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Full-Text Articles in Educational Assessment, Evaluation, and Research

Approach To Developing Basic And Scientific Writing Competency In Dnp Students At Samuel Merritt University, Michelle Hampton Jan 2018

Approach To Developing Basic And Scientific Writing Competency In Dnp Students At Samuel Merritt University, Michelle Hampton

Faculty Publications

No abstract provided.


Are Audience Response Systems Worth The Cost? Comparing Question-Driven Teaching Strategies For Emergency Medical Technician Education, Lauren M. Maloney, James P. Dilger, Paul A. Werfel, Linda M. Cimino Jan 2018

Are Audience Response Systems Worth The Cost? Comparing Question-Driven Teaching Strategies For Emergency Medical Technician Education, Lauren M. Maloney, James P. Dilger, Paul A. Werfel, Linda M. Cimino

Internet Journal of Allied Health Sciences and Practice

Purpose: As Emergency Medical Technician educators develop curricula to meet new national educational standards, effective teaching strategies validated for course content and unique student demographics are warranted. Three methods for answering multiple choice questions presented during lectures were compared: a) Audience Response System (ARS, clickers), b) hand-raising-with-eyes-closed (no-cost option), and c) passive response (no-cost option). The purpose was to determine if using the ARS resulted in improved exam scores. Method: 113 Emergency Medical Technician (EMT) students participated in this cross-over, block randomized, controlled trial, which was incorporated into their Cardiac Emergencies and Pulmonary Emergencies course lectures. Students took …


Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan Jan 2018

Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan

Walden Dissertations and Doctoral Studies

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …


Teaching High School Seniors About Transitioning To Adult Healthcare, Christine Clune, Teresa Hickam, Adrienne Olney Jan 2018

Teaching High School Seniors About Transitioning To Adult Healthcare, Christine Clune, Teresa Hickam, Adrienne Olney

Posters

This poster describes an educational intervention consisting of two classroom sessions to teach high school seniors how to successfully transition to adult care. Topics covered included the ability to fill out medical forms, when to contact one's doctor and where to get medical care when the doctor's office is closed, how health care privacy changes at age 18, the need for health insurance, the need to keep medical records, etc.


Athletic Training Students Demonstrate Supplemental Oxygen Administration Skill Decay, But Retain Knowledge Over Six Months, David C. Berry, Jennifer K. Popp Jan 2018

Athletic Training Students Demonstrate Supplemental Oxygen Administration Skill Decay, But Retain Knowledge Over Six Months, David C. Berry, Jennifer K. Popp

Internet Journal of Allied Health Sciences and Practice

Purpose: Research suggests skill decay occurs with emergency skills, such as supplemental oxygen administration (OA), since the frequency of medical emergencies in clinical settings is low. Identifying the presence and timeline for skill decay allows educators to employ strategies to prevent this occurrence. Therefore, this study evaluated retention of knowledge and clinical skills associated with supplemental oxygen administration, specifically nasal cannula (NC) and non-rebreather mask (NrM) usage in professional athletic training students.

Methods: Cross-sectional study. Twenty-nine athletic training students (males=11, females=18; age=21.03+1.38) enrolled in a Commission on Accreditation of Athletic Training Education (CAATE)-accredited professional athletic training programs. Participants’ …


College Choice In Distance-Based Nursing Programs, Jill Lansing Jan 2018

College Choice In Distance-Based Nursing Programs, Jill Lansing

Legacy Theses & Dissertations (2009 - 2024)

The expansion and diversification of postsecondary education in the United States has led to greater options for students and prospective students for pursuing a college degree. An important trend in higher education today is distance education. Despite the growing prevalence of distance learning opportunities and the expanding body of research on distance education, research on the college-going decisions of distance learners is sparse. As more students enroll in distance-based higher education programs, it is increasingly important to understand how and why students make the decision to enroll in collegiate degree-granting programs. This study bridges the college choice and distance education …


Laptop Versus Longhand Note Taking In A Professional Doctorate Course: Student Performance, Attitudes, And Behaviors, Shane P. Desselle, Patricia A. Shane Jan 2018

Laptop Versus Longhand Note Taking In A Professional Doctorate Course: Student Performance, Attitudes, And Behaviors, Shane P. Desselle, Patricia A. Shane

Faculty Publications & Research of the TUC College of Pharmacy

Objective: To determine the relationship between longhand note taking versus laptop note taking on pharmacy students’ examination performance and identify differences in attitudes and behaviors as it relates to the note taking process.

Methods: A small group of students consented voluntarily to take longhand notes, doing away with their laptops during portions of the course administered by study investigators. Analyses were conducted on block examination performance, with each student’s score on the first examination serving as a performance benchmark to assess change. Laptop and longhand note takers completed a survey regarding various aspects of their note taking attitudes …


Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing Jan 2018

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …


Improving Health Literacy Assessments In Pediatrics, Kristina Michelle Wright Jan 2018

Improving Health Literacy Assessments In Pediatrics, Kristina Michelle Wright

Walden Dissertations and Doctoral Studies

Low health literacy (LHL)--when patients do not understand their treatment or medications--has been linked to poor healthcare outcomes. Nurses need to know how to assess health literacy (HL) and teach pediatric patients and their families to help ensure that patients and family members can understand and follow health education messages. Evidence-based HL tools were obtained from a literature search and used to create a nursing staff education program on pediatric patient HL assessment and education. The project answered the practice-focused question that asked whether a staff education program on HL assessment and management would improve nursing knowledge of HL for …


Effectiveness Of Continuous Subcutaneous Insulin Infusion Therapy Education In A Clinic Setting, Kimberly Rizzo Jan 2018

Effectiveness Of Continuous Subcutaneous Insulin Infusion Therapy Education In A Clinic Setting, Kimberly Rizzo

Walden Dissertations and Doctoral Studies

Diabetes affects an estimated 29.1 million Americans, with approximately another 1/3 of Americans not yet diagnosed. Complications associated with diabetes include heart disease, stroke, hypertension, blindness, kidney disease, neuropathy and death. All of these complications can be prevented with optimal control of blood glucose levels. Advances in technology provide people living with diabetes (PLWD) a multitude of treatment options such as continuous subcutaneous insulin infusion (CSII) therapy. Unfortunately, sustained improvement in glycated hemoglobin A1c (HgA1c) is not always achieved even with this advanced therapy. The purpose of this doctoral project was to educate nurses on CSII therapy and promote improved …


Perceptions Among Women On Education For Health Information Management Career Advancement, Meagan Sampogna Williams Jan 2018

Perceptions Among Women On Education For Health Information Management Career Advancement, Meagan Sampogna Williams

Walden Dissertations and Doctoral Studies

The increased use of technology has affected almost every aspect of how data are collected, stored, retrieved, and analyzed across the health care system. The health information management (HIM) workforce in the United States is predominantly composed of women. With HIM employment rising by 2020, additional education of the current workforce is a necessity. This qualitative phenomenological study evaluated women working with HIM associate degrees and RHIT certifications to determine their perceived need for advanced education for career advancement. This study used the social cognitive career theory (SCCT) to determine how women in HIM perceive needs based on self-efficacy, expected …


Developing An Impella Education Program For The Critical Care Registered Nurse, Sara Jackson Jan 2018

Developing An Impella Education Program For The Critical Care Registered Nurse, Sara Jackson

Walden Dissertations and Doctoral Studies

Every year, hundreds of thousands of patients have coronary angiograms performed in the United States. The Impella is a percutaneous ventricular support device that provides hemodynamic support for patients if hemodynamic instability occurs during the procedure. The critical care nurse is responsible for the recovery and management of the patient with the Impella device in place. The purpose of this scholarly project is to provide registered nurses (RN) who have not previously managed the Impella device with the appropriate education in order to demonstrate competency. The program demonstrated improved RN knowledge about the Impella and increased confidence when managing the …


Assessment Of Midwifery And Nursing Students’ Nutrition Competence In Ethiopia: A Cross Sectional Study, Endris Mekonnen Yimer, Firew Ayalew Desta, Kefyalew Muleta Akassa, Tadele Bogale Yitaferu, Mesfin Goji Abebe, Mebit Kebede Tariku, Hannah Gibson Nov 2017

Assessment Of Midwifery And Nursing Students’ Nutrition Competence In Ethiopia: A Cross Sectional Study, Endris Mekonnen Yimer, Firew Ayalew Desta, Kefyalew Muleta Akassa, Tadele Bogale Yitaferu, Mesfin Goji Abebe, Mebit Kebede Tariku, Hannah Gibson

International Journal of Health Sciences Education

Background: Malnutrition is a major public health problem in Ethiopia contributing to half of infant and child mortality. The 2014 mini Ethiopian Demographic and Health Survey revealed that four out of ten children under five are stunted, nearly one out of ten are wasted, and a quarter are underweight. One of the factors that contributed to the high stunting rate is the shortage of capable providers who are competent to provide nutrition services. The purpose of this study was to assess graduating midwifery and nursing students’ nutrition competence and explore the factors that influence their competence.

Methods: A cross-sectional survey …


Effects Of A Hospital-Wide Physician Communication Skills Training Workshop On Self-Efficacy, Attitudes And Behavior, Minna Saslaw, Dana R. Sirota, Deborah P. Jones, Marcy Rosenbaum, Steven Kaplan Nov 2017

Effects Of A Hospital-Wide Physician Communication Skills Training Workshop On Self-Efficacy, Attitudes And Behavior, Minna Saslaw, Dana R. Sirota, Deborah P. Jones, Marcy Rosenbaum, Steven Kaplan

Patient Experience Journal

Hospital systems interested in improving patient experience and physician engagement may look to physician communication skills training (CST) as a means of improving both. This study examines a 7.5-hour, multi-specialty, hospital-wide physician CST workshop in a large academic hospital system and its effects on participants’ self-efficacy, attitudes, and behaviors related to communicating with patients. Data was gathered from October 2014 through June 2016 through a web-based questionnaire sent to participants 6-weeks post-workshop which focused on skills taught in the course, attitudes toward communication training, and provider behaviors when communicating with patients. Along with demographic questions, a ten question retrospective pre-post …


Occupational Therapy Students In Norway: Do Their Approaches To Studying Vary By Year In The Program?, Tore Bonsaksen, Mikkel M. Thørrisen, Talieh Sadeghi Oct 2017

Occupational Therapy Students In Norway: Do Their Approaches To Studying Vary By Year In The Program?, Tore Bonsaksen, Mikkel M. Thørrisen, Talieh Sadeghi

The Open Journal of Occupational Therapy

Approaches to studying may be influenced by students’ age, maturity, and experience in higher education. Students’ approaches to studying may develop toward deep and/or strategic approaches and away from a surface approach as they move through the curriculum, which is generally considered a positive development. This study aimed to identify differences in approaches to studying among first-, second-, and third-year students enrolled in an occupational therapy program. Three cohorts of students (n = 160) from one university college completed the Approaches and Study Skills Inventory for Students (ASSIST) along with sociodemographic information. One-way analyses of variance were used to …


Occupational Therapy Faculty Perspectives On The Use Of Telehealth As A Delivery Method For Healthcare Services, Holly Wasserman Aug 2017

Occupational Therapy Faculty Perspectives On The Use Of Telehealth As A Delivery Method For Healthcare Services, Holly Wasserman

All Theses And Dissertations

The use of telehealth for healthcare delivery is on the rise and is expected to increase due to the expansion of technological advances and the shortage of healthcare professionals to serve rural and remote communities. The use of telehealth by occupational therapists (OT) is relatively new, and it is unknown whether educational programs are adequately preparing OT students to practice in this context or if OT faculty members are adequately trained to deliver this content to their students. The purpose of this qualitative descriptive case study was to examine how faculty members teaching in a master’s level occupational therapy program …


An Exploratory Study On The Teaching Of Evidence-Based Decision Making, Erica Baarends, Marcel Van Der Klink, Aliki Thomas Jul 2017

An Exploratory Study On The Teaching Of Evidence-Based Decision Making, Erica Baarends, Marcel Van Der Klink, Aliki Thomas

The Open Journal of Occupational Therapy

Background: There is no clear guideline on how to teach students evidence-based decision making (EBDM), so this study aimed to assess the impact of an educational intervention on students’ EBDM skills.

Methods: This was an explorative mixed-method study of 12 undergraduate occupational therapy students and their teacher. The teaching was aimed at increasing self-efficacy and cognitive skills in EBDM. Semi-structured interviews were conducted to gather the students’ perceived learning benefits. Before and after the intervention, a self-efficacy questionnaire, a critical thinking test, and scored generic cognitive skills in an argument were used as measures of learning achievements. Content …


Entertainment-Education Videos As A Persuasive Tool In The Substance Use Prevention Intervention "Keepin' It Real", Youngju Shin, Michelle Miller-Day, Michael L. Hecht, Janice L. Krieger Jun 2017

Entertainment-Education Videos As A Persuasive Tool In The Substance Use Prevention Intervention "Keepin' It Real", Youngju Shin, Michelle Miller-Day, Michael L. Hecht, Janice L. Krieger

Communication Faculty Articles and Research

Based on social cognitive theory and narrative engagement theory, the current study examined hypothesized indirect effects of engagement with keepin’ it REAL (kiR) curriculum entertainment–education (E–E) videos on youth alcohol use via youth drug offer refusal efficacy. Students in 7th grade (N = 1,464) at 25 public schools in two Midwestern states were randomly assigned to one of the two versions of the kiR curriculum, the kiR urban version and the kiR rural version. Each version had their own set of five culturally-grounded E–E videos depicting communicative skills to refuse drug offers. Differential effects for engagement components …


Effect Of Implementation Of Simulation On Critical Thinking Skills In Undergraduate Baccalaureate Nursing Students, Joanne M. Knoesel Jun 2017

Effect Of Implementation Of Simulation On Critical Thinking Skills In Undergraduate Baccalaureate Nursing Students, Joanne M. Knoesel

Dissertations, Theses, and Capstone Projects

Human patient simulation (HPS) is a time and cost intensive teaching modality that is used widely in nursing education, and has been implemented with little evidence to support its efficacy (Jeffries & Rizzolo, 2006). Researchers note the lack of reliable tools to measure learning using this teaching modality, and consequentially there is a paucity of research linking critical thinking and simulation (Jeffries, 2007; Kneebone, 2003; Nehring, 2008). Nursing clinical decision making affects patient outcomes. Critical thinking is a key factor in clinical decision making. A review of the relevant literature is equivocal on the use of simulation in undergraduate nursing …


Pilot Test Of Communication With A ‘Rapid Fire’ Technique, Desiree A. Díaz, Candace Pettigrew, Christine Dileone, Meredith Dodge, Deborah Shelton May 2017

Pilot Test Of Communication With A ‘Rapid Fire’ Technique, Desiree A. Díaz, Candace Pettigrew, Christine Dileone, Meredith Dodge, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

Abstract

An innovative communication training technique, ‘Rapid Fire’, was created to enhance communication and was incorporated into the debrief component of a simulation designed for correctional nurses to promote learning and engagement. The term ‘Rapid Fire’ was used to expose the critical time element that appears in the first five minutes of many crisis situations, where a quick relay of information and problem solving is essential; such as in a cardiac arrest or other rapidly deteriorating patient situations. This technique consists of a five-minute session prior to the structured debrief. During the ‘Rapid Fire’ portion of the debrief, all learners …


Public Schools, And Health Care: A Strategy To Promote Social Inclusion, Jana Sladkova, Anahi Viladrich, Nicholas Freudenberg May 2017

Public Schools, And Health Care: A Strategy To Promote Social Inclusion, Jana Sladkova, Anahi Viladrich, Nicholas Freudenberg

Occasional Paper Series

Sladkova, Viladrich, and Freudenberg refer to “social inclusion” as the process through which the newly arrived find their voice in an already complex, cacophonous society. They describe an approach to social inclusion for adult immigrants that melds learning English at the same time as learning to negotiate our often-Byzantine health care system. They highlight programs that work and a new perspective on how to maximize the effectiveness of limited adult education opportunities.


Coming To The New D.A.R.E.: A Preliminary Test Of The Officer-Taught Elementary Keepin’ It Real Curriculum, L. Edward Day, Michelle Miller-Day, Michael L. Hecht, Desiree Fehmie May 2017

Coming To The New D.A.R.E.: A Preliminary Test Of The Officer-Taught Elementary Keepin’ It Real Curriculum, L. Edward Day, Michelle Miller-Day, Michael L. Hecht, Desiree Fehmie

Communication Faculty Articles and Research

The present study reports a preliminary evaluation of D.A.R.E.’s new elementary school keepin’ it REAL substance abuse prevention program. Given the widespread dissemination of D.A.R.E., this evaluation, even though of short term effects, has important implications for national prevention efforts. The new prevention curriculum teaches social and emotional competencies such as decision making and resistance skills. Social and emotional competencies and other risk factors were examined among students (N = 943) in 26 classrooms, 13 classrooms in the treatment condition (n = 359) and 13 classrooms in the control condition (n = 584) using a quasi-experimental matched group design. Pretest …


Analysis Of Graded Gross Anatomy Dissections And Demonstrations As A Supplemental Educational Tool, Stephanie Leanne Cummings May 2017

Analysis Of Graded Gross Anatomy Dissections And Demonstrations As A Supplemental Educational Tool, Stephanie Leanne Cummings

Theses & Dissertations

Teaching and assessment modalities for human anatomy curriculums vary between schools. The University of Nebraska Medical Center utilizes an integrated gross anatomy lab curriculum including hands-on dissection, lecture, and 3-D models. The GCBA 909 course, Human Gross Anatomy Lab, just recently incorporated graded dissections and demonstrations into their master of medical anatomy (MMA) curriculum. Students were required to complete and demonstrate eight additional dissections compared to physician assistant (PA), physical therapy (PT) students. Upon completion of these dissections, students were assessed based on the quality of their dissections and were also required to demonstrate the cadaveric dissections to anatomy faculty …


Improving New Graduate Critical Care Nurse Practitioner Knowledge And Retention Using A Dedicated Orientation And Mentoring Program, Katherine Huffer Apr 2017

Improving New Graduate Critical Care Nurse Practitioner Knowledge And Retention Using A Dedicated Orientation And Mentoring Program, Katherine Huffer

Dissertations

Abstract

Background: There has been a significant amount of research into the many challenges that nurse practitioners (NPs) face as they transition from school to practice, however, there is limited research on how to improve this transition. Regardless of the setting in which the NPs are working, novices NPs alike report feelings of being unprepared and experiencing high levels of stress, anxiety, fear, and frustration. New research suggests that a comprehensive NP orientation and residency programs may provide a way to integrate the new NPs into their practice environment successfully.

Method: Kern’s Six Step Approach to Curriculum Development for Medical …


Many Hands Make Light Work: Crowdsourced Ratings Of Medical Student Osce Performance, Mark Grichanik Apr 2017

Many Hands Make Light Work: Crowdsourced Ratings Of Medical Student Osce Performance, Mark Grichanik

USF Tampa Graduate Theses and Dissertations

Clinical skills are often measured using objective structured clinical examinations (OSCEs) in healthcare professions education programs. As with assessment centers, it is challenging to provide learners with effective feedback due to burdensome human capital demands. The aim of this dissertation was to evaluate the viability of using a crowdsourced system to gather OSCE ratings and feedback. Aggregating evaluations of student performance from a crowd of patient proxies has the potential to mitigate biases associated with single-rater evaluations, allow the patient a voice as the consumer of physician behavior, improve reliability, reduce costs, improve feedback latency, and help learners develop a …


Australian General Practice Training Program: National Report On The 2016 Registrar Satisfaction Survey, Ali Radloff, Daniel Edwards, Darren Matthews Apr 2017

Australian General Practice Training Program: National Report On The 2016 Registrar Satisfaction Survey, Ali Radloff, Daniel Edwards, Darren Matthews

Higher education research

The AGPT Registrar Satisfaction Survey was an annual, national survey of GP registrars currently training in the AGPT program that collects information about registrar satisfaction, experience and future career plans. The survey undertaken in November and December 2016 was part of the Department of Health’s monitoring and quality improvement activities and the information used to assure the quality of training provision, enable continuous improvement and allow results to be benchmarked nationally. It also collected information on registrars’ demographics, training contexts, career plans and other aspects of their training experience.


Investigating Personality Traits Of Registered Nurses: Implications For Personnel Evaluation, Stephanie N. Means Apr 2017

Investigating Personality Traits Of Registered Nurses: Implications For Personnel Evaluation, Stephanie N. Means

Dissertations

The United States is currently facing a registered nurse (RN) shortage that is expected to reach the millions in the next few years. Since the beginning of the century, healthcare professionals and administrators have strived to develop and implement ways to increase recruitment and retention in the nursing field. It has been recognized that the key to recruitment and retention is to get the right nurse in the right place, which means focusing on clinical proficiencies as well as personality qualities and characteristics. Personality assessment has long been used to evaluate person-job (P-J) fit of applicants for positions across the …


Competency Development In Community-Based Occupational Therapy, Sunny R. Winstead Apr 2017

Competency Development In Community-Based Occupational Therapy, Sunny R. Winstead

All Theses And Dissertations

The aims of this study were: a) to discover which strategies community-based occupational therapists (OTs) find most effective for developing the competencies that have been identified as unique to community-based occupational therapy (OT) practice, b) to examine respondents’ perceptions of the effectiveness of their academic training and of current professional development resources, and c) to explore respondents’ suggestions for improving academic training and continuing education for OTs in community-based practice. Data collection was completed using an electronic survey that targeted members of the American Occupational Therapy Association who have experience in community-based OT. The survey was completed by 81 OTs …


Awareness And Use Of Electronic Health Records In Entry-Level Occupational Therapy And Occupational Therapy Assistant Curricula, Louis F. Dmytryk, Tina M. Deangelis Mar 2017

Awareness And Use Of Electronic Health Records In Entry-Level Occupational Therapy And Occupational Therapy Assistant Curricula, Louis F. Dmytryk, Tina M. Deangelis

The Open Journal of Occupational Therapy

The Accreditation Council for Occupational Therapy Education (ACOTE) requires programs to instruct entry-level occupational therapy (OT) and occupational therapy assistant (OTA) students in technology that may include electronic documentation systems, distance communication, virtual environments, and telehealth (standard B1.8). At this time, there are no publications describing if and how electronic health record (EHR) instruction is implemented in entry-level OT and OTA programs. The purpose of this study is to investigate awareness and use of EHRs in entry-level OT and OTA curricula. Respondents from 76 nationally accredited entry-level programs (two OT doctoral, 24 OT masters, two OT combined bachelors/masters, and 48 …


Role Emerging Placements In Undergraduate Occupational Therapy Training: A Case Study, Martin Fitzgerald, Abigail Kate Smith, Nazman Rehman, Michelle Taylor Jan 2017

Role Emerging Placements In Undergraduate Occupational Therapy Training: A Case Study, Martin Fitzgerald, Abigail Kate Smith, Nazman Rehman, Michelle Taylor

Internet Journal of Allied Health Sciences and Practice

Purpose: Role-emerging placements in occupational therapy training are contributing to professional and workforce development because of their strong occupational focus and placement of students in emerging practice. This manuscript explores how one role-emerging placement challenged and developed student theoretical and clinical skills, presented new ways of working at the recipient site, and enhanced service delivery. Methods: The background to role-emerging placements in occupational therapy is explored through the use of a case study which reflects on and analyses how the assessment and treatment of occupation enhanced service delivery at a local, non-traditional site. Eight students in England developed and …