• Participant number and type
• Study eligibility criteria
• Limitations of your study
• Implications of your study's conclusions or areas for additional research

Your abstract should avoid unnecessary wordiness and focus on quickly and concisely summarizing the major points of your work. An abstract is not an introduction; you are not trying to capture the reader's attention with timeliness or to orient the reader to the entire background of your study. When readers finish reading your abstract, they should have a strong sense of your article's purpose, approach, and conclusions. The Walden Office of Research and Doctoral Services has additional  tutorial material on abstracts .

Clinical or Empirical Study Abstract Exemplar

In the following abstract, the article's problem is stated in red , the approach and design are in blue , and the results are in green .

End-stage renal disease (ESRD) patients have a high cardiovascular mortality rate. Precise estimates of the prevalence, risk factors and prognosis of different manifestations of cardiac disease are unavailable. In this study a prospective cohort of 433 ESRD patients was followed from the start of ESRD therapy for a mean of 41 months. Baseline clinical assessment and echocardiography were performed on all patients.  The major outcome measure was death while on dialysis therapy. Clinical manifestations of cardiovascular disease were highly prevalent at the start of ESRD therapy: 14% had coronary artery disease, 19% angina pectoris, 31% cardiac failure, 7% dysrhythmia and 8% peripheral vascular disease. On echocardiography 15% had systolic dysfunction, 32% left ventricular dilatation and 74% left ventricular hypertrophy. The overall median survival time was 50 months. Age, diabetes mellitus, cardiac failure, peripheral vascular disease and systolic dysfunction independently predicted death in all time frames. Coronary artery disease was associated with a worse prognosis in patients with cardiac failure at baseline. High left ventricular cavity volume and mass index were independently associated with death after two years. The independent associations of the different echocardiographic abnormalities were: systolic dysfunction--older age and coronary artery disease; left ventricular dilatation--male gender, anemia, hypocalcemia and hyperphosphatemia; left ventricular hypertrophy--older age, female gender, wide arterial pulse pressure, low blood urea and hypoalbuminemia. We conclude that clinical and echocardiographic cardiovascular disease are already present in a very high proportion of patients starting ESRD therapy and are independent mortality factors.

Foley, R. N., Parfrey, P. S., Harnett, J. D., Kent, G. M., Martin, C. J., Murray, D. C., & Barre, P. E. (1995). Clinical and echocardiographic disease in patients starting end-stage renal disease therapy. Kidney International , 47 , 186–192. https://doi.org/10.1038/ki.1995.22

Literature Review Abstract Exemplar

In the following abstract, the purpose and scope of the literature review are in red , the specific span of topics is in blue , and the implications for further research are in green .

This paper provides a review of research into the relationships between psychological types, as measured by the Myers-Briggs Type Indicator (MBTI), and managerial attributes, behaviors and effectiveness. The literature review includes an examination of the psychometric properties of the MBTI and the contributions and limitations of research on psychological types. Next, key findings are discussed and used to advance propositions that relate psychological type to diverse topics such as risk tolerance, problem solving, information systems design, conflict management and leadership. We conclude with a research agenda that advocates: (a) the exploration of potential psychometric refinements of the MBTI, (b) more rigorous research designs, and (c) a broadening of the scope of managerial research into type.

Gardner, W. L., & Martinko, M. J. (1996). Using the Myers-Briggs Type Indicator to study managers: A literature review and research agenda. Journal of Management, 22 (1), 45–83. https://doi.org/10.1177/014920639602200103

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How to Write a Stellar Abstract

Writing solid and meaningful abstracts for computer science (CS) education research is a key factor in getting your important research used by others. After all, there is an end goal for publishing research–research is meant to be shared and used as a building block for future research as well as for practice.

Although the field of K-12 CS education research is still relatively new, other fields have been publishing research for many decades. These research communities have also struggled with similar issues and have already adopted standards and practices for reporting on research, including the development of guides for writing abstracts. These practices continue to evolve as the community needs shift.

The American Psychological Association (APA) has published guides for creating abstracts across several types of study designs. In general, they recommend including objectives, participants, study method, findings and conclusions/implications (as shown in the table below).

This is a great summary of what to include in an abstract, but practically, how can you do this?

Let’s talk about the exceptions first. Many research papers are unique. Maybe it’s a position paper and the authors are trying to build a case for why their position is valid. Or, maybe another paper didn’t involve an intervention or other form of data analysis. Why is this uniqueness of the paper important? Each type of paper may require some nuance and a little more thought about how to construct an abstract so that a reader is not left wondering what the paper entails.

Outside of those exceptions, the majority of CS education papers papers report on studies that include an intervention or study of some sort. For those, we recommend the use of a structured abstract . Structured abstracts are abstracts that follow a standard, predetermined format. Some structured abstract templates cover exactly what the APA JARS recommends reporting.

An example of a structured abstract is A Pair of ACES: An Analysis of Isomorphic Questions on an Elementary Computing Assessment by Parker, Garcia, Kao, Franklin, Krause, and Warschauer (2022):

Background and Context. With increasing efforts to bring computing education opportunities into elementary schools, there is a growing need for assessments, with arguments for validity, to support research evaluation at these grade levels. After successfully piloting a 10-question computational thinking assessment (Assessment of Computing for Elementary Students – ACES) for 4th graders in Spring 2020, we used our analyses of item difficulty and discrimination to iterate on the assessment. Objectives. To increase the number of potential items for ACES, we created isomorphic versions of existing questions. The nature of the changes varied from incidental changes that we did not believe would impact student performance to more radical changes that seemed likely to influence question difficulty. We sought to understand the impact of these changes on student performance. Method. Using these isomorphic questions, we created two versions of our assessment and piloted them in Spring 2021 with 235 upper-elementary (4th grade) students. We analyzed the reliability of the assessments using Cronbach’s alpha. We used Chi-squared tests to analyze questions that were identical across the two assessments to form a baseline of comparison and then ran Chi-Squared and Kruskal-Wallis H tests to analyze the differences between the isomorphic copies of the questions. Findings. Both assessment versions demonstrated good reliability, with identical Cronbach’s alphas of 0.868. We found statistically similar performance on the identical questions between our two groups of students, allowing us to compare their performance on the isomorphic questions. Students performed differently on the isomorphic questions, indicating the changes to the questions had a differential impact on student performance. Implications. This paper builds on existing work by presenting methods for creating isomorphic questions. We provide valuable lessons learned, both on those methods and on the impact of specific types of changes on student performance.

An example of a structured abstract that slightly modified the structure is Practitioner Perspectives on COVID-19’s Impact on Computer Science Education Among High Schools Serving Students from Lower and Higher Income Families by McGill, Snow, Vaval, DeLyser, Wortel-London, and Thompson (2022). In this article, the authors chose to use a structured abstract, but chose to include more of their findings, so space prohibited them from adding implications to the abstracts.

Research Problem. Computer science (CS) education researchers conducting studies that target high school students have likely seen their studies impacted by COVID-19. Interpreting research findings impacted by COVID-19 presents unique challenges that will require a deeper understanding as to how the pandemic has affected underserved and underrepresented students studying or unable to study computing. Research Question. Our research question for this study was: In what ways has the high school computer science educational ecosystem for students been impacted by COVID-19, particularly when comparing schools based on relative socioeconomic status of a majority of students? Methodology. We used an exploratory sequential mixed methods study to understand the types of impacts high school CS educators have seen in their practice over the past year using the CAPE theoretical disaggregation framework to measure schools’ Capacity to offer CS, student Access to CS education, student Participation in CS, and Experiences of students taking CS. Data Collection Procedure. We developed an instrument to collect qualitative data from open-ended questions, then collected data from CS high school educators ( n = 21) and coded them across CAPE. We used the codes to create a quantitative instrument. We collected data from a wider set of CS high school educators ( n = 185), analyzed the data, and considered how these findings shape research conducted over the last year. Findings. Overall, practitioner perspectives revealed that capacity for CS Funding, Policy & Curriculum in both types of schools grew during the pandemic, while the capacity to offer physical and human resources decreased. While access to extracurricular activities decreased, there was still a significant increase in the number of CS courses offered. Fewer girls took CS courses and attendance decreased. Student learning and engagement in CS courses were significantly impacted, while other noncognitive factors like interest in CS and relevance of technology saw increases. Practitioner perspectives also indicated that schools serving students from lower-income families had 1) a greater decrease in the number of students who received information about CS/CTE pathways; 2) a greater decrease in the number of girls enrolled in CS classes; 3) a greater decrease in the number of students receiving college credit for dual-credit CS courses; 4) a greater decrease in student attendance; and 5) a greater decrease in the number of students interested in taking additional CS courses. On the flip-side, schools serving students from higher income families had significantly higher increases in the number of students interested in taking additional CS courses.

So far, we’ve talked about how meaningful abstracts can be structured. We now turn our attention to a simplified process for writing an abstract that uses the following steps:

Tips for Writing a Meaningful Education Research Abstract Write your paper first. Set up the structure for your abstract. We recommend choosing an abstract template similar to the above examples. For the research problem, identify one or two key sentences in your introduction section that highlight the research problem. Copy and paste those sentences into the Research Problem section of your abstract. Don’t worry about length or readability right now. For the research question, identify your question(s) and add them to the Research Question(s) section. For each of the other sections, look in the corresponding sections of your paper and identify the key sentence(s) from each. Once you find them, copy and paste those sentences into the appropriate area of the abstract. Don’t forget to include the population studied and the number of participants where appropriate. Review what you’ve written and start editing your abstract, modifying it so that it fits the abstract word count requirements for your particular publication venue where it will be submitted. Check your final abstract with the APA (or other) abstract guidelines to make sure that your abstract still meets the guidelines for best practices.

Sometimes you need to write an abstract first and submit that. If the abstract is accepted, then you have a green light to write your paper. In these instances, starting with an outline for a structured abstract can help guide its development and help ensure that it has sufficient details for reviewers to accept your abstract.

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How to Write an Abstract APA Format

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

An APA abstract is a brief, comprehensive summary of the contents of an article, research paper, dissertation, or report.

It is written in accordance with the guidelines of the American Psychological Association (APA), which is a widely used format in social and behavioral sciences. 

An APA abstract summarizes, usually in one paragraph of between 150–250 words, the major aspects of a research paper or dissertation in a prescribed sequence that includes:

• The rationale: the overall purpose of the study, providing a clear context for the research undertaken.
• Information regarding the method and participants: including materials/instruments, design, procedure, and data analysis.
• Main findings or trends: effectively highlighting the key outcomes of the hypotheses.
• Interpretations and conclusion(s): solidify the implications of the research.
• Keywords related to the study: assist the paper’s discoverability in academic databases.

The abstract should stand alone, be “self-contained,” and make sense to the reader in isolation from the main article.

The purpose of the abstract is to give the reader a quick overview of the essential information before reading the entire article. The abstract is placed on its own page, directly after the title page and before the main body of the paper.

Although the abstract will appear as the very first part of your paper, it’s good practice to write your abstract after you’ve drafted your full paper, so that you know what you’re summarizing.

Note : This page reflects the latest version of the APA Publication Manual (i.e., APA 7), released in October 2019.

Structure of the Abstract

[NOTE: DO NOT separate the components of the abstract – it should be written as a single paragraph. This section is separated to illustrate the abstract’s structure.]

1) The Rationale

One or two sentences describing the overall purpose of the study and the research problem(s) you investigated. You are basically justifying why this study was conducted.

• What is the importance of the research?
• Why would a reader be interested in the larger work?
• For example, are you filling a gap in previous research or applying new methods to take a fresh look at existing ideas or data?
• Women who are diagnosed with breast cancer can experience an array of psychosocial difficulties; however, social support, particularly from a spouse, has been shown to have a protective function during this time. This study examined the ways in which a woman’s daily mood, pain, and fatigue, and her spouse’s marital satisfaction predict the woman’s report of partner support in the context of breast cancer.
• The current nursing shortage, high hospital nurse job dissatisfaction, and reports of uneven quality of hospital care are not uniquely American phenomena.
• Students with special educational needs and disabilities (SEND) are more likely to exhibit behavioral difficulties than their typically developing peers. The aim of this study was to identify specific risk factors that influence variability in behavior difficulties among individuals with SEND.

2) The Method

Information regarding the participants (number, and population). One or two sentences outlining the method, explaining what was done and how. The method is described in the present tense.

• Pretest data from a larger intervention study and multilevel modeling were used to examine the effects of women’s daily mood, pain, and fatigue and average levels of mood, pain, and fatigue on women’s report of social support received from her partner, as well as how the effects of mood interacted with partners’ marital satisfaction.
• This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998–1999.
• The study sample comprised 4,228 students with SEND, aged 5–15, drawn from 305 primary and secondary schools across England. Explanatory variables were measured at the individual and school levels at baseline, along with a teacher-reported measure of behavior difficulties (assessed at baseline and the 18-month follow-up).

3) The Results

One or two sentences indicating the main findings or trends found as a result of your analysis. The results are described in the present or past tense.

• Results show that on days in which women reported higher levels of negative or positive mood, as well as on days they reported more pain and fatigue, they reported receiving more support. Women who, on average, reported higher levels of positive mood tended to report receiving more support than those who, on average, reported lower positive mood. However, average levels of negative mood were not associated with support. Higher average levels of fatigue but not pain were associated with higher support. Finally, women whose husbands reported higher levels of marital satisfaction reported receiving more partner support, but husbands’ marital satisfaction did not moderate the effect of women’s mood on support.
• Nurses in countries with distinctly different healthcare systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physicians appear satisfactory, core problems in work design and workforce management threaten the provision of care.
• Hierarchical linear modeling of data revealed that differences between schools accounted for between 13% (secondary) and 15.4% (primary) of the total variance in the development of students’ behavior difficulties, with the remainder attributable to individual differences. Statistically significant risk markers for these problems across both phases of education were being male, eligibility for free school meals, being identified as a bully, and lower academic achievement. Additional risk markers specific to each phase of education at the individual and school levels are also acknowledged.

4) The Conclusion / Implications

A brief summary of your conclusions and implications of the results, described in the present tense. Explain the results and why the study is important to the reader.

• For example, what changes should be implemented as a result of the findings of the work?
• How does this work add to the body of knowledge on the topic?

Implications of these findings are discussed relative to assisting couples during this difficult time in their lives.

• Resolving these issues, which are amenable to managerial intervention, is essential to preserving patient safety and care of consistently high quality.
• Behavior difficulties are affected by risks across multiple ecological levels. Addressing any one of these potential influences is therefore likely to contribute to the reduction in the problems displayed.

The above examples of abstracts are from the following papers:

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H., … & Shamian, J. (2001). Nurses’ reports on hospital care in five countries . Health affairs, 20(3) , 43-53.

Boeding, S. E., Pukay-Martin, N. D., Baucom, D. H., Porter, L. S., Kirby, J. S., Gremore, T. M., & Keefe, F. J. (2014). Couples and breast cancer: Women’s mood and partners’ marital satisfaction predicting support perception . Journal of Family Psychology, 28(5) , 675.

Oldfield, J., Humphrey, N., & Hebron, J. (2017). Risk factors in the development of behavior difficulties among students with special educational needs and disabilities: A multilevel analysis . British journal of educational psychology, 87(2) , 146-169.

5) Keywords

APA style suggests including a list of keywords at the end of the abstract. This is particularly common in academic articles and helps other researchers find your work in databases.

Keywords in an abstract should be selected to help other researchers find your work when searching an online database. These keywords should effectively represent the main topics of your study. Here are some tips for choosing keywords:

Core Concepts: Identify the most important ideas or concepts in your paper. These often include your main research topic, the methods you’ve used, or the theories you’re discussing.

Specificity: Your keywords should be specific to your research. For example, suppose your paper is about the effects of climate change on bird migration patterns in a specific region. In that case, your keywords might include “climate change,” “bird migration,” and the region’s name.

Consistency with Paper: Make sure your keywords are consistent with the terms you’ve used in your paper. For example, if you use the term “adolescent” rather than “teen” in your paper, choose “adolescent” as your keyword, not “teen.”

Jargon and Acronyms: Avoid using too much-specialized jargon or acronyms in your keywords, as these might not be understood or used by all researchers in your field.

Synonyms: Consider including synonyms of your keywords to capture as many relevant searches as possible. For example, if your paper discusses “post-traumatic stress disorder,” you might include “PTSD” as a keyword.

Remember, keywords are a tool for others to find your work, so think about what terms other researchers might use when searching for papers on your topic.

The Abstract SHOULD NOT contain:

Lengthy background or contextual information: The abstract should focus on your research and findings, not general topic background.

Undefined jargon, abbreviations,  or acronyms: The abstract should be accessible to a wide audience, so avoid highly specialized terms without defining them.

Citations: Abstracts typically do not include citations, as they summarize original research.

Incomplete sentences or bulleted lists: The abstract should be a single, coherent paragraph written in complete sentences.

New information not covered in the paper: The abstract should only summarize the paper’s content.

Subjective comments or value judgments: Stick to objective descriptions of your research.

Excessive details on methods or procedures: Keep descriptions of methods brief and focused on main steps.

Speculative or inconclusive statements: The abstract should state the research’s clear findings, not hypotheses or possible interpretations.

• Any illustration, figure, table, or references to them . All visual aids, data, or extensive details should be included in the main body of your paper, not in the abstract. 
• Elliptical or incomplete sentences should be avoided in an abstract . The use of ellipses (…), which could indicate incomplete thoughts or omitted text, is not appropriate in an abstract.

APA Style for Abstracts

An APA abstract must be formatted as follows:

Include the running head aligned to the left at the top of the page (professional papers only) and page number. Note, student papers do not require a running head. On the first line, center the heading “Abstract” and bold (do not underlined or italicize). Do not indent the single abstract paragraph (which begins one line below the section title). Double-space the text. Use Times New Roman font in 12 pt. Set one-inch (or 2.54 cm) margins. If you include a “keywords” section at the end of the abstract, indent the first line and italicize the word “Keywords” while leaving the keywords themselves without any formatting.

Example APA Abstract Page

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Further Information

• APA 7th Edition Abstract and Keywords Guide
• Example APA Abstract
• How to Write a Good Abstract for a Scientific Paper or Conference Presentation
• How to Write a Lab Report
• Writing an APA paper

How long should an APA abstract be?

An APA abstract should typically be between 150 to 250 words long. However, the exact length may vary depending on specific publication or assignment guidelines. It is crucial that it succinctly summarizes the essential elements of the work, including purpose, methods, findings, and conclusions.

Where does the abstract go in an APA paper?

In an APA formatted paper, the abstract is placed on its own page, directly after the title page and before the main body of the paper. It’s typically the second page of the document. It starts with the word “Abstract” (centered and not in bold) at the top of the page, followed by the text of the abstract itself.

What are the 4 C’s of abstract writing?

The 4 C’s of abstract writing are an approach to help you create a well-structured and informative abstract. They are:

Conciseness: An abstract should briefly summarize the key points of your study. Stick to the word limit (typically between 150-250 words for an APA abstract) and avoid unnecessary details.

Clarity: Your abstract should be easy to understand. Avoid jargon and complex sentences. Clearly explain the purpose, methods, results, and conclusions of your study.

Completeness: Even though it’s brief, the abstract should provide a complete overview of your study, including the purpose, methods, key findings, and your interpretation of the results.

Cohesion: The abstract should flow logically from one point to the next, maintaining a coherent narrative about your study. It’s not just a list of disjointed elements; it’s a brief story of your research from start to finish.

What is the abstract of a psychology paper?

An abstract in a psychology paper serves as a snapshot of the paper, allowing readers to quickly understand the purpose, methodology, results, and implications of the research without reading the entire paper. It is generally between 150-250 words long.

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Writing an abstract - a six point checklist (with samples)

Posted in: abstract , dissertations

The abstract is a vital part of any research paper. It is the shop front for your work, and the first stop for your reader. It should provide a clear and succinct summary of your study, and encourage your readers to read more. An effective abstract, therefore should answer the following questions:

• Why did you do this study or project?
• What did you do and how?
• What did you find?
• What do your findings mean?

So here's our run down of the key elements of a well-written abstract.

• Size - A succinct and well written abstract should be between approximately 100- 250 words.
• Background - An effective abstract usually includes some scene-setting information which might include what is already known about the subject, related to the paper in question (a few short sentences).
• Purpose  - The abstract should also set out the purpose of your research, in other words, what is not known about the subject and hence what the study intended to examine (or what the paper seeks to present).
• Methods - The methods section should contain enough information to enable the reader to understand what was done, and how. It should include brief details of the research design, sample size, duration of study, and so on.
• Results - The results section is the most important part of the abstract. This is because readers who skim an abstract do so to learn about the findings of the study. The results section should therefore contain as much detail about the findings as the journal word count permits.
• Conclusion - This section should contain the most important take-home message of the study, expressed in a few precisely worded sentences. Usually, the finding highlighted here relates to the primary outcomes of the study. However, other important or unexpected findings should also be mentioned. It is also customary, but not essential, to express an opinion about the theoretical or practical implications of the findings, or the importance of their findings for the field. Thus, the conclusions may contain three elements:
• The primary take-home message.
• Any additional findings of importance.
• Implications for future studies.

Example Abstract 2: Engineering Development and validation of a three-dimensional finite element model of the pelvic bone.

Abstract from: Dalstra, M., Huiskes, R. and Van Erning, L., 1995. Development and validation of a three-dimensional finite element model of the pelvic bone. Journal of biomechanical engineering, 117(3), pp.272-278.

And finally...  A word on abstract types and styles

Abstract types can differ according to subject discipline. You need to determine therefore which type of abstract you should include with your paper. Here are two of the most common types with examples.

Informative Abstract

The majority of abstracts are informative. While they still do not critique or evaluate a work, they do more than describe it. A good informative abstract acts as a surrogate for the work itself. That is, the researcher presents and explains all the main arguments and the important results and evidence in the paper. An informative abstract includes the information that can be found in a descriptive abstract [purpose, methods, scope] but it also includes the results and conclusions of the research and the recommendations of the author. The length varies according to discipline, but an informative abstract is usually no more than 300 words in length.

Descriptive Abstract A descriptive abstract indicates the type of information found in the work. It makes no judgements about the work, nor does it provide results or conclusions of the research. It does incorporate key words found in the text and may include the purpose, methods, and scope of the research. Essentially, the descriptive abstract only describes the work being summarised. Some researchers consider it an outline of the work, rather than a summary. Descriptive abstracts are usually very short, 100 words or less.

Adapted from Andrade C. How to write a good abstract for a scientific paper or conference presentation. Indian J Psychiatry. 2011 Apr;53(2):172-5. doi: 10.4103/0019-5545.82558. PMID: 21772657; PMCID: PMC3136027 .

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School of Education

Dissertation abstracts, selected dissertation abstracts relating to education in the following small states.

• Aminath Shiyama, PhD 2020
• Terra Sprague, PhD 2019
• Karen Ione Best, EdD 2019
• Rhonda DiBiase, PhD 2016
• Aminath Muna, EdD 2014
• Michele Mills, PhD 2013
• Guy le Fanu, EdD 2011
• Abdulla Zameer, EdD 2010
• Beatrice Fulford, EdD 2008  
• Terra Sprague, MEd 2008  
• Harris Hadjithemistos, MEd 2008  
• Herbert Fulford, EdD 2008
• Nkobi Owen Pansiri, EdD 2008  
• Graham Fisher, PhD 2004
• Mark James, PhD 2003
• George Bristol, MEd 2003  
• Keith Holmes, PhD 2002
• Willy Yamuna Ako, EdD 2002
• Glynn Galo, EdD 2001
• Thomas Kuli Webster, EdD 1997
• Akhila Nand Sharma, EdD 1995  
• Gabatshwane Taka Tsayang, EdD 1995
• Calliopa Pearlette Louisy, PhD 1993

Primary teacher professional learning in the Maldives: An explorative study of science process skills pedagogies

Aminath Shiyama, PhD 2020, School of Education, University of Bristol

The teaching of science process skills (SPS), such as observing, measuring, hypothesising, and investigating, are integral to school science education and with constructivist pedagogies, those SPS can be taught with contextual contingencies. This study is focussed on the context of upper primary schools in the Maldives, where science is taught by generalist teachers. The aim of this study was to work in collaboration with those teachers to explore a contextually contingent approach to teach SPS in upper primary schools. The collaboration, informed by social learning theories, was designed as a form of continuing teacher professional development that allowed insights into teachers’ professional learning for teaching

SPS. Hence, exploring SPS pedagogies and teacher professional learning in tandem offers a nuanced view into the contextual contingencies of these practices.

An epistemological view of social-constructivism was adopted to explore the intricate and subjective processes of teacher learning. A participatory teacher research methodology comprising two phases of data collection and analysis was adopted as the research methodology. In the first phase, interview data from 14 generalist primary teachers was used to identify widespread practices of SPS pedagogies and teacher professional development. Focus group interviews with teacher educators and curriculum developers provided contextualisation for these practices. Findings from the first phase informed development of the second phase of data collection. The second phase engaged four generalist primary teachers in professional learning activities over a period of six months; the intervention focussed on the planning and implementing of inquiry-based investigation approaches as a form of SPS pedagogies. Acting as both professional learning facilitator and researcher, I gathered data through individual interviews, classroom observations, and group meetings; supplementing them with our co-developed teaching resources, and teacher-led classroom-based research inquiry. For this phase, narrative, thematic data analysis was conducted and combined with findings from the first phase, which provided a richly textured and complex picture of SPS pedagogies and teacher professional learning.

When generalist teachers instruct science classes, the SPS pedagogies that they can practice are variations of formalist pedagogies and progressive constructivist approaches. These seemingly opposite teaching strategies create tension between the enactment and experiences of the SPS pedagogies prescribed in the curriculum. Further, applying a social learning lens to teacher professional learning offers a contextually-situated understanding of the micro-processes and the micro-dynamics of teachers’ learning, pedagogical praxis, professionalism, and the incessant challenges in teaching outside of one’s specialism. These findings add to the existing empirical base that argues against ‘one-size-fits-all’ educational practices that are emblematic of uncritical borrowing in global education. Thus, this study highlights that SPS needs to be flexibly defined and taught as an integrated set of skills which are applied in learning the content of science using contextually sensitive pedagogies. In order to support generalists who are teaching science outside of their specialism, professional learning that is centred on their classroom is critical. Additionally, this study emphasises the importance of contextually contingent practices of professional development and pedagogical praxis; an approach that allows for flexibility and differentiation in teacher learning. Finally, this study highlights the crucial role of local researchers in bringing contextual realities and sensitivities to the forefront of comparative research.

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Conversing with Island Mangroves: Towards a New Story of Humanity’s Relationship with the Earth

Terra Sprague, PhD 2019, School of Sociology, Politics and International Studies, University of Bristol

The old story of humanity’s relationship with planet Earth, one characterised by domination, disposability and inattention to equilibrium, no longer serves us. Humanity needs a New Story about its relationship with the Earth for the age of the Anthropocene in order to cultivate responses to environmental change which are not rooted in fear. This thesis contributes to the project of writing that New Story through a narrative inquiry into the concerns and responses of islanders from Fiji, Mauritius and St Lucia to their changing environmental conditions.

Grounded in Deleuze’s concepts of multiplicity, the rhizome and mapping, the thesis draws further inspiration from Pacific Island concepts of Sokota (voyaging) and Talanoa (dialogic inquiry) methodology. The narrative analysis brings together the contributions of a range of participants, gathered over the course of six site visits to Fiji, Mauritius and St Lucia, by creating a set of conversations within a metaphorical mangrove forest. This mangrove forest represents the multiplicity of local perspectives in these islands and becomes the site of conversation and story-telling. As such, it becomes a literary tool through which the inquiry’s participants, who are otherwise mostly unknown to each other, are connected on the page through sharing folktales and discussion of current experiences and offering insights and messages to others.

The conversations answer three primary questions: what are the pressing environmental concerns in these island nations; what have been some of the responses to those concerns; and, what are the messages that islanders wish to convey to themselves and others regarding what actions need taking. Through these conversations, a number of themes arise, including trust in nature, resisting fear, identifying barriers to resilience, citizen led responses to environmental issues and an approach to blending different knowledges for strengthened responses.

As well as contributing elements of a New Story of humanity’s relationship with the Earth, the thesis offers a methodological contribution to the global pursuit of that New Story. It first listens to a multiplicity of perspectives, then engages in conversations before going deeper to acknowledge that matters of human equity underpin today’s environmental issues. It builds and presents its analysis using metaphor and through constructing dialogue in order to blend different knowledges. It argues that the development of a New Story about humanity’s relationship with the Earth is one that must be collectively written and shared in order to meet the environmental challenges of this day, and that narrative inquiry can help us to do this.

Gauging Stakeholders Perceptions on Policy Shifts in the Financing of Tertiary Education at the University of the West Indies - Cave Hill Campus, Barbados

Karen Ione Best, EdD 2019, University of Sheffield

My study sought to gauge stakeholders’ perceptions of policy shifts in the financing of tertiary education at the University of the West Indies - Cave Hill Campus, Barbados. The financing of tertiary education in Barbados has been borne by the government since 1966 with zero cost to the student. In September 2014, the government of Barbados introduced a 20% tuition fee paid by the student with the government paying the remaining 80% of the economic cost. The study employed individual and focus group interviews to determine the perceptions of the various categories of stakeholders on financing tertiary education at the University of the West Indies (UWI) Barbados. The research also documented the views of the stakeholders on alternative models of financing tertiary education for the university. The findings indicate that the stakeholders felt that the public financing of tertiary education resulted in the political, social and national development of the country while it also contributed to the increase in public expenditure. In response to the change in public funding, the participants felt that the new model could reduce the public expenditure but it could also have the potential to reduce the access to persons from the lower socio-economic strata. The stakeholders suggested alternative models with the mixed model of financing being the one most supported. Finally, based on the data emerging from the study, there is a need for a larger and more detailed evaluation of the current model of financing tertiary education because of its impact on access, sustainable financing for tertiary education and further research.

Investigating Active Learning Reform in The Small State of the Maldives: What works and under what circumstances?

Rhonda DiBiase, PhD 2016, Melbourne Graduate School of Education, The University of Melbourne

Globally, national governments and donor organisations have endorsed pedagogical reform in their efforts to improve the quality of education, yet disparity between policy and practice is well-documented. In the small state of the Maldives, UNICEF supported Child Friendly School’s project and the new National Curriculum both endorse active learning pedagogy, but implementation challenges have been widely acknowledged. The aim of this qualitative study was to investigate how teachers can enact active learning pedagogy in the Maldivian education system. It was conceived using design-based research, an interventionist methodology, which examines the conditions that influence how educational innovations work in real-life practice. The study was situated in an island school selected for offering optimum conditions for implementation of the pedagogical intervention, and was conducted over two phases: a contextual analysis phase; and an intervention phase.

Using an adaptation of the World Café (J. Brown & Isaacs, 2005), a participatory approach to data collection, the contextual analysis was undertaken with members of the school community — parents, teachers and school leadership — to identify local priorities and perspectives of active learning. The results from this phase revealed features of active learning considered important in the school community: the active participation of students; the use of group work to aid learning; emphasis on the role of teacher as facilitator; the necessity for a friendly classroom environment; and the potential of active learning to cater more equally for all students. Embracing these features of active learning, a pedagogical intervention was developed in collaboration with teachers and school management, to support teachers’ enactment of active learning in the school. The intervention, an instructional model, was then enacted in the island school with two groups of primary teachers and studied over eight months. Data on the teachers’ use of the instructional model were collected through multiple sources that included, teacher recording booklets, questionnaires, interviews and classroom observations.

The data revealed the factors that both supported and inhibited teachers’ use of the intervention. These were converted into design principles; an anticipated outcome of design-based research, highlighting three broad areas that revealed what worked in what circumstances, and represented the study’s key findings identifying the need to: develop a contextually relevant model of active learning that respects local priorities, fits with the circumstances of teachers’ work, and takes into account the available resources; and moves from conceptual ambiguity to operational clarity; support teachers’ knowledge-practice refinement by creating space for reform, providing on-going classroom-based support and drawing on available resources; and foster a change-welcoming school reform approach through an inclusive process that mobilises community participation.

The conceptual framework of design principles that evolved from the study can potentially guide like schools and communities engaging with reform around active learning pedagogy. It is recommended that future research explores the transferability of these design principles to other contexts.

The Evolution and Development of Tertiary Education in the Maldives

Aminath Muna, EdD 2014, Graduate School of Education, University of Bristol

Education has always been highly valued in the Maldives. Every historical document, from times ancient, testifies to the deference and respect that the learned person has received from the society. Historically, an education comprised of acquiring knowledge on the religion of Islam, which constitutes the foundations of culture and society in the country. For centuries, the purpose of education has been twofold: the proliferation and maintenance of religious knowledge in the country, and the transmission of essential skills for maritime people. The shape of the existing organized system of education began to emerge only in the latter half of the twentieth century.

The appearance of vocation-oriented postsecondary training centres has closely linked to the needs and priorities of programs for national development. The growth and amalgamation of these centres culminated in the establishment of the Maldives National University in 2011and led to the rise of private tertiary education providers.

This dissertation traces the historical progressions that led to the evolution and development of tertiary education in the Maldives within the framework of the small state’s paradigm. It investigates the economic, social and political forces that guided and steered the emergence of this sector. While many influences and trends that parallel those in other small states can be seen, some crucial differences exist. Vulnerability to climate change and the narrow economic base of the country are shared characteristics. On the other hand, the isolation of Maldives among a group of larger neighbouring states has profound implications for the development of the national university. Key issues of access, quality, governance and collaboration emerged from a detailed qualitative case study of the Maldives National University. The case study reveals the achievements, challenges and priorities of the new national university. In the light of this analysis, it is argued that there is a pressing need to strengthen tertiary education by creating a sustainable policy framework for transforming the sector to better cater for its growth, quality improvement, research profile, governance and autonomy. Unlike many small states, Maldives is isolated and consequently faces further challenges in exploiting the potential benefits of regional cooperation and alliances. This has related theoretical implications for tertiary education that are identified and that need to be explored and addressed in future studies on tertiary education in small states.

Dilemas and dynamics relating to selection for secondary schooling in Trinidad And Tobago

Michele Mills, Graduate School of Education-PhD (2013)

The high-stakes eleven-plus placement examination has remained a feature of the education systems of many postcolonial Anglophone Caribbean territories. Originally based on a British model, it was introduced to the Republic of Trinidad and Tobago in 1961 and was perceived to be the fairest means of allocating the limited number of secondary school places. The expansion of the secondary sector and the achievement of universal secondary education, however, have had little impact on the selection role and societal significance of the examination in the local context.

This qualitative study draws on concepts of cultural and social capital and power, and the theoretical work of sociological and educational researchers such as Bourdieu, Foucault, Bernstein, Dore and Broadfoot, to investigate whose interests are being served by maintaining the selective examination system. This is done with reference to implications that stem from the uncritical transfer of educational and assessment policies and practices to, and within, small states. More specifically, critical discourse analysis, and four detailed school case studies, are employed to examine the extent to which the Trinidad and Tobago eleven-plus reproduces patterns of power and social inequity in practice. In developing the arguments, the study draws upon experiential knowledge based on my own varied professional experience within the Trinidad education system. Metaphor informs the stages of data analysis and allows the voices of the research participants to be foregrounded in the presentation of the data. Additionally, metaphor offers an important bridge that connects the findings with the key theoretical concepts that guide the study.

The findings suggest that students are unequally positioned in terms of access to the cultural, social and linguistic capital that is taken for granted, and indeed required and rewarded, by the examination. It is argued that the linguistic and cultural competence demanded by the examination process requires initial familiarisation within the family and that those students who are better placed, in terms of the quantity and quality of such capital, have a better feel for the game and a significant advantage at the eleven-plus level. These findings are consistent with Bourdieu’s theory that education systems reproduce the unequal distribution of cultural capital and therefore contribute to the reproduction of inequities in the social structure. In concluding, it is argued that the eleven-plus examination symbolises and is located within the power struggles and ideological disconnections that marked its introduction to Trinidad and Tobago in the 1960s.

Exploring Leadership in Primary Schools in the Maldives: A Local Perspective

Abdulla Zameer, Graduate School of Education, EdD Student (2010)

This study offers an understanding of primary school head leadership in the Maldives, following an exploration of their perspectives and practices. More specifically, the study examines the relationship between the Head Teacher’s espoused leadership aspirations and accounts of their practice, what these practices are in reality, and asks the question, ‘What are the implications for ‘leadership’ when espoused theories and headship actions do not coincide?’

This study, the first of its kind on primary school head leadership in the Maldives, employs a qualitative approach. It uses biographical data and semi-structured interviews to understand the meanings school principals attribute to leadership, their actions, and the dilemmas they face as they operate in the public schooling sector. I also draw upon documentary evidence from school logs, school handbooks, personal diaries and memos.

The findings reveal that the principals readily associate leadership with concepts and theories of leadership that are prevalent in contemporary literature on educational management and leadership. These concepts include a sense of vision and goals, engaging the emotions of individuals in the organisation, involving others through a participative approach, relationship building, and responding to the challenges arising from the context. However, the data suggests that the Primary School Heads do not engage themselves in the perceived definitions of leadership. Rather, their definitions and concepts of leadership are largely rhetorical and barely deployed in practice.

It is argued in this thesis that the gap between their philosophical understandings and pragmatic reality is largely a product of the context that confines their practices to the particular social-political setting they are placed in. The role of school head is structured by more managerial modes of engagement imposed on them, so that their leadership actions are not guided by strong democratic principles based on a personal philosophy or a theoretical foundation expressed in literature. Instead, their practices tend towards fragmented, dysfunctional engagements as part of their bureaucratic obligations, stakeholder’s expectations, and personal goals and aspirations.

In conclusion, this study raises concerns over the quality of their leadership and its implications for schools in the local context. Several suggestions are put forward in this study for training and to improve policy practised in terms of school leadership in the Maldives.  

The transposition of inclusion: an analysis of the relationship between curriculum practice and curriculum prescription in Papua New Guinea

Guy le Fanu, Graduate School of Education, EdD Student (2011)

Guy's doctoral research focuses on the implementation of the new national curriculum in Papua New Guinea, a curriculum which is intended to promote inclusive education for students who at present are either marginalised within the education system or excluded from the education system altogether. The research explores the extent to which the new curriculum is being implemented in schools and the various factors explaining its implementation/ non-implementation. His research not only involves documentary analysis but carrying out a case study of two rural primary schools in the Eastern Highlands . The primary purpose of the research is to identify the barriers to and opportunities for inclusive education in Papua New Guinea and other developing countries, and to identify ways in which governments and international development organisation can overcome these barriers and make best use of these opportunities. However, the research also seeks to identify ways in which ethnographers can sensitively, insightfully and ethically research complex and unfamiliar social worlds.

  Factors impacting upon teacher recruitment and retention in small states with particular reference to the Turks & Caicos Islands

Beatrice Louise Fulford, Graduate School of Education, EdD Student (2008)

Globally, education systems are threatened by teacher shortages at a time when the demand for teachers is steadily increasing, and expectations of improved quality in education delivery and outcomes are higher than ever.  This has repercussions for small states that are already challenged by scarce human resources.  A country's inability to provide a steady supply of appropriately trained and experienced teachers threatens not only its education sector, but also the sustainability of its social and economic development.

In the light of insights derived from the related theoretical literature, this study seeks to identify those factors that impact upon teacher recruitment and retention in the Turks & Caicos Islands (TCI), a UK Overseas Territory.  The study largely adopts the methodological orientation of the interpretive/hermeneutic paradigm, but employs both qualitative and quantitative approaches to data collection.  These are supplemented by a review of primary and secondary source documents.  Semi-structured interviews were conducted with a cross section of education personnel and students within the TCI.  A purpose-built questionnaire was also administered to teachers who had served in the TCI Teaching Service (TCITS), but had left, or were about to leave.

The findings suggest that, locally, many young school leavers are not attracted to teaching because the profession currently suffers from al loss of prestige, student indiscipline, and low salaries and other disincentives.  The findings also suggest that  teachers are not being retained at satisfactory rates due to unfavourable teachers' personal circumstances, a poor image of the profession, lack of training and professional development opportunities, limited involvement in decision-making processes, challenges with school leadership and other staff relations, and student indiscipline.  Collectively, these make teaching unappealing and challenge teacher recruitment and retention policies and practices.

Simultaneously, opportunities in more appealing and lucrative professional fields are expanding, and are attracting the kind of knowledge, skills and attitudes that teachers possess.  The findings also draw attention to the negative impact that the departure of teachers from the classroom has on students' learning and overall development.

The research has distinctive implications for policy and practice in the Turks & Caicos Islands and other small states.  These implications, and those for the related theoretical literature, for capacity building in small states, and for future research are explored in the conclusions.

  EFL teachers'  perceptions and understandings of the unified school-leaving and university-entrance examination policy in the small, transitional state of Armenia

Terra L Sprague, Graduate School of Education, MEd Student (2008)

In a rapidly changing educational setting influenced by global and economic forces, the small transitional state of Armenia is implementing changes to its pupil assessment policy, including the introduction of a Unified School-leaving and University-entrance Examination.  This holistic, qualitative study investigates the Unified Examination Policy through the lens of teachers of English as a Foreign Language by seeking to identify their perceptions and understandings of this new policy, as implemented during the 2007-2008 academic year.

The study includes a theoretical literature review, critical documentary analysis and empirical fieldwork carried out in Armenia.  The fieldwork component consists of observation, semi-structured interviews and a focus group.  These dimensions involve a total of ten teachers and 11 additional stakeholders.  The study additionally benefits from the author's experiential knowledge gained from three years of professional work in Armenia as a teacher trainer.

The findings show that, while teachers share a positive opinion of the new Unified Examination Policy, they feel the pressure of heightened stakes and there is early evidence of backwash effects of examination standardisation which have significant cultural implications.  The findings also reveal internal contradictions within the Unified Examination Policy and external contradictions between this and other current education policies in Armenia.  Conflict between small states and transitional states contexts is highlighted, bringing an interesting dimension to the study and offering lessons for policy makers.

Conclusions both support and challenge existing theoretical literature relating to large-scale, high-stakes examinations and small states.  Future research that builds upon the study could help to better understand the backwash effects of the new Unified Examination and to assess to what extent it may impact upon Armenia's group culture and oral heritage.

  Maintaining identity in a globalisation world:  the case of the small state of Cyprus

Harris Hadjithemistos, Graduate School of Education, MEd Student (2008)

This study investigates the case of the small state of Cyprus relating to the debates about education and identity in a globalised world.  It argues that incorporating global values and agendas into the local education system might prove dangerous for the well grounded national identity of the island and the culture of its people.  However, it further argues that learning from various other sources and mobilising local resources, knowledge and expertise can help the island mediate external pressures and interventions and achieve change that is best suited to its cultural realities and conditions.

Human resource management and staff performance appraisal in small states:  a case study of the Turks & Caicos Islands

Hubert Fulford, Graduate School of Education, EdD Student (2008)

This dissertation examines the impact that Human Resource Management (HRM) strategies and Staff Performance Appraisal Systems (SPAS) have on public sector organisations.  The available literature suggests that, while there are strong advocates of SPAS, a number of critics also challenge such initiatives.  Three bodies of international literature are reviewed to provide a theoretical framework for the study.  These are related to:  international and comparative research, HRM, and education and development in small states.

In the light of the literature reviews, the research adopts a multi-layered approach for a case study of the SPAS in the Public Service of the Turks & Caicos Islands (TCI).  By examining recent initiatives pursued in the TCI, this study clarifies the ways in which SPAS strategies have been used to improve efficiency and effectiveness in the public service, along with the constraints that these new initiatives have encountered.  The time period covered for the case study deals with the implementation of two phases of SPAS, implemented from 1993 and 2003 respectively.  Two major research strategies were employed for the empirical part of the study.  The first, as indicated above, was to adopt a case study framework.  Secondly, a mixed methods approach to data collection was employed.  Data were collected from local TCI archives, from published and un-published reports, from qualitative interviews and from questionnaires administered to senior government officials in the TCI as well as staff they supervise.  Field work was also carried out in Jamaica and Saint Lucia where qualitative interviews were undertaken with senior personnel involved in HRM.

Findings suggest that SPS can be empowering instruments in human resource development, but their operation, in practice, can be both problematic and a very time consuming exercise.  Moreover the study suggests that, often, staff appraisal exercises are not accorded the level of attention they deserve.  This constraint is particularly evident in small states where administrators often have multifunctional roles.

Conclusions identify implications for policy and practice in the TCI, and for the theoretical literature related to HRM and educational development in small states.  At the broadest level, the study cautions against the uncritical international transfer of policies and practices, and highlights the importance of HRM strategies being carefully tailored to local cultural and contextual conditions.

School retention in basic education: a rural ethnic minority case study in Botswana

Nkobi Owen Pansiri, Graduate School of Education, EdD Student (2008)

Low retention in basic education in Botswana particularly in rural ethnic minority areas is a complex educational issue.  This study aims at identifying dominant factors and discourses that shape the behaviour of children and their commitment towards schooling.  The research is being carried out in two linked schools (primary and junior secondary) in the remote areas of the North West District in Botswana.  I draw my frame of reference from theories of ethnocentrism and social reproduction.  Ethnocentrism is applied to explore the place of indigenous knowledge in educational policies and practices - and how this impacts on behaviours of both parents and pupils towards schooling.  Education and social reproduction, is used to explore the implications of educational policies and practices at the school level.  Literature from both Western and African perspectives shows that school retention is still an unexplained educational problem.  This affects children from poor families and minorities more than the rich and dominant social groups.  Much literature has identified, policy related issues, in-school and out of school factors that contribute to low school retention. From the African perspective, common in-school factors are associated with perceived deficiencies in school cultures, guidance and teaching;  whereas out-of-school issues relate to health, indigenous culture and the low socio-economic status of parents. Most previous studies have used traditional research methodologies focused upon attitudinal assessments of children, teachers and parents. Many studies have taken hegemonic stances in which early school leavers are criticised for their decisions to disengage from schooling. There is, however, a growing critique of such methodologies, because they do not help to generate a clear and field-based understanding of the problems of low retention. There, therefore, is a renewed call for research that accommodates the ‘voice’ of the affected children. It is argued that client-based narratives could lead to the formulation of improved evidence-based educational policy making, which may make research more relevant for practitioners and specific contexts.

The potential and limitations of post-compulsory education in the overseas territories of the UK, with particular reference to the Cayman Islands and Montserrat

Graham Fisher, Graduate School of Education, University of Bristol - unpublished PhD (2004)

The UK Overseas Territories face many similar development challenges to those encountered by small states:  scale and isolation;  economic, political, social, environmental and cultural vulnerability;  the impact of rapid globalisation;  the implications of information and communications technologies;  and the growing importance of high skills economies.  Many writers argue that if small states are to fully utilise their limited human resources to cope with these challenges, take part in any global sharing and communication of knowledge, and exercise greater control over their own destiny, then the expansion of post-compulsory education is vital.  Despite the progress of the past 40 years, many small states nevertheless rely heavily upon external control and provision of post-compulsory education.

For the UK Overseas Territories these problems become more complex given their micro scale and constitutional status.  The UK Government is seeking to improve local government, increase local autonomy and economic self-sufficiency and end support to the territories, at a time of falling birth rates and increased migration for some of them.

This research adopts a combination of comparative and qualitative research strategies, and draws upon literature from the fields of international and comparative education, small states research and post-compulsory education. Existing work on the Overseas Territories is reviewed and focus is placed on a critical analysis of trends in policy and practice and an exploration of the potential and limitations for post-compulsory education in these contexts.  Detailed case studies of the Cayman Islands and Montserrat form the original fieldwork component of the research.  Implications for future policy and practice within the territories are examined in detail and broader conclusions are drawn concerning the related theoretical and methodological literature and priorities for future research.

Evaluating rural primary education development programmes in low income countries:  a comparative study of the nature and process of evaluatory activities and their role in improving quality

Mark James, Graduate School of Education, University of Bristol - unpublished PhD (2003)

There is a powerful international rhetoric concerned with the need for education, at present focused on the target of universal primary schooling.  The quality of that schooling has, however, been a subsidiary target, often poorly defined, and in reality seldom well implemented.  This study starts from the premise that this is a major weakness in the drive for Universal Primary Education, and investigates how to improve learning and teaching in low income country rural primary school systems.

An initial hypothesis is that an important route to better educated children is the quality of the evaluative activities that are used by the actors at various levels of the system.  Drawing on three bodies of research literature, concerned with donor supported country systems, classroom interaction, and evaluation, this dissertation tests the theory that failure to weave insights from all three perspectives together, when formulating policies, is a root cause of poor results.

The research applies a comparative case study approach, drawing on fieldwork in the Indian State of Andhra Pradesh, The Gambia and Tanzania, where donor funded programmes are being implemented.

The methodological orientation of the study is critical/hermeneutic, and though not formally collaborative, accepts as given the aims and objectives of the programmes under study.  In tune with the philosophy of illuminating what was happening in the programme, findings were shared with actors observed or interviewed.  Data are qualitative, consisting of classroom observation, semi-structured interviews and local documentation.

The study’s findings apply Riddell’s (1999) concepts of programme and evaluation capacity building success.  The analysis explores and compares issues within the levels of each system that support, challenge, or constrain attempts to improve teaching and learning.  The findings suggest that the school improvement paradigm holds real possibilities for quality improvement if evaluative activities are developed, not on their own, but as part of improved professionalism at teacher and administrative levels.

  Whose knowledge for educational development?  Research capacity in small states, with special reference to St Lucia

Keith Holmes, Graduate School of Education, University of Bristol - unpublished PhD (2002)

In recent years, governments, development agencies and civil society organisations have prioritised education. Strengthening ‘research capacity’ is high on their agendas in the global ‘knowledge economy’. Yet, while efforts to strengthen research capacity are underway worldwide, established modalities of social and educational research are being criticised for not contributing enough to the improvement of policy and practice. Indeed, orthodox modalities of social and educational research are widely challenged for not being suited to contemporary needs in the ‘North’ or the ‘South’.

Dilemmas arising from the uncritical international transfer of educational policies and practices are well documented in the subject field of international and comparative education. The cross-cultural transfer of research agendas, methodologies and paradigms is also problematic. For example, attempts to strengthen research capacity in the South often draw uncritically upon Euro-American modalities of research. This raises questions about how knowledge for educational development is produced and whose interests are served. These questions are critically explored here through an analysis of discourses relating to knowledge for educational development and ‘research capacity’ in small states, with special reference to St Lucia in the Caribbean.

A postcolonial analytical framework is developed from two bodies of theoretical literature. The first of these relates to knowledge, development and postcolonialism. The second relates to contemporary debates about the nature and purpose of social and educational research. Consistent with a postcolonial perspective, the case study of St Lucia utilises and tests a collaborative research methodology. Data from observations, interviews, focus groups and documentary sources are analysed in the interpretative tradition. Critical perspectives and themes emerge which highlight the complex interrelationships between cultures, research capacity and knowledge for educational development. Finally, implications for social and educational research in St Lucia, the Commonwealth Caribbean, other small states, metropolitan countries, and for the related policy and theoretical literature are considered.

Education policy priorities for the small states of the eastern Caribbean, with special reference to St Vincent and the Grenadines

George Bristol, Graduate School of Education, University of Bristol - unpublished MEd (2003)

This study examines the extent to which currently powerful international themes and agendas, promoted by the World Bank and other multi-lateral institutions, have impacted education policy priorities in the small nation-states of the Eastern Caribbean.

The study is conducted within the critical hermeneutics tradition and employs the method of documentary analysis in an intrinsic case study of St Vincent and the Grenadines.  A theoretical framework, which is developed in chapter two, guides the study.  It examines how the intensification of globalisation, combined with currently powerful agendas of multi-lateral developmental institutions, continue to create new and important challenges for education development in the Eastern Caribbean nation-states.

The study reveals that these small economies have turned to regionalisation and functional co-operation in an attempt to better prepare their citizens to take greater advantage of emerging global economic opportunities.  Functional co-operation provides mechanisms through which many of the unique and often problematic features of these small nation-states (now aggravated by the intensification of globalisation), could be more adequately addressed.  It also provides the platform from which OECS education reforms were initiated and co-ordinated, and through which the financial and technical assistance needed to realise the reforms were negotiated.

The analysis of the emerging education policy priorities, both at the local and sub-regional level reveal that, although the identification of these priorities benefits significantly from public inputs throughout the sub-region, they nonetheless show significant resemblance to many of the currently powerful themes promoted by development agencies such as the World Bank.  The analyses also reveal that local and sub-regional education policy-makers adapted many of these themes to suit their particular educational and developmental needs.  However, local and sub-regional education reforms were not limited to the narrow economic view of education promoted mainly by the World Bank.  These reforms incorporated important cultural components into local and sub-regional educational provisions which were geared towards the empowerment of the ‘Ideal Caribbean Person’.  Local adaptation of currently powerful global education themes and agendas is visible in the practice of educational policy-makers in St Vincent and the OECS, which demonstrates a strengthening of the existing dialectic of the global, the local and sub-regional.

Factors affecting the formulation and implementation of the 1993 educational reform in Papua New Guinea

Willy Yamuna Ako, Graduate School of Education, University of Bristol - unpublished EdD (2002)

This study investigates the policy-making and implementation of educational reforms in developing countries, and more specifically the nature and implementation of the 1993 Educational Reform in Papua New Guinea.  The study focused on the achievements and problems of this reform in the light of praise, from both the government of Papua New Guinea and the international donor agencies, that contrasts with the criticism from local stakeholders, such as teachers, children and parents.

The empirical part of the study was conducted at the national and provincial education offices in Port Moresby and Mendi, and in two case study primary schools in the Southern Highlands Province of Papua New Guinea.  Thirty key informants participated in the fieldwork.  The research strategy is largely hermeneutic and interpretive in nature.  It involved gathering, transcribing and interpreting data from a variety of sources, including document analysis, structured and unstructured interviews, observations and field notes.

The findings indicate that the reform initiative ‘mirrors’ the Jomtien Conference (1990) agendas and the aims of the Papua New Guinea Educational Sector Study (1991).  Both the Conference and the Sector Study were initiated and sponsored by the donor agencies.  The study reveals that the reform was largely centrally designed and the ability to fund it rests with the donor agencies.  The input and resources of the donor agencies thus outweigh those of the Papua New Guinea government.  It is argued that this resulted in the donor agencies being able to significantly influence the nature and implementation of the reform  This reflects theoretical literature that suggests that donor agencies are too influential in research, policy-making and implementation concerning educational reforms in many developing countries.  Data from the provincial and school levels in Papua New Guinea suggest that local personnel were not consulted with respect to the policy-making process.  This has inhibited the effective implementation, practicality and ownership of the reform by the local people.

The management and leadership roles of Solomon Islands headteachers:  perceptions, priorities and practices

Glynn Galo, Graduate School of Education, University of Bristol - unpublished EdD (2001)

The study examines the relevance of the international literature relating to school management and leadership for policy and practice in the Solomon Islands.  This is done with reference to two detailed case studies of community high schools in the Solomon Islands.  Detailed ethnographic fieldwork was carried out in these schools during 1999.  Focus was placed on identifying headteachers’ perceptions, priorities and practices in the arena of management and leadership.  Findings from the Solomon Islands’ fieldwork are compared and contrasted with key issues identified in the international literature.

Seven key themes emerged from the study and form the basis for the conclusions.  These explore the implications of the study for:  a) educational policy and practice in the Solomon Islands;  and b) the critique of the related international literature.  Above all, the study suggests that the uncritical international transfer of western management concepts and ideas can be wrought with much difficulty, if it is not anchored effectively enough to contextual realities and experiences.  The dissertation also highlights the need for context specific headteacher training in the Solomon Islands;  and for more relevant research of this nature to be conducted by local personnel if we are to better determine the needs of the headteachers in differing national and cultural contexts.

  International and national influences on universal primary education policies, with specific reference to Papua New Guinea

Thomas Kuli Webster, Graduate School of Education, University of Bristol - unpublished EdD (1997)

The study examines factors that have shaped policies for the universalisation of primary education in developing countries with specific reference to Papua New Guinea (PNG).  It explores the premise that ideas generated in international policy research influence and shape the educational priorities of developing countries.  A review of the related literature highlights the dominance of international donor agencies, particularly in directing the policy discourse that influences decisions on educational problems and possible solutions.  It is argued that many such policy prescriptions are increasingly seen to be contextually irrelevant and do not reflect the priorities articulated in context.  Nor can they be successfully implemented in the varying situations encountered.  A case study of universal primary education (UPE) policy formulation in PNG is undertaken to analyse critically the extent of international and national influences in the light of the theoretical review.

The case study analysis focuses on three contexts of influence:  the shaping of ideas;  the production of policy texts;  and the implementation of UPE policy.  In the context of influence, the study examines how national and international influences have competed for dominance in PNG.  In the second context, two key policy texts are analysed:  the Education For all (EA) Plan, where an international consultant was engaged;  and a more home-grown Education Sector Study.  Finally, the context of practice is explored, largely through reflections on experiential knowledge, qualitative interviews with senior administrative officers from the PNG National Department of Education and three provincial education administrators, and a brief survey of provincial education administrators.

In the light of the PNG research, a reconsideration of the theoretical literature relating to the concepts of UPE and the effect on policy choices is carried out.  A strong case is also made for the conduct and analysis of policy research in PNG and other developing countries.

  Management of the Vocational Education and Training Programme (VETP) in Fijian secondary schools

Akhila Nand Sharma, Graduate School of Education, University of Bristol - unpublished EdD (1995)

In the light of the international literature on the educational change process and that relating more directly to vocational education and training in developing countries, this dissertation examines the management of the Fijian Vocational Education and Training Programme (VETP) in selected secondary schools.  This is a two-year programme for early school-leavers and offers four courses:  Automotive Engineering;  Carpentry and Joinery;  Tailoring, Food and Catering;  and Secretarial Studies.  The study addresses three key questions:  a) what is the nature of the Fijian innovation;  b) how does it relate to similar initiatives in other developing countries; and c) how are its initiation, implementation and institutionalisation processes being managed?

Theoretical and conceptual frameworks derived from the international literature on the management of planned educational change (Fullan 1991) are adopted for the Fijian study.  This literature identifies three phases in the change process:  initiation;  implementation;  and institutionalisation.  Applying this framework for analysis, this investigation involves the study of change agents, users, the nature of innovation and internal and external environmental factors associated with the Fijian VETP.

The theoretical perspective that underpins the methodology and the data-collecting methods of this study is drawn from the phenomenological and qualitative case-study research literature.  An attempt is made to understand the management of the Fijian VETP from the perspectives of those involved in it at the Ministry of Education headquarters and in two case-study schools.  The data-collecting methods emphasise participant observation, in-depth interviewing and documentary analysis.

Based on the fieldwork findings, the study argues that:  a) the VET innovation is regarded by its clients as a second best option to mainstream education and that it receives less attention by policy-practitioners and members of the school community.  This is consistent with similar initiatives in many other developing countries;  b) the successful implementation of an innovation depends largely on its characteristics;  c) a Fijian secondary school context is not suitable for a separate stream of VET, although vocational education could be more effectively provided as a familiarisation programme in the mainstream secondary school curriculum;  d) the relevant international literature is helpful in studying, understanding and improving the management of educational innovations, although its relevance for developing country context and their incorporation in this body of international literature would strengthen its relevance significantly;  f) traditional ceremonies and practices, such as ‘talanoa’ and sevusevu’, can be gainfully employed to collect qualitative data in developing countries.

The study concludes by exploring various implications for Fijian educational policy-makers and practitioners and for the international literature on the management of education change.  Areas for further research are also identified.

An evaluation of community involvement in the implementation of the Community Junior Secondary School Partnership Policy (CJSSPP):  case studies in Botswana

Gabatshwane Taka Tsayang, Graduate School of Education, University of Bristol - unpublished EdD (1995)

This study is an evaluation of community involvement in the implementation of the Community Junior Secondary School Partnership Policy (CJSSPP) in Botswana.  This is carried out in the light of the argument that once government becomes involved in locally initiated projects in Botswana, community interest wanes.  The dissertation looks in detail at the experience of the six case study schools and argues that policy makers must better understand how policy is interpreted and implanted, if they are to improve their own potential to change educational practice.

The conceptual framework adopted for the study is drawn from a critical review of literature relating to community involvement in education in both developed and developing countries.  Secondly, the methodological underpinning of the study is derived largely from comparative and international orientations to research that draws attention to the importance of detailed qualitative fieldwork, and the observation and analysis of educational practice in context.  The study, therefore, documents various participants’ interpretation of the CJSSPP in six carefully selected community schools located in the Central District of Botswana

Data were primarily gathered through semi-structured, in-depth interviews;  through detailed observations;  and through the collection and analysis of relevant documentary evidence.  The findings of this study reveal that while board of governor members had a poor understanding of the partnership policy (and this constrained implementation), the professionals and policy-makers did little to help them understand it.  Evidence also indicated that, besides lay governor members, many professionals and policy-makers do not understand what is required for the success of their own policy in practice.  The use of a talent bank, an obligatory contribution of resources by the community and the training of all those involved in the partnership are suggested as possible ways to improve understanding and the chances of successful implementation.

The study concludes by drawing attention to more general and theoretical issues that emerge from the Botswana experience, including the value that developing countries can derive from the increased use of qualitative approached in educational research.

Tertiary education in St Lucia:  implications for small island states

Calliopa Pearlette Louisy, Graduate School of Education, University of Bristol - unpublished PhD (1993)

The expansion of tertiary education in small states is both problematic and controversial.  On the one hand, the international literature on small states has generally portrayed them as being constrained by size, remoteness and dependence on external factors.  Their economies have been regarded as open, constrained by a small internal market with limited demand for specialisation, and capable of sustaining only a small modern sector.  This, and the small size of their populations has been used as the rationale for discouraging the development of national tertiary education sectors and for the regional provision of higher education in large groupings of small states.  On the one hand, economic and political pressures are leading small states to challenge this received wisdom and to re-appraise their tertiary education capabilities.  Policies aimed at strengthening national capacity have, thus, re-opened the debate about the credibility and viability of national tertiary level institutions.

In the light of the small-state literature, the thesis critically evaluates recent developments in tertiary education in the two largest groupings of small states – the Caribbean and the South Pacific.  The study is based upon original fieldwork data collected for a detailed case study of the Sir Arthur Lewis Community College in St Lucia.  A comparative analysis of tertiary provision in the non-campus territories served by the two regional universities – the University of the West Indies and the University of the South Pacific – supplements the case study data.  The analysis identifies factors which have contributed to the establishment of national tertiary level institutions in both regions, and considers the policies that national authorities have adopted for the on-going expansion of in-country provision of tertiary education.

The thesis argues that the development of national tertiary education sectors is primarily motivated by issues of access, cost, control and human resource development needs.  National responses to a wide range of local needs have thus resulted in a multi-level tertiary sector which has the potential to be both politically and economically viable.  In both regions, parallel processes of centralisation and decentralisation are leading, on the one hand, to the establishment of national multi-purpose institutions, and, on the other, to a form of regional provision based on networks of mutually-supporting institutions.  In what can be considered new responses to the challenge of scale, isolation and dependence, small states are consolidating provision at the national level, establishing mechanisms for harmonising policy and practice at the regional level and strengthening international linkages.

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Sample Abstracts

Sample physical and life sciences abstract.

Do Voles Select Dense Vegetation for Movement Pathways at the Microhabitat Level? Biological Sciences The relationship between habitat use by voles (Rodentia: Microtus) and the density of vegetative cover was studied to determine if voles select forage areas at the microhabitat level.  Using live traps, I trapped, powdered, and released voles at 10 sites.  At each trap site, I analyzed the type and height of the vegetation in the immediate area.  Using a black light, I followed the trails left by powdered voles through the vegetation.  I mapped the trails using a compass to ascertain the tortuosity or amount the trail twisted and turned, and visually checked the trails to determine the obstruction of the movement path by vegetation.  I also checked vegetative obstruction on 4 random paths near the actual trail, to compare the cover on the trail with other nearby alternative pathways.  There was not a statistically significant difference between the amount of cover on a vole trail and the cover off to the sides of the trail when completely covered; there was a significant difference between on and off the trail when the path was completely open.  These results indicate that voles are selectively avoiding bare areas, while not choosing among dense patches at a fine microhabitat scale.

Sample Social Science Abstract

Traditional Healers and the HIV Crisis in Africa:  Toward an Integrated Approach Anthropology The HIV virus is currently destroying all facets of African life. It, therefore, is imperative that a new holistic form of health education and accessible treatment be implemented in African public health policy which improves dissemination of prevention and treatment programs while maintaining the cultural infrastructure. Drawing on government and NGO reports, as well as other documentary sources, this paper examines the nature of current efforts and the state of health care practices in Africa. I review access to modern health care and factors that inhibit local utilization of these resources, as well as traditional African beliefs about medicine, disease, and healthcare. This review indicates that a collaboration of western and traditional medical care and philosophy can help slow the spread of HIV in Africa. This paper encourages the acceptance and financial support of traditional health practitioners in this effort owing to their accessibility and affordability and their cultural compatibility with the community.

Sample Humanities Abstract

Echoes from the Underground European and American Literature Friedrich Nietzsche notably referred to the Russian novelist Fyodor Dostoevsky as “the only psychologist from whom I have anything to learn.” Dostoevsky’s ability to encapsulate the darkest and most twisted depths of the human psyche within his characters has had a profound impact on those writers operating on the periphery of society. Through research on his writing style, biography, and a close reading of his novel Notes from the Underground I am exploring the impact of his most famous outcast, the Underground Man, on counterculture writers in America during the great subculture upsurge of the 1950s and 60s. Ken Kesey, Allen Ginsberg, and Jack Kerouac employ both the universal themes expressed by the Underground Man as well as more specific stylistic and textual similarities. Through my research, I have drawn parallels between these three writers with respect to their literary works as well as the impact of both their personal lives and the worlds that they inhabit. The paper affirms that Dostoevsky has had a profound influence on the geography of the Underground and that this literary topos has had an impact on the writers who continue to inhabit that space.

Sample Creative Writing Abstract

Passersby Creative Writing Richard Hugo wrote in his book of essays, The Triggering Town , that “knowing can be a limiting thing.” His experiences, however brief, in many of the small towns that pepper Montana’s landscape served as the inspiration to much of his poetry, and his observations came to reveal more of the poet than of the triggering subject. For Hugo, the less he knew of a place, the more he could imagine. My project, “Passersby,” is a short collection of poems and black and white photographs that explore this notion of knowledge and imagination. The place is the triggering subject in “Passersby” and will take the audience or viewer to a variety of national and international locations, from Rome and Paris to Beaver, Utah, and the Oregon Coast, and from there, into an exploration of experience and imagination relished by the poet. Hugo believed that as a writer “you owe reality nothing and the truth about your feelings everything.” While reality will play a role in “Passersby,” this work aims to blur the lines between knowing and imagination in order, perhaps, to find a truer place for the poet.

Sample Visual and Performing Arts Abstract/Artist Statement

The Integration of Historic Periods in Costume Design   Theatre As productions turn away from resurrecting museum pieces, integrating costumes from two different historical periods has become more popular. This research project focuses on what makes costume integration successful. A successful integration must be visually compelling, but still, give characters depth and tell the story of the play. By examining several Shakespearean theatre productions, I have pinpointed the key aspects of each costume integration that successfully assist the production. While my own experiences have merged Elizabethan with the 1950s, other designers have merged Elizabethan with contemporary and even a rock concert theme. By analyzing a variety of productions, connecting threads helped establish “rules” for designers.

Through this research, I have established common guidelines for integrating two periods of costume history while still maintaining a strong design that helps tell a story. One method establishes the silhouette of one period while combining the details, such as fabric and accessories, of another period, creating an equal representation of the two. A second option creates a world blended equally of the two periods, in which the design becomes timeless and unique to the world of the play. A third option assigns opposing groups to two different periods, establishing visual conflict. Many more may exist, but the overall key to costume integration is to define how each period is represented. When no rules exist, there is no cohesion of ideas and the audience loses sight of character, story, and concept. Costumes help tell a story, and without guidance, that story is lost.

Sample Journalism Abstracts

International Headlines 3.0: Exploring Youth-Centered Innovation in Global News Delivery Traditional news media must innovate to maintain their ability to inform contemporary audiences. This research project analyzes innovative news outlets that have the potential to draw young audiences to follow global current events. On February 8, 2011, a Pew Research Center Poll found that 52 percent of Americans reported having heard little or nothing about the anti-government protests in Egypt. Egyptians had been protesting for nearly two weeks when this poll was conducted. The lack of knowledge about the protests was not a result of scarce media attention. In the United States, most mainstream TV news sources (CNN, FOX, MSNBC, ABC) ran headline stories on the protests by January 26, one day after the protests began. Sparked by an assignment in International Reporting J450 class, we selected 20 innovative news outlets to investigate whether they are likely to overcome the apparent disinterest of Americans, particularly the youth, in foreign news. Besides testing those news outlets for one week, we explored the coverage and financing of these outlets, and we are communicating with their editors and writers to best understand how and why they publish as they do. We will evaluate them, following a rubric, and categorize them based on their usefulness and effectiveness.

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Action Research Abstracts

A Message From the Director

At this time, I am pleased to present the collected abstracts of the action research projects conducted by the Masters of Education students spanning the years 2000-2004.  Day in and day out, the dedication and enthusiasm of our graduate student researchers excites and challenges me in my role as Director of Graduate Programs, and I am continually impressed with the depth and variety of our students’ research endeavors.   Studies conducted in both public and private schools as well with home schooling and alternative schools are represented here.  Studies of gifted and talented education, inclusion, reading readiness, and writing fluency are all included.  From athletic motivation to academic achievement, from preschool to college, from math to French, and from vocabulary to music, our students consider the many faces of education.  As our Graduate Programs in Education continue to grow and flourish, we will strive to have our students broaden their scope of study even further so as to deepen our collective impact on Maryland’s learners. 

With gratitude for the hard work involved and pride in the body of knowledge the synopses represent, I present to you these abstracts.  

Sincerely, Phyllis M. Sunshine, PhD.

Action Research Prize Winners

2017 winners.

Megan Varga found that improved relationships between teachers and students significantly reduced student off-task classroom behavior. Read Megan's work:   https://mdsoar.org/handle/11603/3893 .

Jane Dulin found that 11th grade students who received direct instruction in SAT preparation significantly increased their SAT test scores . Read Jane's work:  https://mdsoar.org/handle/11603/4349 .

2016 Winners 

Al-Amin Johnson found a significant improvement in the academic achievement of at-risk high school students in an advanced placement psychology course through the use of project-based learning. Read Al-Amin's work:  https://mdsoar.org/handle/11603/2805 .

Stacy S. Doucette found that a mentoring adult had a significant impact on at-risk ninth graders who earned more credits, and increased both cumulative grade point averages and motivation. Read Stacy's work:  https://mdsoar.org/handle/11603/3075 .

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The learner identity of adolescents with trajectories of resilience: the role of risk, academic experience, and gender

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• Published: 22 May 2024

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• Jose Antonio Matías-García   ORCID: orcid.org/0000-0002-3832-3804 1 ,
• Mercedes Cubero   ORCID: orcid.org/0000-0003-0417-4246 1 ,
• Andrés Santamaría   ORCID: orcid.org/0000-0002-1191-9536 1 &
• Miguel Jesús Bascón   ORCID: orcid.org/0000-0003-0226-8943 1  

In at-risk areas of social exclusion, a higher number of adolescents drop out of school. Dropout from compulsory education and early school leaving are associated with unemployment, poverty, and greater health problems, posing a significant threat to the youth’s development and wellbeing. Nevertheless, some students manage to pursue formal education even in high-risk areas, exhibiting resilience. Interwoven between the processes of risk and resilience, the students’ identity development plays a vital role. The present study aimed to analyze the learner identity of students who exhibit a resilience trajectory in areas at risk of social exclusion, and its relation to the degree of risk they face, their academic experience, and their gender. The sample consisted of 132 students from at-risk neighborhoods in Spain who successfully completed compulsory secondary education and continued beyond that level. To measure their academic selves, a modified version of the Twenty Statement Test (TST) was used, which was analyzed using a category system that included four dimensions: organization of the self, emotional valence, plane of action, and thematic reference. The results indicate the participants primarily used personal, positive, evaluative self-descriptions related to the academic world, mostly based on effort. A higher degree of risk was associated to more self-descriptions referring good relationships with others and class attendance, while higher academic experience was associated to more independent selves. The study also found several gender differences. The implications of these findings for research and social intervention in at-risk contexts are discussed.

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Introduction

In 2022, 12.3 million people, which accounts for 26% of the Spanish population, were at risk of poverty and/or social exclusion, according to the European Anti-Poverty Network (EAPN, 2023 ). Social exclusion is a structural and multidimensional process that affects various spheres, including the economic, labor, educational, socio-health, residential, relational, and participatory (Contreras-Montero, 2020 ; Hernández, 2010 ). One of the most significant factors related to social exclusion is the lack of access to formal education. Individuals with limited formal education have reduced access to employment and participation, increased health problems, and are more likely to fall into poverty (Hernández, 2010 ; Moreno, 2015 ).

Dropping out of the educational system is a significant issue in Spain. Early school leaving (ESL) is defined as the percentage of students between 18 and 24 years of age who have not completed and are not currently studying any type of post-compulsory education (Eurostat, 2022 ). In 2022, Spain had a percentage of 13.9%, which is one of the highest rates among European countries ( X̅ = 9.6%) (Eurostat, 2022 ). Students can also drop out without finishing compulsory studies. In the scientific literature, school dropout is attributed to a process of progressive disengagement of students from the educational system (Mena et al., 2010 ).

Students who drop out generally refer to discourses of deficit, to a perceived lack of ability to complete their studies, and place a low value to formal education (Romero & Hernández, 2019 ). These students often encounter multiple risk factors that increase the likelihood of dropping out of formal schooling. Most of these factors are associated with social and economic inequalities, such as low levels of education and poverty in the family (Bayón-Calvo et al., 2021 ; EAPN, 2023 ; Huisman & Smits, 2015 ). Conflicting relationships with teachers and/or family members (Romero & Hernández, 2019 ) are also related.

In addition, gender is considered a significant risk factor in the literature. Male students tend to drop out of school more frequently than their female counterparts (Eurostat, 2022 ). This trend may be attributed to gender roles, as men often face greater pressure to enter the labor market (Bayón-Calvo et al., 2021 ; Ruiz et al., 2013 ). Additionally, male gender socialization can make it challenging for adolescents to integrate into school, as it is sometimes incompatible with maintaining status within their group of friends (Reay, 2018 ). Males exhibit more behavioral problems than females, which can impede their integration into school and their relationship with teachers (Fortin et al., 2010 ).

In institutional and organizational contexts, factors such as school segregation both between and within schools (Save the Children, 2019 ) and the higher rate of teacher turnover in areas at risk of social exclusion (Allen et al., 2018 ; Llorent-Bedmar et al., 2021 ) hinder students’ school attainment. The presence of more risk factors increases the likelihood of students dropping out of school (Rouse et al., 2020 ). Therefore, areas at risk of social exclusion are the most affected. We can consider that social class and inequalities are at the root of students’ school attainment and success (Save the Children, 2019 ).

However, even in areas of higher risk, some students complete their compulsory studies and continue with further formal schooling. The concept of resilience helps define these situations for study. Resilience refers to the process of successfully coping or recovering in the face of adverse situations (Gartland et al., 2019 ; Toland & Carrigan, 2011 ). It comprises two elements: significant exposure to severe risk and evidence of positive adaptation despite such risk (Masten, 2007 ). In the educational context, positive adaptation refers to a student’s ability to perform adequately in school, achieving similar or better results than the normative population that does not face risk (Masten et al., 2006 ; Lessard et al., 2014 ; Longás et al., 2019 ).

It is essential to emphasize that resilience should be understood as an interactive and dynamic process that involves individuals, families, schools, and communities (Gartland et al., 2019 ; Toland & Carrigan, 2011 ). It is not an ability or a characteristic of individuals, and does not make people invulnerable, even if achieved in a specific context under certain conditions. If the conditions are altered, individuals who exhibit resilience may no longer demonstrate it. In this sense, the concept of resilience constitutes a definition of situations of positive adaptation in the face of adversity, and not an explanation of such adaptation (Matías-García, 2022 ).

Precisely, for resilience to occur, risk factors must be controlled by protective factors, defined as such because they allow or facilitate positive adaptation in individuals (Gartland et al., 2019 ). Protective factors against ESL in situations of social exclusion may include greater public spending on scholarships and grants (Alegre & Benito, 2010 ), opportunities for family participation in school (Borman & Overman, 2004 ), and the formation of supportive relationships with family, teachers, and/or other students (Lessard et al., 2014 ; Longás et al., 2019 ), among others (Matías-García, 2022 ; Matias-Garcia et al., 2024 ). Protective factors enable students to establish positive academic expectations for the future, engage more with school, and develop an internal locus of control (Lessard et al., 2014 ; Longás et al., 2019 ), which helps them better adapt to the school environment.

Interwoven between the processes of academic risk and resilience, the development of students’ learner identity plays a vital role. According to Lawson ( 2014 ), learner identity is defined as “…how an individual feels about himself/herself as a learner and the extent to which he/she describes himself/herself as a ‘learner’” (p. 344). These identity constructs are known to mediate achievement, particularly in students with low socioeconomic status (Li et al., 2020 ; Hansen & Henderson, 2019 ).

From a cultural psychology theoretical background, our approach to identity involves the study of self or self-construal, which refers to an individual’s sense of self in relation to others (self-description or self-view) (Sedikides & Brewer, 2001 ). From our perspective, cognition is situated in activity settings (Werstch, 1991 ). Thus, we understand the self as a dynamic, distributed, and dialogical entity, and not as stable and homogeneous. For instance, Bruner ( 1996 ) proposed the existence of a distributed self, which he described as a “swarm” of participations that arise from the situations in which an individual participates. While constructing their identity as an individual distinct from others in each sociocultural setting, the person maintains a close relationship with them.

In this sense, the literature shows that students internalize the positive or negative academic discourses from their interpersonal relationships with teachers, peers, and family members, impacting their identity as learners (Matías-García, 2022 ; Matias-Garcia et al., 2024 ; McFarland et al., 2016 ). In the educational contexts, the influence of academic activities and discourses has a particularly high effect on its development. Characteristics such as the ability to learn or to be attentive during classes are constantly evaluated throughout formal schooling, explicitly and individually. These tasks and discourses shape students’ identity construction towards teachers’ demands, in a positive or negative way.

Also, there is extensive evidence from cross-cultural research about the relationship between formal schooling and changes in cognitive processes (Cole, 1996 ; Rogoff, 1990 ; Scribner & Cole, 1981 ), such as the development of abstract, decontextualized verbal thinking. Due to the type of discourse employed in formal instructional contexts, the literature relates formal schooling to the development of more individual, autonomous, reflective, and agentive selves (De la Mata et al., 2015 ; 2019 ). Authors such as Kagitcibasi ( 2007 ), Greenfield ( 2009 ), and Keller ( 2007 ) claim that formal schooling is an important factor that fosters a cultural model of the self that is characterized by autonomy and agency.

Through educational institutions and interactions with others, between risk and protective factors, students develop a unique understanding of themselves, others, and their environment. This understanding allows them to make the identitarian decision to continue with their studies. Thus, the aim of the present work is to describe and analyze the development of the learner identity of students who present a trajectory of resilience in contexts at risk of social exclusion. This will be done so through variables such as the degree of general risk to which they are exposed to, the educational level attained (academic year), or their gender.

In line with Agenda 2030's Sustainable Development Goals current concerns on No Poverty, Education, Inclusion, and Peace and Justice (SDG 1, 4, 11, and 16; United Nations, n.d. ), this study will help us gain the necessary knowledge for the development of psychoeducational interventions that favor educational continuity in students facing social exclusion. Therefore, the present research presents the following exploratory objectives:

To analyze the characteristics of the learner identity of students with resilience trajectories in contexts at risk of social exclusion.

To compare the learner identity of students from two high schools that present different degrees of risk for dropping out.

To study the role of academic experience (in terms of participants’ academic year) in the development of learner identity.

To investigate the impact of gender on the development of learner identity.

Participants

An a priori power analysis to estimate the sample size required for Mann-Whitney U tests, based on data from Santamaría et al. ( 2010 ), was conducted. This study employed the same instrument and similar analytical categories as the one used in the present work and reported moderate to large effect sizes, so a moderate effect size according to Cohen’s ( 1988 ) criteria was established for the estimation ( d  = 0.5). With an alpha of 0.05 (two-tailed) and a statistical power of 0.80, the sample size required for detecting this effect size is approximately N  = 134.

Rates of social exclusion are higher in the southern half of Spain (Bayón-Calvo et al., 2021 ; EAPN, 2023 ), which constituted the focus of this research. The high schools from areas at risk of social exclusion in Seville (Andalusia) were sampled. These areas are labelled as Zones in Need of Social Transformation (ZNST) by local administrators. We used purposeful sampling and selected two high schools from different neighborhoods, which, although both were in ZNST, differed in the degree of risk they presented. According to their principals and teachers, High School A presented a higher proportion of migrant students and ethnic minorities (i.e. gypsy population), a higher rate of conflict, and greater deterioration of the school facilities and the neighborhood. Likewise, all the students in the High School A come from the same neighborhood in which the school is located, which according to City Hall of Seville ( 2017 ) has the highest rate of absenteeism in the city. According to the literature, these variables are associated to increased risk for dropping out (Cordero et al., 2014 ; Mena et al., 2010 ; Romero & Hernández, 2019 ). However, the students from High School B come both from the high school’s neighborhood and from other surrounding neighborhoods of lower risk, providing a different profile of school. More differences between both high schools can be seen in the “ Results ” section, where sociodemographic data is presented.

All students from post-compulsory secondary education ( Bachillerato , ISCED Level 3) from the aforementioned high schools were studied. In Spain, this academic course is comprised of 2 years and traditionally prepares the students for accessing university studies. Following Masten ( 2007 )’s definition, we considered these students presented a resilience trajectory. They completed compulsory education and continue in the education system beyond that level, showing proper academic performance in the face of risk (Lessard et al., 2014 ; Longás et al., 2019 ). Students from vocational training ( Grado Medio , ISCED Level 3) could also fall within this definition but were not the focus of the present research. The final sample was comprised of 132 Bachillerato students (statistical power = 0.795).

The variables considered for the study were high school, academic year, and gender (Table  1 ). The mean age of the participants was 17.43. Concerning the students’ educational gap, 21.4% of them were older than the age expected for their grade level, with a gap from 1 to 7 years. In the most extreme cases, these students had dropped out of school and returned several years later.

Many of the students came from single-parent (21.9%), extended (15.1%), or reunited (3.8%) families. In general, they belonged to large families, with an average of 3.82 persons in the household. A mean of 1.37 people in the family had an income, which essentially came from low-skilled or temporary jobs. 44.7% were low-skilled or unskilled, unstable jobs; 25.2% were in medium-skilled jobs or which involved merit selection or passing an exam, while only 3.5% were in high-skilled jobs. Also, 24.8% were unemployed or housewives and 1.7% were retired or pensioned. Finally, parents’ formal education was predominantly low, with 11.8% of the parents having no formal education, 41.4% having basic education (primary or secondary school), 33.8% having intermediate education (post-compulsory secondary school or vocational training), and 12.9% having higher education (technical college or university).

Instruments

A sociodemographic questionnaire and, as a self-report measure of learner identity, a modified version of the Twenty Statement Test (TST) (Kuhn & McPartland, 1954 ; Santamaría et al., 2010 ; Santamaría & Cubero, 2019 , among others) was applied. The original version consisted of 20 sentences beginning with “I am.” The participants were asked to complete them with adjectives, nouns, or short phrases describing what they thought of themselves, or what others thought of them, whether positive or negative. The TST does not provide a priori information like other questionnaires or Likert-type scales, and therefore has the advantage of a more qualitative and flexible approach to the dimensions of meaning individuals construct about themselves. Based on previous research from the literature, some modifications to the instrument were made in order to adapt it to the goals and the context of assessment:

Reducing the 20 items to 10. Previous studies have shown participants have difficulty in completing all 20 sentences (Santamaría et al., 2010 ).

To specifically ask their characteristics as a student to study their learner identity.

Changing the “I am” (“Yo soy”) item structure for only “I” (“Yo”). The English “I am” may be translated by two different verbs in Spanish, either “ ser ” or “ estar ,” which offers a richer range of possible answers than its direct translation in Spanish, “Yo soy.” This change enabled a similar range of answers for the Spanish population.

The instructions specified that answers could also include membership to groups or personal relationships with others. The reason was to avoid the individualistic bias shown by previous studies (Santamaría et al., 2010 ), since these elements tend to be underrepresented.

G*power ver. 3.1 and SPSS ver. 25 were used for calculating the a priori estimation of the sample and analyzing the data, respectively.

Approval was obtained from the local ethics committee (Granting Body: Portal de Ética de la Investigación Biomédica de Andalucía; Protocol Number: 0191-N-18). For the selection of participants, we obtained research approval and the support of the local education administration. Then, the high schools were contacted. Informed consent was obtained from parents and students over 18 years old. The dates for the data gathering sessions were agreed with the teachers from each high school.

A pilot study was carried out in the same high schools and classrooms to ensure that the instructions were understood and that there were no problems with the TST and sociodemographic questionnaire. Some modifications were done to the latter to facilitate its completion and avoid missing data. The definitive data were collected by researchers from the research group over 2 years, applying the TST to all post-compulsory students at both high schools. The instruments were completed in writing and during class time, after a brief explanation of the research and the procedure to be followed. The students took approximately 15 to 20 min to complete them. The students did not receive financial compensation for their participation.

Data analysis

A category system was applied to analyze the self-descriptions that students provided in the TST. Each statement was categorized under four different dimensions. These were organization of the self, emotional valence, plane of action, and thematic reference (Table 2 ). For the reliability analysis of each dimension, 20% of participants were randomly selected from the total sample and their self-descriptions as students were independently coded by two researchers, authors of the present work. Subsequently, the kappa index was calculated as a measure of inter-rater reliability (Cohen, 1960 ).

The first three dimensions were conformed a priori and have already been used in the literature. The organization of the self dimension is based on the distinction of Triandis ( 1989 ) between the private, public, and collective self (Santamaría et al., 2010 ; Yuste et al., 2021 ). A second dimension focuses on the emotional valence of the participants’ description of the self, distinguishing between positive, negative, and ambivalent (Santamaría & Cubero, 2019 ). The third dimension analyzes the plane of actions of self-descriptions. It moves in relation to the trichotomy descriptions, actions, and evaluations (Yuste et al., 2021 ). These dimensions showed good reliability (Table 2 ) according to Cohen ( 1960 ).

Finally, an inductive thematic analysis of the self-descriptions was developed, based on the participants’ answers (Clarke et al., 2015 ). Seventy-six different categories were iteratively elaborated a posteriori, which were very similar to the descriptions that the participants themselves filled out in the TST. Subsequently, they were recategorized into hierarchically higher categories, until five final general categories were created: academic world, social relations, ways of being, work, and finally, leisure and other activities (Matías-García et al., 2023 ). Given the interest in academics, data are also presented for the five subcategories that form Academic World at its previous level (Table 3 ). For reasons of space, microlevel categories will be presented only if they show statistical differences. The kappa index was calculated from the micro level, from 76 different categories, giving a value of 0.866, considered a very good value (Cohen, 1960 ).

Chi-squared ( X 2 ), Fishers’ exact, and Mann-Whitney  U tests were used depending on data type. Percentage of appearance of TST categories was used for analysis. Cramer’s V and Rosenthal’s r were calculated as effect size measures and interpreted according to Cohen ( 1988 ).

First, the descriptive data obtained from the TST will be shown. Subsequently, data referring to the comparison between the different explanatory variables, school, academic year, and gender will be presented.

Descriptive data

The participants’ self-descriptions were mainly personal, positive, evaluative, and referred to the academic world (Table 4 ). The organization of the self shows a small percentage of relational categories and minimal group categories, while in the emotional valence, negative valence is found in one-third of the responses and ambivalent in one-tenth. In the plane of action, very few actions and even fewer descriptions were categorized. Finally, in the thematic reference dimension, in addition to the high percentage referring to the academic world, we found some categories related to social relations and ways of being, and very few referring to work or leisure.

Within the academic world, the highest percentage of self-descriptions are those referring to the abilities and activities of the students. The next most numerous category would be academic emotions. Finally, with less than 5%, we find the categories global conception, academic relationships, and academic goals.

Differences in terms of the explanatory variables high school, academic year, and gender

High school.

First, further differences will be presented between the two high schools to help contextualize and interpret data, based on the analysis of the sociodemographic questionnaire. Subsequently, the differences referred to the TST will be shown.

High School A had a lower number of students who reached the second year of post-compulsory education (34.1%) than High School B (52.3%), X 2 (1, N  = 132) = 3.9, p  = .048, V  = 0.17). Likewise, High School A’s students are significantly older ( M  = 18.3, DT  = 1.71), U  = 985, p  < .001, r  = .41. In terms of family configuration, High School A also showed a higher percentage of extended family (27.3%) than High School B (9.1%), X 2 (1, N  = 132) = 7.54, p  = .006, V  = 0.24). Father’s ( M  = 1.93, SD  = 0.73) and mother’s ( M  = 1.97, SD  = 0.67) educational levels were also lower relative to High School B ( M  = 2.82, SD  = 0.95 and M  = 2.61, SD  = 0.71, respectively), U  = 500, p  < .001, r  = .43 y U  = 740, p  < .001, r  = .38, respectively. The parents’ job analysis also revealed significant socioeconomic differences. Students at High School A came from families whose parents had mostly low-level jobs (81.5%). Few had medium-level jobs (11.1%) and there were no parents with high-level jobs. Finally, 7.4% were unemployed. On the other hand, at High School B, their families had mostly medium level jobs (53.6%). A lower percentage had low-level jobs (32.1%), and few had high level jobs (1.8%). Finally, 1.8% were retired and/or pensioned and 10.7% were unemployed. These differences were significant ( p  < .001, Fisher’s exact test, V  = 0.47). All these data confirmed that High School A presents a higher degree of risk for dropout than High School B.

Data referring to the analysis of self-descriptions as a function of the high schools will be next presented (Table 5 ). High School A has a significantly higher percentage of unspecific relational and positive self-descriptions. There also were more self-descriptions related to academic relationships and more social (non-academic) relationships.

On the other hand, High School B presents a higher percentage of personal self-descriptions and of ambivalent emotional valence, and referred more to the academic world. Within the academic world, we also find more self-descriptions related to abilities and activities and to academic emotions in High School B. No significant differences were found in the plane of action.

In addition, there were significant differences related to the micro-level categories that make up the thematic reference analysis (Table 6 ). For reasons of space, only statistically significant categories are included.

Thus, we find that students from High School A use more self-descriptions categorized as referring to supportive and helpful relationships with classmates, high non-academic relational abilities, and high attendance and punctuality. However, they also present more self-descriptions of overall poor student conception and other people’s (perceived as) negative academic motivations, in which participants feel pressured or obligated to perform their studies. On the other hand, students from High School B use more self-descriptions that allude to their capacity for effort and organization as a student, either low or high, and to high intelligence. However, they present more descriptions referring to low study and learning and to negative academic emotions, such as anxiety or felling overwhelmed.

All significant differences related to their high school have a small-moderate effect size.

Academic year

Relating to organization of the self, second-year students presented a significantly higher percentage of personal self-descriptions ( M  = 86.2, SD  = 12.3) than first-year students ( M  = 75.6, SD  = 20.4), U  = 1548, p  = .004, with a small effect size ( r  = .25). No significant differences were found for emotional valence. In the plane of action, there were less descriptive self-descriptions in second-year students ( M  = 0, SD  = 0) than in first-year students ( M  = 1.65, SD  = 6.81), U  = 1983, p  = .021, with a small effect size ( r  = .2). In the thematic reference, second-year participants presented a higher percentage of academic world categories ( M  = 88.6, SD  = 14.2) than the first-year students ( M  = 75, SD  = 25.7), U  = 1477, p  = .001, with a small effect size ( r  = .28).

Likewise, within the academic world, second-year students used more self-descriptions referring to abilities and activities ( M  = 64.4, SD  = 19.2) than first-year students ( M  = 52.2, SD  = 23.2), U  = 1526, p  = .003, with a small effect size ( r  = .25). On the other hand, second-year students presented less self-descriptions related to social relations ( M  = 3.55, SD  = 6.66) than the first-year students ( M  = 13.9, SD  = 17.1), U  = 1402, p  < .001, with a small effect size ( r  = .34).

In addition, there also were significant differences related to micro-level categories (Table 7 ). The second-year students presented more self-descriptions related to their capacity for effort and organization, whether low or high, high participation in class, and positive academic emotions, such as satisfaction with their studies.

However, they presented a higher proportion of categories related to low attention in class. As for the first-year students, they presented a greater number of categories related to their behavior in class, either behaving calmly or nervously in class, non-academic relational skills, and high creativity. All these significant differences have small to moderate effect sizes.

No significant gender differences were found in organization of the self, emotional valence, or plane of action. In thematic reference, female students presented more academic world categories ( M  = 84.9, SD  = 21.6) than males ( M  = 78.4, SD  = 22.4), U  = 1612, p  = .011, with a small effect size ( r  = .22). However, males presented more ways of being categories ( M  = 9.7, SD  = 14.5) than females ( M  = 6.03, SD  = 12.2), U  = 1740, p  = .032, with a small effect size ( r  = .19).

In the micro-level analysis, there also were statistical differences (Table 8 ). Female students presented a greater number of self-descriptions referring to a high capacity for effort and organization. However, they presented more self-descriptions referring to a low ability to pass or get a good grade, as well as more self-descriptions referring to both academic optimism and pessimism. On the other hand, male students had more self-descriptions referring to support and help among classmates, calm classroom behavior, and high creativity. All these differences showed small effect sizes.

The present study analyzed the learner identity of students presenting a trajectory of educational resilience in contexts at risk of social exclusion (Lessard et al., 2014 , Longás, 2019 ; Toland & Carrigan, 2011 ). For this purpose, the participants’ self-descriptions as students were studied through the TST. Understanding how these students elaborate their learner identity allows us to better understand educational resilience in these contexts.

Students who drop out generally allude to a lack of ability, motivation, and social value of school (Romero & Hernández, 2019 ). Leaving the education system is viewed as a success rather than a failure by these students, as they believe they can stop wasting time and engage in more productive activities (Mena et al., 2010 ). However, when asked about their learner identity, the study’s participants employed mainly personal, positive, evaluative self-descriptions, linked to the academic world. These descriptions are associated with higher academic performance and mastery-focused academic goals (Hansen & Henderson, 2019 ; Li et al., 2020 ).

In addition, the most common micro-level category was effort in academic tasks, whether high or low (see Tables  6  or 7 ). For the participants, making an effort is one of their primary characteristics as learners. In this sense, incremental beliefs of one’s own abilities, that is, beliefs that one’s ability and intelligence can be improved and developed through effort, have been related to greater motivation, academic performance, task mastery goals, persistence in the face of failure, and greater academic resilience, especially in students at risk of social exclusion (Burnette et al., 2013 ; Matías-García & Cubero-Pérez, 2021 ; Sarrasin et al., 2018 ). Likewise, interventions on these beliefs have been shown to be especially beneficial to at-risk students (Sarrasin et al., 2018 ). Explaining successes and failures in terms of effort has the advantage of making academic difficulties controllable, which gives them agency over their own life trajectory (Burnette et al., 2013 ; Skinner & Zimmer-Gembeck, 2011 ). This alternative to deficit discourses in at-risk students who show a trajectory of resilience is consistent with previous research in the literature (Cubero-Pérez et al., 2023 ; Matias-Garcia et al., 2024 ).

Thus, identity serves as an attributional resource that explains the students’ successes and failures. Despite being in ZNST, these students identify themselves as students who make an effort and are capable and participative in academic settings. This is identitarily coherent with pursuing further studies, allowing them to make such a decision. The importance of building positive learner identities has also been highlighted by other authors (Rosales & Cubero, 2016 ) and their development depends on both the context and the students’ interactions with significant others, such as families, teachers, and classmates (Matías-García, 2022 ; Matias-Garcia et al., 2024 ; McFarland et al., 2016 ). The next section will discuss the impact of risk, academic experience, and gender on the development of learner identity.

Although both high schools are located in contexts at risk of social exclusion, they differed in the degree of risk they presented. High School A had older students, resulting in a greater educational gap. Its students only came from ZNST and had families with a significantly lower socioeconomic status. Additionally, High School A had a higher number of migrant students, a higher rate of conflict, and greater facility deterioration.

In High School A, there was a higher frequency of self-descriptions related to supporting and helping classmates as well as attending class. In contrast, High School B had more self-descriptions related to abilities and activities. This suggests that, even though both high schools are in ZNST, the learning relationships and interactions between teachers and students that occur within them are different (McFarland et al., 2016 ). The higher rate of conflict and absenteeism in High School A indicates that one of the main tasks of its teachers is to ensure that students attend class and maintain good student behavior, in terms of them staying quiet during lessons and not provoke fights with others. Thus, those High School A students who do not fail and who remain in the educational system highlight to a greater extent their good behavior and attendance as something important in their role as students. They elaborate their learner identity in relation to others (Sedikides & Brewer, 2001 ), as a way of differentiating themselves from more troubling students. In contrast, in High School B, the students focused more on their own abilities as students (study, intelligence, effort, organization, etc.), characteristics that education usually values highly in the absence of other difficulties.

According to the data provided by the TST, the students from High School A had the most interdependent selves, based on supportive relationships among peers and friends. On the other hand, the High School B students’ selves were more personal and associated with education. They also presented a more ambivalent and less positive emotional valence, showing a certain greater degree of reflection on their own self-descriptions (De la Mata et al., 2015 ).

These differences are coherent with cross-cultural research. The literature on self-construals advocates a broad distinction between independent and interdependent selves (De la Mata et al., 2015 ; 2019 ; Greenfield, 2009 ; Kitayama et al., 2007 ). People with an independent self-construal view the self as unique, private, and autonomous, whereas people with an interdependent self-construal view the self as related to others, incorporating and referencing the views of other people and groups in their identity. Interdependent selves are related to rural societies and low levels of schooling, whereas independent selves are associated with urban societies which has a greater role for school (De la Mata et al., 2015 ; 2019 ; Greenfield, 2009 ; Kitayama et al., 2007 ). In our sample, the parents from High School A had a lower level of formal education than those from High School B families.

The idea that educational experience fosters the development of independent selves is supported by the significant differences observed between first- and second-year students (Matías-García et al. 2023 ). Second-year students, who are more acclimated to the school environment (Mena et al., 2010 ) and have more educational experience than first-year students, also exhibited more personal self-descriptions and greater association with the academic world (effort, organization, participation, emotions) than first-year students. In contrast, first-year students referenced their social relationships and behavior in class more frequently than second-year students. The educational discourse in class interaction influenced the development of students’ identities, leading to increasingly independent selves associated with school characteristics (De la Mata et al., 2015 ; 2019 ). Matías-García et al. ( 2023 ) show how this process takes place in the development of future selves as well.

However, it is important to note that both profiles of learner identities in the sample, independent or interdependent, demonstrate a trajectory of resilience in their respective high schools and are strongly associated with academic selves. Therefore, it is important to emphasize the relevance of interdependent academic identities in the especially disadvantaged schools and neighborhoods, such as High School A. Cultivating such identities, as well as building good relationships among students and with teachers, could be effective ways to achieve good school integration of students at risk of social exclusion (Longás et al., 2019 ).

In fact, the results of High School A show that fostering an autonomous self does not necessarily imply the undermining of relational selves (Santamaría et al., 2010 ). In contrast to the consideration of two major models of the self, the independent and the interdependent self (Markus & Kitayama, 1991 ), there are authors such as Kagitcibasi ( 2007 ) who reject the traditional consideration of autonomy as opposed to relatedness, which has been predominantly assumed in psychology and in Western thought in general. It is precisely in the specific field of education that this idea has been reinforced in recent years, pointing out that formal education should not only promote aspects of rationality, but also relationality.

Regarding gender, research shows that dropout rates are higher in males than in females (Eurostat, 2022 ). In the present study’s data, female students presented more school-associated identities than male students, indicating greater adaptation and integration in the educational system. Qualitative research suggests that working-class male students may face challenges in maintaining their status within their peer group while integrating into school due to male gender roles (Reay, 2018 ). As a result, they may be more reticent than female students to identify with academic selves. Although female students have more academic success (Eurostat, 2022 ) and display positive self-descriptions regarding their school performance (such as high capacity for effort and organization), they also exhibited more categories of academic pessimism and about obtaining poor grades. In this sense, the literature demonstrates that female students experience greater pressure in school, particularly in certain areas (Kim et al., 2018 ).

In turn, male students presented fewer academic categories and more categories of calm behavior in class, while male students traditionally manifest more behavioral problems (Moreno et al., 2012 ). As mentioned, students who exhibit resilience and do not experience such issues, or at least experience them to a lesser extent, tend to identify these characteristics of themselves as relevant to their identity as a student.

Limitations

Regarding limitations, this research understood resilience as the completion of secondary education and its maintenance in the educational system as a goal in itself. However, the students from this research are still at risk of ESL. Economic needs and other factors may still force them out of the educational system (Mena et al., 2010 , Romero & Hernández, 2019 ). Therefore, measuring other academic adaptation indices, such as the number of passed subjects or the completion of post-compulsory studies, could complement the results. In addition to academic achievement, mental health indicators could be further analyzed in this population. Some students might progress with high levels of stress, discomfort, or “suffering great pressure,” which could also be a problem to address.

Also, it would be worthwhile to analyze the relationship between the students’ learner identity and other non-academic characteristics, such as emotional and affective development, or the social relationships they have. These students face a multitude of difficulties, both in the school context and in the family or peer context, which are interrelated (Toland & Carrigan, 2011 ).

Finally, our results have explanatory value only for students from the post-compulsory bachillerato , a course that traditionally prepares them for university studies. Our sample did not include students from different academically resilient trajectories, such as students from vocational training Grado Medio . These students might develop different types of learner identities, which should be further explored in future research.

Conclusions

This study examined the characteristics of the learner identity of students who exhibit a resilient trajectory. These characteristics align with the healthy learner identity construct found in the literature (Rosales & Cubero, 2016 ). Through their participation in class and interaction with teachers and other students, they elaborated their learner identity in a positive way, while being connected to others. They rejected deficit discourses about the self, common in areas at risk of social exclusion, and built an agentic learner identity mostly based on effort.

The identities constructed by the participants are influenced by the degree of risk present in their high school (and neighborhood), gender, and educational experience. These identities may be more independent or interdependent, more focused on behavior and attendance or on capabilities as learners. In one way or another, all of these students remain resiliently in the educational system beyond the compulsory.

The identification of these characteristics adds necessary information for intervening in ZNST, aligned with national, European, and international goals (Agenda 2030's Sustainable Development Goals; United Nations, n.d. ). The school, in conjunction with families, should promote the construction of positive learner identities attending to the emotional needs that students face when navigating the various challenges presented by their school and context. Identifying and reinforcing characteristics such as effort, attendance, behaving calmly during lessons, being supportive to other students, or the overall conception of being a good student can help build identities consistent with remaining in the educational system. This is especially important for ZNST students, as it can reduce feelings of disengagement and promote adaptive behaviors and persistence.

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Funding for open access publishing: Universidad de Sevilla/CBUA This research was carried out within the framework of the research project funded by the Spanish Government, Ministry of Science and Innovation, State Research Agency and European Regional Development Fund-ERDF, entitled “Challenges of the self: Identity reconstruction in situations of inequality and social exclusion” (reference: PSI2016–80112–P). It was also funded by the VI-PPITUS (University of Seville).

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José Antonio Matías-García . Department of Experimental Psychology, Universidad de Sevilla, Camilo José Cela Street, 41018 Seville, Spain. E-mail: [email protected]

Current themes of research :

Educational resilience. Learner identity. Conceptions of intelligence. Early school leaving.

Most relevant publications in the field of Psychology of Education :

Matías-García, J. A., Santamaría, A., Cubero, M., Cubero-Pérez, R. (2023). From current to possible selves: Self-descriptions of resilient post-compulsory secondary education Spanish students at risk of social exclusion. Children and Youth Services Review, 155 , 1-10. https://doi.org/10.1016/j.childyouth.2023.107257

Cubero-Pérez, R., Cubero, M., Matías-García, J. A., & Bascón, M. J. (2023). Learner identity in secondary post-compulsory education students from areas in need of social transformation: An example of resilience. European Journal of Psychology of Education, 0 (0), 1-22, https://doi.org/10.1007/s10212-023-00704-6

Matías-García, J. A. (2022). Identidad de aprendiz y desigualdad social. Resiliencia académica en contextos en riesgo de exclusión social [Learner identity and social inequality. Academic resilience in contexts at risk of social exclusion]. [Unpublished Doctoral Thesis]. Universidad de Sevilla.

Matías-García, J. A., & Cubero-Pérez, R. (2021). La naturaleza heterogénea del concepto de inteligencia en los seres humanos: discurso y contextos de práctica [The heterogeneous nature of the concept of intelligence in humans: Discourse and contexts of practice]. In S. Arias-Sánchez (Coord.), Construyendo identidad(es) en escenarios culturales (pp. 97-122). Editorial Universidad de Sevilla.

Matías-García, J. A., & Cubero-Pérez, R. (2021). Heterogeneity in the conceptions of intelligence of university teaching staff. Culture & Psychology, 27 (3), 451–472. https://doi.org/10.1177/1354067X20936926

Matias-Garcia, J. A., & Cubero-Perez, R. (2020). “Einstein worked his socks of”. Conceptions of intelligence in university teaching staff. International Journal of Educational Psychology, 9 (2), 161–194. https://doi.org/10.17583/ijep.2020.4553

Mercedes Cubero . Department of Experimental Psychology, Universidad de Sevilla, Camilo José Cela Street, 41018 Seville, Spain.

Concept formation processes. Teaching practices. Learner identity. Gender and education. Educational discourse.

Cubero, M., Bascón, M. J., & Cubero-Pérez, R. (2020). “My tutor doesn’t say that”: The legitimized voices in dialogic refection on teaching practices. Dialogic Pedagogy, 8 , 26–44. https://doi.org/10.5195/dpj.2020.311

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Cubero-Pérez, R., Cubero, M., & Bascón, M. J. (2019). The reflective practicum in the process of becoming a teacher: The tutor’s discursive support. Education Sciences, 9 (96), 1–21. https://doi.org/10.3390/educsci9020096

Cubero, M., Contreras, R., & Cubero, R. (2016). Cultural origins and schooling infuence on scientific and everyday concepts: The case of border and citizen on the border concepts. Culture & Psychology, 22 (2), 182–205. https://doi.org/10.1177/1354067X15601189

Cubero, M., Santamaría, A., Rebollo, M. A., Cubero, R., García, R., & Vega, L. (2015). Teachers negotiating discourses of gender (in)equality: The case of equal opportunities reform in Andalusia. Gender & Education, 27 (6), 635–653. https://doi.org/10.1080/09540253.2015.1083947

Andrés Santamaría . Department of Experimental Psychology, Universidad de Sevilla, Camilo José Cela Street, 41018 Seville, Spain.

Identity. Narrative. Cultural psychology. Formal schooling. Gender and self.

De la Mata, M.L., Santamaría, A., Trigo, E., Cubero, M., Arias, S., Antaliková, R., Hansen, T.G.B., & Ruiz, M. (2019). The relationship between sociocultural factors and autobiographical memories from childhood: The role of formal schooling. Memory, 27 (1), 103-114. https://doi.org/10.1080/09658211.2018.1515316

De la Mata, M.L., Santamaría, A., y Ruiz, M.L. (2016). Toward the model of independence: The influence of formal schooling experience on earliest autobiographical memories and self-construals: A preliminary study. Journal of Cross-Cultural Psychology, 47 (5), 670–679.   https://doi.org/10.1177/0022022116635745

Cubero, M., Santamaría, A., Rebollo, M.A., Cubero, R., García, R., y Vega, L. (2015). Teachers negotiating discourses of gender (in)equality: The case of equal opportunities reform in Andalusia. Gender & Education, 27 (6), 635-653. https://doi.org/10.1080/09540253.2015.1083947

De la Mata, M.L., Santamaría, A., Hansen, T.G., & Ruiz, L. (2015). Earliest autobiographical memories in college students from three countries: Towards a situated view. Memory Studies, 8 , 151-168. https://doi.org/10.1177/1750698014543966

Santamaría, A., de la Mata, M. L. y Ruiz, M. L. (2012). Escolarización formal, memoria autobiográfica y concepciones culturales del yo [Formal schooling, autobiographical memory and cultural conceptions of the self]. Infancia y Aprendizaje, 35 , 1, 73-86.

Miguel Jesús Bascón . Department of Experimental Psychology, Universidad de Sevilla, Camilo José Cela Street, 41018 Seville, Spain.

Current themes of research : Gender and education. Learner identity. Teaching-learning processes. Educational discourse.

Saavedra. F. J., Bascón, M. J., Prados. M. M., & Sabuco, A. (2013). Indicadores y criterios de calidad de buenas prácticas coeducativas. Una propuesta innovadora. [Indicators and quality criteria of good coeducational practices. An innovative proposal]. Profesorado. Revista de curriculum y formación del profesorado, 17 (1), 201–220.

Rebollo, M. A., Piedra, J., Sala, A., Sabuco, A., Saavedra, F. J., & Bascón, M. J. (2012). La equidad de género en educación: Análisis y descripción de buenas prácticas en educación. [Gender equity in education: Analysis and description of good practices in education]. Revista de Educación, 358 , 129–152.

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Matías-García, J., Cubero, M., Santamaría, A. et al. The learner identity of adolescents with trajectories of resilience: the role of risk, academic experience, and gender. Eur J Psychol Educ (2024). https://doi.org/10.1007/s10212-024-00839-0

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This study investigates the usefulness of integrating the Kahoot application as an instructional tool to boost motivation and academic achievement among 10th-grade mathematics students in Abu Dhabi Emirate Schools. A sample of 60 10th-grade students was deliberately selected and randomly assigned to either an experimental group (30 students) instructed with Kahoot, or a control group (30 students) taught using traditional methods. A quasi-experimental approach was selected for this study to investigate a cause-and-effect relationship between the utilization of Kahoot in mathematical education and its impact on student motivation and academic achievement. A comprehensive statistical analysis, specifically employing an independent samples t-test for the motivation scale and a one-way ANCOVA for academic performance, revealed statistically significant differences favouring the experimental group. These results signify that Kahoot integration holds promise in positively influencing motivation and academic achievement for 10th-grade mathematics students in Abu Dhabi Emirate Schools. This research underscores the potential of Kahoot as a valuable educational tool, offering insights for educators and policymakers seeking to enhance student motivation and achievement through technology-integrated instruction.

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• Reem Hashem, Nagla Ali, Farah El Zein, Patricia Fidalgo, Othman Abu Khurma, AI to the rescue: Exploring the potential of ChatGPT as a teacher ally for workload relief and burnout prevention , Research and Practice in Technology Enhanced Learning: Vol. 19 (2024): RPTEL

A modern way to teach and practice manual therapy

Affiliations.

• 1 School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK.
• 2 Allied Health Research Unit, University of Central Lancashire, Preston, PR1 2HE, UK. [email protected].
• 3 Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
• 4 Nottingham CityCare Partnership, Bennerley Rd, Nottingham, NG6 8WR, UK.
• 5 School of Medicine, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2HA, UK.
• 6 Department of Orthopaedics, West Herts Hospitals Trust, Watford, WD18 0HB, UK.
• 7 School of Physiotherapy, Manchester Metropolitan University, Manchester, M15 6GX, UK.
• 8 Department of Orthopaedics, Duke University, 200 Morris Street, Durham, NC, 27701, USA.
• 9 School of Sport and Health Sciences, University of Brighton, Darley Rd, Eastbourne, BN20 7UR, UK.
• 10 Clinical Neuroscience, Trafford Building, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK.
• 11 University College of Osteopathy, 275 Borough High St, London, SE1 1JE, UK.
• 12 Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, S-90187, Umeå, Sweden.
• 13 The School of Soft Tissue Therapy, Exmouth, Devon, EX8 1DQ, UK.
• 14 Department of health, LUNEX, Differdange, 4671, Luxembourg.
• 15 Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, Differdange, 4671, Luxembourg.
• 16 Department of Occupation and Health, School of Organization and Development, HAN University of Applied Sciences, Nijmegen, the Netherlands.
• PMID: 38773515
• PMCID: PMC11110311
• DOI: 10.1186/s12998-024-00537-0

Background: Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician-centred assessment, patho-anatomical reasoning, and technique specificity. These historical principles are not supported by current evidence. However, data from clinical trials support the clinical and cost effectiveness of manual therapy as an intervention for musculoskeletal conditions, when used as part of a package of care.

Purpose: The purpose of this paper is to propose a modern evidence-guided framework for the teaching and practice of MT which avoids reference to and reliance on the outdated principles of TMT. This framework is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety, comfort, and efficiency. These practical elements are contextualised by positive communication, a collaborative context, and person-centred care. The framework facilitates best-practice, reasoning, and communication and is exemplified here with two case studies.

Methods: A literature review stimulated by a new method of teaching manual therapy, reflecting contemporary evidence, being trialled at a United Kingdom education institute. A group of experienced, internationally-based academics, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through reviews of contemporary literature and discussions in an iterative process. Public presentations were made to multidisciplinary groups and feedback was incorporated. Consensus was achieved through repeated discussion of relevant elements.

Conclusions: Manual therapy interventions should include both passive and active, person-empowering interventions such as exercise, education, and lifestyle adaptations. These should be delivered in a contextualised healing environment with a well-developed person-practitioner therapeutic alliance. Teaching manual therapy should follow this model.

Keywords: Chiropractic; Evidence-based healthcare; Manual Therapy; Osteopathy; Person-centred healthcare; Physiotherapy; Soft-tissue therapy.

© 2024. The Author(s).

Publication types

• Musculoskeletal Diseases / therapy
• Musculoskeletal Manipulations* / education
• Musculoskeletal Manipulations* / methods

• Open access
• Published: 14 May 2024

Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study

• Jocelyn Schroeder 1 ,
• Barbara Pesut 1 , 2 ,
• Lise Olsen 2 ,
• Nelly D. Oelke 2 &
• Helen Sharp 2  

BMC Nursing volume  23 , Article number:  326 ( 2024 ) Cite this article

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Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada’s legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses’ (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education; and bereavement care for family. Nurses have a right under the law to conscientious objection to participating in MAiD. Therefore, it is essential to prepare nurses in their entry-level education for the practice implications and moral complexities inherent in this practice. Knowing what nursing students think about MAiD is a critical first step. Therefore, the purpose of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context.

The design was a mixed-method, modified e-Delphi method that entailed item generation from the literature, item refinement through a 2 round survey of an expert faculty panel, and item validation through a cognitive focus group interview with nursing students. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

During phase 1, a 56-item survey was developed from existing literature that included demographic items and items designed to measure experience with death and dying (including MAiD), education and preparation, attitudes and beliefs, influences on those beliefs, and anticipated future involvement. During phase 2, an expert faculty panel reviewed, modified, and prioritized the items yielding 51 items. During phase 3, a sample of nursing students further evaluated and modified the language in the survey to aid readability and comprehension. The final survey consists of 45 items including 4 case studies.

Systematic evaluation of knowledge-to-date coupled with stakeholder perspectives supports robust survey design. This study yielded a survey to assess nursing students’ attitudes toward MAiD in a Canadian context.

The survey is appropriate for use in education and research to measure knowledge and attitudes about MAiD among nurse trainees and can be a helpful step in preparing nursing students for entry-level practice.

Peer Review reports

Medical Assistance in Dying (MAiD) is permitted under an amendment to Canada’s Criminal Code which was passed in 2016 [ 1 ]. MAiD is defined in the legislation as both self-administered and clinician-administered medication for the purpose of causing death. In the 2016 Bill C-14 legislation one of the eligibility criteria was that an applicant for MAiD must have a reasonably foreseeable natural death although this term was not defined. It was left to the clinical judgement of MAiD assessors and providers to determine the time frame that constitutes reasonably foreseeable [ 2 ]. However, in 2021 under Bill C-7, the eligibility criteria for MAiD were changed to allow individuals with irreversible medical conditions, declining health, and suffering, but whose natural death was not reasonably foreseeable, to receive MAiD [ 3 ]. This population of MAiD applicants are referred to as Track 2 MAiD (those whose natural death is foreseeable are referred to as Track 1). Track 2 applicants are subject to additional safeguards under the 2021 C-7 legislation.

Three additional proposed changes to the legislation have been extensively studied by Canadian Expert Panels (Council of Canadian Academics [CCA]) [ 4 , 5 , 6 ] First, under the legislation that defines Track 2, individuals with mental disease as their sole underlying medical condition may apply for MAiD, but implementation of this practice is embargoed until March 2027 [ 4 ]. Second, there is consideration of allowing MAiD to be implemented through advanced consent. This would make it possible for persons living with dementia to receive MAID after they have lost the capacity to consent to the procedure [ 5 ]. Third, there is consideration of extending MAiD to mature minors. A mature minor is defined as “a person under the age of majority…and who has the capacity to understand and appreciate the nature and consequences of a decision” ([ 6 ] p. 5). In summary, since the legalization of MAiD in 2016 the eligibility criteria and safeguards have evolved significantly with consequent implications for nurses and nursing care. Further, the number of Canadians who access MAiD shows steady increases since 2016 [ 7 ] and it is expected that these increases will continue in the foreseeable future.

Nurses have been integral to MAiD care in the Canadian context. While other countries such as Belgium and the Netherlands also permit euthanasia, Canada is the first country to allow Nurse Practitioners (Registered Nurses with additional preparation typically achieved at the graduate level) to act independently as assessors and providers of MAiD [ 1 ]. Although the role of Registered Nurses (RNs) in MAiD is not defined in federal legislation, it has been addressed at the provincial/territorial-level with variability in scope of practice by region [ 8 , 9 ]. For example, there are differences with respect to the obligation of the nurse to provide information to patients about MAiD, and to the degree that nurses are expected to ensure that patient eligibility criteria and safeguards are met prior to their participation [ 10 ]. Studies conducted in the Canadian context indicate that RNs perform essential roles in MAiD care coordination; client and family teaching and support; MAiD procedural quality; healthcare provider and public education; and bereavement care for family [ 9 , 11 ]. Nurse practitioners and RNs are integral to a robust MAiD care system in Canada and hence need to be well-prepared for their role [ 12 ].

Previous studies have found that end of life care, and MAiD specifically, raise complex moral and ethical issues for nurses [ 13 , 14 , 15 , 16 ]. The knowledge, attitudes, and beliefs of nurses are important across practice settings because nurses have consistent, ongoing, and direct contact with patients who experience chronic or life-limiting health conditions. Canadian studies exploring nurses’ moral and ethical decision-making in relation to MAiD reveal that although some nurses are clear in their support for, or opposition to, MAiD, others are unclear on what they believe to be good and right [ 14 ]. Empirical findings suggest that nurses go through a period of moral sense-making that is often informed by their family, peers, and initial experiences with MAID [ 17 , 18 ]. Canadian legislation and policy specifies that nurses are not required to participate in MAiD and may recuse themselves as conscientious objectors with appropriate steps to ensure ongoing and safe care of patients [ 1 , 19 ]. However, with so many nurses having to reflect on and make sense of their moral position, it is essential that they are given adequate time and preparation to make an informed and thoughtful decision before they participate in a MAID death [ 20 , 21 ].

It is well established that nursing students receive inconsistent exposure to end of life care issues [ 22 ] and little or no training related to MAiD [ 23 ]. Without such education and reflection time in pre-entry nursing preparation, nurses are at significant risk for moral harm. An important first step in providing this preparation is to be able to assess the knowledge, values, and beliefs of nursing students regarding MAID and end of life care. As demand for MAiD increases along with the complexities of MAiD, it is critical to understand the knowledge, attitudes, and likelihood of engagement with MAiD among nursing students as a baseline upon which to build curriculum and as a means to track these variables over time.

Aim, design, and setting

The aim of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context. We sought to explore both their willingness to be involved in the registered nursing role and in the nurse practitioner role should they chose to prepare themselves to that level of education. The design was a mixed-method, modified e-Delphi method that entailed item generation, item refinement through an expert faculty panel [ 24 , 25 , 26 ], and initial item validation through a cognitive focus group interview with nursing students [ 27 ]. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

Participants

A panel of 10 faculty from the two nursing education programs were recruited for Phase 2 of the e-Delphi. To be included, faculty were required to have a minimum of three years of experience in nurse education, be employed as nursing faculty, and self-identify as having experience with MAiD. A convenience sample of 5 fourth-year nursing students were recruited to participate in Phase 3. Students had to be in good standing in the nursing program and be willing to share their experiences of the survey in an online group interview format.

The modified e-Delphi was conducted in 3 phases: Phase 1 entailed item generation through literature and existing survey review. Phase 2 entailed item refinement through a faculty expert panel review with focus on content validity, prioritization, and revision of item wording [ 25 ]. Phase 3 entailed an assessment of face validity through focus group-based cognitive interview with nursing students.

Phase I. Item generation through literature review

The goal of phase 1 was to develop a bank of survey items that would represent the variables of interest and which could be provided to expert faculty in Phase 2. Initial survey items were generated through a literature review of similar surveys designed to assess knowledge and attitudes toward MAiD/euthanasia in healthcare providers; Canadian empirical studies on nurses’ roles and/or experiences with MAiD; and legislative and expert panel documents that outlined proposed changes to the legislative eligibility criteria and safeguards. The literature review was conducted in three online databases: CINAHL, PsycINFO, and Medline. Key words for the search included nurses , nursing students , medical students , NPs, MAiD , euthanasia , assisted death , and end-of-life care . Only articles written in English were reviewed. The legalization and legislation of MAiD is new in many countries; therefore, studies that were greater than twenty years old were excluded, no further exclusion criteria set for country.

Items from surveys designed to measure similar variables in other health care providers and geographic contexts were placed in a table and similar items were collated and revised into a single item. Then key variables were identified from the empirical literature on nurses and MAiD in Canada and checked against the items derived from the surveys to ensure that each of the key variables were represented. For example, conscientious objection has figured prominently in the Canadian literature, but there were few items that assessed knowledge of conscientious objection in other surveys and so items were added [ 15 , 21 , 28 , 29 ]. Finally, four case studies were added to the survey to address the anticipated changes to the Canadian legislation. The case studies were based upon the inclusion of mature minors, advanced consent, and mental disorder as the sole underlying medical condition. The intention was to assess nurses’ beliefs and comfort with these potential legislative changes.

Phase 2. Item refinement through expert panel review

The goal of phase 2 was to refine and prioritize the proposed survey items identified in phase 1 using a modified e-Delphi approach to achieve consensus among an expert panel [ 26 ]. Items from phase 1 were presented to an expert faculty panel using a Qualtrics (Provo, UT) online survey. Panel members were asked to review each item to determine if it should be: included, excluded or adapted for the survey. When adapted was selected faculty experts were asked to provide rationale and suggestions for adaptation through the use of an open text box. Items that reached a level of 75% consensus for either inclusion or adaptation were retained [ 25 , 26 ]. New items were categorized and added, and a revised survey was presented to the panel of experts in round 2. Panel members were again asked to review items, including new items, to determine if it should be: included, excluded, or adapted for the survey. Round 2 of the modified e-Delphi approach also included an item prioritization activity, where participants were then asked to rate the importance of each item, based on a 5-point Likert scale (low to high importance), which De Vaus [ 30 ] states is helpful for increasing the reliability of responses. Items that reached a 75% consensus on inclusion were then considered in relation to the importance it was given by the expert panel. Quantitative data were managed using SPSS (IBM Corp).

Phase 3. Face validity through cognitive interviews with nursing students

The goal of phase 3 was to obtain initial face validity of the proposed survey using a sample of nursing student informants. More specifically, student participants were asked to discuss how items were interpreted, to identify confusing wording or other problematic construction of items, and to provide feedback about the survey as a whole including readability and organization [ 31 , 32 , 33 ]. The focus group was held online and audio recorded. A semi-structured interview guide was developed for this study that focused on clarity, meaning, order and wording of questions; emotions evoked by the questions; and overall survey cohesion and length was used to obtain data (see Supplementary Material 2  for the interview guide). A prompt to “think aloud” was used to limit interviewer-imposed bias and encourage participants to describe their thoughts and response to a given item as they reviewed survey items [ 27 ]. Where needed, verbal probes such as “could you expand on that” were used to encourage participants to expand on their responses [ 27 ]. Student participants’ feedback was collated verbatim and presented to the research team where potential survey modifications were negotiated and finalized among team members. Conventional content analysis [ 34 ] of focus group data was conducted to identify key themes that emerged through discussion with students. Themes were derived from the data by grouping common responses and then using those common responses to modify survey items.

Ten nursing faculty participated in the expert panel. Eight of the 10 faculty self-identified as female. No faculty panel members reported conscientious objector status and ninety percent reported general agreement with MAiD with one respondent who indicated their view as “unsure.” Six of the 10 faculty experts had 16 years of experience or more working as a nurse educator.

Five nursing students participated in the cognitive interview focus group. The duration of the focus group was 2.5 h. All participants identified that they were born in Canada, self-identified as female (one preferred not to say) and reported having received some instruction about MAiD as part of their nursing curriculum. See Tables  1 and 2 for the demographic descriptors of the study sample. Study results will be reported in accordance with the study phases. See Fig.  1 for an overview of the results from each phase.

Fig. 1  Overview of survey development findings

Phase 1: survey item generation

Review of the literature identified that no existing survey was available for use with nursing students in the Canadian context. However, an analysis of themes across qualitative and quantitative studies of physicians, medical students, nurses, and nursing students provided sufficient data to develop a preliminary set of items suitable for adaptation to a population of nursing students.

Four major themes and factors that influence knowledge, attitudes, and beliefs about MAiD were evident from the literature: (i) endogenous or individual factors such as age, gender, personally held values, religion, religiosity, and/or spirituality [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], (ii) experience with death and dying in personal and/or professional life [ 35 , 40 , 41 , 43 , 44 , 45 ], (iii) training including curricular instruction about clinical role, scope of practice, or the law [ 23 , 36 , 39 ], and (iv) exogenous or social factors such as the influence of key leaders, colleagues, friends and/or family, professional and licensure organizations, support within professional settings, and/or engagement in MAiD in an interdisciplinary team context [ 9 , 35 , 46 ].

Studies of nursing students also suggest overlap across these categories. For example, value for patient autonomy [ 23 ] and the moral complexity of decision-making [ 37 ] are important factors that contribute to attitudes about MAiD and may stem from a blend of personally held values coupled with curricular content, professional training and norms, and clinical exposure. For example, students report that participation in end of life care allows for personal growth, shifts in perception, and opportunities to build therapeutic relationships with their clients [ 44 , 47 , 48 ].

Preliminary items generated from the literature resulted in 56 questions from 11 published sources (See Table  3 ). These items were constructed across four main categories: (i) socio-demographic questions; (ii) end of life care questions; (iii) knowledge about MAiD; or (iv) comfort and willingness to participate in MAiD. Knowledge questions were refined to reflect current MAiD legislation, policies, and regulatory frameworks. Falconer [ 39 ] and Freeman [ 45 ] studies were foundational sources for item selection. Additionally, four case studies were written to reflect the most recent anticipated changes to MAiD legislation and all used the same open-ended core questions to address respondents’ perspectives about the patient’s right to make the decision, comfort in assisting a physician or NP to administer MAiD in that scenario, and hypothesized comfort about serving as a primary provider if qualified as an NP in future. Response options for the survey were also constructed during this stage and included: open text, categorical, yes/no , and Likert scales.

Phase 2: faculty expert panel review

Of the 56 items presented to the faculty panel, 54 questions reached 75% consensus. However, based upon the qualitative responses 9 items were removed largely because they were felt to be repetitive. Items that generated the most controversy were related to measuring religion and spirituality in the Canadian context, defining end of life care when there is no agreed upon time frames (e.g., last days, months, or years), and predicting willingness to be involved in a future events – thus predicting their future selves. Phase 2, round 1 resulted in an initial set of 47 items which were then presented back to the faculty panel in round 2.

Of the 47 initial questions presented to the panel in round 2, 45 reached a level of consensus of 75% or greater, and 34 of these questions reached a level of 100% consensus [ 27 ] of which all participants chose to include without any adaptations) For each question, level of importance was determined based on a 5-point Likert scale (1 = very unimportant, 2 = somewhat unimportant, 3 = neutral, 4 = somewhat important, and 5 = very important). Figure  2 provides an overview of the level of importance assigned to each item.

Ranking level of importance for survey items

After round 2, a careful analysis of participant comments and level of importance was completed by the research team. While the main method of survey item development came from participants’ response to the first round of Delphi consensus ratings, level of importance was used to assist in the decision of whether to keep or modify questions that created controversy, or that rated lower in the include/exclude/adapt portion of the Delphi. Survey items that rated low in level of importance included questions about future roles, sex and gender, and religion/spirituality. After deliberation by the research committee, these questions were retained in the survey based upon the importance of these variables in the scientific literature.

Of the 47 questions remaining from Phase 2, round 2, four were revised. In addition, the two questions that did not meet the 75% cut off level for consensus were reviewed by the research team. The first question reviewed was What is your comfort level with providing a MAiD death in the future if you were a qualified NP ? Based on a review of participant comments, it was decided to retain this question for the cognitive interviews with students in the final phase of testing. The second question asked about impacts on respondents’ views of MAiD and was changed from one item with 4 subcategories into 4 separate items, resulting in a final total of 51 items for phase 3. The revised survey was then brought forward to the cognitive interviews with student participants in Phase 3. (see Supplementary Material 1 for a complete description of item modification during round 2).

Phase 3. Outcomes of cognitive interview focus group

Of the 51 items reviewed by student participants, 29 were identified as clear with little or no discussion. Participant comments for the remaining 22 questions were noted and verified against the audio recording. Following content analysis of the comments, four key themes emerged through the student discussion: unclear or ambiguous wording; difficult to answer questions; need for additional response options; and emotional response evoked by questions. An example of unclear or ambiguous wording was a request for clarity in the use of the word “sufficient” in the context of assessing an item that read “My nursing education has provided sufficient content about the nursing role in MAiD.” “Sufficient” was viewed as subjective and “laden with…complexity that distracted me from the question.” The group recommended rewording the item to read “My nursing education has provided enough content for me to care for a patient considering or requesting MAiD.”

An example of having difficulty answering questions related to limited knowledge related to terms used in the legislation such as such as safeguards , mature minor , eligibility criteria , and conscientious objection. Students were unclear about what these words meant relative to the legislation and indicated that this lack of clarity would hamper appropriate responses to the survey. To ensure that respondents are able to answer relevant questions, student participants recommended that the final survey include explanation of key terms such as mature minor and conscientious objection and an overview of current legislation.

Response options were also a point of discussion. Participants noted a lack of distinction between response options of unsure and unable to say . Additionally, scaling of attitudes was noted as important since perspectives about MAiD are dynamic and not dichotomous “agree or disagree” responses. Although the faculty expert panel recommended the integration of the demographic variables of religious and/or spiritual remain as a single item, the student group stated a preference to have religion and spirituality appear as separate items. The student focus group also took issue with separate items for the variables of sex and gender, specifically that non-binary respondents might feel othered or “outed” particularly when asked to identify their sex. These variables had been created based upon best practices in health research but students did not feel they were appropriate in this context [ 49 ]. Finally, students agreed with the faculty expert panel in terms of the complexity of projecting their future involvement as a Nurse Practitioner. One participant stated: “I certainly had to like, whoa, whoa, whoa. Now let me finish this degree first, please.” Another stated, “I'm still imagining myself, my future career as an RN.”

Finally, student participants acknowledged the array of emotions that some of the items produced for them. For example, one student described positive feelings when interacting with the survey. “Brought me a little bit of feeling of joy. Like it reminded me that this is the last piece of independence that people grab on to.” Another participant, described the freedom that the idea of an advance request gave her. “The advance request gives the most comfort for me, just with early onset Alzheimer’s and knowing what it can do.” But other participants described less positive feelings. For example, the mature minor case study yielded a comment: “This whole scenario just made my heart hurt with the idea of a child requesting that.”

Based on the data gathered from the cognitive interview focus group of nursing students, revisions were made to 11 closed-ended questions (see Table  4 ) and 3 items were excluded. In the four case studies, the open-ended question related to a respondents’ hypothesized actions in a future role as NP were removed. The final survey consists of 45 items including 4 case studies (see Supplementary Material 3 ).

The aim of this study was to develop and validate a survey that can be used to track the growth of knowledge about MAiD among nursing students over time, inform training programs about curricular needs, and evaluate attitudes and willingness to participate in MAiD at time-points during training or across nursing programs over time.

The faculty expert panel and student participants in the cognitive interview focus group identified a need to establish core knowledge of the terminology and legislative rules related to MAiD. For example, within the cognitive interview group of student participants, several acknowledged lack of clear understanding of specific terms such as “conscientious objector” and “safeguards.” Participants acknowledged discomfort with the uncertainty of not knowing and their inclination to look up these terms to assist with answering the questions. This survey can be administered to nursing or pre-nursing students at any phase of their training within a program or across training programs. However, in doing so it is important to acknowledge that their baseline knowledge of MAiD will vary. A response option of “not sure” is important and provides a means for respondents to convey uncertainty. If this survey is used to inform curricular needs, respondents should be given explicit instructions not to conduct online searches to inform their responses, but rather to provide an honest appraisal of their current knowledge and these instructions are included in the survey (see Supplementary Material 3 ).

Some provincial regulatory bodies have established core competencies for entry-level nurses that include MAiD. For example, the BC College of Nurses and Midwives (BCCNM) requires “knowledge about ethical, legal, and regulatory implications of medical assistance in dying (MAiD) when providing nursing care.” (10 p. 6) However, across Canada curricular content and coverage related to end of life care and MAiD is variable [ 23 ]. Given the dynamic nature of the legislation that includes portions of the law that are embargoed until 2024, it is important to ensure that respondents are guided by current and accurate information. As the law changes, nursing curricula, and public attitudes continue to evolve, inclusion of core knowledge and content is essential and relevant for investigators to be able to interpret the portions of the survey focused on attitudes and beliefs about MAiD. Content knowledge portions of the survey may need to be modified over time as legislation and training change and to meet the specific purposes of the investigator.

Given the sensitive nature of the topic, it is strongly recommended that surveys be conducted anonymously and that students be provided with an opportunity to discuss their responses to the survey. A majority of feedback from both the expert panel of faculty and from student participants related to the wording and inclusion of demographic variables, in particular religion, religiosity, gender identity, and sex assigned at birth. These and other demographic variables have the potential to be highly identifying in small samples. In any instance in which the survey could be expected to yield demographic group sizes less than 5, users should eliminate the demographic variables from the survey. For example, the profession of nursing is highly dominated by females with over 90% of nurses who identify as female [ 50 ]. Thus, a survey within a single class of students or even across classes in a single institution is likely to yield a small number of male respondents and/or respondents who report a difference between sex assigned at birth and gender identity. When variables that serve to identify respondents are included, respondents are less likely to complete or submit the survey, to obscure their responses so as not to be identifiable, or to be influenced by social desirability bias in their responses rather than to convey their attitudes accurately [ 51 ]. Further, small samples do not allow for conclusive analyses or interpretation of apparent group differences. Although these variables are often included in surveys, such demographics should be included only when anonymity can be sustained. In small and/or known samples, highly identifying variables should be omitted.

There are several limitations associated with the development of this survey. The expert panel was comprised of faculty who teach nursing students and are knowledgeable about MAiD and curricular content, however none identified as a conscientious objector to MAiD. Ideally, our expert panel would have included one or more conscientious objectors to MAiD to provide a broader perspective. Review by practitioners who participate in MAiD, those who are neutral or undecided, and practitioners who are conscientious objectors would ensure broad applicability of the survey. This study included one student cognitive interview focus group with 5 self-selected participants. All student participants had held discussions about end of life care with at least one patient, 4 of 5 participants had worked with a patient who requested MAiD, and one had been present for a MAiD death. It is not clear that these participants are representative of nursing students demographically or by experience with end of life care. It is possible that the students who elected to participate hold perspectives and reflections on patient care and MAiD that differ from students with little or no exposure to end of life care and/or MAiD. However, previous studies find that most nursing students have been involved with end of life care including meaningful discussions about patients’ preferences and care needs during their education [ 40 , 44 , 47 , 48 , 52 ]. Data collection with additional student focus groups with students early in their training and drawn from other training contexts would contribute to further validation of survey items.

Future studies should incorporate pilot testing with small sample of nursing students followed by a larger cross-program sample to allow evaluation of the psychometric properties of specific items and further refinement of the survey tool. Consistent with literature about the importance of leadership in the context of MAiD [ 12 , 53 , 54 ], a study of faculty knowledge, beliefs, and attitudes toward MAiD would provide context for understanding student perspectives within and across programs. Additional research is also needed to understand the timing and content coverage of MAiD across Canadian nurse training programs’ curricula.

The implementation of MAiD is complex and requires understanding of the perspectives of multiple stakeholders. Within the field of nursing this includes clinical providers, educators, and students who will deliver clinical care. A survey to assess nursing students’ attitudes toward and willingness to participate in MAiD in the Canadian context is timely, due to the legislation enacted in 2016 and subsequent modifications to the law in 2021 with portions of the law to be enacted in 2027. Further development of this survey could be undertaken to allow for use in settings with practicing nurses or to allow longitudinal follow up with students as they enter practice. As the Canadian landscape changes, ongoing assessment of the perspectives and needs of health professionals and students in the health professions is needed to inform policy makers, leaders in practice, curricular needs, and to monitor changes in attitudes and practice patterns over time.

Availability of data and materials

The datasets used and/or analysed during the current study are not publicly available due to small sample sizes, but are available from the corresponding author on reasonable request.

Abbreviations

British Columbia College of Nurses and Midwives

Medical assistance in dying

Nurse practitioner

Registered nurse

University of British Columbia Okanagan

Nicol J, Tiedemann M. Legislative Summary: Bill C-14: An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying). Available from: https://lop.parl.ca/staticfiles/PublicWebsite/Home/ResearchPublications/LegislativeSummaries/PDF/42-1/c14-e.pdf .

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Acknowledgements

We would like to acknowledge the faculty and students who generously contributed their time to this work.

JS received a student traineeship through the Principal Research Chairs program at the University of British Columbia Okanagan.

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JS made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and drafting and substantively revising the work. JS has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. BP made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and drafting and substantively revising the work. BP has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. LO made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and substantively revising the work. LO has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. NDO made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and substantively revising the work. NDO has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. HS made substantial contributions to drafting and substantively revising the work. HS has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Schroeder, J., Pesut, B., Olsen, L. et al. Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study. BMC Nurs 23 , 326 (2024). https://doi.org/10.1186/s12912-024-01984-z

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Received : 24 October 2023

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Published : 14 May 2024

DOI : https://doi.org/10.1186/s12912-024-01984-z

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Effect of Machine Learning on Anaesthesiology Clinician Prediction of Postoperative Complications: The Perioperative ORACLE Randomised Clinical Trial

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Background: Anaesthesiology clinicians can implement risk mitigation strategies if they know which patients are at greatest risk for postoperative complications. Although machine learning models predicting complications exist, their impact on clinician risk assessment is unknown. Methods: This single-centre randomised clinical trial enrolled patients age ≥18 undergoing surgery with anaesthesiology services. Anaesthesiology clinicians providing remote intraoperative telemedicine support reviewed electronic health records with (assisted group) or without (unassisted group) also reviewing machine learning predictions. Clinicians predicted the likelihood of postoperative 30-day all-cause mortality and postoperative acute kidney injury within 7 days. Area under the receiver operating characteristic curve (AUROC) for the clinician predictions was determined. Results: Among 5,071 patient cases reviewed by 89 clinicians, the observed incidence was 2% for postoperative death and 11% for acute kidney injury. Clinician predictions agreed with the models more strongly in the assisted versus unassisted group (weighted kappa 0.75 versus 0.62 for death [difference 0.13, 95%CI 0.10-0.17] and 0.79 versus 0.54 for kidney injury [difference 0.25, 95%CI 0.21-0.29]). Clinicians predicted death with AUROC of 0.793 in the assisted group and 0.780 in the unassisted group (difference 0.013, 95%CI -0.070 to 0.097). Clinicians predicted kidney injury with AUROC of 0.734 in the assisted group and 0.688 in the unassisted group (difference 0.046, 95%CI -0.003 to 0.091). Conclusions: Although there was evidence that the models influenced clinician predictions, clinician performance was not statistically significantly different with and without machine learning assistance. Further work is needed to clarify the role of machine learning in real-time perioperative risk stratification. Trial Registration: ClinicalTrials.gov NCT05042804

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

NCT05042804

Funding Statement

This work was supported by grants from the National Institute for Nursing Research (R01 NR017916) and from the Foundation for Anesthesia Education and Research (grant MRTG08152020), as well as departmental funding from Washington University School of Medicine. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; or the decision to submit the manuscript for publication.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The institutional review board at Washington University School of Medicine gave ethical approval for both TECTONICS (approval #201903026) and Perioperative ORACLE (#202108022) with a waiver of informed consent.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Data Availability

The Washington University Human Research Protection Office did not permit sharing of individual patient-level data due to enrollment with a waiver of informed consent. However, group cross-tabulations with sufficient detail to replicate the analyses in this manuscript are available on request.

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