A mixed-method study evaluating an innovative care model for rural patients undergoing outpatient breast surgery.

BACKGROUND: The Delta Oasis program was launched in New Brunswick in 2006 to offer patients from rural areas who were undergoing breast cancer surgery and their families 1 night of free accommodations and a postoperative consultation with an extramural nurse. We sought to investigate patient experiences with this program. METHODS: This mixed-method retrospective study took place from 2020 to 2022 and compared the preoperative anxiety and quality of recovery of program participants and control patients who were discharged home over 100 km from hospital. We conducted 2 × 2 analysis of variance to evaluate the effects of intervention group and surgery type. We conducted semistructured interviews with intervention participants, which we then thematically analyzed. Two patient partners were engaged during data synthesis to support the interpretation of results. RESULTS: We included 34 patients who participated in the program and 18 control patients. No statistically significant differences were found between treatment groups in preoperative anxiety and quality of recovery, regardless of surgery type. Thematic analysis of interviews with 17 intervention participants revealed that they were highly satisfied with the program and that the experience helped reduce stress and discomfort related to their surgery. INTERPRETATION: The Delta Oasis program is a cost-effective alternative to inpatient care after breast cancer surgery and is highly regarded by rural patients; expansion to other regions with the inclusion of additional low-risk surgeries could help address hospital capacity issues. This study contributes to our understanding of the patient experience with the Delta Oasis program and informs the development of similar programs elsewhere.

Development of Two-Dimensional Classroom Discourse Analysis Tool (CDAT): scientific reasoning and dialog patterns in the secondary science classes.

BACKGROUND: In a science classroom, students do not simply learn scientific ways of doing, knowing, and reasoning unless they find ways of appropriating scientific discourse. In the Next Generation Science Standards, major forms of scientific discourse are emphasized as a main part of the Science and Engineering Practices. To enhance student engagement in scientific discourse, teachers need to help students differentiate scientific ways of talking from everyday ways of talking. Thus, science teachers should be able to be aware of the differences to provide opportunities for students to engage in scientific discourse. RESULTS: In this study, the classroom discourse analysis tool (CDAT) was developed to help science teachers and educators identify the patterns of their classroom discourse with the lens of scientific reasoning. The CDAT suggests a new way of discourse pattern finding with the two-dimensional graphic organizer and the quantitative data produced by the coding. To pilot the CDAT analysis, 13 videos and transcripts of two middle and one high school teachers' physical science classes were viewed and analyzed. The results from CDAT coding show illustrative information that characterizes the classroom discourse patterns in relation to scientific reasoning and teachers' questioning and feedback. A coded CDAT table shows what reasoning components used in the classroom dialogs between the teacher and students. It also shows how students engaged in the dialogs with the variations of their answers by the teacher's question and feedback. CONCLUSION: The results show the patterns of students' responses strongly depend on teacher's question or feedback. In addition, this analysis also generates various quantitative data that represent certain characteristics of the classroom discourse, i.e., length of dialog and the number of reasoning components used. The possible implications of CDAT analysis are to explore the relationships between teachers' discourse patterns and students' achievement along with changes in their reasoning skills. Student attitudinal outcomes such as motivations, interests, or self-efficacy could also be compared by the classroom discourse patterns revealed by CDAT. CDAT analysis itself can also be used in a teacher professional development as an intervention to help teachers see their classroom discourse patterns.