The curriculum in education has always been and continues to be discussed using different approaches and terminology. In the 1990s the focus was on an 'inclusive curriculum'. 1 'Decolonizing the university' has been in currency since at least 2011, following on from the Malaysian conference on this, with its quest for non-Eurocentric paradigms. 2 The recent prominent 'decolonizing the curriculum' movement can be seen as a continuation of this, originating at the University of Cape Town, South Africa. In what became known as the Rhodes Must Fall movement, 3 students demanded that the Cecil Rhodes statue prominently and centrally on display at that University be removed for what it symbolized and the history it represented in a place of education. This movement was then mirrored in the Rhodes Must Fall Oxford campaign. 4 The theme of questioning what message was being communicated by the voices that were included in canons being taught, and those that are absent, was picked up by the National Union of Students in the Why is my curriculum white? film 5 and Mariya Hussain's Why is My Curriculum White? 6 in 2015. This movement has been slowly spreading in the UK, and there is an ongoing movement of higher education institutions (HEIs) reviewing their curricula and using the decolonizing lens to do so. Additionally, or in some cases as a starting point, this is being debated by the student body via student unions. Change is being demanded by the student unions in the
Technology-rich student-centered classrooms such as SCALE-UP and TEAL are designed to actively engage students. We examine what happens when the design of the classroom (conventional or teachercentered versus student-centered classroom spaces) is consistent or inconsistent with the teacher's epistemic beliefs about learning and teaching (traditional or teacher-centered versus student-centered pedagogies). We compare two types of pedagogical approaches and two types of classroom settings through a quasiexperimental 2 × 2 factorial design. We collected data from 214 students registered in eight sections of an introductory calculus-based mechanics course given at a Canadian publicly funded two-year college. All students were given the Force Concept Inventory at the beginning and at the end of the 15-week-long course. We then focused on six teachers assigned to teach in the student-centered classroom spaces. We used qualitative observations and the Approaches to Teaching Inventory (ATI), a self-reported questionnaire, to determine the teachers' epistemic beliefs (teacher-centered or student-centered) and how these beliefs affected their use of the space and their students' conceptual learning. We report four main findings. First, the student-centered classroom spaces are most effective when used with student-centered pedagogies. Second, student-centered classrooms are ineffective when used with teacher-centered pedagogies and may have negative effects for students with low prior knowledge. Third, we find a strong correlation between six instructors' self-reported epistemic beliefs of student centeredness and their classes' average normalized gain (r ¼ 0.91; p ¼ 0.012). Last, we find that some instructors are more willing to adopt student-centered teaching practices after using student-centered classroom spaces. These data suggest that student-centered classrooms are effective only when instructors' epistemic framework of teaching and learning is consistent with a student-centered pedagogy. However, the use of the studentcentered classrooms may change instructors' epistemic frameworks over time. Further research should focus on how to better support teachers with shifting epistemic frameworks as well as helping students with lower prior knowledge in student-centered classroom spaces.
With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention. We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet, it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students for class. We set out to effectively move some of our course content outside of class and decided to tweak the Just-in-Time-Teaching approach (JiTT). To our surprise, this tweak - which we like to call the flip-JiTT - ended up completely flipping our classroom. What follows is narrative of our experience and a procedure that any teacher can use to extend JiTT to a flipped classroom.Comment: Submitted to The Physics Teache
ImportanceIn patients with severe aortic valve stenosis at intermediate surgical risk, transcatheter aortic valve replacement (TAVR) with a self-expanding supra-annular valve was noninferior to surgery for all-cause mortality or disabling stroke at 2 years. Comparisons of longer-term clinical and hemodynamic outcomes in these patients are limited.ObjectiveTo report prespecified secondary 5-year outcomes from the Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement (SURTAVI) randomized clinical trial.Design, Setting, and ParticipantsSURTAVI is a prospective randomized, unblinded clinical trial. Randomization was stratified by investigational site and need for revascularization determined by the local heart teams. Patients with severe aortic valve stenosis deemed to be at intermediate risk of 30-day surgical mortality were enrolled at 87 centers from June 19, 2012, to June 30, 2016, in Europe and North America. Analysis took place between August and October 2021.InterventionPatients were randomized to TAVR with a self-expanding, supra-annular transcatheter or a surgical bioprosthesis.Main Outcomes and MeasuresThe prespecified secondary end points of death or disabling stroke and other adverse events and hemodynamic findings at 5 years. An independent clinical event committee adjudicated all serious adverse events and an independent echocardiographic core laboratory evaluated all echocardiograms at 5 years.ResultsA total of 1660 individuals underwent an attempted TAVR (n = 864) or surgical (n = 796) procedure. The mean (SD) age was 79.8 (6.2) years, 724 (43.6%) were female, and the mean (SD) Society of Thoracic Surgery Predicted Risk of Mortality score was 4.5% (1.6%). At 5 years, the rates of death or disabling stroke were similar (TAVR, 31.3% vs surgery, 30.8%; hazard ratio, 1.02 [95% CI, 0.85-1.22]; P = .85). Transprosthetic gradients remained lower (mean [SD], 8.6 [5.5] mm Hg vs 11.2 [6.0] mm Hg; P < .001) and aortic valve areas were higher (mean [SD], 2.2 [0.7] cm2 vs 1.8 [0.6] cm2; P < .001) with TAVR vs surgery. More patients had moderate/severe paravalvular leak with TAVR than surgery (11 [3.0%] vs 2 [0.7%]; risk difference, 2.37% [95% CI, 0.17%- 4.85%]; P = .05). New pacemaker implantation rates were higher for TAVR than surgery at 5 years (289 [39.1%] vs 94 [15.1%]; hazard ratio, 3.30 [95% CI, 2.61-4.17]; log-rank P < .001), as were valve reintervention rates (27 [3.5%] vs 11 [1.9%]; hazard ratio, 2.21 [95% CI, 1.10-4.45]; log-rank P = .02), although between 2 and 5 years only 6 patients who underwent TAVR and 7 who underwent surgery required a reintervention.Conclusions and RelevanceAmong intermediate-risk patients with symptomatic severe aortic stenosis, major clinical outcomes at 5 years were similar for TAVR and surgery. TAVR was associated with superior hemodynamic valve performance but also with more paravalvular leak and valve reinterventions.
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