Explaining the changes in procrastination in an ACT-based course - psychological flexibility and time and effort management as mediators.

Introduction: The aim of our study is to explore the relationship between procrastination, time management skills and psychological flexibility and the changes in them during an Acceptance and Commitment therapy (ACT)-based course that included time management training. We also explored the effects of time management skills and psychological flexibility on procrastination. The study used an experimental design in an ACT-based well-being course that included time management training. Methods: The participants were 109 students taking the course and 27 waiting list students. Analyses were conducted with Pearson correlation, mixed ANOVA and causal mediation analysis. Results and discussion: Our results show that time management skills, psychological flexibility and procrastination were related to each other, and all changed during the course. In addition, change in both time management and psychological flexibility had an impact on the change in procrastination during the course. The results show that both time management and psychological flexibility influence the change in procrastination during an ACT-based course.

Clinical reasoning in pharmacy: What do eye movements and verbal protocols tell us about the processing of a case task?

This study investigates pharmacy students' reasoning while solving a case task concerning an acute patient counselling situation in a pharmacy. Participants' (N = 34) reasoning processes were investigated with written tasks utilizing eye-tracking in combination with verbal protocols. The case was presented in three pages, each page being followed by written questions. Eye movements were recorded during case processing. Success in the task required differentiating the relevant information from the task redundant information, and initial activation of several scripts and verification of the most likely one, when additional information became available. 2nd (n = 16) and 3rd (n = 18)-year students' and better and worse succeeding students' processes were compared. The results showed that only a few 2nd-year students solved the case correctly, whereas almost all of the 3rd-year students were successful. Generally, the average total processing times of the case material did not differ between the groups. However, better-succeeding and 3rd-year students processed the very first task-relevant sentences longer, indicating that they were able to focus on relevant information. Differences in the written answers to the 2nd and 3rd question were significant, whereas differences regarding the first question were not. Thus, eye-tracking seems to be able to capture illness script activation during case processing, but other methods are needed to depict the script verification process. Based on the results, pedagogical suggestions for advancing pharmacy education are discussed.

Comparison of voluntary and forced digital leaps in higher education - Teachers' experiences of the added value of using digital tools in teaching and learning.

The study examines the benefits of digital tools in teaching and learning as experienced by university teachers in two different time periods: 1) during the controlled digital leap before the Covid-19 pandemic (2017-2019) and 2) during the emergency imposition of remote teaching in response to the lockdown aimed at containing the Covid-19 pandemic (2020). Teachers in different academic fields at a large multidisciplinary Finnish university (N1 = 303 and N2 = 265) responded to two open-ended questions as part of a broader questionnaire. The research identified four kinds of benefits related to digital teaching: (1) practical and administrative and (2) independence of time and place, implying practical and technical benefits; as well as (3) enhancing learning and (4) developing teaching, which are primarily pedagogical benefits, related to teaching and learning. Voluntary and forced digital leaps provided different kinds of consequences in teaching and learning. Digital tools generally provided practical and technological benefits for teaching and learning during the controlled digital leap, but they also had positive pedagogical effects. The forced digital leap, in turn, demonstrated the value of time-and-place-independent online teaching and learning. It also exposed differences among academic fields in how teachers experienced the benefits of using digital tools. Support of and training for university teachers should take into account the different needs of faculties and disciplines, and promote dialogue between pedagogical and technological interests.

Development of a Web-Based Intervention Course to Promote Students' Well-Being and Studying in Universities: Protocol for an Experimental Study Design.

BACKGROUND: The decline in the well-being among university students well as increasing dropouts has become a serious issue in universities around the world. Thus, effective ways to support students' well-being and their ability to study are highly needed. OBJECTIVE: The purpose of this study was to build an intervention course for university students, which promotes both students' well-being as well as their learning and study skills, and to describe the experimental study design that explores the effects of this intervention course. METHODS: Research has shown that psychological flexibility has a great effect on the well-being as well as the study skills of students pursuing higher education. The basis of our intervention course was to promote psychological flexibility and students' study skills with the help of peer support and reflection. RESULTS: This course was offered as a voluntary course to all the students at the University of Helsinki twice during the academic year 2020-2021. The first course was from October to December and the second course was from January to March. This course was advertised in fall 2020 through social media and by different student organizations and program leaders at different faculties of the University of Helsinki. As of October 2020, we enrolled 566 students comprising 310 students for the course in fall 2020 and 256 students for the course in spring 2021. Of the 256 students who enrolled in the second course, 170 students voluntarily participated in this study and they answered the questionnaires, including all the measures, simultaneously with the participants in the first group and thus served as the control group. The effect of this course will be measured with multiple data, including questionnaire data, reflective journals, and physiological data of well-being with a longitudinal experimental design. This research very strictly follows the ethical guidelines drawn up by the Finnish National Board on Research Integrity. We expect to publish the results of this study in fall 2021 at the latest. CONCLUSIONS: We argue that a web-based, 8-week intervention course, which promotes both student well-being and their study skills, is a good way to support students pursuing higher education, and both aspects should be considered when supporting university students. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/23613.

Pharmacy Practice and Education in Finland.

The Pharmacy Education in Europe (PHARMINE) project studies pharmacy practice and education in the European Union (EU) member states. The work was carried out using an electronic survey sent to chosen pharmacy representatives. The surveys of the individual member states are now being published as reference documents for students and staff interested in research on pharmacy education in the EU, and in mobility. This paper presents the results of the PHARMINE survey on pharmacy practice and education in Finland. Pharmacies have a monopoly on the dispensation of medicines. They can also provide diagnostic services. Proviisori act as pharmacy owners and managers. They follow a five-year (M.Sc. Pharm.) degree course with a six-month traineeship. Farmaseutti, who follow a three-year (B.Sc. Pharm.) degree course (also with a six-month traineeship), can dispense medicines and counsel patients in Finland. The B.Sc. and the first three years of the M.Sc. involve the same course. The current pharmacy curriculum (revised in 2014) is based on five strands: (1) pharmacy as a multidisciplinary science with numerous opportunities in the working life, (2) basics of pharmaceutical sciences, (3) patient and medication, (4) optional studies and selected study paths, and (5) drug development and use. The learning outcomes of the pharmacy graduates include (1) basics of natural sciences: chemistry, physics, technology, biosciences required for all the students (B.Sc. and M.Sc.), (2) medicine and medication: compounding of medicines, holism of medication, pharmacology and biopharmaceutics (side-effects and interactions), patient counseling, efficacy and safety of medicines and medication, (3) comprehensive and supportive interactions of the various disciplines of pharmacy education and research: the role and significance of pharmacy as a discipline in society, the necessary skills and knowledge in scientific thinking and pharmaceutical research, and (4) basics of economics and management, multidisciplinarity, hospital pharmacy, scientific writing skills, management skills. In addition, teaching and learning of "general skills", such as the pharmacist's professional identity and the role in society as a part of the healthcare system, critical and creative thinking, problem-solving skills, personal learning skills and life-long learning, attitude and sense of responsibility, and communication skills are developed in direct association with subject-specific courses. Professional specialization studies in industrial pharmacy, and community and hospital pharmacy are given at the post-graduate level at the University of Helsinki.

The Use of Video Instructions in Patient Education Promoting Correct Technique for Dry Powder Inhalers: An Investigation on Inhaler-Naïve Individuals.

Introduction: The correct use of a prescribed inhaler device is crucial for achieving successful disease management in asthma. This study investigates non-verbal, demonstrational videos as a method of teaching inhaler naïve individuals how to use a dry powder inhaler (DPI). Methods: Video instructions for four DPIs were examined using a mixed methodology; 31 inhaler-naïve individuals participated in the study. Participants were each shown a demonstrational video of one the four inhalers, after each video the participant demonstrated how they would use the inhaler. After demonstrating the use, participants crossed over to the next inhaler. The demonstrations were videotaped. A common questionnaire was filled at the beginning of the study and four inhaler-specific questionnaires which were filled out by the participant after each inhaler demonstration. Results: The frequency of participant error varied between inhalers. When asked about how they perceived the video instructions, participants often stated they would have liked to receive feedback on their performance. The importance of feedback was further highlighted by the fact that participants tended to overestimate their own inhaler technique. Conclusion: Non-verbal videos may be more efficient for some DPIs than for others as a method for providing inhaler instructions. Lack of feedback on the participants' inhaler performance emerged as a clear shortcoming of this educational method. Some steps in the inhalation process may be harder for individuals to remember and therefore require extra emphasis in order to achieve correct inhaler technique.

Competence-Based Pharmacy Education in the University of Helsinki.

In order to meet the expectations to act as an expert in the health care profession, it is of utmost importance that pharmacy education creates knowledge and skills needed in today's working life. Thus, the planning of the curriculum should be based on relevant and up-to-date learning outcomes. In the University of Helsinki, a university wide curriculum reform called 'the Big Wheel' was launched in 2015. After the reform, the basic degrees of the university are two-cycle (Bachelor-Master) and competence-based, where the learning outcomes form a solid basis for the curriculum goals and implementation. In the Faculty of Pharmacy, this curriculum reform was conducted in two phases during 2012-2016. The construction of the curriculum was based on the most relevant learning outcomes concerning working life via high quality first (Bachelor of Science in Pharmacy) and second (Master of Science in Pharmacy) cycle degree programs. The reform was kicked off by interviewing all the relevant stakeholders: students, teachers, and pharmacists/experts in all the working life sectors of pharmacy. Based on these interviews, the intended learning outcomes of the Pharmacy degree programs were defined including both subject/contents-related and generic skills. The curriculum design was based on the principles of constructive alignment and new structures and methods were applied in order to foster the implementation of the learning outcomes. During the process, it became evident that a competence-based curriculum can be created only in close co-operation with the stakeholders, including teachers and students. Well-structured and facilitated co-operation amongst the teachers enabled the development of many new and innovative teaching practices. The European Union funded PHAR-QA project provided, at the same time, a highly relevant framework to compare the curriculum development in Helsinki against Europe-wide definitions of competences and learning outcomes in pharmacy education.

Evaluation of dry powder inhalers with a focus on ease of use and user preference in inhaler-naïve individuals.

Inhaler errors are common amongst inhaler users. Therefore, in the development work of new inhalation devices, it is important to characterize the ease of use of the inhalers. In this study four dry powder inhalers, Diskus, Easyhaler, Ellipta and Turbuhaler, were evaluated, focusing on ease of use and patient preference. The study used a triangular methodology. The sample consisted of 31 inhaler naïve individuals. Educational videos for all inhalers were watched, and afterwards, the use of all four inhalers was demonstrated in a random order. The demonstrations were videotaped. Thereafter they were checked against a predefined checklist and all mistakes were recorded. Only 33% of inhaler demonstrations were completed without the participants making any mistakes. The proportions of subjects who used the devices correctly were as follows: Diskus 48%, Easyhaler 19%, Ellipta 55% and Turbuhaler 16%. When comparing correct and incorrect inhaler technique for each inhaler pair the following differences were statistically significant: Diskus vs. Easyhaler (p<0.05), Ellipta vs. Easyhaler (p<0.01), Diskus vs. Turbuhaler (p<0.01), Ellipta vs. Turbuhaler (p<0.01). In the participants' ranking, the inhalers Ellipta, followed by Turbuhaler, were most often ranked as most preferred. Participants' preference of Ellipta over Easyhaler (p<0.01) and over Diskus (p<0.001) were statistically significant.

Relationships between students' approaches to learning, perceptions of the teaching-learning environment, and study success: a case study of third-year veterinary students.

The relationships among veterinary students' approaches to learning, perceptions of the teaching-learning environment, and study success were evaluated in a demanding, discipline-based curriculum. The aim was to elicit elements for improving student counseling. As part of a large multidisciplinary survey, 36 third-year students (74% response rate) answered a modified version of the Experiences of Teaching and Learning Questionnaire in 2006. In this study, the authors used students' responses to questions regarding examinations and the progress of studies. In addition, students were classified in the large survey into four clusters according to their approaches to studying. Study success was evaluated by exploring the number of study credits students had earned and their grade point averages. The differences in study success between the clusters were not statistically significant, but, in general, students applying a deep approach were most successful, whereas unorganized students applying a deep approach showed the largest variation in study progress. The most commonly mentioned factors for enhancing or impeding study progress were related to the curriculum and to the students' actions or experiences. Unorganized students applying a deep approach seemed to suffer the most from the workload and pressure of progressing in their studies according to a predetermined timetable. These students were also most unaware of the examinations' demands. The findings suggested that, in addition to curriculum development, there is a need to explicitly make students aware of their approaches to learning and to support the development of their study practices.

Curriculum reform in Finnish pharmacy education.

OBJECTIVE: To improve pharmacy education through integrating theory and practice, coherent constructively aligned course entities, and enhanced deep-level learning. DESIGN: The reform was conducted collaboratively with faculty and staff members, students, and stakeholders in pharmacy. The curriculum, syllabus, and teaching methods were assessed through evaluations and research, conducting core content analyses, and measuring the workload of pharmacy education courses. The new curriculum, launched in August 2005, consists of 6 strands, comprised of different courses which run through the entire program. ASSESSMENT: Three years after the introduction of the reformed curriculum, the results of the reform are being evaluated. Ongoing assessments of teaching and learning will reveal how the education at the faculty level has developed since the reform. These assessment procedures are an integral part of the faculty's quality assurance program. CONCLUSION: The integration of practical training and theoretical studies was improved with personal study plans introduced to enhance students' learning.

Feedback in patient counselling training--pharmacy students' opinions.

OBJECTIVE: The aims were to analyse Finnish pharmacy students' opinions of feedback given to them in patient counselling training during their internship period, and to evaluate the guidelines used. METHODS: The study was based on reports written by 136 students, analysed qualitatively. To examine the significance of the guidelines and the perceived quality of the feedback, students were categorised into groups. Correlations were assessed by frequencies and cross-tabulations. RESULTS: A statistically significant correlation was found (p<0.001) between the perceived quality of the feedback and the use of the guidelines. The relations between the perceived usefulness of the guidelines and the use of the guidelines in patient counselling exercises were also statistically significant (p=0.034). CONCLUSIONS: The results indicate that the perceived quality of the feedback was indeed associated with the use of the guidelines. They not only offer a training method focusing on essential communication skills in patient counselling, but are also a useful tool for developing counselling practices in general. PRACTICAL IMPLICATIONS: Since mentors are probably unfamiliar with the guidelines, students should be trained to explain their use. To ensure that mentors are competent in analysing communication skills, further training for them is essential.

The relevance of prior knowledge in learning and instructional design.

OBJECTIVES: To determine how different types of prior knowledge (declarative and procedural) impact student achievement and how prior-knowledge assessment can be used as an instructional design tool. METHODS: A questionnaire was developed based on the prior-knowledge model, which distinguishes between declarative and procedural knowledge. One hundred fifteen pharmacy students were tested prior to beginning 4 successive basic science courses and then prior to beginning a pharmaceutical chemistry course. Regression analysis was used to determine which type of knowledge was the best predictor of student achievement. The 4 course instructors were interviewed and their comments analyzed. RESULTS: Prior knowledge from previous courses significantly influenced student achievement. Procedural knowledge was especially related to student achievement. Instructors and students had mainly positive reactions towards the prior-knowledge tests. CONCLUSIONS: Students' prior knowledge should be taken into consideration in instructional design and curriculum planning. Furthermore, the results of prior-knowledge assessments may be used as a tool for student support in addressing areas of deficiency.

A qualitative study of the difficulties of smoking cessation; health care professionals' and smokers' points of view.

OBJECTIVE: To obtain a deeper understanding of smokers feelings and to establish co-operative networking groups, the opinions about smoking cessation of health care professionals and smokers were studied. DESIGN: Focus group discussions were held in order to gain ideas and tools to be used in smoking cessation work, in particular in network groups. Two focus group discussion for health care professionals (n = 7) and one focus group discussion for ex-smokers/smokers (n = 3) were held. RESULTS: The study suggests that problems exist in smoking cessation work among health care professionals. The main issues among the health care professionals were lack of motivation and consistency of approach. Information concerning the health risk related to smoking no longer reaches people. New ways of health promotion are desired. Smokers feel that lack of positive support and nicotine dependence are the main problems in their attempts to quit. CONCLUSIONS: Society and smokers have the same goal: smoking cessation. However, both parties do not seem to agree on ways of achieving this goal. A local network among health care professionals could motivate and give rise to new methods of smoking cessation counselling. Positive support and nicotine replacement therapy could significantly improve smokers success rates. Trained personnel have better opportunities for meeting smokers and that is why cessation should be part of the core curriculum and basic training for health care professionals.