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The teacher may also mark a randomsample to establish controls and to discourage cheating or self-delusion purchase 100mg imitrex with visa. We urge you to give this approach to assessment very serious consideration indeed. In our view, it is among the most educationally promising ideas in recent years, and we suggest you study the book by Boud listed at the end of this chapter. THE LEARNING PORTFOLIO All assessment methods require that students present evidence of their learning, yet in most cases (with theses and project work being notable exceptions) it is the teacher who controls the character of that evidence. Requiring students to respond to objective tests, write essays and participate in clinical examinations for example, does this. If we really believe in student-centred learning then we must work hard to ensure that our assessment practices reflect, encourage and rewardthis belief. In Chapter 1, we noted that assessment in student-centred learning needs to be more flexible with greater emphasis on student responsibility. The learning portfolio is one way of reinforcingstudent-centred learning. The portfolioclearly has validity as an assessment method in this situation, but its reliability for summative purposes has yet to be deter- 156 mined. This should not, however, discourage you from experimenting with learning portfolios with your students. A learning portfolio is a collection of evidence presented by students to demonstrate what learning has taken place. In the portfolio, the student assembles, presents, explains, and evaluates his or her learning in relation to the objectives of the course and his or her own purposes and goals.

Such assessment is notoriously deficient in medical schools cheap 50mg imitrex with mastercard, particularly in regard to clinical teaching (see Chapter 5). As no formal examination is required at the completion of the course, the major emphasis of the assessment activities is formative. However, assessment activities of a summative type are conducted during the final two weeks of the programme when aspects of the students’ performance are observed by preceptors and by other staff members. You will note that the assessment of knowledge is left largely to the students themselves. In other circumstances we might have used a written test to assess this component of the course. SEQUENCING AND ORGANISING THE COURSE It is unlikely that the way in which you have set out your objectives, teaching and assessment on the planning chart will be the best chronological or practical way to present the course to students. There are likely to be circumstances in your own context that influence you to sequence a course in a particular way, such as semesters or teaching terms. However, there are also a number of educational grounds upon which to base the sequencing. These include: Proceeding from what students know to what they do not know; Proceeding from concrete experiences to abstract reasoning; The logical or historical development of a subject; Prioritising important themes or concepts; Starting from unusual, novel or complex situations and working backwards towards understanding (e. As our understanding of how different factors can influence learning advances, you should give consideration to the ways in which you can facilitate deep-learning approaches by your students through the way in which you organise 104 105 and manage the course and the kinds of intellectual and assessment demands you place on them. We suggest that you review the relevant sections in Chapter 1 to guide you in this matter. Finally, you will need to consider the broad organising principles behind your course.

X During the interview cheap imitrex 100mg visa, firm eye contact with little move- ment indicates that you’re interested in what is being said. On the other hand, if your eyes wander all over the place and only briefly make contact with the eyes of the interviewee, low self-esteem, deceit or boredom HOW TO CONDUCT INTERVIEWS / 71 can be indicated. Conversely, watch the eyes of your interviewees which will tell you a lot about how the interview is progressing. Try not to sit directly opposite them – at an angle is better, but not by their side as you will have to keep turning your heads which will be un- comfortable in a long interview. By watching the eye movements and body language of the interviewees, and by listening to what they’re saying, you’ll soon know when you’ve established rapport. If, however, you notice the interviewees becoming uncomfortable in any way, respect their feelings and move on to a more general topic. Sometimes you might need to offer to turn off the recorder or stop taking notes if you touch upon a particularly sensitive issue. Negotiate a length of time for the interviews and stick to it, unless the interviewees are happy to continue. Make sure you thank them for their help and leave a contact number in case they wish to speak to you at a later date. You might find it useful to send a transcript to the inter- viewees – it is good for them to have a record of what has been said and they might wish to add further information. Do not disclose information to third parties unless you have received permission to do so (see Chapter 13). ASKING QUESTIONS AND PROBING FOR INFORMATION As the interview progresses, ask questions, listen carefully 72 / PRACTICAL RESEARCH METHODS to responses and probe for more information. When you probe, you need to think about obtaining clar- ification, elaboration, explanation and understanding. There are several ways to probe for more detail, as the fol- lowing list illustrates. PROBING FOR MORE DETAIL X That’s interesting; can you explain that in more de- tail? You’ll find that most people are uncomfortable during silences and will elaborate on what they’ve said rather than experience discomfort.

Observational studies suggest similar benefit in children imitrex 100 mg overnight delivery, although the potential for complications due to plasma exchange increases with smaller body size. On balance, these therapies are recommended only for the minority of children who manifest more severe forms GBS: those that have lost the ability to ambulate or have bulbar weakness causing dysphagia or aspiration. Because of the difficulty with vas- cular access and potential problems with fluid shifts given smaller blood volume, of the two therapies, treatment with IVIg has become the accepted therapy for GBS in children. The recommended schedule is 2 g=kg of body weight divided into five con- secutive daily doses of 400 mg=kg each. Side effects are generally minor, but severe side effects can include chemical meningitis, acute tubular necrosis, and renal failure (particularly in patients with pre-existing renal disease), thomboembolic events, and rarely anaphylaxis. Table 3 Treatment Options for GBS Therapy Regimen Side effects Plasma exchange Remove 200–250 mL=kg Catheter placement may cause of plasma over 7–10 days pneumothorax, bleeding, deep vein thrombosis, pulmonary emboli, or sepsis. Blood removal may cause hypotension, anemia, thrombocytopenia, or electrolyte derangements Intravenous 0. In centers with appropriate experience, this may be safely done in children who weigh more than 10 kg. The usual protocol, derived from experience with adults, involves exchanges on the 1st, 3rd, 5th, and 7th days targeting a total exchange volume of 250 mL=kg. Problems with plasma exchange include difficulty with placement and maintenance of central lines and hypotension during exchanges. If patients experience a relapse within approximately 10 days of the first treatment, retreatment with the same initial agent at half the dose is recommended. Prognosis Overall prognosis in GBS is good with approximately 90–95% of affected children making a complete functional recovery within 6–12 months.