Categories
Coronavirus Randomised Controlled Trial (RCT) Research methodology

6-Step vs 3-Step Hand Hygiene Technique

Blog Authors: Tracey Howe, John McVeigh, Walter Patterson, Joe Wilson, Lynn Brown

Image: Tracey Howe

The UK and Scottish Governments and NHS services have been advocating hand washing as the primary public health prevention for the Covid-19 outbreak. So what should we be advocating for our staff and students.

Fortunately we were aware of a study that evaluated the microbiologic effectiveness of the World Health Organization’s 6-step and the Centers for Disease Control and Prevention’s 3-step hand hygiene techniques using alcohol-based handrub.

Here’s what they did

The Glasgow based group used a parallel group randomized controlled trial in an acute care inner-city teaching hospital. Doctors (n =42) and nurses (n =78) undertaking direct patient care. intervention. Random 1:1 allocation of the 6-step (n =60) or the 3-step (n= 60) technique.

Here’s what they found

  • The 6-step technique was microbiologically more effective at reducing the median log10 bacterial count.
  • The 6-step technique reduced the count from 3.28 CFU/mL (95% CI, 3.11–3.38 CFU/mL) to 2.58 CFU/mL (2.08–2.93 CFU/mL), whereas the 3-step reduced it from 3.08 CFU/mL (2.977–3.27 CFU/mL) to 2.88 CFU/mL (−2.58 to 3.15 CFU/mL) (P= .02).
  • However, the 6-step technique did not increase the total hand coverage area (98.8% vs 99.0%, P= .15) and required 15% (95% CI, 6%-24%) more time (42.50 seconds vs 35.0 seconds, P= .002).
  • Total hand coverage was not related to the reduction in bacterial count.
  • For the 6-step technique, the back of hands were more frequently missed, whereas the back of the index and the middle finger of the right hand were less frequently missed, compared with 3-step.
  • Doctors and nurses achieved a comparable level of hand coverage with similar areas of the hands not covered: a median of 1.2% for doctors and 1.1% for nurses.

The author/s concluded

The study provides the first evidence in a randomized controlled trial that the 6-step technique is superior, thus these international guidance documents should consider this evidence, as should healthcare

Our Journal Club’s views

Who are the authors of the paper and where do they work? The Glasgow based team work across NHS Scotland and Glasgow Caledonian University. Tracey Howe declared an interest as she has worked with this team on a number of projects and publications.

What do we know about the journal? Infection Control & Hospital Epidemiology publishes scientifically authoritative, clinically applicable, peer-reviewed research on control and evaluation of the transmission of pathogens in healthcare institutions and on the use of epidemiological principles and methods to evaluate and improve the delivery of care. ICHE is the official publication of the Society for Healthcare Epidemiology of America (SHEA).

What about the methodology used? The pragmatic parallel group randomized controlled trial is an established clinical trial design in health. Pragmatic meaning it was based in ‘normal clinical practice setting’ not a laboratory or constrained environment. It had ethical approval and informed consent of participants. The authors used random allocation of wards and assessments- microbiology and statistics were undertaken blind to allocation. Participants were instructed in the hand hygiene techniques which were standardised. Specific amounts of hand rub were supplied and were detailed in the paper. A standardised technique of collection and analysis of samples was used. Participants were observed and timed. Statistical analyses were well described. Overall this was a very well reported study.

Our conclusions are – that this evidence has a low risk of bias.

Implications for our practice

As a College we have a number of areas that routinely teach hand hygiene these include, health and early years, culinary, sports, beauty and leisure. Many of these areas teach the 6 step method and this study provides evidence that our teaching is evidence based.

Next steps

Convene a cross College group to look at the following:

  • identify curriculum areas delivering hand hygiene
  • identify staff expertise and development needs
  • identify and share physical resources
  • identify and share teaching resources internally and externally
  • provide advice to the College leadership team especially at this time.

View from.. one of the authors

This research led by the SHIP Research Group at Glasgow Caledonian University has had an amazing impact. At the time of publication it was widely discussed in the media worldwide. The evidence it provided has been considered by the World Health Organization for inclusion in their guidelines and the publication won the Society for Healthcare Epidemiology of America 2017 William Jarvis Award.

Professor Lesley Price, Co-Lead SHIP Research Group, Department of Nursing and Community Health, Glasgow Caledonian University.

What do you think?

We would love to hear your view on this blog. Please send us your comments.

References

Keywords: Hand hygiene, 6-steps, 3-steps, RCT, coronavirus

Our Blog Posts are written by staff at City of Glasgow College to inform and inspire our practice. We meet together at the Journal Club to consider the latest evidence to provide insights on hot topics related to learning and teaching, quality assurance and subject needs. It forms part of our activity for General Teaching Council Scotland registration and Professional Standards for lecturers in Scotland’s Colleges demonstrating that we are a self-critical staff community.

Categories
Assessment and feedback Delivery and assessment of the curriculum Digital technologies to enhance learning and teaching and assessment. review Student engagement in learning Technology and digital literacies

Student-generated video creation for assessment?

Blog Authors: Fiona Balloch, Jan Robertson, John McVeigh, Robertson, Lisa Shields, Joe Wilson, Tracey Howe

Image: Photo by Hermes Rivera on Unsplash

Student-generated video creation assessments are an innovative and emerging form of assessment in higher education. Academic staff may be reluctant to transform assessment practices without robust evidence of the benefits and rationale for doing so and some guidance regarding how to do so successfully. JISC have recently published Future of assessment: five principles, five targets for 2025 which states ‘In a move away from the traditional essay or exam, assessments are building in authenticity by asking students to develop websites, set up online profiles, shoot and edit videos, and use social media.’

We explored the idea, with reference to the article Student-generated video creation for assessment: can it transform assessment within Higher Education? published in the International Journal of Transformative Research, 2018.

Here’s what they did

They searched literature and conducted a thematic analysis related to the use of student-generated video for assessment.

Here’s what they found

For successful use of video creation for assessment:

  • Align video creation task set to both learning outcomes and skills development required for graduate capabilities for relevant industry
  • Ensure technological support, resources and infrastructure are all in place
  • Have an intentional change management process to support both staff and students in the transition to a new assessment format.
  • Involve students in the generation of clear guidance for the assessment and development of an assessment rubric.

The author/s concluded

Video assessment is beneficial for students’ digital communication skills and an effective and enjoyable method of assessment.

Our Journal Club’s views

Who are the authors of the paper and where do they work? At the time of publication the authors are Ruth Hawley and Cate Allen, who work at University of Derby.  Our view is that the authors may be biased in favour of video assessment, in order to provide evidence to support an initiative taking place within their own institution.

What do we know about the journal? The fully refereed Journal of International Journal of Transformative Research does not seem to be live yet and will be issued for the first time in Fall 2020. Our view is that the journal does not meet its stated aims, as it says that articles should explore transformative impact but this is not the case in this article.

What about the methodology used? Research could not be easily replicated based on the level of detail provided in the paper. In addition, the findings lack critical analysis. that this evidence is inconclusive and biased. It lacks a rationale for the use of video assessment or guidance on how it can be used effectively.

Our conclusions are – that this evidence has a high risk of bias.

Implications for our practice

  • How can Nautical courses extend their use of asynchronous video assessment with international students?
  • How could the COGC Health suite integrate video assessment into assessments?
  • How could issues such as trolling, and confidence with one’s own image on video be addressed through digital communication skills training?
  • How could YouTube and Flipgrid be used for assessment?
  • How issues such as trolling, and confidence with one’s own image on video could be addressed through digital communication skills training. It is easier for assessors to view videos asynchronously at the time of the assessor’s choosing, than assessing a large run of live events, one after the other.
  • Training and support is available through the College Learning and Teaching Academy

Next steps

Create a working group to pursue this topic in the College with a view to group-creation of a paper on this area.

View from

What do you think?

References

Keywords: assessment, video, student-generated, Higher Education, digital, technology

Our Blog Posts are written by staff at City of Glasgow College to inform and inspire our practice. We meet together at the Journal Club to consider the latest evidence to provide insights on hot topics related to learning and teaching, quality assurance and subject needs. It forms part of our activity for General Teaching Council Scotland registration and Professional Standards for lecturers in Scotland’s Colleges demonstrating that we are a self-critical staff community.

Categories
Enabling student development and achievement qualitative Student engagement in learning Student experience Student support

A place for mature students in Further Education?

Blog Authors: Jan Robertson, Joe Wilson, Lynn Brown, Maggie Darroch, John McVeigh, Tracey Howe, Paulo Monachello.

Image: COD Newsroom / CC BY (https://creativecommons.org/licenses/by/2.0)

An increasing proportion of the United Kingdom’s (UK) full-time undergraduate student population is mature. Student retention in higher education has been defined ‘as the process of helping students meet their needs so that they will persist in their education’ (Bolam 2003). renewed focus within Scottish FE to re-engage with the missing numbers of mature students as a whole, and for City of Glasgow College to attract and retain students through the offer of the best student experience the findings of Paula Dunne in “Here’s my story: Mature students narratives of Further Education” potentially offer us some insights into the particular experiences and challenges of this group, in order to be able to respond with appropriate support and adjustments to encourage mature adult learners and retain and develop this valuable resource.

Here’s what they did: The author delivered a small scale narrative enquiry into the lived experience of 5 returning students to Further Education in Ireland with the hope to capture their experiences through listening to their stories. Semi-structured individual interviews lasting 40 mins were then carried out towards the end of the academic year. The Interview transcripts were used to identify key themes using McAdam’s life story method protocol.

The key themes identified were:

  • Personal motivations for returning to education
  • Challenges faced & support needed to overcome
  • The influence of past life educational experiences
  • The impact on identity

Here’s what they found

FE could provide a worthwhile experience for these mature student returners. Students could gain qualifications; upskill and reskill. Students could potentially progress onto Higher Education

Further benefits for mature returning students included increased confidence, self-esteem, re-writing earlier educational experiences and building their sense of identity.

Returning to Further Education for mature students presented special challenges such as juggling family commitments, costs & availability of childcare, difficulty in securing part-time employment to fit around study demands & College attendance, feeling initially socially isolated & lacking confidence, (perception that everything is geared up to a “young” world), a fear of failure, lack of ability in IT, and overcoming earlier poor educational experiences

Support from family, peers and supportive teaching staff presented a way to overcome these challenges

The author/s concluded

Embracing education as a mature student for most could be a transformational and positive experience with the correct supports in place.

Our Journal Club’s views

Who are the authors of the paper and where do they work? This paper is single-authored by Paula Dunne from Dundalk Institute of Technology. Our view is that there may have been some gains in having a collaborative approach.

What do we know about the journal? The All Ireland Journal of Teaching & Learning in Higher Education (AISHE-J) is an open-access, peer-reviewed, journal of scholarly research into Teaching and Learning in Higher Education. AISHE-J was first published in 2009 with Sylvia Huntley-Moore as inaugural Editor and welcomes the submission of manuscripts presenting original scholarly work or commentary in any aspect of teaching and learning in higher education.

What about the methodology used? The method is clearly stated as narrative enquiry – a form of qualitative research. Interviews were digitally recorded and later transcribed verbatim were used to identify common themes and strands.

We agreed that an ethical approach had been used in that the participants had voluntarily responded to an email to take part were advised that they could withdraw from the process at any stage. We are told also that password protections were in place and anonymization of participants.

Nevertheless, there were quite a few noted limitations of the study. It was felt that the aim was not explicitly stated in light of the named methodological approach taken. You had to really delve into the “Discussion” section to find this.

A lack of framework for the questions and explanation of the scoring methodology and further detail of the analysis were possibly missing. Perhaps the transcripts could even have been supplied to enrich the article – as the sampling was quite small (although it is stated that it is a pilot.)

McAdam’s life story method protocol (McAdams 1993) was noted as a seminal piece of work. However, it was felt that there were a lack of recent references.

There was no data given in the results section. It was felt that there was a lack of information on the technique to identify the sample. The sample itself is very small, five volunteers; four female and one male. It is limited in time and space. It was felt amongst that there may have been value in a longitudinal approach to examine the experiences of the mature FE students across the academic year rather than only at the end of the year.

Whilst there were reference to two other studies undertaken in Ireland the many studies that the author mentions undertaken within an HE setting are not referred to at any time to offer contrast or add to our knowledge of shared experiences of mature students. It may have been interesting to look at age as a determining factor in experience of the students given that in FE mature students are considered to be those 21years+ and in HE mature students are considered to be those 23years +. The study does only consider the situation in Ireland.

Note this article was published in a Teaching Journal which has a strong focus on the implementation of national teaching policies such as DES, 2008 and DETE, 2002 as referred to in the article.

Overall we thought there was a lack of focus. It was suggested that there may have been greater value in examining the experience of mature students who leave Further Education to find out their experiences this may give a richer picture. In addition it was considered that may be of value to look at the stories of those who were refused a place. Although it was noted it may be difficult to get access to that information

Our conclusions are – that this evidence has a high risk of bias.

Implications for our practice

The article refers to articulation routes into Higher Education. There is space for these pathways to be really clear for mature students to access. Other questions we could consider in relation to our own practice at City of Glasgow College could be bespoke IT learning spaces for returning mature students, future childcare provision and identifying those life events when students consider returning to offer up our learning in a context that compliments that life stage

As an organisation we need to be more mindful of the needs of mature students and from a Worldkills point of view there will be a new focus beyond the 16-24 year olds. For mature learners there is greater need for negotiating things like deadlines for this who are balancing other life events. A place for mutual respect, we need to place relationship at the centre of learning. Things are changing and we need to keep a pace.

Next steps

  1. As an Organisation we ned to reconsider the place of “student confidence levels” and “prior life experiences” in the way that we approach future learning.
  2. Consider tailored support groups for mature students
  3. Consider ways to make the learning experience of mature students authentic and inclusive
  4. Support Mature Students Association development

View from

As a mature student at COGC, who has changed careers and is at least a decade older than most of the class I have enjoyed a mostly positive experience. As a mature student you are very focussed on your goals and serious about success. Through the support of the STEM Girls Group I have found support and encouragement and a Group I can be part of with mixed ages and backgrounds. This has helped.

Ketle Santos, Maritime Operations Level 5, City of Glasgow College

What do you think?

References

Keywords: mature students, FE, HE,

Our Blog Posts are written by staff at City of Glasgow College to inform and inspire our practice. We meet together at the Journal Club to consider the latest evidence to provide insights on hot topics related to learning and teaching, quality assurance and subject needs. It forms part of our activity for General Teaching Council Scotland registration and Professional Standards for lecturers in Scotland’s Colleges demonstrating that we are a self-critical staff community.

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