Using a Wireless Electroencephalography Device to Evaluate E-Health and E-Learning Interventions.

BACKGROUND: Measuring engagement and other reactions of patients and health professionals to e-health and e-learning interventions remains a challenge for researchers. OBJECTIVE: The aim of this pilot study was to assess the feasibility and acceptability of using a wireless electroencephalography (EEG) device to measure affective (anxiety, enjoyment, relaxation) and cognitive (attention, engagement, interest) reactions of patients and healthcare professionals during e-health or e-learning interventions. METHODS: Using a wireless EEG device, we measured patient (n = 6) and health professional (n = 7) reactions during a 10-minute session of an e-health or e-learning intervention. The following feasibility and acceptability indicators were assessed and compared for patients and healthcare professionals: number of eligible participants who consented to participate, reasons for refusal, time to install and calibrate the wireless EEG device, number of participants who completed the full 10-minute sessions, participant comfort when wearing the device, signal quality, and number of observations obtained for each reaction. The wireless EEG readings were compared to participant self-rating of their reactions. RESULTS: We obtained at least 75% of possible observations for attention, engagement, enjoyment, and interest. EEG scores were similar to self-reported scores, but they varied throughout the sessions, which gave information on participants' real-time reactions to the e-health/e-learning interventions. Results on the other indicators support the feasibility and acceptability of the wireless EEG device for both patients and professionals. DISCUSSION: Using the wireless EEG device was feasible and acceptable. Future studies must examine its use in other contexts of care and explore which components of the interventions affected participant reactions by combining wireless EEG and eye tracking.

What is reflection? A conceptual analysis of major definitions and a proposal of a five-component model.

CONTEXT: Although reflection is considered a significant component of medical education and practice, the literature does not provide a consensual definition or model for it. Because reflection has taken on multiple meanings, it remains difficult to operationalise. A standard definition and model are needed to improve the development of practical applications of reflection. OBJECTIVES: This study was conducted in order to identify, explore and analyse the most influential conceptualisations of reflection, and to develop a new theory-informed and unified definition and model of reflection. METHODS: A systematic review was conducted to identify the 15 most cited authors in papers on reflection published during the period from 2008 to 2012. The authors' definitions and models were extracted. An exploratory thematic analysis was carried out and identified seven initial categories. Categories were clustered and reworded to develop an integrative definition and model of reflection, which feature core components that define reflection and extrinsic elements that influence instances of reflection. RESULTS: Following our review and analysis, five core components of reflection and two extrinsic elements were identified as characteristics of the reflective thinking process. Reflection is defined as the process of engaging the self (S) in attentive, critical, exploratory and iterative (ACEI) interactions with one's thoughts and actions (TA), and their underlying conceptual frame (CF), with a view to changing them and a view on the change itself (VC). Our conceptual model consists of the defining core components, supplemented with the extrinsic elements that influence reflection. CONCLUSIONS: This article presents a new theory-informed, five-component definition and model of reflection. We believe these have advantages over previous models in terms of helping to guide the further study, learning, assessment and teaching of reflection.

Relations among competence beliefs, utility value, achievement goals, and effort in mathematics.

BACKGROUND: Research has shown that motivation is a key factor in the learning process as well as in school achievement. In essence, a number of researchers have highlighted the close link between motivation and achievement-related behaviours such as effort. AIMS: The present study aims to acquire more specific information concerning the relations between competence beliefs, utility value and achievement goals in mathematics among secondary school students, to further document the influence of social agents, and to better understand the relationships between these variables, as well as to effort. SAMPLE: Participants were 759 Grade 7 to Grade 11 students (389 males, 370 females). METHOD: Structural equation modelling techniques were used to test a model of achievement-related behaviours (effort) in mathematics based on support from social agents, competence beliefs, utility value and achievement goals. Several self-reported scales were administered. RESULTS: Results indicate that effort in mathematics is mainly explained by mastery goals and competence beliefs. As for the role of social agents, results demonstrated that the perception of parental support chiefly explained variables associated with the valuing of mathematics while teachers' support acted most on competence beliefs. CONCLUSIONS: Two main conclusions stem from our results. First, mastery goals have an important and significant impact on students' effort in the learning of mathematics. Second, the nature and the strength of the relationships between competence beliefs, utility value, achievement goals and effort are not significantly influenced by age and gender, at least in mathematics.

Web-Based Intervention to Teach Developmentally Supportive Care to Parents of Preterm Infants: Feasibility and Acceptability Study.

BACKGROUND: Preterm birth affects 8% to 11% of the population and conveys a significant risk of developmental delays. Intervention programs that support child development have been shown to have a positive impact on early motor and cognitive development and on parental well-being. However, these programs are often difficult to implement in a real-life setting due to lack of resources. Hence, our multidisciplinary team developed Mieux Agir au Quotidien (MAQ) to teach developmentally supportive care to parents of preterm infants with the goal of improving child development and parental outcomes. Our intervention included 3 in-person workshops that occurred prior to hospital discharge and a Web-based platform with written and videotaped materials that addressed 5 main themes: (1) infant behavioral cues, (2) flexion positioning; (3) oral feeding support, (4) parent-infant interactions, and (5) anticipation of developmental milestones. OBJECTIVE: This study aimed to test the feasibility and acceptability of the intervention by parents of preterm infants and assess clinical benefits on child neurodevelopment and parental outcomes during the first year of life. METHODS: A total of 107 infants born at <30 weeks and admitted to Sainte-Justine Hospital neonatal intensive care unit and their parents were enrolled in a nonrandomized controlled before-and-after interventional study (intervention n=55, comparison n=52). Acceptability of the program was assessed with a user satisfaction questionnaire. When the infants were at 4 months' corrected age, all parents completed questionnaires on infant temperament, parenting stress, sense of competence, and parenting satisfaction. At 12 months' corrected age, neurodevelopmental testing was performed on infants using the Alberta Infant Motor Scale and the Bayley Scales of Infant and Toddler Development, Third Edition. Comparisons between the 2 groups were done using independent t tests, Wilcoxon rank-sum tests, and Fisher exact tests. RESULTS: The majority of parents (43/45) were satisfied with the intervention program and all would recommend MAQ to others. MAQ met their need for evidence-based information that proved useful to support their child development. No difference in parental or child neurodevelopmental outcomes was detected in this pilot study for most outcomes except for higher median scores for parental coercive behaviors in the intervention group, although proportions scoring in the coercive range did not differ. CONCLUSIONS: Acceptability of the program was high among parents thus supporting the relevance of such intervention. A larger study using a randomized controlled trial design is needed to better document impact on parent and children and investigate how Web-based technologies can efficiently complement individualized intervention to alleviate the burden on health care resources.