Safety competence promotion in secondary education - A case of the Finnish NouHätä! Programme.

The Nouhätä! safety education programme has been organised in secondary schools in Finland for over 25 years. However, to date, it has not been systematically evaluated. The purpose of this quantitative survey is to provide information about good practices, benefits and limitations of the NouHätä! Programme; this has been done by answering the research question what variables explain pupils' safety competence after participating in a NouHätä! safety education programme? The results show that the best learning outcomes in safety education are achieved when training is organised in collaboration with teachers and safety experts. Practical training also seems to have a significant impact on the safety competence of pupils. The results suggest that background variables like school success and the sources of safety knowledge affect the level of pupils' safety competence. The results of the study can be used to develop the programme and other safety education programmes for children and young people.

Sense of coherence, its components and depressive and anxiety symptoms in expecting women and their partners - A FinnBrain Birth Cohort Study.

OBJECTIVE: Expecting mothers with high sense of coherence (SOC) exhibit improved physical, emotional, and childbearing health. However, the dimensions of SOC and the factor structure of the SOC-13 scale during prenatal period is slightly known. Especially the differences in experiencing SOC and its components (comprehensibility, manageability, meaningfulness) among both expecting parents (mothers and fathers) is poorly understood. The association between SOC and mood disorder symptoms (depression and anxiety) during pregnancy is scarcely studied. METHODS: The structure of the SOC-13 scale, differences in SOC experiences, and the associations between SOC and depressive and anxiety symptoms were studied in a sample of 2784 pregnant women (mothers) and 1661 men/partners (fathers) belonging to the FinnBrain Birth Cohort Study. Self-reports (SOC-13, EPDS, SCL-90: ANX) from gestational week 24 were used. Confirmatory factor analysis (CFA) and invariance testing was carried out to investigate the factorial structure of SOC-13 among both groups (mothers and fathers). Group comparisons were used to study differences in the level of SOC among mothers vs. fathers, low vs. high depression and anxiety subgroups, and multiparous vs. nulliparous mothers. RESULTS: A two-factor model for SOC-13 consisting of comprehensibility-manageability and meaningfulness fitted the data best. Mothers reported higher levels of meaningfulness, whereas fathers reported higher levels of comprehensibility-manageability. SOC was significantly higher among fathers vs. mothers, but mothers with depressive symptoms reported higher SOC than fathers with depressive symptoms. CONCLUSIONS: During pregnancy, SOC can be viewed as a two-dimensional (vs. one- or three-dimensional) concept, and mothers and fathers have differences in the components of SOC. Importantly, mothers vs. fathers with depressive symptoms express higher overall SOC indicating that pregnancy may relate to higher than usual SOC especially among women with psychological distress. Understanding how expecting mothers and fathers experience SOC during pregnancy, particularly in relation to depressive symptoms, helps midwives and maternity care providers to focus health promoting support more precisely.

Development and psychometric evaluation of the Emotional Intelligence Test (EMI-T) for social care and healthcare student selection.

AIM: To develop an emotional intelligence (EI) test and evaluate its psychometrics for social and healthcare student selection. DESIGN: A cross-sectional methodological design. METHODS: The test was developed based on a systematic review and focus group interviews. Content validity was evaluated with expert panels, and preliminary psychometrics with two pilot studies. Descriptive statistics, correlations and item response theory were used. DATA SOURCES: Search was conducted in six databases 2018. Focus group interviews were conducted with educators and professionals in 2019. Expert panels with doctoral students, researchers and educators were conducted in 2020. Pilot tests with students were conducted 2020-2021. The developed test was administered to 4808 applicants 2021. RESULTS: The test included four subscales. Correlations support the test's theoretical structure. The items were mainly easy. CONCLUSION: The test assesses EI objectively and comprehensively. The item-level distractor analysis can be used for further test development. IMPACTS: Social care and healthcare students engage in clinical practice early in their studies, and these environments can be emotionally challenging. Assessing EI in student selection with adequate test can help the institutions of higher education to select the students with required abilities to succeed in the studies. The assessment of EI during student selection also provides information higher education institutions could use to develop and provide support interventions. The results may also encourage practice placements to include EI elements as learning objective. The results of this study and especially the use of IRT and detailed distractor analysis to evaluate the psychometric properties of EMI-T can benefit researchers and educators that develop or evaluate objective assessment tools with multiple choice questions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Emotional intelligence is important for students to enable professional interaction.

Closeness, Conflict, and Culturally Inclusive Pedagogy: Finnish Pre- and In-service Early Education Teachers' Perceptions.

This study explored the factorial and concurrent validity of a scale developed for assessing teachers' self-efficacy beliefs in engaging with diversity in early childhood education settings. According to tests of measurement invariance, the conceptualization of the constructs varied to some extent between Finnish student teachers and qualified teachers. Qualified teachers reported, at the item level, higher confidence in engaging with diversity in mainstream early childhood classrooms than student teachers. Structural equation modeling demonstrated that for both groups, higher levels of reported confidence in planning and implementing inclusive teaching-learning interactions were related to a higher level of closeness during interactions with children. The evidence for concurrent validity may imply beneficial and reciprocal influences between teachers' confidence in their professional competence and close teacher-child relationships. The implications of the study are discussed from the perspective of teacher training and professional development in the early childhood education context.

Nursing applicants' reasoning skills and factors related to them: A cross-sectional study.

BACKGROUND: The assessment of reasoning skills is recommended in undergraduate nursing student selection. Reasoning skills are crucial for sound decision-making, improving patient safety and are necessary from the very beginning of studies. Nursing applicants' reasoning skills based on the reasoning process have not been previously measured. OBJECTIVES: To assess undergraduate nursing applicants' reasoning skills and factors related to them. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: Undergraduate nursing applicants (n = 1056, response rate 55.4%), who consented to the study and performed a joint electronic entrance examination to six Finnish Universities of Applied Sciences in spring 2019, participated in the study. METHODS: The Reasoning Skills (ReSki) test, based on the steps of the reasoning process, was used, comprising three question sections (collecting information, processing information, and identifying the problem and establishing goals). Background variables were collected through a questionnaire and the Positive System Usability Scale (P-SUS). The data were analysed with descriptive statistics, Pearson correlation coefficients and analysis of covariance with Tukey's test in post-hoc multiple group comparisons. RESULTS: Applicants' total reasoning skills mean scores were above the centre of the range of possible scores (2.72/4.5, SD = 0.80). The applicants scored higher in collecting and processing information than in identifying the problem and establishing goals. Standard deviations demonstrated variance between the applicants' ability. Age, gender, and previous education were statistically significantly related to applicants' reasoning skills. Previous work experience was statistically significantly related to success only in the step of identifying the problem and establishing goals. CONCLUSIONS: Nursing applicants' reasoning skills vary in the student selection phase. Applicants are less able to identify the problem and establish goals than to collect and process information. Vocational education does not necessarily develop adequate reasoning skills and thus prepare students for higher education studies. The results have implications for educational institutions and further research.

Development and psychometric testing of Reasoning Skills test for nursing student selection: An item response theory approach.

AIMS: To develop and psychometrically test the Reasoning Skills (ReSki) test assessing undergraduate nursing applicants' reasoning skills for student selection purposes. DESIGN: A methodological cross-sectional design was applied for the psychometric testing. METHODS: The ReSki test was developed as part of a wider electronic entrance examination. The ReSki test included a case followed by three question sections assessing nursing applicants' reasoning skills according to the reasoning process. Item response theory was used for psychometric testing to assess item discrimination, difficulty and pseudoguessing parameters. The ReSki test was taken by 1056 nursing applicants in six Finnish Universities of Applied Sciences (28 May 2019). RESULTS: In the development process, the expert evaluations indicated acceptable content validity. In the psychometric testing, the test reliability was supported by item variance, the theoretical structure was supported by the correlation coefficients and the applicant mean performance supported an acceptable overall test difficulty. The item response theory indicated variance between the items' difficulty and discrimination ranges. However, most of the wrong items failed at being functional distractors. CONCLUSION: The ReSki test is a new and valid objective assessment of undergraduate nursing applicants' reasoning skills. The item response theory provided item-level information that can be used for further development of the test, especially related to the revisions needed for the distractor items to achieve the desired level of difficulty. IMPACT: What problem did the study address? The assessment of nursing applicants' reasoning skills is suggested, but there is a lack of admission tools. What were the main findings? The results provided support for the reliability and validity of the ReSki test. Item response theory indicated the need for further item-level improvement. Where and on whom will the research have an impact? The results may benefit higher education institutions and researchers when developing a test and/or student selection processes.

Seeing beyond variables: applying a person-centered approach to identifying regulation strategy profiles among Finnish preclinical medical and dental students.

BACKGROUND: High-quality learning during medical school and beyond requires appropriate study strategies and taking responsibility for one's studies, thus self-regulation of one's learning. In contrast to traditional studies focusing on a variable-centered approach, a person-centered approach to regulation strategies was utilized. METHODS: The participants were 162 Finnish medical and dental students who answered the regulation scale of the Inventory of Learning Styles at three measurement points. First, the functionality of the scale was analyzed in Finnish medical education context. Latent profile analyses were used to examine regulation strategy profiles. Last, the connections of these profiles with the study success were investigated. RESULTS: The analyses yielded a three-factor solution, which was reliable across time. Four profiles of regulation strategies were identified and they were found to be connected to study success: Students with the lowest self-regulation and increasing lack of regulation performed worse than the other groups. CONCLUSION: The use of a person-centered approach along with variable-centered approach increases understanding of the complex nature of learning in higher education. Person-centered approach could be used as a tool for supporting student learning and to help early diagnosing of learning difficulties, since it enables individualization of students with different regulation strategy profiles.

The developmental trajectory of perceived self-regulation, personal interest, and general achievement throughout high school: a longitudinal study.

BACKGROUND: Our interest in perceived self-regulation of learning arose in the context of educational reform. After decades of stability, the Finnish high school system underwent reform in the 1990s, with a significant emphasis being placed on promoting student self-regulation of learning. AIMS: The purposes of the study were (1) to evaluate changes in the mean level of perceived self-regulation throughout high school and (2) to evaluate the nature of the developmental relations between achievement, perceived self-regulation, and personal interest. SAMPLE: The participants consisted of 245 systematically sampled high school students from a mid-sized Finnish city. METHODS: T tests for paired samples were employed to assess changes in the level of personal interest and perceived self-regulation. Analysis of the developmental relations was carried out within a structural equations modelling framework. RESULTS: The main result was that perceived self-regulation at the beginning of high school predicted not only scholastic achievement at the end of high school over and above prior achievement, but also subsequent personal interest. Additionally, following an international trend, the level of perceived self-regulation decreased from the first to third year of study. CONCLUSIONS: The study has important theoretical and practical implications. First, the results suggest that perceived self-regulation and personal interest are only partially explained by achievement. Second, it appears that perceived self-regulation drives personal interest, not the other way around. Finally, ways for teachers and schools to sustain perceived self-regulation throughout the high school years are discussed.

Social Anxiety Scale for Adolescents (SAS-A): measuring social anxiety among Finnish adolescents.

The aim of this study was to investigate symptoms of social anxiety and the psychometric properties of the Social Anxiety Scale for Adolescents (SAS-A) among Finnish adolescents, 13-16 years of age. Study 1 (n = 867) examined the distribution of SAS-A scores according to gender and age, and the internal consistency and factor structure of the SAS-A. In a subsample (n = 563; Study 2) concurrent and discriminant validity of the SAS-A were examined relative to the Social Phobia Inventory and the Beck Depression Inventory. Test-retest stability was examined over a 30-month period by repeated measures every 6 months in another subsample (n = 377; Study 3). Results mostly revealed no gender differences in social anxiety, except that boys reported more general social avoidance and distress than girls. Older adolescents (14-16-year-olds) reported higher social anxiety than younger adolescents (12-13-year-olds). Internal consistency for the SAS-A was acceptable for both genders and for all three SAS-A subscales. Confirmatory factor analysis replicated the original 18-item three-factor structure of the SAS-A, accounting for 61% of the variance between items. Evidence for concurrent and discriminant validity was found. Test-retest stability over 6 months was satisfactory. Results support the reliability and validity of the Finnish adaptation of the SAS-A, and further indicate that gender differences in adolescents' social anxiety may vary across Western countries.

Malpresentations--impact on mode of delivery.

Fetal malpresentation, including persistent occipitoposterior position, is a major cause of dystocia resulting in obstetric interventions. We studied malpresentation among 11 957 consecutive singleton deliveries from 1995 to 2004. There were 1 030 deliveries with a malpresentation (8.6%). Cephalic malpresentations occurred in 5.4% of deliveries (persistent occipitoposterior 5.2%, face 0.1%, brow 0.14%), and 3.1% had breech presentation and 0.12% a transverse lie. The odds ratios (OR) for cesarean section were 14.89 (95%CI 11.91-18.63) in breech presentation and 4.57 (95% CI 3.85-5.42) in persistent occipitoposterior presentation. With persistent occipitoposterior position, the OR for instrumental vaginal delivery was 3.84 (95%CI 3.14-4.70). Primiparity was associated with increased malpresentation risks, as 54.6% of those with malpresentations were primiparous compared with 41.7% of those without (OR 1.68, 95%CI 1.48-1.91, p < 0.001). Primiparous women required more cesarean sections (OR 1.92, 95%CI 1.50-2.47) and instrumental deliveries (OR 2.89, 95%CI 1.50-2.47). Malpresentation frequently leads to cesarean section or instrumental delivery, especially among primiparous women.

Repeatability (test-retest variability) of refractive error measurement in clinical settings.

PURPOSE: To estimate the repeatability of refractive error measurement (REM) in a clinical environment in cataractous, pseudophakic and healthy eyes. METHODS: The refractive error of patients referred for cataract surgery or consultation measured by ophthalmic professionals was re-examined and the measurement results were compared. A total of 99 eyes from 99 persons (41 cataractous, 36 pseudophakic and 22 healthy eyes) with visual acuity (VA) of 0.3-1.3 (logMAR 0.52 to - 0.11) were included. The differences between measurements 1 and 2 were calculated as 3-dimensional vector values and spherical equivalents (SEs) and expressed as the coefficient of repeatability (CR). The mean time interval between the first and second examinations was 45 days. RESULTS: The CRs for all eyes for vertical (V), torsional (T) and horizontal (H) vectors were 0.74 D, 0.34 D and 0.93 D, respectively. The CR of SE for all eyes was 0.74 D. Eyes with lower VA (0.3-0.45) had larger variability in vector and SE values but the differences between VA groups were not statistically significant. The difference in the mean defocus equivalent (DE) between measurements 1 and 2 was, however, significantly greater in the group with lower VA. In all VA groups the mean difference vector was very close to the zero vector, which means that there was no systematic difference. CONCLUSIONS: Repeatability of refractive error measurements in clinical settings has a certain degree of variability. In this series, the variability in eyes with better VA was not great and was in accordance with earlier findings in healthy eyes. Eyes with lower VA had greater variability due to greater tolerance to defocus. Thus, conclusions concerning changes in the refractive state and the need to make changes in the refractive correction of eyes with poorer vision should be made with caution.

Random measurement error in visual acuity measurement in clinical settings.

PURPOSE: To estimate the random measurement error in visual acuity (VA) determination in the clinical environment in cataractous, pseudophakic and healthy eyes. METHODS: The VAs of patients referred for cataract surgery or consultation by ophthalmic professionals were re-examined and the VA results for distance using projector acuity charts were compared. Refractive errors were also remeasured. A total of 99 eyes (41 cataractous, 36 pseudophakic and 22 healthy eyes) were examined. The healthy comparison group consisted of hospital staff. Only one eye of each person and eyes with Snellen VAs of 0.3-1.3 (logMAR 0.52 to - 0.11) were included. The mean time interval between the first and second examinations was 45 days. RESULTS: The estimated standard deviation of measurement error (SDME) of repeated VA measurements of all eyes was logMAR 0.06. Eyes with the lowest VA (0.3-0.45) had the largest variability (SDME logMAR 0.09), and eyes with VA > or = 0.7 had the smallest (SDME logMAR 0.04). The variability may be partly explained by the line size progression in lower VAs, partly by the difference in the remeasurement of the refractive error. The difference in the average VA between examinations 1 and 2 (logMAR 0.15 versus 0.12) was considered to be of some interest because it indicates that some learning effect is possible. CONCLUSION: Visual acuity results in clinical settings have a certain degree of inherent variability. In this series variability ranged from SDME logMAR 0.04 (eyes with good vision) to logMAR 0.09 (in the lower vision group) in the Snellen VA range of 0.3-1.3. Changes should be judged with caution, especially in cases of decreased VA.

Recurrent persistent occipito-posterior position in subsequent deliveries.

A nine year follow up study of the delivery pattern of 119 women after delivery in the persistent occiput posterior position and their occipito-anterior controls. The studied parameters were: number of deliveries, number of repeated cases of persistent occiput posterior position and operative deliveries. Deliveries in the occipito-posterior position were more common in the study group than in the controls (P= 0.031). Except for this, no statistically significant differences were found between the groups. According to the results, recurrence of the persistent occiput posterior position is common. A history of delivery in the persistent occiput posterior position does not seem to have any major impact on future childbearing.