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This paper is an analysis of two articles, about different aspects of education. The study in the first article identified school-based health centers as a way to increase academic outcomes and decrease the number of days students miss school. The study in the second article is a opportunity to research a study that examines the result of teacher in servicing on practical teacher behaviors. The first article critiqued is written by Cura (2010) titled: The relationship between school-based health centers, rates of early dismissal from school, and loss of seat time. The second article reviewed is from Teaching and Teaching Education and discusses the effects of training teachers on new model of instructional behavior.
Section 1: A Review of the Data Analysis
A quasi-experimental method with a nonequivalent control group design was used to compare early dismissal rates and loss of seat time between students in the article identifying the relationship between school-based health centers, rates of early dismissal from school and loss of seat time (Cura. (2010). There were two principal research problems. First problem do students enroll in a secondary level school-based health center have lower rates of early dismissal from school than students who receive only traditional school nursing services. Second problem do students enrolled in a secondary level school-based health center lose less seat time due to fewer early dismissals from school than students who receive only traditional school nursing services (Cura. (2010).
Students enrolled in the school-based health center in school group A were the experimental group and was compared with students in two groups that received only traditional school nursing services. This particular study had 764 walk-in visits during a three week period in two urban high schools. Data on early dismissal were collected on the Welligent school health electronic medical system. All visits that met the inclusion criteria for the three-week study were entered into the Statistical Program for the Social Services (Cura, (2010).
The variables entered into the Statistical Program for the Social Services included gender, race, age, eligibility for free or reduced lunch (indicator of poverty status), health problems, date of service, and whether the student was referred to the Statistical Program for the Social Services. Outcome after services such as return to class, early dismissal from school, emergency care, and the time of day the student entered and left the health center(Cura, 2010). The null hypothesis is students who are not enrolled in school-based health center receive only traditional school nursing services will not lose any more seat time than a student enrolled in a school-based health center.
The study had a total of six hypotheses:
H1: The student's gender will not be a predictor for a loss of seat time or early dismissal.
H2: The student's race will not be a predictor for loss of seat time or early dismissal.
H3: The student's age will not be an influence for the loss of seat time or early dismissal.
H4: The student's poverty status will not influence the loss of seat time or early dismissal.
H5: The student's who have pre existing health issues will not influence the study.
H6: The students enrolled in an SBHC will have more seat time and less early dismissal.
Reviewing the four assumptions Munro speaks of the sample must first represent the population in the stated article the sample was high school students from two schools. The correlating variable must each have a normal distribution; Cura demonstrates normal distribution of the variables. Also, the assumption of homoscedasticity must be present and in the article equal variability was present. Munro's final assumption is that the relationship between IV and DV is linear and the above article did present linear a relationship (Munro, 2005).
Three groups of students represented the demographic composite for comparison. One group was experimental and two groups were comparison. This demonstrated no significant difference between the students by poverty status (p,052; ?2=5.910, df=2). However a significant difference was found by race (p=.001;2=27.132,df=8), age (p=.000;F (8,761)=5.30) and gender (p=.005;?2=10.533,df=2) (Cura, 2010).
The frequency tabulation for each group was demonstrated in a table. The table provides both the actual count and the expected count for participants who return as compared to those who received and early dismissal. A significant relationship at the .05 level (p=.013) was found between the groups and rates of early dismissal (?2=8.614,df=2) (Cura, 2010). The exact count for each group indicated that the students enrolled in a school-based health center were significantly more likely to return to class or not be dismissed early from school than a student not enrolled in a school-based health center. The univariate analysis showed that these findings were not influenced by age, gender, race, or poverty level. However, race and gender were measured with nominal scales. Age used interval scales and poverty status was measured using ordinal scales. The students were coded one for returned to class and coded two for early dismissal demonstrating nominal scale of measurement (Cura, 2010).
A review of the data analysis of the second article this paper demonstrates a research study that will examine teacher behavior with the training of new techniques in teaching. The authors focus on answering a specific research question and the problem attempting to demonstrate that teachers in primary education can be introduced to and learn new models such as cognitive apprenticeship or direct instruction (De Jager, Reesigt, & Creemers,. 2008 p. 832). The research is designed with a pre test, post test, and control group demonstrating quantitative research (De Jager, et al., 2008).
The authors hoped to reach educators throughout the world but fall short of that goal and identify 83 primary teachers all in the Netherlands. The sample became identifiable by locale and occupation, and each participant needed to have familiarity with a specific curriculum for reading comprehension called "I know what I read". Even though 83 volunteer of that number only 20 participated resulting in two experimental and one control group. The two experimental groups consisted of eight teachers who were in serviced in cognitive apprenticeship and the second experimental group consisted of five teachers who were in serviced in direct instruction. The control group consisted of the remaining seven teachers. The subjects are shown to be comparable in terms of years teaching (average 22.1, SD=1.9) and their experience with the identified curriculum (average 2.8, SD=1.9) (De Jager, et al., 2008).
Methods for evaluation of this quantitative study is a survey style observation tool which was administered four times for each of the identified groups and will be administered twice for the control group. The instrument used falls into the category of nonparametric testing. The ordinal scaling test (The Mann-Whitney U test) was given to the participants identifying the data generated by the observation tool (De Jager, et al., 2008).
The independent variables in this research are directly related to the training of the two experimental groups in the different models, Cognitive Apprenticeship and Direct Instruction. . The dependent variable is the inclusion of instructional methods which are designed to develop metacognitive reading skills (De Jager, et al., 2008). Other key independent variables exist such the preexisting familiarity with a specific curriculum model, past educational experience and the rage of ages of participants.
The study has a total of three hypotheses:
H1: The teachers will show an increase of the main characteristics of models (cognitive apprenticeship or direct instruction).
H2: The teacher will demonstrate an increase in quality of their presentation.
H3: The teachers will learn comprehension skills and meta cognitive skills. (De Jager et al., 2008, p. 834).
The results of this research article prove the hypotheses to be correct. While this is the case the represented data in the charts do not correspond and I feel it would have been transparent to the reader if the results where combined into one single chart. The internal validity to the test is high and the author took explicitly outline efforts in development of the observation tool regarding low and high inference observations. Five individuals were trained administer the observational tool and the interrater was quite high (0.81) (De Jager et al.,2008). .
The development of the observation tool included two sections. The first section asked the participant to complete a low inference checklist in two minute intervals. The second section of the tool consisted of a high inference in the form of a Likert Scale ( De Jager et al.,2008). Using a Likert Scale questions the internal validity in that the administrator may not want to indicate extremes thus stick to mid ranges on the scale (De Jager et al., 2008). Further question comes into play when it is discussed that lay people are trained to do the observation rather than a trained researcher.
Appropriate statistical test, such as Mann-Whitney U test where administered and the four assumptions according to Munro where met. Stated population was teachers, normal distribution of the variable with homoscedasticity and the relationship between the IV and DV did present linear (Munro, 2005).
Section II: Data Analysis Evaluation
The analysis from the first article "The relationship between school-based health centers, rates of early dismissal from school, and loss of seat time" demonstrated school-based health centers significantly reduced the number of early dismissals from school (p=.013) in a comparison with students who received school nursing services alone (Cura, 2010). Cura stated that the findings provide key accountability outcomes for schools that currently have an SBHC and can serve as a catalyst for the development of others especially in schools that serve high-risk youth or youth without access to health care (Cura, 2010). The data gather from this study not only demonstrated how early dismissal and availability of health care can indeed increase days in schools it created the foundation for further studies. Maintaining the physical and emotional health of students will directly improve academic outcomes and offer the ideal opportunity for further research on the benefits of a SBHC within the school.
The three week period of data collection is one of the limitations to this study. A suggestion would be for further studies to extend possibly over an entire school year. The data would be not only richer the study would be broader and identify other patterns or barriers to seat days and improvement to academic performance. Cross-Tabulation between study groups and early dismissal rates, Univariate Analysis of Early Dismissal by group, Mean and standard deviation of loss of seat time for all 3 study groups, chi-square analysis, t test, ANOVA and a regression analysis of the relationship between age and loss of seat time found no significant relationship between the two variables at the .05 level (B=.047, t= 1.248, significance = .212) (Cuva, 2010). Honestly, I feel this study was well conducted and absolutely affirmed the hypothesis and demonstrate SBHC will decrease rates of early dismissal and increase time available for academic success. The results unequivocally have my trust.
The analysis from the second article provided the reader with results of the research that do not demonstrate validity. The difference reported demonstrated positive results but sample size was small and insufficient and thus represent to be statically invalid. The author states the teachers who were trained in direct instruction and cognitive apprenticeship showed more characteristics of these models the teachers who were not in serviced in the implementation of these models. My issue is that showing these characteristics of instruction does not constitute success. The authors would indicate success when the teachers behavior changes when trained and coached with new practices and presentation (De Jager et al., 2008). I would be remiss to not inform the reader of this paper that the research team also informed the reader that the scores of the experimental groups did not produce significantly different results from the control teachers (De Jager et al., 2008 p. 839). In the end the researcher are left with no other option from their work than to state that their study is non-conclusive. My trust in this study goes with the author's statement that they recommend amendments to the research methods and call upon others to repeat the experiment (De Jager et al., 2008). I could not agree more.
Section III: Understanding the Data
The study to examine to understand the relationship between school-based health centers and academic outcomes would have a direct impact on success academically for students. The study in my opinion sets the wheels in motion for federal funding to incorporate this model throughout the United States. I want to say to my professional peers watch for this legislation and change as we go through health care reform. Health Care Professionals and Nurses in particular need to be the voice of this change and be prepared to staff these centers when they arrive. The study articulated findings clearly and the graphs and charts are visual aids in the success of the study. What you may find confusing and need sufficient evidence of success in the area where the schools where and in the allotted time for the study.
The usefulness of statistics is critical when it comes to identifying best practice and demonstrating success in modalities of treatment. Statistics done well can change how we deliver health care for greater outcomes and a healthier nation. As nurses we need to be able to read and know what we are reading as to drive forward the best practices and be advocates for our communities and patients.
The benefits of school-based health center are many and to name a few thoughts. SBHC attends to unmet health care needs, supports students by providing a safe place to talk about sensitive issues (depression, family problems, relationships, and substance abuse to name a few). SBHC supports the school environment by helping children to stay in school by addressing health issues that may interfere with the learning process. Another benefit of SBHC is families and parents have easy access to health care and education. My final statement would be what if children had easy access to health care the emergency room use would decrease and the children's relationship between the community and the school would strengthen. I am passionate about this opportunity and support with the evidence in the study a change in practice.
As a whole, I found the second article reviewed to be lacking in merit. While it is interesting to see that training of other best practices can indeed have a direct impact on the quality of teaching in the classroom the sample groups were poorly selected. In the end the results themselves are not convincing as there is not an identified difference from the sample and control groups.
Attempting to find the usefulness of this study to my nursing peers I would be remiss to not mention the instructional methods, cognitive apprenticeship and direct instruction as model of engagement and retention of students. Yet the authors clearly demonstrated that educators who are experienced in their education style/practice will have a more difficult time adjusting or incorporating change into their instructional methods. In and of itself does demonstrate the difficult of change into practice even when the end result for the students may be greatly enhanced by different modalities of education.
The article did offer me the opportunity to critique a study that challenged me differently and that was showing me that all research being done does not yield a change in practice but a reinforcement that the study must go on. I have attempted in this paper to develop a consistent explanation which not only talk about the particulars of the research but also identify a clear understanding of the research done. The study was confusing, the sample size small, and the method of selecting subjects and administering the survey all yielded a study less than valid.
Two very different articles have been presented that have a direct impact on the quality of and success of the educational experience. The first critiqued article clearly defined a research project that resulted in very clear outcomes of success in improving the academic experience and health care of students. The second article critiqued offered the reader two state of the art models of education and the difficultly infusing a change of process into a tenured educator. The study offered an inadequate sample size and an experiment that could be invalid simply by the way the sample/subjects were chosen and by whom the survey was administered.
Critiquing these articles simultaneously was an exercise that offers me the opportunity to present on two very different studies yet have an impact on education. I was also able to compare and contrast two articles that offered very different analysis on each article. When I set out to review the articles I did not recognize how I would develop a greater understanding of each article by the comparing and contrasting a well research process and one that lack validity and thus created confusion.