SUPPORTING SCIENCE STUDIES FOR CHILDREN WITH LONG TERM HEALTH PROBLEMS USING NEFREDUCA

Denise Whitelock, Roser Pinto* and Marcel·la Saez*

The Open University

*CRECIM, Universitat Autònoma de Barcelona

d.m.whitelock@open.ac.uk

CBLIS 2010

Context of the research

Children with chronic illness hospitalised for long periods

Miss out on schooling

Difficult to catch up with Maths and Science

Context of the research

Lower science literacy level

Science/Medical nomenclature

lack of science teachers in hospital schools

Solving the Problem

Targeted children with kidney disease

Science lessons have more effect targeted to child’s illness (Korta, 2003, Arnau et al, 2005)

Science material delivered by Moodle

Nefreduca

It’s all connected

Holistic

Nutrition and kidney sequence

Normal kidney eliminates waste

What waste?

How does the waste get to the kidney?

Informatics management block

Introduction block

Initial questionnaire

The Science content block

Quick access to the list of themes templates and

activities

List of participants list

The Nefreduca materials

The Nefreduca blocks

Presents the learning objectives for the whole series of activities

The instructions about how to

use the program with its variety of teaching resources

An Initial questionnaire (to ascertain students’ prior knowledge of the science before they worked through the program).

Separates the content into four major themes which included:

a) Food digestion and nutrient absorption

b) Blood transport of nutrients and waste products

c) Kidney excretion of waste products

d) Kidney dysfunction and the role of dialysis

The Introduction and Informatics management block

The Science content block

The Nefreduca themes

The Nefreduca ICT resources

Video

Animations

On-line image editor

Research Questions

1. What were the hospitalized students’ Initial ideas of the normal

biological kidney function?

2. How do the students understand the role of the kidney in relation to

Urine production and the blood transport system?

3. What are the students’ initial ideas of the normal urine content? How

do they explain alterations to normal urine content?

4. What are their explanations of the urine changes seen and blood

alterations which are caused by kidney dysfunction?

Methodology

32 chronically ill children(10-16 years). 22 finished.

Sessions in the hospital school, hospital rooms dialysis suite and lasted between 1-1h30min.

All the students’ logins and answers to the activities collected by the system

probing students’ ideas

Analysis categories Data collected in the following

students answers

The kidney function related with the urine production Question 1 of the initial questionnaire Question 3 of the 3a activity

The kidney function related with the blood filtering Question 1 of the initial questionnaire Questions 2 & 3 of the 3a activity

The urine content Question 2 of the initial questionnaire Question 3 of the 3a activity

Consequences of kidney dysfunction in the urine Question 2 of the initial questionnaire Question 1 of the 4a activity

Consequences of kidney dysfunction in the blood Question 2 of the 4a activity

Analysis and resultsExample : Consequences of kidney dysfunction in the urine

What are the urine

components?

What happens to the urine when the kidney doesn’t work properly?

Imagine that you’re in charge of analyzing a sample of pee and blood of a hospital patient. The first test result is that the pee containts substances the body needs and have come out.

Explain how those substances might have arrived to the pee and why.

You know yet that the blood circulates to all parts of the body and gains and loss substances. So, if you suspect that a hospital patient has kidney problems, you could think that she/he might have more quantity of certain type of substances.

Do you know which substances could be? Why it could be possible?

Question 2 of the initial questionnaire

Activity 4a from theme 4

Analysis and results: What were the hospitalized students’ initial ideas of the normal biological kidney function? (RQ 1)

The data analysis revealed that the students initially held a number of different hierarchical conceptions for the kidney function .

Level Example Before After

1.1 - Kidney as urine eliminator i.e. It makes you urinate 8/32 -

1.2 - Kidney as a waste cleaner (from the blood or the body fluids)

i.e. It cleans the blood; it purifies the body fluids

14/32 -

2- Kidney as urine eliminator + waste cleaner (from the blood or the body fluids

i.e. It cleans the blood and makes me urinate 9/32 -

3- Kidney as urine producer + blood waste eliminator

i.e. The kidney eliminate the metabolism waste products of the blood

- 4/22

4 - Kidney as urine producer + blood filter

i.e. It filters the waste products of the blood and produce the urine

1/32 18/22

No answer - 11/32

Analysis and results: How do the students understand the role of the kidney in relation to urine and blood? (RQ 2)

Level Example Before After

1.1 - Kidney as urine eliminator i.e. It makes you urinate 8/32 -

1.2 - Kidney as a waste cleaner (from the blood or the body fluids)

i.e. It cleans the blood; it purifies the body fluids

14/32 -

2- Kidney as urine eliminator + waste cleaner (from the blood or the body fluids

i.e. It cleans the blood and makes me urinate 9/32 -

3- Kidney as urine producer + blood waste eliminator

i.e. The kidney eliminate the metabolism waste products of the blood

- 4/22

4 - Kidney as urine producer + blood filter

i.e. It filters the waste products of the blood and produce the urine

1/32 18/22

No answer - 11/32

Analysis and results: What are the students’ initial ideas of the normal urine content? How do they explain alterations to normal urine content? (RQ3)

Students explanations of urine content: Initial Final Water 3/32 - Liquid 5/32 - Waste products 1/32 Water and mineral salts 3/32 - Water + nephrology tested substances (i.e. urea, bacteria, toxin) 3/32 Water + waste products + mineral salts - 1/22 Water and waste products 8/32 21/22 No answer 8/32 -

Students explanations of urine content: Initial Final Water 3/32 - Liquid 5/32 - Waste products 1/32 Water and mineral salts 3/32 - Water + nephrology tested substances (i.e. urea, bacteria, toxin) 3/32 Water + waste products + mineral salts - 1/22 Water and waste products 8/32 21/22 No answer 8/32 -

Analysis and results: What are the students’ initial ideas of the normal urine content? How do they explain alterations to normal urine content? (RQ3)

Analysis and results:What are their explanations of the urine changes seen and blood alterations which are caused by kidney dysfunction? (RQ4)

Students explanations of urine alterations caused by a kidney dysfunction:

Initial Final

Alterations in the content or quality of the urine 4/32 22/22

Alterations in the quantity of the urine 12/32 -

Alterations in the colour or smell of the urine 6/32 -

Finding a Feedback model

Recorded teacher and student talk when using Nefreduca

Analysed with Bales categories

DMW, CALRG, May 2010

Bales Categories

DMW, CALRG, May 2010

Categories Specific Examples

Positive Reactions

A1

A2

A3

1. Shows solidarity

2. Shows tension release

3. Shows agreement

Jokes, gives help, rewards others

Laughs, shows satisfaction

Understands, concurs, complies, passively accepts

Attempted Answers

B1

B2

B3

4. Gives suggestion

5. Gives opinion

6. Gives information

Directs, proposes, controls

Evaluates, analyses, expresses feelings or wishes

Orients, repeats, clarifies, confirms

Questions

C1

C2

C3

7. Asks for information

8. Asks for opinion

9. Asks for suggestion

Requests orientation, repetition, confirmation, clarification

Requests evaluation, analysis, expression of feeling or wishes

Requests directions, proposals

Negative Reactions

D1

D2

D3

10. Shows disagreement

11. Shows tension

12. Shows antagonism

Passively rejects, resorts to formality, withholds help

Asks for help, withdraws

Deflates others, defends or asserts self

Feedback incident 1 occurred when children were reading the text or templates for the activities

Bales Category Teachers’ action Teachers talk during action Teacher identifier

B1- GIVES SUGGESTION

Suggest the student re-examines the task instructions or reviews the video animation

“When we don’t know something we should go back and revise what has been explained in the Nefreduca texts”

T1

B3- GIVES INFORMATION

Clarifies some science concepts

“The student asks: What does it mean “the unassimilated food”, and the teacher answers “The food that is not assimilated, not dissolved, not useful”

T1, T2, T3

Clarifies some aspects of the images

”The student asks about the size of the ‘strainer’ holes. This part of the program is referring to diagrams of the filtration system in the kidney. The student rephrases the same question by asking if the images are microscopic. The teacher agrees and explains that the holes are only visible with the microscope”

T1, T2, T3

Feedback incident 2 occurred during a child’s activity with the Nefreduca program

Bales Category Teachers’ action

Teachers talk during action

Teacher identifier

A2- SHOWS TENSION RELEASE

Smile and make statements to prevent and avoid the building of negative emotions (frustration, worry)

“(Smile) Well, don’t worry, try to explain it in your own words”, “Listen, if you don’t know the answer, you could write “I don’t know”. We could also answer this way, eh?

T1, T2, T3

B1- GIVES SUGGESTION + C1-ASK FOR INFORMATION

Propose a hint in a direct or indirect way

The teacher helps the student to remember the text that has been read and the images seen. Then the student gives the right answer and the teacher concurs. The student says: Small tubes and the teacher: What have those small tubes…? The student says: ah! Holes!, the teacher replies: aha!

T1, T2, T3

Feedback incident 3 occurred after the children answered a questionChildren’s answer to Nefreduca questions or tasks

Bales Category Teachers’ action Teachers talk during action

Teacher identifier

If the answer is incomplete

3.2

B1-GIVES SUGGESTION

Propose to revise the video or animation of the activity or to revise the text of the previous templates

“Let’s see the activity video again!” T1

Gives a hint“And this also, eh! (the teacher is pointing to the computer screen)“

T2, T3

A3-SHOWSAGREEMENT

+

C1-ASK INFORMATION

Complies“Ok! Put this answer here. Well, the water and what else? Which kind of nutrients do you have here?” T2

Clarification

C2-ASK FOR OPINION

The teachers intonation is expressing that the student answer is not complete, the teacher also give hints

“Really? They move it from one side to another? And what else? They move it alone or they put in something”, It renews them, do you think so? It’s difficult to renew something that you don’t want any more, that’s not useful for anything. What do you think?”; “Already? So quickly?”

T2

Final Thoughts

Pedagogy matches student needs

Cognitive change with holistic approach

Making connections Good teachers make

connections tell coherent stories

Bales analysis lens for viewing emerging pattern of feedback

Open educational resources Call for standards

Acknowledgements

The project was funded by both:

Consell Social de la Universitat Autonoma de Barcelona (UAB, Ref: 200700047154) and

Spanish Ministerio de Educacion y Ciencia (MICCIN, Ref: CCT005-06-00169)

DMW, CALRG, May 2010