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Quaschning K.,Freiburg University of Education | Korner M.,Albert Ludwigs University of Freiburg | Wirtz M.,Freiburg University of Education
Patient Education and Counseling | Year: 2013

Objectives: The aims of the study are: (1) To develop and test a theory-based model for the predictive power of " Shared decision making (SDM)" , " Empathy" and " Team interaction" for " Patient satisfaction" and " Treatment acceptance" (2) To identify mediating effects of " Compliance" and " Satisfaction with decision" Methods: Within a multi-center cross-sectional study (11 inpatient rehabilitation clinics at different indication fields), the model was evaluated in descriptive and structure analytical terms based on survey data of N=402 inpatients. Results: The structural equation model proved to exhibit an appropriate data fit. A high proportion of variance of " Patient satisfaction" (61%) and " Treatment acceptance" (67%) can be predicted by " SDM" , " Empathy" , " Satisfaction with decision" and " Team interaction" While no mediating effects were found for the two subcomponents of " Compliance" (" Patient cooperation" , " Adherence" ), " Satisfaction with decision" showed a full mediation for " Treatment acceptance" and a partial mediation for " Patient satisfaction" Conclusion: " Team interaction" should be considered as an important predictor of process and patient-centered outcome characteristics. Practice implications: The current findings can be used to derive measures as well as interventions to optimize the organization of participatory care within teams in order to strengthen patient centeredness and to ensure a high quality of care. © 2012 Elsevier Ireland Ltd.


Korner M.,Albert Ludwigs University of Freiburg | Wirtz M.A.,Freiburg University of Education
BMC Health Services Research | Year: 2013

Background: Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Many scales are designed for measuring teamwork from the perspective of one type of health care professional (e.g. physician or nurse), rather than for the use for all health care professionals as well as patients. Hence, this paper's purpose is to develop a scale for measuring internal participation from all relevant perspectives and to check its psychometric properties. Methods. In a multicentre cross-sectional study, a 6-item Internal Participation Scale (IPS) was developed and administered to 661 health care professionals (staff) and 1419 patients in 15 rehabilitation clinics to test item characteristics, acceptance, reliability (internal consistency) and construct validity. Additionally, we performed an exploratory factor analysis (EFA) to determine the factorial structure and explained variance. Confirmatory factor analysis (CFA) was used to verify the theoretically assumed one-dimensional factorial structure. Results: A total of 275 health care professionals and 662 patients participated, and the complete data sets of 272 staff members and 536 patients were included in the final analysis. The discrimination index was above.4 for all items in both samples. Internal consistency was very good, with Cronbach's alpha equalling.87 for the staff and.88 for the patient sample. EFA supported a one-dimensional structure of the instrument (explained variance: 61.1% (staff) and 62.3% (patients)). CFA verified the factorial structure, with the factor loadings exceeding.4 for five of six items in both samples. Global goodness-of-fit indices indicated a good model fit, with a Tucker-Lewis index (TLI) of.974 (staff) and.976 (patients) and a comparative fit index (CFI) of.988 (staff) and.989 (patients). The root mean square error of approximation (RMSEA) amounted to.068 for the patient sample and.069 for the staff sample. There is evidence of construct validity for both populations. Conclusions: The analysis of the scale's psychometric properties resulted in good values. The scale is a promising instrument to assess internal participation from the perspective of both patients and staff. Further research should investigate the scale's psychometric properties in other interprofessional health care settings to examine its generalizability as well as its sensitivity to change. © 2013 Körner and Wirtz; licensee BioMed Central Ltd.


Korner M.,Albert Ludwigs University of Freiburg | Ehrhardt H.,Freiburg University of Education | Steger A.-K.,Albert Ludwigs University of Freiburg | Bengel J.,Albert Ludwigs University of Freiburg
Patient Education and Counseling | Year: 2012

Objective: The aim of the study was to evaluate the interprofessional SDM training program " Fit for SDM" in medical rehabilitation, which was implemented in two steps: (1) university staff trained providers in executive positions as trainers and (2) the providers trained their staff. Methods: For the evaluation of the first step a questionnaire for shared decision-making (SDM) skills and satisfaction with the training was completed by the providers in executive positions. A staff survey was used in a cluster-randomized controlled study to determine the overall impact of the train-the-trainer program on internal and external participation in the team. Results: The providers in the six clinics evaluated their SDM competences and satisfaction very positively after training (step 1). External participation was enhanced by application of the training content, with significant changes recorded for females and nurses in particular. However, it had no direct influence on internal participation. Conclusions: This is the first interprofessional SDM train-the-trainer program in Germany to bridge interprofessionalism (internal participation) and SDM (external participation); it was implemented successfully and evaluated positively. Practice implications: Establishing interprofessional SDM training programs should be encouraged for all health care professionals. Implementation in the interprofessional setting should consider interprofessional team factors. © 2012 Elsevier Ireland Ltd.


Korner M.,Albert Ludwigs University of Freiburg | Ehrhardt H.,Freiburg University of Education | Steger A.-K.,Albert Ludwigs University of Freiburg
Journal of Interprofessional Care | Year: 2013

For implementation of patient-centered treatment in interprofessional health care units, such as rehabilitation teams, external participation (interaction between patient and health care professionals) and internal participation (communication, coordination and cooperation in the interprofessional team) need to be considered. The aim of this study is to identify the preferences of patients and health care professionals concerning internal and external participation in rehabilitation clinics, in order to develop an interprofessional shared decision-making (SDM) training program for health care professionals to enhance both types of participation. Therefore, a cross-sectional mixed-methods study was implemented in four rehabilitation clinics. The study consists of two parts: focus groups with patients and a survey of experts (senior health care professionals from medicine, psychotherapy, physical therapy and nursing). More time, more respect from the health care professionals and the desire for more participation in decision-making processes were mentioned most frequently by patients (n = 36) in the focus groups. The health care professionals (n = 32) saw most deficits in internal participation, e.g. management of feedback, talking with difficult team members and moderate conflict discussion. The results of both assessments have been used to develop an interprofessional SDM training program for implementing internal and external participation in interprofessional teams in medical rehabilitation. © 2013 Informa UK, Ltd.


Nieminen K.,University of Lausanne | Robischon M.,Freiburg University of Education | Immanen J.,University of Helsinki | Helariutta Y.,University of Helsinki
New Phytologist | Year: 2012

To secure a sustainable energy source for the future, we need to develop an alternative to fossil fuels. Cellulose-based biofuel production has great potential for development into a sustainable and renewable energy source. The thick secondary walls of xylem cells provide a natural source of cellulose. As a result of the extensive production of wood through cambial activity, massive amounts of xylem cells can be harvested from trees. How can we obtain a maximal cellulose biomass yield from these trees? Thus far, tree breeding has been very challenging because of the long generation time. Currently, new breeding possibilities are emerging through the development of high-throughput technologies in molecular genetics. What potential does our current knowledge on the regulation of cambial activity provide for the domestication of optimal bioenergy trees? We examine the hormonal and molecular regulation of wood development with the aim of identifying the key regulatory aspects. We describe traits, including stem morphology and xylem cell dimensions, that could be modified to enhance wood production. Finally, we discuss the potential of novel marker-assisted tree breeding technologies. © 2011 The Authors. New Phytologist © 2011 New Phytologist Trust.


Ploetzner R.,Freiburg University of Education | Lowe R.,Curtin University Australia
Computers in Human Behavior | Year: 2012

Despite the rapid and widespread adoption of animations in education, there is still no systematic account of the main characteristics of expository animations that have been targeted by educational research. A literature search and analysis was conducted to address this deficiency. First, overviews, reviews, and meta-analyses were analysed to extract an initial set of dimensions to characterise expository animations. Next, a representative set of descriptions of expository animations used in past research on learning from animation was retrieved from the research literature. The animations employed in the 44 investigations analysed covered 30 different topics in 14 different domains. The characterisation developed distinguishes attributes that are inherent characteristics of animations from attributes that are external supplements to animations. The potential advantages of the characterisation developed as a framework for future research on learning from animation are discussed. © 2012 Elsevier Ltd. All rights reserved.


Ploetzner R.,Freiburg University of Education | Schlag S.,University of Wuppertal
Computers and Education | Year: 2013

In an experimental study, we investigated whether making use of a cognitive learning strategy (1) improves learning from different expository animations, (2) leads to an acquisition of knowledge which is available beyond the learning period, and (3) equally benefits students with low and high cognitive ability alike. A total of 152 sixth graders participated in the study: 69 students learned from an animation about the dances of honeybees and 83 students learned from an animation about sailing. With respect to both animations, the students who made use of the learning strategy significantly outperformed the students who had to write a summary. Effect sizes are medium to large. The beneficial effects of the learning strategy were also verified one week after the learning took place. The results of this study do not support the assumption that students with low and high cognitive ability benefit differently from the strategy. © 2013 Elsevier Ltd. All rights reserved.


Reports on the quality of care aim at health and patient-reported outcomes in routine clinical care. To achieve meaningful information the study designs must be robust against bias through highly selected patient populations or health care providers but also allow for adequate control of confounding. The article describes the potential and pitfalls of administrative claims data and surveys of beneficiaries. The large potential of using both sources is illustrated in the primary inpatient treatment for prostate cancer. However, linking claims data and patient survey data still leaves some problems to be addressed in the final section. Linking claims data and beneficiary survey information on patient reported outcomes overcomes sectoral barriers and allows for an integrated evaluation of pathways of care in the short-, mid- and long-term. It is economical and well suited for a variety, but not all health care problems. Future efforts might be directed towards more collaboration among sickness funds. © Georg Thieme Verlag KG Stuttgart New York.


Ruf T.,Freiburg University of Education | Ploetzner R.,Freiburg University of Education
Computers in Human Behavior | Year: 2014

In an experimental study, we investigated how the presentation of cognitive learning aids, as well as the availability of self-monitoring questions affect the frequency of use of cognitive learning aids in a multimedia learning environment. The learning aids were presented either dynamically, statically, or they were initially collapsed and the students had to activate them by clicking on a button. The comparability of all three versions of the multimedia learning environment was assured by means of repeated usability testing. Self-monitoring questions were either presented to the learners or not. A total of 60 undergraduate students participated in the study. Their activities in the learning environment, together with their eye movements were recorded. The students took advantage of the learning aids most when they were dynamically presented, less when they were statically presented, and least when they were presented in a collapsed form. The differences in use of the learning aids were statistically significant with large effect sizes. The availability of self-monitoring questions had no significant effect on the use of learning aids. © 2014 Elsevier Ltd. All rights reserved.


Leuders J.,Freiburg University of Education
British Journal of Visual Impairment | Year: 2016

In this article, touch and hearing are analysed regarding their use in inclusive mathematics education of children who are blind, focussing on the development of the number concept in primary school. Relevant publications from different psychological and educational disciplines were compiled resulting in a research synthesis. This review shows that acoustic teaching material is a viable option to supplement tactile material for representing number. In practice, decisions have to be made about the most valuable resources regarding the individual needs of the child with visual impairment, the situation in the inclusive classroom and the concrete learning objectives for all children. To facilitate decisions in choosing or designing teaching material, an evaluation procedure is proposed and explained with examples. © The Author(s) 2015.

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