Preparing adults with intellectual disabilities for their future: How do support services staff view their role?

BACKGROUND: Person-centred service delivery underpins current approaches to working with individuals with intellectual disabilities. We investigated views of staff from a service organisation regarding their roles in creating desired futures for adults with intellectual disabilities. METHODS: Data were gathered from staff of a large organisation that provided a range of services to adults with intellectual disabilities. Respondents were asked to describe their role in assisting an individual with intellectual disability to meet their goals for the future. Responses were analysed using a text analysis programme. RESULTS: Two major themes were identified: 'Support for self-determination' and 'Business-as-usual'. These themes were not entirely separate but had some overlap. There were indications that staff experienced competing demands in their role(s). CONCLUSION: Although central to person-centred planning, staff who work with adults with intellectual disabilities may not see support of self-determination as a key factor in creating a desired future.

Using cultural historical activity theory to reflect on the sociocultural complexities in OSCE examiners' judgements.

Examiners' judgements play a critical role in competency-based assessments such as objective structured clinical examinations (OSCEs). The standardised nature of OSCEs and their alignment with regulatory accountability assure their wide use as high-stakes assessment in medical education. Research into examiner behaviours has predominantly explored the desirable psychometric characteristics of OSCEs, or investigated examiners' judgements from a cognitive rather than a sociocultural perspective. This study applies cultural historical activity theory (CHAT) to address this gap in exploring examiners' judgements in a high-stakes OSCE. Based on the idea that OSCE examiners' judgements are socially constructed and mediated by their clinical roles, the objective was to explore the sociocultural factors that influenced examiners' judgements of student competence and use the findings to inform examiner training to enhance assessment practice. Seventeen semi-structured interviews were conducted with examiners who assessed medical student competence in progressing to the next stage of training in a large-scale OSCE at one Australian university. The initial thematic analysis provided a basis for applying CHAT iteratively to explore the sociocultural factors and, specifically, the contradictions created by interactions between different elements such as examiners and rules, thus highlighting the factors influencing examiners' judgements. The findings indicated four key factors that influenced examiners' judgements: examiners' contrasting beliefs about the purpose of the OSCE; their varying perceptions of the marking criteria; divergent expectations of student competence; and idiosyncratic judgement practices. These factors were interrelated with the activity systems of the medical school's assessment practices and the examiners' clinical work contexts. Contradictions were identified through the guiding principles of multi-voicedness and historicity. The exploration of the sociocultural factors that may influence the consistency of examiners' judgements was facilitated by applying CHAT as an analytical framework. Reflecting upon these factors at organisational and system levels generated insights for creating fit-for-purpose examiner training to enhance assessment practice.

Engaging clinical examiners with structured feedback to enhance assessment practices.

INTRODUCTION: Examiners' professional judgements of student performance are pivotal to making high-stakes decisions to ensure graduating medical students are competent to practise. Clinicians play a key role in assessment in medical education. They are qualified in their clinical area but may require support to further develop their understanding of assessment practices. However, there are limited studies on providing examiners with structured feedback on their assessment practices for professional development purposes. METHODS: This study adopts an interpretive paradigm to develop an understanding of clinical examiners' interpretations of receiving structured feedback and its impacts on enhancing their assessment literacy and practice. Data were collected from 29 interviews with clinical examiners who assessed the final-year medical objective structured clinical examinations (OSCEs) at one university. RESULTS: Inductive thematic analysis of these data revealed that the examiners considered the feedback to be useful with practical functions in facilitating communication, comparisons and self-reflection. However, the examiners' level of confidence in the appropriateness of their assessment practices and difficulties in interpreting feedback could be barriers to adopting better practices. CONCLUSION: Feedback for examiners needs to be practical, targeted, and relevant to support them making accountable and defensible judgements of student performance.

Reliability of a method for establishing the capacity of individuals with an intellectual disability to respond to Likert scales.

BACKGROUND: The study reported here was an examination of the reliability of a method for determining acquiescent responding and the capacity to respond to items using a Likert scale response format by adults with an intellectual disability. METHOD: Reliability of the outcomes of these procedures was investigated using a test-retest design. Associations with receptive vocabulary were examined. RESULTS: The majority of the participants did not demonstrate acquiescent responding. Individuals' responses to the Likert-type discrimination tasks were consistent, although this varied somewhat depending upon the abstractness of the task. There was some association between receptive language age equivalence scores and respondent performance. CONCLUSION: It is recommended that the pretest protocol (a) be modified to improve its reliability, and (b) this modified version be used with study participants who have an intellectual disability to ascertain the appropriate level of choice to be used for items that use a Likert response format.

Student perceptions and use of an assessment rubric for a group concept map in physiology.

We previously reported how the opinions of second-year dentistry students and faculty members can be used to construct an assessment rubric to grade group-based concept maps in physiology. This article describes the second phase of this study of the subsequent year's cohort. A case study approach was used to investigate how groups of students used the criteria to complete their complex concept maps. Students' opinions about the assessment task and newly constructed rubric were sampled. Opinions across groups were correlated to academic achievements in the course. Two groups of four students volunteered to be videorecorded during a 4-h workshop, during which they completed their maps. The mapping task was not generally favored by students. However, those students who did favor the task achieved higher academic grades. Most students favored the newly constructed assessment rubric, commenting that it was easy to understand, fair, and appropriate, but reported that extra guidance from tutors and other resources were required. Coded videorecordings of the two observation groups revealed complex interactions around the three criteria of content, logic and understanding, and presentation. Two broad patterns of working were identified. One group distributed their efforts more evenly across the criteria, whereas the other group completed their maps by addressing the criteria in stages. These findings clearly indicate the academic challenges and social complexity in how students work in groups to complete complex concept maps in physiology.

Using explicit teaching to improve how bioscience students write to the lay public.

The media role model was recently developed to frame how science faculty members can teach their students to write more effectively to lay audiences (14). An Opinion Editorial (Op-Ed) was introduced as a novel assignment for final-year physiology and pharmacology undergraduates. This second phase of this study, reported here, demonstrated the efficacy of explicit teaching of the Op-Ed, using a one-shot, pre-/posttest research design. Baseline writing skills of students were determined from a communication assignment. Students were then explicitly taught how to write an Op-Ed and subsequently wrote an Op-Ed based on a recent, relevant scientific article. Most students achieved higher grades for their Op-Ed following explicit teaching [mean (SD) = 84.4% (9.1%), n = 216] compared with their communication assignment [mean (SD) = 74.7% (11.9%), n = 218]. Improvement in student writing was also evident by an increase in text readability, which mirrored the features of Op-Eds written by professional journalists. A survey of students (n = 142) indicated that most believed that the assignments were valuable and that their ability to write to a lay audience had improved. Members of the lay public were then surveyed for their opinions on student writing. Two assignments were selected from one student whose grades had improved after explicit teaching. Respondents (n = 78) indicated that the Op-Ed was easier to read than the communication assignment. Thus, explicit teaching of the Op-Ed improved the ability of students to write to members of the lay public.

Assessing core manipulative skills in a large, first-year laboratory.

Responding to the concern from our faculty that undergraduate students do not have robust laboratory skills, we designed and implemented a strategy to individually teach and assess the manipulative skills of students in first-year laboratories. Five core laboratory skills were selected for the course entitled Human Biology, a large, first-year class of students, most of whom were enrolled in Bachelor of Pharmacy and Human Movement Studies. Here, we report details for the 365 students enrolled primarily in Pharmacy and Human Movement Studies bachelor degree programs in semester 1 of 2006. We designed a specific strategy to assess five core laboratory skills: 1) accurate and precise use of a micropipette, 2) calculation of dilutions and preparation of diluted samples of saline, 3) accurate representation of data using a graph, 4) use of a light microscope, and 5) acquisition of digital data by measuring the latent period for the Achilles reflex. Graduate tutors were trained to teach and assess each student on each skill. The development of competency was tracked for all students across all five skills. Most students demonstrated proficiency on their first attempt. The development of proficiency across the core skills depended on both the skill and degree program. In semester 2 of 2006, 854 students mostly enrolled in the Bachelor of Science degree program and were similarly taught and assessed on the same five core skills. This approach was an effective teaching and assessment strategy that, when applied beyond first year, should increase the level of laboratory skills across undergraduate programs in physiology.

The personal response: A novel writing assignment to engage first year students in large human biology classes.

The teaching of highly valued scientific writing skills in the first year of university is challenging. This report describes the design, implementation, and evaluation of a novel written assignment, The Personal Response and accompanying Peer Review, in the course, Human Biology (BIOL1015) at The University of Queensland. These assignments were the first assessment tasks of the course and were set early in the first semester of university. BIOL1015 had a diverse cohort of 319 first year students from five bachelor degree programs, primarily from Pharmacy and Human Movement Studies. Audio files in the form of interviews with eminent biomedical scientists were obtained from a leading public radio program. Students used these files as triggers to submit a short but highly structured assignment written from a personal perspective and in an expressive style. Evaluations revealed that overall, students found the task interesting and challenging. Students performed well, regardless of their background knowledge, disciplinary interest, or preference for topics within human biology. This study demonstrated that The Personal Response was an appropriate task for these first year students of human biology. It represents an alternative to traditional essay writing.

Biohorizons: An eConference to assess human biology in large, first-year classes.

We detail the design, implementation and evaluation of an eConference entitled "Biohorizons", using a presage-process-product model to describe the development of an eLearning community. Biohorizons was a summative learning and assessment task aiming to introduce large classes of first-year Human Biology students to the practices of professional scientists. It was implemented in semester 1 for students enrolled in Pharmacy and Human Movement Studies degree programs, and in semester 2, for Science students. Pairs of students selected a topic of interest in Human Biology, registered into on-line clusters, then developed and wrote a short scientific paper and accompanying PowerPoint presentation. They then individually participated in an online Discussion. All three tasks were assessed using standards-referenced assessment rubrics. Learning was supported by eTutors, working in asynchronous mode. Biohorizons was evaluated by analyzing student achievement data, surveys and focus group interviews. Most students were able to achieve high academic standards (global mean scores for semester 1, 85-96%; semester 2, 81-90%). Student evaluations support: 1) the successful integration of eLearning into large classes of Human Biology, 2) the engagement of first-year students through collaborative learning, and 3) the fostering of learning through challenging assessment relevant to the core practices of professional scientists.

Breaking the hype cycle: using the computer effectively with learners with intellectual disabilities.

There has been huge growth in the use of information technology (IT) in classrooms for learners of all ages. It has been suggested that computers in the classroom encourage independent and self-paced learning, provide immediate feedback and improve self-motivation and self-confidence. Concurrently there is increasing interest related to the role of technology in educational programs for individuals with intellectual disabilities. However, although many claims are made about the benefits of computers and software packages there is limited evidence based information to support these claims. Researchers are now starting to look at the specific instructional design features that are hypothesised to facilitate education outcomes rather than the over-emphasis on graphics and sounds. Research undertaken as part of a post-school program (Latch-On: Literacy and Technology - Hands On) at the University of Queensland investigated the use of computers by young adults with intellectual disabilities. The aims of the research reported in this paper were to address the challenges identified in the 'hype' surrounding different pieces of educational software and to develop a means of systematically analysing software for use in teaching programs.

Using student feedback to construct an assessment rubric for a concept map in physiology.

Constructing quality assessment rubrics can be challenging, especially when they are used for integrated, group-centered, applied learning. We describe a collaborative assessment task in which groups of second-year dentistry students developed a complex concept map. In groups of four, the students were given a written, simulated, medical history of a patient and required to construct a concept map illustrating relevant pathophysiological concepts and pharmacological interventions. This report describes a research project aimed at making educational goals of the task more explicit through investigating student and faculty member understandings of the criteria that might be used to assess the concept map. Information was gathered about the perceptions of students in relation to the learning goals associated with the task. These were compared with faculty member perceptions. The findings were used to develop an assessment rubric intended to be more accessible to learners. The new rubric used the language of both faculty members and students to more clearly represent expectations of each criterion and standard. This assessment rubric will be used in 2005 for the next phase of the project.

What's it all about? Investigating reading comprehension strategies in young adults with down syndrome.

The purpose of reading is for the reader to construct meaning from the text. For many young adults with Down syndrome, knowing what the text is all about is difficult, and so for them the activity of reading becomes simply the practice of word calling. It is suggested in the literature that for those individuals with Down syndrome, learning can continue into adolescence and that this may be the optimal time for learning to occur. However, a review of the literature revealed limited empirical research specifically relating to the reading comprehension of young adults with Down syndrome. Recent findings from Latch-On (Literacy And Technology Hands On), a research-based literacy and technology program for young adults with Down syndrome at the University of Queensland, revealed that comprehension remained the significant area of difficulty and showed least improvement (Moni & Jobling, 2001). It was suggested by Moni and Jobling (2001) that explicit instruction in comprehension using a variety of strategies and meaningful, relevant texts was required to improve the ability of young adults with Down syndrome to construct meaning from written texts. This paper is based on an action research project that was developed within the Latch-On program. The project utilised a modification of Elliot's (1991) action research model and was conducted to investigate specific teaching and learning strategies that would enhance the reading comprehension of young adults with Down syndrome. The participants were 6 young adults with Down syndrome ranging in age from 18 to 25 years. As the data from this project are still being analysed, preliminary findings of one participant are presented as a case study. The preliminary findings appear to indicate that the program of specific teaching and learning reading comprehension strategies used in this project was beneficial in the participant's reading comprehension.

Reading with Abby: a case study of individual tutoring with a young adult with Down syndrome.

This case study examined the impact of a series of tutoring sessions on the literacy development of a young woman with Down syndrome. The sessions were conducted within the LATCH-ON (Literacy and Technology-Hands On) program at the Schonell Special Education Centre at the University of Queensland and made use of technology resources in addition to other methods of instruction. The first author assumed the role of participant observer through the reported sessions and acted as an individual tutor to the young woman. Data obtained from an initial screening indicated that the young woman had only limited word decoding strategies when reading text, and consequently, had significant problems with comprehension. Instruction during individual tutoring sessions focused primarily on phonics instruction, as well as other decoding strategies, such as sight word recognition. Specific instructional strategies employed by the first author are discussed. Within the context of the LATCH-ON program, the impact of individual instruction on the development of literacy is examined and discussed.