The Doctrine of the Church Research Paper Example | Topics and Well Written Essays - 3250 words

The Doctrine of the Church - Research Paper Example For what reason would you say you are so dejected, O my spirit? For what reason do you sign inside me? Expectation in God! For I will again be expressing gratitude toward him, within the sight of my rescuer and my God.† (Psalm 41:5-6). Through these two scriptural sections, we can infer that God planned for the individuals to save one day for His love, a day where there can be no different interruptions. God additionally urged the individuals to gather in a â€Å"procession to the place of God,† so as to express gratefulness and to lift the spirit - for trust in God, and thanksgiving within the sight of God, with others in a crowd, is the antitoxin to a sad soul. God plainly proposed that the individuals not overlook Him, which is the reason He educated the individuals to put aside daily to recall him every week, and the support to gather, both in the Hebrews section and the Psalm entry shows that get together is the picked approach to recollect Him. The Lord additionally implied for the gatherings to be a route for individuals to assemble to â€Å"arouse each other to noble cause and great works.† (Hebrews 10:24). This is the initial segment of the epistle wherein the Lord urges the individuals to not spurn collection. The Lord obviously needs us to be aware of noble cause and acts of kindness for other people, and He plainly means that the collection be a route for individuals to assemble to excite each other to play out these works. This is one of His aims for these gatherings, alongside recalling and loving Him and giving Him much obliged. Jews 10:25 likewise contained the expression â€Å"and this even more as you see the Day moving near.† (Hebrews 10:25).â

Military Leadership in the Union Armies Term Paper

Military Leadership in the Union Armies - Term Paper Example The fight proceeded for a long time from year 1861 to 1865 and afterward finished with the acquiescence of the Confederate and banned subjection all through the Country.1 Union gathering was served by more than 2.2 million military men, while approx 1.4 million individuals battled from Confederate side. The military faculty had increased proficient military training and worked under the initiative of officials from assorted foundations. These military officials were expertly prepared West Pointers, organizations people and political authorities. At first confederate had solid authority, yet Union had driven by poor officers. Later on, Union supplanted such authorities and utilized adroit and potential military men who had order understanding, subsequently carried triumph to the Union.2 This paper breaks down front line methodology and initiative of Military authorities in Union Army which drove the powers to vanquish Confederate men. The US Civil War never confronted setback of energ y in light of the fact that numerous youngsters needed to join the military in 1861. Every one of these individuals chipped in light of the fact that they were eager to battle with regards to the Union military power, fully expecting snappy advancements as lead by their experience. The difficulty made during the time spent chipping in was a serious absence of authority, arranging and association at the loftiest levels.3 The American Civil War provided a huge number of leaders and reasonable correlation in the midst of fight conditions and issues. The Union military armed force had a particular prerequisite for strong equipped battle authorities during the Civil War and those administrators and officials were basically should have been explicitly instructed and very much prepared to lead the individuals in war which would thus safeguard and maintain the new country. This exceptional need was acknowledged and comprehended by government and lawmakers, so they put forth attempts for mil itary training.4 Though, all military chiefs had not created through increasing proper military instruction and preparing. Numerous cells of expert authorities were framed by the United States Naval Academy at Annapolis and the United States Military Academy at West Point. These cells were involved proficient military officials who had total information on military science in order to make an exceptional effect on the mien of the American Civil War. All through the Civil War, Abraham Lincoln was the President of United States and simultaneously filled in as the Commander-in-Chief of the Union military, the most elevated positioning military official .5 The military staff had the power to choose the lesser officials, while the state governors designated the senior officials, and the President Lincoln assigned the generals.6 The huge military pioneers for the Union armed force included Ulysses S. Award, William T. Sherman, George B. McClellan, George Meade, John C. Fremont, Ambrose Bu rnside, Joseph Hooker, Irvin McDowell, and Winfield Scott.7 This paper tosses light particularly on the pretended by Generals George B. McClellan, Ulysses S. Award, George Meade, and William T. Sherman. During the American Civil War, George Brinton McClellan was a significant general. He filled in as the general-in-head of the Union Army for a brief period from November 1861 to March 1862, and facilitated the prestigious Army of the Potomac. In the start of the war, McClellan’s endeavors for raising an all around prepared and formulated armed force for the Union had been significant. Promontory Campaign started by McClellan in 1862 got fizzled, as his military retreated due to

When and How to Effectively Take a Mental Health Day

When and How to Effectively Take a Mental Health Day Stress Management Job Stress Print When You Should Take a Mental Health Day By Elizabeth Scott, MS twitter Elizabeth Scott, MS, is a wellness coach specializing in stress management and quality of life, and the author of 8 Keys to Stress Management. Learn about our editorial policy Elizabeth Scott, MS Updated on September 10, 2019 RelaxFoto.de/Getty Images More in Stress Management Job Stress Workplace Bullying Effects on Health Management Techniques Situational Stress Household Stress Relationship Stress Everyone has to deal with varying levels of stress. This can be particularly difficult to manage if you also have symptoms of depression or anxiety. When you feel like youre stress levels have reached their peak, it might be time to take a quick break to reset. Sometimes taking a mental health dayâ€"a day off thats specifically geared toward stress relief and burnout preventionâ€"is the best thing you can do for yourself. While one day might not solve heavy underlying problems that lead to burnout, a mental health day can provide a much-needed break to pause, regroup, and come back with greater levels of energy and a fresh, less-stressed perspective. Unfortunately, employers are not always supportive of psychological issues that workers may face. Yet mental health issues take a serious economic toll worldwide.?? According to research conducted by the World Health Organization, anxiety and depressive disorders cost more than a trillion dollars globally in lost productivity each year. Whatever stressors you face, these tips can help you take a mental health day and make the most of it. Take a  Day Once you have decided to take a mental health day, the question then becomes when and how. Ideally, if you can schedule a day off ahead of time, ensuring that youve taken steps to rearrange your workload or find a replacement for the day, this is the best way to do it, so youre not feeling stress about taking the day off. However, if you wake up in the morning and just feel that you cant face the stress of the day, this may be a good time to take a mental health day and make the most of it. While there has been a growing movement to destigmatize mental health issues in the workplace, many employers still believe that mental health concerns are not legitimate reasons to miss a day of work. A survey commissioned by the British government found that 70% of employers did not believe that stress, anxiety, and depression were valid reasons for missing work.?? More than half of employees felt that their employer did not take mental health issues seriously. For that reason, many workers report faking illness in order to get time off to cope. The decision of when to take a mental health day really depends on your personal situation. If your employer is supportive and you are comfortable sharing your reasons, feel free to plan a mental health day out in advance. If you dont want to divulge your reasons for taking a day or if your employer is less understanding, dont feel obligated to share. You can: Plan to use some of your time offSchedule your mental health day for a day you already have offIf absolutely necessary, call in sick Weekends work well, too. While a traditional mental health day generally includes taking a day off from work, its not necessary to call in sick to take a day to focus on stress relief. How to Cope With Mental Health Stigma What to Expect Knowing what you can expect to get out of a mental health day is important. Its important to remember that it isnt a day to hide from your problems.   An effective mental health day can help you: DestressReset your perspectiveTake a step back to evaluateGet a handle on your emotionsRelaxRest Problems can seem harder to deal with when they seem close, overwhelming, and inescapable. Taking a mental break from work and spending some time on self-care can sometimes give you that mini-break you need to head back into things with a clear head. Decide What You Need Most Sometimes this one is a no-brainerâ€"if youre exhausted, your body will be screaming that it needs to rest; if you feel you cant face another day of hard work, you may just need to have some fun. However, if youre feeling overwhelmed, you may not be as aware of your needs. Take a minute and really reflect: would you benefit the most from some tension relief? Or from making a few changes that will relieve stress in the future? Some time with a loved one? Or just a change of scenery? As different stressors require different responses, different types of mental health days fill unique needs. If You Need to Relax Taking a mental health day often means taking time out to relax. That can mean watching TV  in pajamas for hours or puttering around the house and doing nothing, and as long as this isnt an everyday thing, thats fine. However, some activities can take a little front-end effort and feel immensely relaxing once theyre completed. Some things you can try include:?? Taking a walk in natureAttending a yoga classSwimming at the gymGetting a massage The key is to spend time doing an activity that you find relaxing, whether its taking a hike, exploring a museum, or just spending some time immersed in a good book. Things NOT to Do Binge-watch TVAvoid friends and familySmoke, drink, or use other substancesOvereat unhealthy foodsRuminate or wallow in negative emotionsSpend all day reading posts on social media There are plenty of ways to spend your day, whether you decide to catch up on some much-needed sleep, indulge in a hobby you love, or hang out with a friend. Spend your day on activities that boost your physical and mental wellness. Simple Ways to Relax If You Need Some Fun If you really need a change of scenery and a Ferris Buellers Day Off kind of mental health day, be sure you make the most of it. Plan at least one fun eventâ€"either something you normally love to do and dont do enough  or something youve always wanted to try. Take along a good friend, if possible, to really make the day memorable. If nothing grabs your attention, try to engage in gratifications  or activities that provide just the right type of challenge: hobbies, games, and the like. If You Need to Make Some Changes If the stressors seem to pile up and youre looking for a way to slow down and stop the noise, you may want to take a day to restructure things. You may not be able to eliminate all of your ongoing stressors in a day, but you might be able to make a significant reduction in a few areas, and that may create a lasting impact on your stress levels. Start by: Create a list of things that drain your energyWork from there on eliminating stressorsTake a look at your prioritiesCut out some of your larger stressorsWork on increasing job satisfaction Dont expect to be able to take on all of this in a single day. If you want to use your mental health day to make real changes in your life, use it as a chance to evaluate, plan, and get ready to work on those changes. If You Need More of a Break If you need more of a break than just one day, consider taking a staycation or vacation. You may also consider whether youre headed toward burnout.  If youre concerned that your overall stress levels are greater than a mental health day, a vacation, or online resources can help, you may want to bring up your concerns with your doctor, or talk to a professional. There are many steps that can be taken to help. The Best Online Therapy Programs A Word From Verywell Look for ways to keep stress levels low and so that you dont wake up one morning in dire need of an emergency mental health day. A mental health day can be useful on occasion, but you should also strive to make your mental health a priority every day. How to Maintain Balance

Nestle s Marketing Pl Nestle - 961 Words

EXECUTIVE SUMMARY Nestle is a multinational cooperative around the world that was found by Henry Nest in the year 1866. Nestle has more than 280,000 employees worldwide and factories are established and operate more than 86 countries. Nestlà © has launched an initiative to produce infant formula that provides babies who are intolerant to breast milk. Current customers are a very strong demand for children s products, especially in Europe. Many joint venture companies have operated on behalf of a large number of successful Nestlà ©, although many name changes have been going on as well as the way. Nestlà © promotes R D to promote product growth in terms of product varieties. Many products have been presented to customers such as: baby†¦show more content†¦The Company s strategy is guided by several fundamental principles. Existing Nestle products grow through innovation and renewal while maintaining a balance in geographic activities and product lines. The long-term potential is never sacrificed by short-term performance. The Company s priority is to bring the best and most relevant products to people, wherever they may be, whatever their needs may be, throughout their lives. The taste of Nestlà © in each of the countries where Nestlà © sells products. Nestlà © is based on the principle of decentralization, which me ans that each country is responsible for the efficient operation of its business, including the hiring of its staff. PERFORMANCE OF THE COMPANY FOR THE LAST 3 YEARS Parameters DEC’ 15 DEC’14 DEC’13 Operational Financial Ratios: Earnings Per Share (Rs) 58.52 122.97 115.96 DPS(Rs) 48.60 63.10 48.60 Book NAV/Share(Rs) 292.35 294.46 245.77 Margin Ratios: Yield on Advances 1.00 1.00 1.00 Yield on Investments 1.00 1.00 1.00 Cost of Liabilities 1.00 1.00 1.00 NIM 1.00 1.00 1.00 Interest Spread 1.00 1.00 1.00 Performance Ratios: ROA (%) 9.57 19.63 19.67 ROW (%) 19.98 45.57 53.68 ROCE (%) 28.80 55.86 53.62 Efficiency Ratios: Cost Income Ratio 1.00 1.00 1.00 Core Cost Income Ratio 1.00 1.00 1.00 Operating Costs to Assets 1.00 1.00 1.00 Capitalization Ratios: Tier 1 ratio 1.00 1.00 1.00 Tier 2 ratio 1.00 1.00 1.00 Car 1.00 1.00 1.00Show MoreRelatedMarketing Mix - Tesco Poland Case Study Essay3667 Words   |  15 PagesContents List of figures 3 List of Tables 3 Introduction 4 1. Marketing mix using Tesco Poland as an example 5 1.1 Products 5 1.2 Price 6 1.3 Place 6 1.4 Promotion 7 1.5 People 7 1.6 Process 8 1.7 Physical evidence 9 1.7.1 Parking 9 1.7.2 Buildings 9 1.7.3 Stores/decor/furnishings 10 2. Micro environment - competition 11 2.1 Tesco vs. Biedronka (Ladybird) 12 2.2 Tesco vs. Carrefour 12 2.3 Comparison of the top 3 retail chains in Poland 13 Read MoreNestle Accounting Practices8557 Words   |  35 PagesAccounting -I Final Project Report Company – Nestlà © India Submitted By Rahul –PGP25259 Praveen – PGP25258 Pratyush – PGP25257 Prachal Mehrotra – PGP25255 Prajeesh Jayaram L – PGP25256 Sanjay Dhir – FPM10013 1. About Nestlà © Nestlà © is a food and package multinational with its headquarters situated in Vevey, Switzerland. The company came into being in 1905, after a merger between Anglo-Swiss Milk Company and FarineLactà ©e Henri Nestlà © Company. The company now has a strong presenceRead MoreCoffee Industry11409 Words   |  46 Pagesa huge lead through the years. table 1. Coffee Brand Shares 2002 20051 (% retail value rsp) Brand Nescafà © Great taste taster’s Choice Maxwell House Kaffe de Oro blend 45 Gourmet’s Culinary Exchange Others total company Nestlà © Philippines inc Universal Robina Corp Nestlà © Philippines inc Kraft Foods (Philippines) inc. General Milling Corp Universal Robina Corp Gourmet Farms inc Culinary Exchange, the 2002 91.8 2.5 3.2 1.6 0.2 0.1 0.1 0.1 0.5 100.0 2003 91.0 3.0 3.3 1.7 0.3 0.2 0.1 0.1Read MoreThe Mind of a Marketing Manager26114 Words   |  105 PagesThinking: The mind of a marketing genius Thinking: The mind of a marketing genius * Where are the best opportunities for your business today? How do you stand out in crowded markets? How do you deliver the best solutions for customers, and the best returns to shareholders? * Where should you focus amidst this complexity? What is your competitive advantage? Which markets, brands, products and customers should you prioritize in order to maximize value creation?

Web Based Technology And Continuing Medical Education - Free Essay Example

Sample details Pages: 24 Words: 7332 Downloads: 8 Date added: 2017/06/26 Category Statistics Essay Did you like this example? This dissertation explores the use of Web based technology to enhance and maintain procedural skills in the context of continuing medical education. The research was initiated by the perceived need for novel and alternative methods of providing procedural skills training to health practitioners. This observation, supported by learning needs analysis, led to the design and implementation of a Web based educational resource aimed at doctors and other healthcare practitioners. The assessment part of the research focused on an empirical evaluation of the effectiveness of this Web based educational resource. This dissertation draws on a number of strands of Health Informatics: Don’t waste time! Our writers will create an original "Web Based Technology And Continuing Medical Education" essay for you Create order Principals of Heath Informatics Research Methods Clinical Information Systems Creating Online Educational Resources Whilst on a small scale, the results are relevant to medical educators involved in developing and evaluating web based educational resources. BACKGROUND Medical practitioners receive comprehensive procedural skills training and it is expected that this is maintained and regularly updated to limit skills decay and ensure clinical competency. Skills decay is defined as the loss of a trained or an acquired skill after a period of nonuse. Skills decay rapidly as the period of nonuse lengthens; and the extent of the decay is influenced by the characteristics of the skill and how and when these skills were learnt. Arthur et al., (1998) Skills are classified either as à ¢Ã¢â€š ¬Ã…“closed loopà ¢Ã¢â€š ¬? or à ¢Ã¢â€š ¬Ã…“open loop tasks.à ¢Ã¢â€š ¬? Arthur et al., (1998). Closed loop tasks are fixed sequence tasks with a defined beginning and end, for example, the preoperative anaesthetic machine check. à ¢Ã¢â€š ¬Ã…“Open loop tasksà ¢Ã¢â€š ¬? are tracking and problem solving tasks, for example, managing patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s hypoxia. Arthur et al., (1998) in their review on the rate of skills decay and its influencing factors concluded that à ¢Ã¢â€š ¬Ã‹Å"closed loop tasksà ¢Ã¢â€š ¬Ã¢â€ž ¢ decay more slowly than à ¢Ã¢â€š ¬Ã‹Å"opened loop tasks.à ¢Ã¢â€š ¬Ã¢â€ž ¢ Arthur et al., (1998) also mentions that mental tasks decay more quickly than physical tasks and after 28 to 90 days of nonuse of the trained skills, task performance declines by 23% and by 40% after a year of nonuse. Clinical practice alone may be insufficient to prevent skills decay as indicated in a simulated airway management training study Kovacs et al., (2000). Skills decay quickly without practice; and procedural skills are only optimally retained when trainees regularly practiced the procedure on their own, in their own time and received periodic feedback. Training on simulation modalities, mannequins, fresh cadavers and live patients have the potential to successfully teach the procedural skill with significantly less skills decay over time as compared to didactic teaching alone. TI L et al., (2006). The traditional à ¢Ã¢â€š ¬Ã‹Å"one to oneà ¢Ã¢â€š ¬Ã¢â€ž ¢ apprenticeship model of medical procedural skills training and the in-hospital continuous medical education and maintenance of a skills base are often inefficient, expensive, and labour intensive. Patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s, who are often used as practice tests subjects during skills training, safety is reliant on the medical practit ioner skills retention and task competency. Maintaining procedural skills competency may prove to be increasingly more challenging as expense, time constraints, available manpower, lack of resources and patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s reluctance to be used as experimental models make this endeavor increasingly impossible to set up. The resultant worldwide move towards competency based training programs and self directed problem oriented based learning has made necessary the search for alternative valid and reliable educational methods for skills training and its maintenance. Fortunately, the last decade has seen an explosion in the use of technology to enhance medical education. Web-based educational programs, computer aided virtual reality situations, and high fidelity simulation has played an increasingly important role in medical education owning to its efficiency, ability to provide flexible learning experiences, multimedia capabilities, and economies of scale and power to distribute instructional content internationally. Vozenilik et al., (2004) In the last 5 to 10 years extensive empirical research has been conducted on the use of computer aided and web-based instruction in medical education where there has been overwhelming support for these mediums of instruction. Unfortunately the literature is strikingly sparse on the use of Web based instruction for procedural skills training and in the few studies where empirical research has been carried out; study designs were not robust enough to withstand interrogation or had inconclusive results. LITERATURE REVIEW A review of the literature was conducted to ascertain what work had been done in the field of Web based learning, medical education and procedural skills training. A CINAHL and Medline search was carried out exploring all citations up to June 2010. The search using Medical Subjects Headings (MeSH) à ¢Ã¢â€š ¬Ã…“Computer Aided Instructionà ¢Ã¢â€š ¬?, à ¢Ã¢â€š ¬Ã…“Internetà ¢Ã¢â€š ¬?, à ¢Ã¢â€š ¬Ã…“CMEà ¢Ã¢â€š ¬? returned 322 publications. Adding the MeSH term à ¢Ã¢â€š ¬Ã…“Reviewà ¢Ã¢â€š ¬? returned 21 reviews of which four were relevant. Replacing à ¢Ã¢â€š ¬Ã…“CMEà ¢Ã¢â€š ¬? with à ¢Ã¢â€š ¬Ã…“Procedural Skills Trainingà ¢Ã¢â€š ¬? produced only one noteworthy empirical research paper and 2 publications worthy of discussion. Relevant systematic reviews of the literature are summarized in the table below: 3 Title Author / Date Findings Review Conclusions Assessment of the Review Internet-Based Learning in Health Professionals: A Meta-analysis Cook et al., 2008 201 eligible studies with qualitative or comparative studies of Internet based learning accounting for 56 publications Internet formats were equivalent to non-Internet formats in terms of learner satisfaction and changes in knowledge, skills and behavior. Internet based learning is educationally beneficial. Comprehensive work with a robust study design. Skills outcomes included communication with patients, critical appraisal, medication dosing, cardiopulmonary resuscitation, and lumbar puncture. Unfortunately the study had many limitations as many publications were poorly designed with low methodological quality, without validity and reliability evidence for assessment scores and with widely varying interventions What the meta analysis did suggest was that no further studies comparing Internet based interventions with traditional methods or no intervention were merited as these types of studies would almost invariably be in favour of Internet Based interventions. The author of the review suggested that the questions that warranted further research would be when and should Internet based learning be used and how could it be effectively implemented giving impetus to the exploration of Internet based skills training and maintenance. Title Author / Date Findings Review Conclusions Assessment of the Review The Effectiveness of Computer-Aided (CAL) Self-Instructional Programs in Dental Education: Rosenberg et al. 2003 1024 articles systematically reviewed. 12 publications included in the final review. Five studies significantly favored CAL. CAL is as effective as other methods of teaching and can be used as an adjunct to traditional education or as a means of self-instruction. This study is a comprehensive review of controlled randomized studies with clear and relevant inclusion criteria assessed with good inter and intra rated reliability. The reviewer limited the study to dental students. Forms of Computer Aided Instruction was not clearly defined or specified in the inclusion criteria. It is unclear whether web based studies were included. The skills referred to in the studies were dental diagnostic not procedural skills. The apparent dearth of studies assessing procedural skills justified the investigation undertaken by this dissertation. Title Author / Date Findings Review Conclusions Assessment of the Review Internet-based medical education: a realist review of what works, for whom and in what circumstances. Wong et al. 2010 249 papers met their inclusion criteria. Learners were more likely to accept a course if it offered a perceived advantage over available internet alternatives, if it was easy to use technically, had elements of à ¢Ã¢â€š ¬Ã‹Å"interactivityà ¢Ã¢â€š ¬Ã¢â€ž ¢ and gave formative feedback. This study is a realist review and the methodology used answered the question of the study which aimed to provide a theory driven criteria to guide development and evaluation of Internet based tools. The findings and guidelines suggested in this review would later be incorporated in the design of the resource to be investigated in this dissertation. Title Author / Date Findings Review Conclusions Assessment of the Review eLearning: a review of Internet-based continuing medical education (CME). Wuton et al. 2004 16 studies met their eligibility criteria Internet based CME programs were as effective as traditional formats of CME A comprehensive and appropriate search of databases. Randomized controlled trials of Internet based education in practicing health care professionals. These results showed that Internet based interventions do have a place in CME and that these effects on skills behavior warrants further investigation. Title Author / Date Review Conclusions Assessment of the publication Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training. Chenkin et al. 2008 Web based tutorial may be an useful alternative to didactic teaching for learning of procedural skills A randomized control trial with non inferiority data analysis. The non inferiority margin was specified at a 10% margin however the actual amount of improvement was not specified. Blinding bias was not assured and the trial relied on the reputation of the investigator. No mention of inter rated reliability was made. Despite its inherent weaknesses, the trial suggested that web based intervention is as good as the alternatives; however, the study incorporated the use of simulation and live models to teach the actual procedural skill. David Cook is a prolific writer of many reviews and publications investigating Internet based formats in medical education. His noteworthy publications à ¢Ã¢â€š ¬Ã…“Web based learning: pros, cons and controversiesà ¢Ã¢â€š ¬? Cook, (2007) and à ¢Ã¢â€š ¬Ã…“Where are we with Web based educationà ¢Ã¢â€š ¬? Cook,( 2006) extolled the benefits overcoming barriers of distance and time with novel instructional methods, and extenuated the disadvantages which included social isolation, upfront costs and technical difficulties of Web based education. He concluded that Web based instruction can be a potentially powerful tool and strongly recommended that the focus of future studies should concentrate on the timing and application of Web based learning tools. Summary of literature survey The review of the literature has outlined the use of Web based procedural skills training as an area that requires further research. Empirical research and systematic reviews that has been carried out thus far has been limited. The literature research conducted for this dissertation (though in its self may have been limited) was unable to find publications exploring the whole use of the Internet as a means of procedural skills training and skills maintenance. Justification and Learning needs analysis To assess the effectiveness of an Internet based learning resource in the context of procedural skills training, a skill had to be chosen that was relevant, involved both a physical and mental task, and had the potential of decaying. A procedural skill is defined as à ¢Ã¢â€š ¬Ã…“the mental (knowledge) and motor activities (behaviour) required to execute a manual taskà ¢Ã¢â€š ¬? and usually involves patient contact. Kovacs (1997). Furthermore, a learning needs analysis was undertaken to assess the value of this topic choice. Justification Intubation with a Laryngeal Airway Device (LAD) was chosen as the representative procedural skill. When a patient collapses from a cardiac or respiratory cause, timely control of the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s breathing and airway with prompt delivery of cardiopulmonary resuscitation (CPR) and defibrillation have resulted in life saving survival and neurological recovery. The LAD is a breathing maintenance device that can, with minimal training, be inserted effortlessly into the mouth of the patient allowing for breathing and oxygenation. It is increasingly being used in the repertoire of techniques available to frontline practitioners (practitioners first on call to resuscitation events) in emergencies where the technique has proven to be easy to use and life saving in the management of an airway crisis. Kette, (2005). In a survey of family medicine practitioners, all practitioners surveyed agreed that insertion of an LAD during a resuscitation procedure was a core procedural skill that most practitioners were required to perform in any setting; 86% admitting that they had been called upon at some point to perform the procedure. Wetmore et al., (2005). Insertion of a LAD with knowledge of the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s anatomy, indication and contraindication for use and technique of use both under a controlled setting and in an emergency is representative of a procedural skill a frontline practitioners is expected to perform. Learning needs analysis A key step in developing an effective educational website is performing a learning needs analysis to determine what the learning needs the resource hopes to address are and why these needs were not met by existing learning or teaching arrangements. Cook Dupras, ( 2004). A questionnaire not previously validated, making use of closed type questions, were used to assess three broad areas; knowledge and training, skills application and Internet accessibility. Eleven frontline practitioners were asked to provide an indication of how often they were called to attend resuscitation or airway management situations in the last two years. They were surveyed regarding training received in LAD usage and insertion, their desire to obtain more information or skills updating, and whether there was a perceived need for Internet-based continuing medical education courses on LAD usage and intubation. Their attendances at CME workshops in the last year were surveyed and the barriers to CME workshop attendance were assessed. The respondents were surveyed regarding access to the Internet and previous exposure to e-learning modules. This was done to assess whether the uptake of the resource would be biased towards participants with Internet access, frequent Internet uses or previous e-learning experiences. The results of the learning needs analysis showed that most respondents (90%) received exposure to the device. It is a requirement of their post as frontline practitioners, to be Acute Life Support (ALS) trained where usage of the device in resuscitation is taught. Half the respondents indicated that they were not comfortable with their level of knowledge; and 63% felt unconfident about inserting the device as they were on average, only exposed to two resuscitation scenarios per year. All had Internet access at work and at home; and half had previous experience of online learning. Only one percent of the respondents were able to attend a CME session in the last year, citing lack of time and convenience as the main reasons. 80% of respondents were interested in taking courses through the Internet, as continuous education credits are a requirement of a license to practice in medicine. Interest in the topic was high and given the above self-appraisal, it was felt that the course was nee ded and should appeal to this population. METHODS The method section is dealt with in two parts. The first will focus on the development and design of a Web based educational resource and the second on the evaluation of the resource. 1. Development and design The idea was to develop an educational resource that could be used to train, reinforce knowledge and maintain a procedural skill by employing and integrating principles of effective adult learning with the unique features of the web. The development was driven by educational needs and outcomes of learning needs analysis completed by participants in a previous part of this study. 1.1 Development Theories The course design reflected Adult Learning Principles and the aim of the course was to improve knowledge (cognition), integration of attitude changes (confidence) and in so doing result in a change in behaviour (competency). Gale (1986). With accessibility of the Web based educational resource, it was hoped that the resource would be accessed frequently until the task becomes automatic or accessed as a refresher when required or at regular intervals. The resource incorporated principals that were shown to be effective. It was centered on the learners needs, was focused on a specific task and recognised past experiences of the learner (Gale 1986). The theories used in the development of the resource included; Experiential Learning Theory, which concluded that experiential learning should have personal relevance, should be self-initiated and lead to pervasive effects on the learner. Rodgers (1969) Constructivist Theory where learning is an active process with learners constructing new ideas and concepts based upon past and current knowledge. Bruner (1966) Information Processing Theory where knowledge is presentation in sequences or à ¢Ã¢â€š ¬Ã‹Å"chunkingà ¢Ã¢â€š ¬Ã¢â€ž ¢ to accommodate short attention spans (Miller 1956). The educational resource strived to be pedagogically sound uniquely applying these principles online. Information was presented in small chunks in a sequential fashion, was self-contained, had interactive components and contained assessments with instant feedback. Online communication did not occur in real time as which happens with video conferencing and online chat rooms, instead the resource used communication that was asynchronous where participants logged on, viewed and downloaded course material, read postings and submitted interactive tasks. The advantage of using an asynchronous format was that learners and/or the instructor did not need to be online at the same time allowing the participant to work at his or her own pace. The asynchronous nature of this web based learning environment allowed for barriers of time, location and expense to be overcome. Sanoff (2005) 1.2 Moodle Description University College Londonà ¢Ã¢â€š ¬Ã¢â€ž ¢s (UCL) Moodle was the platform used to develop the educational resource. There are many applications offering free alternatives to the commercial software WebCTTM and BlackboardTM, however the UCL Moodle was chosen as a matter of convenience because it was accessible, independent of specific operating systems, fit for purpose and easy to use without much technical computer knowledge thereby potentially removing barriers to any future course design and development.. Moodle (Modular Object Oriented Dynamic Learning Environment) is software freely available to use and was developed by Dougiamas. Moodle. org (1999). The Moodle software was designed on pedagogical principles that encourage learner interaction in a virtual learning environment. Moodle is a course management system used to support Web-based courses and has a number of innovative tools that could be used to create courses that promoted collaborative learning. Moodle is able to run without modification on Unix, Linux, FreeBSD, Windows, Mac OS and Netware. (Moodle. Org). After an initial learning curve, the program was easy to use with simple but comprehensive online instructions. Moodle It did not require pre-existing computer programming knowledge, and in fact the author of this dissertation considered herself a novice computer user. Moodle is written in hypertext pre-processor (PHP) which is HTML embedded scripting language used to create dynamic Web pages.  PHP allows for connecting to remote servers, checking email, URL encoding and setting cookies. It offers good connectivity to many databases including MySQL, and PostgreSQL,  which Moodle uses as a single database. MySQL is a  relational database management system  that runs as a server providing multi-user access to a number of databases. (www.php.net). Moodle had the support for easily displaying multimedia aspects of the educational resource and the interface could be used in over 70 native language translations. The Web based educational resource was easily built up using multimedia activity modules and design elements, which included with easy navigation; Authentication and enrollment, Syndication with a chat forum made available to others as newsfeeds, Current evidence based didactic teaching, Interactive quizzes allowing import/export in a number of methods Hyperlinked resources to provide for branched learning, The use of a Wikipedia, A glossary of commonly used terms, Instructional video presentations. All the attributes of the Moodle made for an international transportable tool ideal for knowledge presentation, learner interaction, comments and reflection, dynamic and interactive assessments, flexibility, extendibility, and most importantly, support for autonomous learning and continued educational development around the world. The only noteworthy disadvantage of using the UCL Moodle was an imposed instructional design. 1.3 Resource Description The educational resource was named; VIRTUAL [emailprotected]/* */: Onà ¢Ã¢â€š ¬Ã¢â‚¬Å"line Laryngeal Airway Device training. à ¢Ã¢â€š ¬Ã¢â‚¬Å" à ¢Ã¢â€š ¬Ã…“Virtualà ¢Ã¢â€š ¬? suggesting both the virtual reality of an Internet based generated environment and the adjective, meaning à ¢Ã¢â€š ¬Ã‹Å"practicallyà ¢Ã¢â€š ¬Ã¢â€ž ¢ or à ¢Ã¢â€š ¬Ã‹Å"almostà ¢Ã¢â€š ¬Ã¢â€ž ¢ Collins English Dictionary ( 2008). The Web based educational resource was developed for distance learning and contained all the elements of a totally Internet delivered educational resource. The content of the course was drawn from the authorà ¢Ã¢â€š ¬Ã¢â€ž ¢s personal experience using the Laryngeal device; peer reviewed journal articles, manufactureà ¢Ã¢â€š ¬Ã¢â€ž ¢s product information and videos downloaded from the Internet. Permission for the use of copywriter-restricted material was sought and obtained where appropriate. 1.3.1 Screen Design The screen design refers to how the information was arranged and presented on the display screen. The guidelines used followed those (amongst others) suggested by DoD HCI Style Guide (1992). The screen was kept simple, orderly, clutter free and consistent with a limited, non-dominating colour palate of four colours à ¢Ã¢â€š ¬Ã¢â‚¬Å" blue, black, white and blue à ¢Ã¢â€š ¬Ã¢â‚¬Å" green, a combination that has been shown to cause little fatigue and distraction. Kelley (1988). The content of each lesson was presented on a plain white background with black text in a non-jarring informal style font that made the lessons easy to read. Clark (1997). One template was used and the navigation bar, top bar and individual lesson heading bars kept the same with only the content of each lesson changing. All the content was displayed statically on one screen with individual lessons accessed by scrolling vertically down to the individual lesson. Unnecessary menus and long selection lists were avoid ed. This allowed for an overall view of the content, minimized pointer and eye movements and caused less distraction with easy navigation. (Gruneberg 1978). A discussion forum, interactive quizzes and an end of resource examination were included to allow engagement and self-assessment. The quizzes and examination included a range of question types à ¢Ã¢â€š ¬Ã¢â‚¬Å" multiple choice questions, true/ false, photo matching and random short answer matching type questions. These varieties of questions were shown to improve the learning experiences of adult learners. (Mackway-Jones, 1998). Information was provided in chunks and the writing style kept informal, with plain, simple language and in conversational tone with some elements of humour. There were fewer than 60 à ¢Ã¢â€š ¬Ã¢â‚¬Å" character positions on a standard 80 à ¢Ã¢â€š ¬Ã¢â‚¬Å" character line, spacing between characters were 25 à ¢Ã¢â€š ¬Ã¢â‚¬Å" 50% of character height and spacing between lines were equal to the character h eight, this to increase reading efficiency. 1.3.2 Course Content The course material was presented as text, graphics, power point presentations, hyperlinks and video demonstrations of the procedural skill presented in animation and on an actual patient. Knowledge was provided in five short lessons that followed the natural sequence of usage and intubation with a Laryngeal device. Aims of the resource and objectives of each lesson were stated at the beginning of the course. Here too a glossary of commonly used terms and a baseline knowledge assessment quiz were included. Each lesson was kept succinct with hyperlinks to websites and folders for those seeking extra information. This was to limit download times. Each lesson was concluded with an interactive quiz used to reinforce and test the knowledge learnt. Instant responses were provided to the quizzes after submission with suggestions to either revisit the lesson or to continue depending on the results obtained in the quizzes. The resource was concluded with an end of course examination and the c ourse was predicted to take 1 to 2 hours to complete. The resource content was accessed with a secured password with all content downloadable by way of an Internet connection. All the participants were supplied with a secure company email address and all the ISTCs had Internet access. Permission was requested for the use of company time and resources e.g. airway device training mannequin and time during the working day for those who chose to access the resource at work. Participants were supplied with instructions on how to use Microsoft Word and how to log on to and navigate the Moodle site. The course material was available online for two weeks with access monitored. 1.4 Pilot Study The aim of the pilot study was to assess the ease of navigation, gauge the time it took to complete the course, the integrity of the hyperlinks and the validity and reliability of the content and examination questions. Font preferences, layout and download speeds were also assessed. A prototype of the resource was tested on a selected sample of five participants of similar profile to the participants used in the study. The participants of the pilot study were excluded from participating in the actual study. An external panel of three Consultant Anaesthetists and two trainee Registrar Anaesthetists where used to provided expert advice. The Consultant Anaesthetists were selected based on their special interest in emergency medicine or difficult intubation scenario teaching. A few typographic errors were corrected, aims and objectives were clarified, difficult navigational issues were corrected and some content deemed repetitive and lengthy by the pilot participants were excluded before rolling out the resource. These changes however, were minor and further usability studies were deemed unnecessary. 1.5 Content Validation The content presented was current, evidence based and peer reviewed for content validity by the panel of experts (made up of three Consultant Anaesthetists and two trainee Registrar Anaesthetists), who deemed the content to be relevant and appropriate. The panel of experts and the pilot participants also judged good face validity. 2. Evaluation of the Resource The study evaluates effectiveness and acceptance of a Web based educational resource used to train and maintain a learnt procedural skill in the context of continuous medical Education (CME). The evaluation of the resource was undertaken in two parts. First the effectiveness of the resource was evaluated and the endpoints measured were changes in knowledge, confidence and technical ability. This evaluation made use of a summative framework redefined by Saettler (1990); which takes place after interaction with the resource. A à ¢Ã¢â€š ¬Ã…“before à ¢Ã¢â€š ¬Ã…“and à ¢Ã¢â€š ¬Ã…“afterà ¢Ã¢â€š ¬? interventional ipsative assessment was undertaken where participantà ¢Ã¢â€š ¬Ã¢â€ž ¢s performance was compared to their own over a period of time. The second part of the evaluation was undertaken to assess the acceptability of the Web based educational resource as a medium for procedural skills training and this was done by way of an evaluation questionnaire completed by the participants after course completion. 2.1 Participants and Setting The participants and settings were specifically targeted, as they would ultimately be interested stakeholders and end users of this type of resource. The research was conducted at five Care UK TM Independent Centers (ISTCs) on practitioners employed at these facilities. The ISTCs are part of the governmentà ¢Ã¢â€š ¬Ã¢â€ž ¢s initiative to reduce long NHS waiting times for elective surgery by adding increased capacity and alternative treatment venues for patients. There are approximately 25 ISTCs in the United Kingdom with Care UK TM represents 20% of this market. The ISTCs were chosen as a setting because: They are not part of the UK NHS medical training scheme and therefore have no formal programs of medical training or teaching that similar grades of staff in the NHS would receive. Contractual obligations of the ISTC contract decreed that the ISTCs could not employ medical practitioners from the NHS; therefore, most of the medical staff employed at the ISTCs have trained abroad and are waiting either to enter a formal career path within the NHS or wanting UK work experience. This situation has resulted in a mixture of nationalities, non-uniform medical training and medical staff with differing levels of post qualification experience and more importantly, a high staff turnover. (ref) These resulting factors were conducive to a system of competency-based appraisals and continuous medical education, which could be addressed with Web, based educational resources. Participants in the study were all frontline practitioners employed at Care UK TM ISTCs, which employs 48 practitioners of this grade. This represents 50% of all frontline practitioners employed in ISTCs throughout the UK. This intended sample size of 48 adequately represented the wider population in this type of analysis. frontline practitioners are the first practitioners on call to the resuscitation of a collapsed patient where they would be called upon to secure the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s airway and ensure oxygenation until the Anaesthetists or the resuscitation team arrives. It is expected that frontline practitioners are trained and certified with acute cardiac and life support skills and confident in dealing with clinical emergencies. In reality, analysis has shown that frontline practitioners in these ISTCs, though some trained and certified, rarely use these skills due to the infrequent nature of resuscitation clinical emergencies, making these scenarios potentially high -risk events when they do occur. Frontline practitioners are made up of Resident Medical Officers (RMOs), Anaesthetic Assistants (ODAs) and Recovery Room Practitioners (RNs). RMOs are doctors who have completed their medical training and have at least two years post graduate work experience as qualified doctors. They are employed to provide 24 hours on site medical management of patients at the ISTCs and like general practitioners (RACGP 2006) and doctors outside NHS academic hospitals, are usually first on call for emergencies and the sole source of medical advice on the premises on which they work. Anaesthetic assistants and recovery room practitioners are nursing practitioners employed to assist the Anaesthetists in theatre and attend to patients just out of theatre recovering from the effects of the anaesthetic agents. Due to the academic isolation and constraints imposed by a busy and often inflexible rota, frontline practitioners find it difficult to attend CME sessions necessary for skills retention. This, coupled with infrequent use of critical resuscitation equipment like LADs, increases the risk of deskilling with potential harm to a patient in an arrest scenario. There is no formal training pathway or formalised program of Continuing Medical Education (CME) within the ISTCs and most of the frontline practitionerà ¢Ã¢â€š ¬Ã¢â€ž ¢s continued professional development is self-directed. This is likely to make them more receptive to Web based learning. It is important to remember that frontline practitioners employed at the ISTCs are in non-training posts with the ISTCs under no obligation to provide CME or time off for CME, therefore the onus and expense of CME is borne by the staff. It is expected that the convenience of time, place and curriculum will generate an interest in this method of gat hering CME credits and maintaining a procedural skills competency base. 2.2 Sampling There were 48 frontline practitioners of which each grade; RMOs (16), Anaesthetic assistants (16) and Recovery room practitioners (16) make up 33% each and were therefore proportionally represented within the Care UK ISTCs. Sampling was a matter of convenience as all 48 frontline practitioners invited to attend and those who choose to accept were recruited. Participants who choose not to interact with the resource or who choose not to undertake the pre and post written and practical examinations were excluded. It was intended that these be the only exclusion criteria. 2.3 Biases The study may be biased towards candidates interested in self- learning, continuing professional development and those interested or confident with e-learning. Experience suggested that the majority of medical practitioners recognised that continuous professional development is vital for career development and as a requirement of the GMCà ¢Ã¢â€š ¬Ã¢â€ž ¢s revalidation process, would therefore choose to participate. As an added incentive, completion of the learning resource was rewarded with internal CPD points. The research study may also be biased towards participants who were comfortable with negotiating the Internet. To minimise biases, the design of the online resource placed emphasis on simplicity, easy to follow instructions and easy navigation through the course. It was likely that most of the participants would have trained abroad with unknown learning styles and English as a second language introducing potential variation in responses. A telephone helpline, email assistance and Internet based FAQ were made available to assist the participants. It was unlikely that there would be a location bias as these treatment centers were equally spread randomly over 4 counties. 2.4 Ethics Ethical issues were considered broadly within the clinical academic research culture with management of ethics complying with Research Governance Framework standards DH ( 2008); Bowling (2002) Submission for ethics approval was made locally to the Care UK TM Companyà ¢Ã¢â€š ¬Ã¢â€ž ¢s Clinical Governance and Ethic Committee. NHS Ethics Committee approval was not needed, as the research conducted did not involve NHS patients or NHS staff. See appendix X Co-operation of each centreà ¢Ã¢â€š ¬Ã¢â€ž ¢s Medical Director was obtained to contact the frontline practitioners and to dispatch consent letters requesting informed consent to participate in the study. Each participant was provided with a description of the study, its purpose and methods, nature and reason for conducting the research, time scales involved and commitment expected. Participants were encouraged to participate and CPD points were offered on completion of the learning task. Participation however was voluntary with withdrawal from the study possible at any time thereby significantly limiting potential for coercion (see appendix). On acceptance, participants were asked to complete a consent form. Participants were assured that their information would be anonymous and that they would not be individually identified by nationality or age. Each participant was assigned a username and password, which was randomly assigned by way of a sealed unmarked envelope. The username and password was used to access the resource and was used as unique identifiers on the pre and post examination papers. The researcher conducted a blind trial with regards to the allocation of the usernames and passwords. All demographic data was treated confidentially within guidelines laid down by the Data Protection Act and all computer files were stored in a secure server which was password protected (DPA 1988). Findings of the study will be disseminated by way of the dissertation report and possible publication in a peer review journal to a wider audience. Results of the study will be offered to the participants and Care UK TM by way of an online report and formal presentation of the study results. 2.5 Summative Assessment Effectiveness of the resource was objectively measured using à ¢Ã¢â€š ¬Ã…“before à ¢Ã¢â€š ¬Ã…“ and à ¢Ã¢â€š ¬Ã…“afterà ¢Ã¢â€š ¬? written multiple choice type questions and a à ¢Ã¢â€š ¬Ã…“preà ¢Ã¢â€š ¬Ã¢â€ž ¢ and à ¢Ã¢â€š ¬Ã…“postà ¢Ã¢â€š ¬? practical skills test assessing change in knowledge, intubation skill performance and confidence. Procedural skills like behaviour are hard to change and difficult to measure, therefore a proxy measure like change in knowledge, which is easier to measure and quantify was used in the belief that an increase in knowledge is related to an increase in skill. To assess baseline knowledge, participants were randomly assigned to two groups (Group A, Group B), each group receiving a set (MCQ A1 or MCQ B1) of 10 written multiple-choice type questions which they were asked to complete before undertaking the resource. The use of multiple choice type questions has been recommended as a reliable method for use in competency based measures to measure the acquisition of knowledge. Association for Medical Education in Europe (1999) These questions were based on the content described in the lessons of the resource. Participants were requested to complete the questions on the answer sheet under examination conditions and within a time period of 15 minutes. The questions in the two sets were different, of varying degrees of difficulty and were worded in a way to prevent guessing and random answering. All the MCQS were one-best answer type with a few true false type questions included. There were no trick or extended-matching items and there was no negative marking. One point was scored for each correct answer with a maximum score of 10 per examination. An assistant was recruited to invigilate and collect the completed question sheets. Each answer sheet was identifiable only by way of the username randomly assigned to each participant and participants were requested not to discuss the questions. After a two-week period of interacting with the resource, a change in knowledge was assessed using à ¢Ã¢â€š ¬Ã…“afterà ¢Ã¢â€š ¬? written multiple choice type questions. The same format used to assess baseline knowledge was used and the same conditions were applied. Group A received MCQ B1 and Group B received MCQ A1 questions. In the event of participants discussing the questions the à ¢Ã¢â€š ¬Ã…“afterà ¢Ã¢â€š ¬? test questions, though the same were ordered and numbered differently. Psychomotor skills à ¢Ã¢â€š ¬Ã…“preà ¢Ã¢â€š ¬? and à ¢Ã¢â€š ¬Ã…“postà ¢Ã¢â€š ¬? completion of the course were evaluated using a specifically designed airway training mannequin on which the participants used the LAD. An initial à ¢Ã¢â€š ¬Ã…“preà ¢Ã¢â€š ¬? skills test was conducted before undertaking the resource and a à ¢Ã¢â€š ¬Ã…“postà ¢Ã¢â€š ¬? skills test two weeks after completing the resource. A modified, validated three pointà ¢Ã¢â€š ¬Ã¢â€ž ¢s global rating scale and a 22 point checklist was used to assess the procedural skill as suggested by the current gold standard for assessment of procedural skills Bould, (2009). Table 1 Modified 3 point global rating score of Laryngeal airway device insertion ability: Score 1 poor 2 competent 3 clearly superior Maneuvers Repeated, tentative, jerky Competent but occasionally awkward and stiff Fluid with no awkwardness Actual score Participants were presented with a scenario and their appropriate approach and performance were scored using a checklist of predetermined maneuvers with scores assigned to each step correctly performed (see appendix à ¢Ã¢â€š ¬Ã‚ ¦.). Time to ventilate the airway mannequin from initial positioning of the head and mouth opening to successful ventilation was considered a major outcome variable as the outcome was reproducible and easily quantifiable. An additional point was awarded if successful intubation was established within a time interval of 50 seconds. (ref)The researcher and a recruited assistant were used to independently assess the performance of individual participants. Participants were also asked to rate their confidence pre and post resource intervention. 2.6 Evaluation of Usability A previously validated (and modified for purpose) questionnaire evaluating learner satisfaction with the Web based educational resource was undertaken in the final part of the study (ref). Qualitative data by way of structured questions and quantitative data using a Likert Scale were collected after the post resource tests were completed. The participants were given a printed version of the questionnaire to fill in by hand and return anonymously as well as an attached word document for those wishing to return the questionnaire by way of an email. To improve the response rate, a collection box for responses were placed at each centre and a representative recruited to assist with reminders and collection. The questionnaire was made up of two parts (see appendix). The first was a set of structured questions used to collect demographic data about the participants e.g. age, gender, Internet user experience. This part of the survey was undertaken to assess whether there would be a relationship between age, gender, Internet user experience and preferences for Web based learning. Webb (2002). The second set of questions surveyed what the participants thought of the course design, course usability, the use of multimedia and interactive components, and the impact of the resource. The participants were also asked about exposure to similar learning through traditional means. This was to gain an understanding of how participants viewed technology as a means of continuing professional development and how the use of technology influenced their learning. The questionnaire consisted of 22 questions with choices ranked on a 5 point Likert scale where participants had to strongly agree, agree, disagree, strongly disagree or remain neutral. Questionnaire surveys are popular because of their low cost and ease of administration Mann (1998) and a well designed questionnaire can provide useful information in a standardised format and is widely used as a tool in continuing medical education. Pereles (1996), Morris (1997). The benefit of this type of closed-ended questions were that they were easy to standardise and analysis. The downside was that it was more difficult to design. Patton (2001). 2.7 Validity and reliability Validity and reliability describes the quality of a method of assessment and where possible previously validated tools were used. 2.7.1 Multiple Choice Questions The multiple choice type questions were drawn from a pool of unvalidated questions from past examination papers used in the training of Anaesthetic trainees. Examination questions from a pool of validated and reliable test questions would have been ideal to use however, as of this writing, availability of such a databank of questions do not exist. The panel of experts assessed the face and content validity of the questions and concurred that the questions were appropriate and tested knowledge. Concurrent validity was established by comparing the questions to a bank of questions used in the local Trust to examine trainees. The panel of experts independently categorized the test questions as easy or difficult. Where agreement could not be reached, the questions were graded as intermediate. Agreement correlation between the experts were calculated using a raw score formula for Pearsonian à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦ To further establish the internal consistency or internal reliability of the questions, a difficulty score (DS) was used to define the degree of difficulty of each question against which the test papers from the pilot study was compared (Crocker 1986). Needs work à ¢Ã¢â€š ¬Ã¢â‚¬Å" speaking to Henry A degree of difficulty for each question was calculated and a Difficulty Score assigned to each grade of question: DS = the number of predicted correct answers that the participants would obtain divided by the number of all answers. Table 2 MCQA MCQB DS Difficult 3 out of 10 2 out of 10 0.25 Intermediate 2 out of 10 3 out of 10 0.125à ¢Ã¢â€š ¬Ã¢â‚¬Å" 0.25 Easy 5 out of 10 4 out of 10 0.55 Participants in the pilot study were given the two test papers (MCQA, MCQ B) to complete and a Difficulty Score was calculated on the actual answers received and compared to the predicted Difficulty Score. Analysis confirmed that different participants tended to do well or badly on the same parts of the tests thereby demonstrating internal consistency (see appendix). To test whether the MCQs were able to distinguish between pilot study participants who knew and understood the material and those who did not (that is to test the reliability of the MCQ), an overall Discriminative Index (DI) was calculated using the following calculation: DI = number of correct answers amongst the highest overall score. A DI score of 0.9 was obtained. Questions with a DI0.30 is considered as adequately discriminative. 2.7.2 Global Rating scale and modified checklist The global rating scale and modified checklist of LMA insertion were tools used in previous studies and were reported as validated, Bello (2005), Naik (2003). However, scanty to no information was provided on the validation process in the two publications and a review of checklists and global rating scales in assessment of procedural skills in anaesthesia did not report the establishment of construct or internal validity specifically for assessing intubation skills. Checklists have been shown to produce excellent reliability in trained observers, are easy to use after some training for optimal reliability, are potentially comprehensive depending on the checklist, Bould ( 2009) and using two experienced Consultant Anaesthetists as examiners of the participants performance resulted in good inter-rater agreement achieved. 2.7.3 Usability Questionnaire The questions used to assess the usability of the resource were a modified version of a validated questionnaire used in a previous study to assess technology (University of Maryland User Interaction Satisfaction 5.0 1995). These questions were specific enough to allow for meaningful, reliable measurement; however its ability to be generalised to wider groups allowed the findings to be reproduced on the participants used in this study (Maxwell 1992). 3 Data Collection and Analysis This study made use of quantitative analysis recorded on standardised data entry forms. Data from open-ended structured questions were categorised and data from closed à ¢Ã¢â€š ¬Ã¢â‚¬Å" ended Likert scale questions required quantitative analysis. 3.1 Power Calculation A power calculation using a web based power calculator for a paired t test was performed to determine the sample and the effect size to make the study significant. www.biomath.info/power/prt.htm). It was estimated that there would be a 30% mean difference of predicted change between pre and post course test scores based on the outcomes of the learning needs analysis. Using approximately one standard deviation in performance, a 5% significance level and a 70% power of the study, a sample size of 8 was suggested by the calculation to show an effect size of 1.1. However, given that it was possible to recruit more than eight participants, it was decided to operate on a smaller effect size and more participants. 3.2 Data presentation Descriptive statistics were used to describe the ordinal data derived from the Likert scale questionnaires. The data was presented as percentages in tables summarised as median or mode with the mode being most suitable for easy interpretation, variability was expressed with a range and the distribution of findings displayed in a dot-plot or bar chart. 3.3 Data Analysis The Wilcoxon signed-rank test, a non-parametric hypothesis test was applied to the ranked data from the à ¢Ã¢â€š ¬Ã…“beforeà ¢Ã¢â€š ¬? and à ¢Ã¢â€š ¬Ã…“afterà ¢Ã¢â€š ¬? MCQs and the à ¢Ã¢â€š ¬Ã…“preà ¢Ã¢â€š ¬? and à ¢Ã¢â€š ¬Ã…“postà ¢Ã¢â€š ¬? practical skills examination. This test was used to compare the two sets of scores from the same participant as an alternative to the paired Students t-test as the population could not be assumed to be normally distributed. The dependent variable was the examination scores and the independent variable the Web based resource. A SPSS data analysing program was used to generate descriptive and quartile statistics for the variables and ranks tables presented data of the comparison of participants à ¢Ã¢â€š ¬Ã…“Beforeà ¢Ã¢â€š ¬? and à ¢Ã¢â€š ¬Ã…“Afterà ¢Ã¢â€š ¬? course completion scores. Examinations of test statistic tables were used to show whether there were changes in examination scores and whether these changes were statis tically significant. Confidence Interval A 95% interval confidence level was chosen to generalise the results to that of the general frontline practitioner population. The selected sample of 48 participants as a proportion of the intended population in all the ISTCs corresponded with a Confidence Interval of ± 19%. That is to say that there was a 95% certainty that the true population proportion would fall into the range from 44% to 82% according to a Web based Confidence Interval for Proportions calculator.

Corporate Finance Essay Free Essays

Corporate Finance Essay Most corporate financing decisions in practice reduce to a choice between debt and equity. The finance manager wishing to fund a new project, but reluctant to cut dividends or to make a rights issue, which leads to the decision of borrowing options. The issue with regards to shareholder objectives being met by the management in making financing decisions has come to become a major issue of recent times. We will write a custom essay sample on Corporate Finance Essay or any similar topic only for you Order Now This relates to understanding the concept of the agency problem. It deals with the separation of ownership and control of an organisation within a financial context. The financial manager can raise long-term funds internally, from the company’s cash flow, or externally, via the capital market, the market for funds of more than a year to maturity. This exists to channel finance from persons and organisations with temporary cash surpluses to those with, or expecting to have, cash deficits, i. e. the shareholders. The agency problem on a firm’s capital structure decisions Potential conflict arises where ownership is separated from management. The ownership of larger companies is widely spread, while the day-to-day control of an organisation’s business interests rests in the hands of a few managers who usually have a relatively small proportion of the total shares issued. This can give rise to the problem of managerial incentives. Examples of this include pursuing more perquisites (splendid offices and company cars, etc. ) and adopting low-risk survival strategies and satisficing behaviour. This conflict has been explored by Jensen and Meckling (1976), who developed a theory of the firm under agency arrangements. Managers are, in effect, agents for the shareholders and are required to act in their best interest. However, they have operational control of the business and the shareholders receive little information on whether the managers are acting in their best interest. According to Jensen and Meckling (1976), if a wholly-owned firm is managed by the owner, he will make operating decisions that maximize his utility. These decisions will involve not only the benefits he derives from pecuniary returns but also the utility generated by various non-pecuniary aspects of his entrepreneurial activities such as the physical appointments of the office, the attractiveness of the office staff, the level of employee discipline, the kind and amount of charitable contributions, personal relations (friendship, respect and so) with employees, a larger than optimal computer to play with, or purchase of production inputs from friends. A company can be viewed as simply a set of contracts, the most important of which is the contract between the firm and its shareholders. This contract describes the principal-agent relationship, where the shareholders are the principals and the management team the agents. An efficient agency contract allows full delegation of decision-making authority over use of invested capital to management without the risk of that authority being abused. However, left to themselves, managers cannot be expected to act in the shareholders’ best interests, but require appropriate incentives and controls to do so. Agency costs are the difference between the return expected from an efficient agency contract and the actual return, given that managers may act more in their own interests than the interests of shareholders. The capital structure of a firm is divided between debt capital and equity. Debt capital is the use of borrowed funds by the management of a firm to carry out its financial decisions. Most companies borrow money on a long-term basis by issuing loan stocks. The terms of the loan will specify the amount of the loan, rate of interest and date of payment, etc. Equity capital on the other hand is the long-term finance of a firm which is provided by the shareholders of a company. By purchasing a portion of, or shares in, a company, almost anyone can become a shareholder with some degree of control over the company. Ordinary share capital is the main source of new money from shareholders. For an established business, the majority of equity funds will normally be internally generated from successful trading. Any profits remaining after deducting operating costs, interest payments, taxation, and dividend are reinvested in the business and regarded as part of the equity capital. The finance manager will monitor the long-term financial structure by examining the relationship between loan capital, where interest and loan repayments are contractually obligatory, and ordinary share capital, where dividend payment is at the discretion of directors. This is known as gearing. There are two basic types of gearing, they are capital gearing which indicates the proportion of debt capital in the firm’s overall capital structure; and income gearing indicates the extent to which the company’s income is pre-empted by prior interest charges. Both are indicators of financial gearing. Now, the advantages of debt capital centre on its relative cost. Debt capital is usually cheaper than equity because, the pre-tax rate of interest is invariably lower than the return required by shareholders. This is due to the legal position of lenders who have a prior claim on the distribution of the company’s income and who in liquidation precede ordinary shareholders in the queue for the settlement of claims. Debt is usually secured on the firm’s assets, which can be sold to pay off lenders in the event of default, i. e. failure to pay interest and capital according to the pre-agreed schedule; debt interest can also be set against profit for tax purposes; the administrative and issuing costs are normally lower, e. . underwriters are not always required, although legal fees are usually involved. Jenson and Meckling (1976) argue that if the manager owns only 95 percent of the stock, he will expend resources to the point where the marginal utility derived from a dollar’s expenditure of the firm’s resources to the point where the marginal utility derived from a dollar’s expenditure of the firm’s resources on such items equals the marginal utility of an additional 95 cents in general purchasing power (i. e. his share of the wealth reduction) and not one dollar. Such activities, on his part, can be limited (but probably not eliminated) by the expenditure of resources on monitoring activities by the outside stockholders. They also add that prospective minority shareholders will realize that the owner-manager’s interests will diverge somewhat from theirs; hence the price which they will pay for shares will reflect the monitoring costs and the effect of the divergence between the manager’s interest and theirs. As the owner-managers fraction of the equity falls, his fractional claim on the outcomes falls and this will tend to encourage him to appropriate larger amounts of the corporate resources in the form of perquisites. This also makes it desirable for the minority shareholders to expend more resources in monitoring his behaviour. Thus, the wealth costs to the owner of obtaining additional cash in the equity markets rise as his fractional ownership falls. Read more: http://www. businessteacher. org. uk/free-finance-essays/corporate-finance-essay. php#ixzz2OdRy7DzZ How to cite Corporate Finance Essay, Essays

Current Issues and Trends in Assessment in Early Childhood Education free essay sample

?Current Issues and Trends in Assessment in Early Childhood Education The 1980s brought a new reform movement in education, accompanied by a new emphasis on testing. The effort to improve education at all levels included the use of standardized tests to provide accountability for what students are learning. Minimum competency tests, achievement tests, and screening instruments were used to ensure that students from preschool through college reached the desired educational goals and achieved the minimum standards of education that were established locally or by the state education agency. As we continue in a new century, these concerns have increased. Trends in a New Century In the 1990s many schools improved the learning environment and achievement for all children; nevertheless, a large percentage of schools were still low performing in 2000 and 2001. Inadequate funding, teacher shortages, teachers with inadequate training, aging schools, and poor leadership affected quality education (Wortham, 2002). During the 2000 presidential campaign, candidate George W. Bush named quality education as one of the goals of his presidency. After his election, President Bush worked for legislation that would improve education for all children. After months of dialogue and debate, Congress passed a new education actin December 2001. The No Child Left Behind Act (NCLB), signed into law onJanuary 8, 2002, had an impact on testing required by individual states. In addition to other provisions, all states were required to administer tests developed by the state and to set and monitor adequate yearly progress (Moscosco, 2001; Wortham, 2002). Former President Bush was also committed to strengthening early childhood programs. In 2002, several projects were conducted to support early childhood programs. Under the Sunshine Schools program, the U. S. Department of Education focused on what is working in early childhood education and gave attention to highly effective state, district, city, county, and campus programs (Grissom, personal communication, April 4, 2002). Another Bush initiative, Good Start, Grow Smart, was intended to strengthen Head Start and improve the quality of experiences for children. The initiative provided the following: Training for nearly 50,000 Head Start teachers in the best techniques Assurance that preschool programs are more closely coordinated with K–12 educational programs A research effort to identify effective early literacy programs and practices (Grissom, personal communication, April 4, 2002). The No Child Left Behind Act of 2001 NCLB requires states to do the following: Provide public school choice and supplemental services for students in failing schools as early as fall 2002. Integrate scientifically based reading research into comprehensive instruction for young children. Set and monitor adequate yearly progress, based on baseline 2001–2002 data. Issue annual report cards on school performance and statewide test results by 2002–2003. Implement annual, standards-based assessments in reading and math for grades 3 to 8 by 2005–2006. Assure that all classes are taught by a qualified teacher by 2005–2006. 10 Selected Emerging Trends and Issues in Early Childhood Education. 1). A reevaluation of the view that early childhood education is a panacea 2). Greater emphasis on planned continuity between kindergartens and the primary grades 3). Increased use of multi-age grouping 4). Need for parenthood education in the high school 5). Importance of parent involvement in the decision making and policy formation processes concerning the education of his child and the implementation of classroom programs 6). Wider acceptance of the structured or prepared environment in programs 7). Development of a quality day care environment based on careful research and evaluation 8). Importance of humanistic or affective education 9). Need for aesthetic education (music, dance, literature, dramatics) in the total education of the child 10). Accountability of teachers to the consumer as well as to the school boards. Multiple Intelligences According to MI Theory, identifying each student’s intelligences has strong ramifications in the classroom. If a childs intelligence can be identified, then teachers can accommodate different children more successfully according to their orientation to learning. Teachers in traditional classrooms primarily teach to the verbal/linguistic and mathematical/logical intelligences. The nine intelligences are: 1. VISUAL/SPATIAL children who learn best visually and organizing things spatially. They like to see what you are talking about in order to understand. They enjoy charts, graphs, maps, tables, illustrations, art, puzzles, costumes anything eye catching. 2. VERBAL/LINGUISTIC children who demonstrate strength in the language arts: speaking, writing, reading, listening. These students have always been successful in traditional classrooms because their intelligence lends itself to traditional teaching. 3. MATHEMATICAL/LOGICAL children who display an aptitude for numbers, reasoning and problem solving. This is the other half of the children who typically do well in traditional classrooms where teaching is logically sequenced and students are asked to conform. 4. BODILY/KINESTHETIC children who experience learning best through activity: games, movement, hands-on tasks, building. These children were often labeled overly active in traditional classrooms where they were told to sit and be still! 5. MUSICAL/RHYTHMIC children who learn well through songs, patterns, rhythms, instruments and musical expression. It is easy to overlook children with this intelligence in traditional education. 6. INTRAPERSONAL children who are especially in touch with their own feelings, values and ideas. They may tend to be more reserved, but they are actually quite intuitive about what they learn and how it relates to themselves. 7. INTERPERSONAL children who are noticeably people oriented and outgoing, and do their learning cooperatively in groups or with a partner. These children may have typically been identified as talkative or too concerned about being social in a traditional setting. 8. NATURALIST children who love the outdoors, animals, field trips. More than this, though, these students love to pick up on subtle differences in meanings. The traditional classroom has not been accommodating to these children. 9. EXISTENTIALIST children who learn in the context of where humankind stands in the big picture of existence. They ask Why are we here? and What is our role in the world? This intelligence is seen in the discipline of philosophy. Developing Multiple Intelligences in Young Learners By Connie Hine Current research on the brain, learning and human intelligence from a variety of disciplines, including medicine, cognitive sciences, and education has provided information with profound implications to education. This research is challenging and stretches the traditional approaches to education and teaching, particularly with regard to the ability to learn, human intelligence, and how efficient learning occurs. Intelligence—What Is It? The traditional theory of intelligence has two fundamental assumptions: 1. that human cognition is unitary; and 2. that individuals can be adequately described as having a single, quantifiable intelligence. The traditional theory of intelligence has helped create a mindset or paradigm as to what smart or intelligent is, who has potential or ability to be smart, and how we can or cannot become smart. This has clearly influenced current educational practices. It is still common educational practice to use the score from standardized intelligence tests to qualify children for various special programs. It is assumed these tests measure intelligence accurately and meaningfully. Current research indicates that the only limit to ones intelligence is what the individual believes is possible and how his or her behaviors either foster or limit his or her intelligence. Research also indicates that intelligence is not a static structure that can be measured and meaningfully quantified, but an open, dynamic system that can continue to develop throughout life. Through his work and studies, Reuven Feuerstein, an Israeli psychologist and educator, has developed a theory of the Modifiability of Intelligence. He has linked the importance of how teachers, through facilitating learning experiences, impact the quality of learning and influence the potential intelligence of each student. Feuersteins educational approach focuses on the quality of interaction between the teacher and the learner, which he calls Mediated Learning Experiences (MLE). He has successfully demonstrated how, through systematic and planned enrichment, intelligence can be modified, expanded, and developed. (Feuerstein, 1988). The Theory of Multiple Intelligences Supporting the new paradigm of intelligence, Howard Gardner of Project Zero at Harvard University has determined that intelligence is a pluralistic phenomenon, rather than a static structure with a single type of intelligence. Gardner defines intelligence as: the ability to solve problems that one encounters in real life; the ability to generate new problems to solve; the ability to make something or offer a service that is valued within ones culture. In his cross-cultural exploration of the ways in which people are intelligent, he has identified seven distinct types of intelligences: Verbal/Linguistic Logical/Mathematical Musical Visual/Spatial Body/Kinesthetic Interpersonal Intrapersonal According to Gardners theory, one form of intelligence is not better than another; they are equally valuable and viable (Gardner, 1983). Yet, he discovered that different cultures are biased towards and against certain types of intelligences. These biases, added to the traditional theory of intelligence, have limited our development of curricula, instructional strategies, and current methods of assessment-including how we measure intelligence. Recent brain/mind research and new theories of human intelligence redirect our attention in three specific areas-first, on the environmental conditions and messages we provide children; second, on the kind of support and relationships we develop between caregivers, educators, and children; and third, on the need to match what we know about the ways kids are intelligent and learn with teaching strategies designed to maximize the full development of each individual child. A Useful Model Gardners Multiple Intelligences theory is a very useful model for developing a systematic approach to nurturing and teaching children and honoring their individual needs and strengths within a classroom setting. The theory of Multiple Intelligences includes the notion that each person is smart in all seven types of intelligence. Every person is smart to varying degrees of expertise in each of the intelligences, stronger in some ways and less developed in others. Heredity and genetics influence the way the brain is neurologically wired before birth and are contributing factors that determine the strongest and/or most favored types of intelligence. This is often seen in children with very strong and overt talents demonstrated at very young ages, such as Mozart, who had started to play and compose music by age five. By broadening our view of intelligence, and valuing and nurturing abilities other than mathematics and reading, we can open doors by using the strengths of children as a means of complementing their less developed areas. Characteristics of Multiple Intelligences The following descriptions can be helpful to identify basic personal characteristics, traits, behaviors, and preferences for each of the seven intelligences. Remember, we are all intelligent to varying degrees in all seven ways. Each person has a unique profile. You may be very strong in one or two intelligences, medium in a few, and perhaps weak or empty (not yet filled) in one or two. Consequently, you may have four or five intelligences that are equally developed and two that are less developed. The important thing is to identify and build on ones strengths to modify and increase the less developed intelligences in ourselves and in children. 1) Verbal/Linguistic Intelligence—The Writer/Orator/Attorney People with high verbal/linguistic intelligence love words. They prefer to process information through words and language versus pictures. They may prefer oral or written methods, or excel in both. Additional characteristics include the following: Sensitive to the meaning, order, and sound of words Uses varied language Avid talkers; good speakers Likes to explain, convince, and persuade through words Enjoys and excels at word games Enjoys listening to, telling, and reading stories Enjoys rhymes and poetry Has good memory recall for names and dates 2) Logical/Mathematical Intelligence—The Scientist/Philosopher People with high logical/mathematical intelligence create order out of chaos by analyzing, grouping, and categorizing. They recognize relationships, connections, and patterns more easily than people with less logical intelligence. Additional characteristics include the following: Ability to handle long chains of reasoning Likes reasons for doing things Possesses good inductive and deductive reasoning Quick to learn equivalencies Asks why and how questions Solves problems rapidly Likes to predict, analyze, and theorize Enjoys dealing with abstraction Strong at math and problem solving skills Sequential thinker Enjoys board games and games with rules 3) Musical Intelligence—The Entertainer/Musician People with high musical intelligence learn best through sound, rhythm, and music. These people learn better when music is playing and through musical metaphors. Additional characteristics include the following: Ability to perceive pitch, tone, and rhythmic pattern Well developed auditory sense and discrimination Ability to create, organize rhythmically, and compose music Picks up and creates melodies/rhythm easily Remembers songs easily Ability to sing or play instruments Sensitive and drawn to sounds Possesses schemas for hearing music Constantly humming, tapping, and singing 4) Visual/Spatial Intelligence—The Architect/Engineer/ Sculptor People with high visual intelligence process information best using pictures, visuals, and imagery. They have a sense of direction and an ability to think and plan in three dimensions. Additional characteristics include the following: Ability to create complex mental images Active imagination Ability to find their way mentally and physically around environment Ability to see the physical world accurately and translate it into new forms Ability to see things in relationship to others Ability to use mind maps Uses imagery and guided visualizations Likes visual support-video, pictures, photos, charts, posters Organizes space, objects, and areas Enjoys designing and decorating 5) Body/Kinesthetic Intelligence—The Athlete/ Dancer/Actor/Surgeon People with high kinesthetic intelligence process information through their bodies-through muscle, sensation, and movement. Their bodies are their avenue to learning and understanding any content or subject and is also their preferred form of self-expression. Additional characteristics include the following: A fine-tuned ability to use the body and handle objects (fine and gross motor) Ability to express emotions through bodily movement Enjoys physical movement and dance Constant movement-likes to get up and move around Commitment to comfort Uses body to accomplish a task Experiences a strong mind/body connection Expands awareness through the body Experiences a total physical response Often good at creative drama 6) Interpersonal Intelligence—The Counselor/Minister/Teacher People with high interpersonal intelligence process information through relatedness to others. They are people people. It is in relationship to and with other people that they best understand themselves and the world. Additional characteristics include the following: Ability to notice and discern subtleties among others, such as moods, temperaments, and feelings Discerns underlying intentions, behavior, and perspectives Easily makes friends and enjoys the company of others Ability to get into the perspective of another Responds to verbal and nonverbal communications-facial cues and body movements Recognizes and empathizes with others feelings Ability to negotiate and handle conflict resolution Works cooperatively in a group Works well with a diverse group of people Good communication skills Loves to talk and influence 7) Intrapersonal Intelligence—The Poet/Efficiency Expert People with high intrapersonal intelligence have a strong sense of themselves, their wants, and needs. They are self reflective and in touch with themselves. They may be the nonconformist individuals who march to their own drummer. Additional characteristics include the following: Well developed sense of self Awareness and expression of different feelings Self reflection and mindfulness Ability to think about thinking (i. e. , metacognition) Transpersonal sense of self. Asks big questions—Why are we here? and What happens when we die? Often is a daydreamer Often writes introspectively including prose, poetry, or journal writing Excellent self planners and good at goal setting Enjoys solitude and likes to think alone Good understanding of strengths and weaknesses Enjoys self discovery Teaching Tools and Strategies Reflect on and identify your own strengths and intelligences which are less developed. Identify the strengths and empties of the children, too. You may begin to notice patterns and correlations between the strengths you enjoy or are less comfortable with in the children and your own strengths and empties. Are the childrens strengths the same as yours or are they most intelligent in a way you are least intelligent? We naturally rely on and use teaching strategies that match our strongest intelligences. Our strengths, therefore, create unconscious teaching biases. When we identify our own less developed intelligences, we may notice that we are untrained in or have avoided using the teaching strategies best designed for developing that intelligence in children. Therefore, it becomes our responsibility first to identify our own strengths and weaknesses and then to stretch and continue our lifelong learning process by developing our own intelligences. Only then can we incorporate teaching strategies which support all seven intelligences and meet the needs of all children. Environmental Strategies to Support Multiple Intelligences Because circle time and whole group instruction activities dictate that we do the same thing with all or most of the children at the same time, these activities are among the least effective strategies for meeting the diverse needs and intelligences of young children. Group activities often favor a teachers strengths while meeting the strengths of only a few of the children. The most significant modification we can make to meet diverse needs is to reduce the use of circle time and replace it by incorporating and using well-planned learning stations or centers where children can spend most of their day. Learning stations are temporary activity locations where materials are put out and later put away, usually by an adult. Learning centers are permanent locations, visually and spatially defined areas, ideally three-sided, where materials are organized by subject and available for children to select independently. Active Learning Centers for Multiple Intelligences The following suggested learning centers foster the development of each intelligence and allow children opportunities to build on and expand their strengths. Verbal/Linguistic Library or book-nook Story time Writing center Listening center Flannel board station Publishing center Logical/Mathematical Math center Science center Take-apart center Puzzle center Recycling center Weather station Computer center (e. g. , logical thinking, sequential software) Cooking center Musical Music center Instrument center Singing circle Listening center Background music Nature sounds Visual/Spatial Art center (e. g. , sculpting dough, collage, painting, drawing) Manipulatives (e. g. , 3-D manipulatives, visual puzzles) Block center, Media center (e. g. , videos, slides, photos, charts) Computer center (e. g. , visual design and layout software) Kinesthetic Gross motor center (e. g. , open space for creative movement, climbing structure, mini-trampoline) Dance circle Woodworking center Manipulative center Take-apart center Imaginative-play center Playground/outdoor play Tactile-learning center (e. g. , sandpaper letters, sample textures and cloth) Interpersonal Puppet theater Dramatic play center Sharing/social area Group discussion area Small group area Cooking center Intrapersonal Lofts One-person centers stations Life skills/self-help center Computer center (e. g. , self-paced software) Teaching Tools and Strategies The following are activities and strategies that can help us strengthen and support the development of each of our intelligences. When we begin systematically to implement these multiple strategies to teach any subject, concept, or activity, we will naturally meet the individual needs of more children. As Colin Rose states, The more ways you teach, the more people you reach. Verbal/Linguistic Activities Reading, Improving vocabulary, Emergent /creative writing, Writing and reading reports/essays, Taking and giving dictation, Giving and listening to verbal instructions (oral and/or written), Lecturing o Impromptu speaking, Story telling, Dialogue and discussion, Debate, Publishing, Telling jokes, Listening to tapes, Doing crossword puzzles, Keeping a diary or journal Logical/Mathematical Activities Sorting and classifying objects or ideas, Taking apart or fixing things, Solving math problems, Solving mysteries, riddles, puzzles, and word problems, Exploring, Outlining, Grouping and calculating activities, Creating timelines and sequences, Comparing and contrasting, Experiences that demonstrate change over time (e. g. , before/after), Using symbols and formulas, Playing pattern games, Socratic questioning-especially open-ended and what if questions Musical Activities Listening to background, instrumental, or environmental music, Unison recall activities, Giving or listening to musical performances, Singing, Clapping and slapping memory games, Rhythm, chants, and rap, Setting new ideas to familiar tunes, Using musical instruments, Composing music Body/Kinesthetic Activities Role playing/drama, Playing sports, Playing physical games such as Pictionaryâ„ ¢ or Charades, Dancing, Miming, Using physical gestures, Physical exercise, Hands-on activities, Changing seats and moving to different learning stations/centers, Creating new room rearrangements, Standing or moving while listening, Learning a topic or idea with a physical gesture associated, Taking things apart and tinkering, Finger writing on palms or back Visual/Spatial Activities Using guided imagery, Playing with patterns and designs, Mind-mapping, Taking pictures/photos, Drawing/painting/sculpting, Watching and making videos, Creating charts and graphs, Using color cues and organizers, Circle/line dancing, Changing teaching locations, Rearranging the room to suit the subject or project, Giving or taking visual/spatial instructions Interpersonal Activities Cooperative learning, Working with a partner, Group projects and games, Creative drama/role playing, Simulation, Practicing empathy, Win/win competition, Peer teaching and buddy systems, Subject drills with partners, Quizzing each other, Discussion, Getting and giving feedback Intrapersonal Activities Guided imagery, Thinking about how to solve a task/problem, Meditation, Journal writing, Self assessment, Personal contracts and goal-setting, Silent reflection and review time for recall or thinking about what has been learned, Emotional processing, Focusing/concentrating, Higher-order reasoning tasks, Time to be alone, Providing choices Multi-age classroom Multi-age classrooms or composite classes are classrooms with students from more than one grade level. They are created when either there are too many students for one class but not enough to form two classes of the same grade level, or as an educational choice by the school. Composite classes are more common in smaller schools; an extreme form is the one-room school. Studies of the performance of students in composite classes shows their academic performance is not substantially different from those in single-grade classrooms; instead, outcomes tend to be a function of the teachers performance Prevalence Social benefits often cited are: Older children in a composite class get more leadership opportunities and frequently build self-esteem as a sort or role model to the younger class mates. Younger children aspire to do work like the older children in the class. There were also social benefits in that my children experienced mixing with a wider range of children than they would have otherwise and that they developed both leadership experiences as seniors and when appropriate benefited from mentoring from older peers. The ability for a child to be educated by the one teacher for two years, creating a stronger relationship[7] Educational benefits often cited are: Because literacy and numeracy is taught in ability groups, teachers need heightened awareness of individual students capabilities they must think of children as individuals. [6] The techniques of classroom teaching and of individual teaching can be still applied. Learning by teaching occurs when students at different stages of learning can help each other with their work; children resolve differences in understanding of material. [8][9] Composite classes provide a range of levels of work, so the needs of both talented children and slower learners can be catered for, while providing a supportive environment for both At any one time, both composite and single-level classes have groups of students at a variety of levels. This is part of the normal delivery of the curriculum. Education expectations are set at curriculum levels which span across two years. Contemporary teaching and learning materials are developed for multi-age classes. By using them, teachers can introduce core concepts to the whole classroom, and then differentiate instruction for the range of learners in the classroom. Culture in the Classroom By Alison Levy For a number of years teachers have become more interested in multicultural education, with the assumption that such approaches help children feel more welcomed, validated, integrated, and able to cooperate with others in their classroom (Allen, McNeill, Schmidt, 1992; Bredenkamp, 1986; Byrnes Kiger, 1992; Gollnick Chin, 1994). In my experience, in addition to these benefits, exposing young children to different cultures makes for a fun and exciting learning environment! There are four main approaches to teaching young children about different cultures. These are multicultural education, anti-bias curriculum, global education, and international education. Multicultural Education Patty Ramsey (1987) defined multicultural education as a perspective which: ? â€Å"encompasses many dimensions of human difference besides culture, such as race, occupation, socioeconomic status, age, gender, sexual orientation, and various physical traits and needs; ? is relevant to all children, even those who live in homogeneous areas; and ? extends beyond the boundaries of this country to beliefs and attitudes about people all over the world†. In practice this means that if your class includes a variety of cultures or abilities, the group spends time learning about and cultivating an understanding of those unique features. The teacher pays careful attention to the types of literature available to the children and to the activities presented, while also encouraging children to cooperate. If there is little diversity within the group, the teacher presents many different cultural practices during the school year. For example, in many classrooms December is spent on the theme â€Å"Christmas around the world. The overall goal is to expose children to differences at an early age so that they can begin to appreciate and value them rather than to dismiss them. Peer Tutoring/teaching Strategies Peer tutoring is an intervention in which students work in pairs to master academic skills or content. Peer tutoring can involve partners who are the same age or different ages (cross-age). Cross-age peer tutoring involves older students serving as tutors for younger, lower-functioning students. Cross-age tutoring occurs, for example, when students in a high school child development class spend regularly scheduled time each week reading with struggling students in a fourth grade class. In this instance, the tutors might be expected to gain less from the content being tutored but may be expected to gain more in social responsibility or understanding of learning as a process. In same-age tutoring, in which students of the same age tutor each other, more skilled students may be paired with less skilled students. In this case, students with stronger skills may provide the first responses, providing a model for the less skilled partner. In other cases, the teacher may decide to pair students of similar ability and have those alternate tutoring roles, which are sometimes referred to as reciprocal peer tutoring. Class-wide Peer Tutoring (CWPT) occurs when the teacher creates highly structured tutoring materials for use during the tutoring session. Peer tutoring is differentiated from tutoring between adults, such as community volunteers, and students. It is also distinguished from cooperative learning, in which students work collaboratively in groups. The instructional components of the peer tutoring model include: a) Explicit teaching of students in how to be tutoring experts b) Purposeful partner assignment c) Careful preparation of tutoring materials d) Highly structured tutoring procedures that include specific feedback for tutors to provide tutees e) Expert role reversal, and f) Active teacher monitoring Peer Assisted Learning Strategies (PALS) is one peer tutoring activity that has been researched for grades kindergarten through 12. This tutoring program is designed to help students improve in reading and other academic skill areas. The steps to the program for reading are: (a) Predicting b) partner reading c) Retelling d) summarizing . . INTRODUCTION AND OVERVIEW What is Emergent Literacy? Over the past ten years, the concept of emergent literacy has gradually replaced the notion of reading readiness. Consequently, it has a significant impact on the way we approach the teaching of literacy in early childhood programs. The theory of emergent literacy developed from research in the fields of child development, psychology, education, linguistics, anthropology, and sociology. It virtually redefined the field of literacy and made educators, teachers, and parents aware that the term reading readiness no longer adequately describes what is happening in the literacy development of young children (Teale, 1986). Reading readiness suggests that there is a point in time when a child is ready to begin to learn to read and write. In contrast, emergent literacy suggests that the development of literacy is taking place within the child. It also suggests that it is a gradual process and will take place over time. For something to emerge it needs to be there at the beginning (the child’s own natural learning ability), and things usually only emerge under the right conditions (Hall, 1987). Literacy refers to the interrelatedness of languagespeaking, listening, reading, writing, and viewing. Traditionally we have viewed reading and writing as processes that were difficult for children to learn. Children were considered knowledgeable about literacy only when their reading and writing approximated adults’ reading and writing. Children who could identify written words without picture clues were considered readers. Similarly, children who could spell words so that adults could read the