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Electricity, especially the flow of current, is a challenging topic for students of all ages. This study conceptualizes students' explanation of electric current as a cluster of knowledge elements. These clusters, in turn, represent students' mental models of electric circuits. Thus, this study aims to identify and characterize students' mental

This article concerns the synergy between science learning, understanding complexity, and computational thinking (CT), and their impact on near and far learning transfer. The potential relationship between computer-based model construction and knowledge transfer has yet to be explored. We studied middle school students who modeled systemic phenomena using the Much.Matter.in.Motion (MMM) platform. A distinct innovation of this work is the complexity-based visual epistemic structure underpinning the Much.Matter.in.Motion (MMM) platform, which guided students' modeling of complex systems. This epistemic structure suggests that a complex system can be described and modeled by defining entities and assigning them (1) properties, (2) actions, and (3) interactions with each other and with their environment. In this study, we investigated students’ conceptual understanding of science, systems understanding, and CT. We also explored whether the complexity-based structure is transferable across different domains. The study employs a quasi-experimental, pretest-intervention-posttest-control comparison-group design, with 26 seventh-grade students in an experimental group, and 24 in a comparison group. Findings reveal that students who constructed computational models significantly improved their science conceptual knowledge, systems understanding, and CT. They also showed relatively high degrees of transfer—both near and far—with a medium effect size for the far transfer of learning. For the far-transfer items, their explanations included entities’ properties and interactions at the micro level. Finally, we found that learning CT and learning how to think complexly contribute independently to learning transfer, and that conceptual understanding in science impacts transfer only through the micro-level behaviors of entities in the system. A central theoretical contribution of this work is to offer a method for promoting far transfer. This method suggests using visual epistemic scaffolds of the general thinking processes we would like to support, as shown in the complexity-based structure on the MMM interface, and incorporating these visual structures into the core problem-solving activities. Supplementary Information The online version contains supplementary material available at 10.1007/s11251-023-09624-w.

A frequent concern about constructivist instruction is that it works well, mainly for students with higher domain knowledge. We present findings from a set of two quasi-experimental pretest-intervention-posttest studies investigating the relationship between prior math achievement and learning in the context of a specific type of constructivist instruction, Productive Failure. Students from two Singapore public schools with significantly different prior math achievement profiles were asked to design solutions to complex problems prior to receiving instruction on the targeted concepts. Process results revealed that students who were significantly dissimilar in prior math achievement seemed to be strikingly similar in terms of their inventive production, that is, the variety of solutions they were able to design. Interestingly, it was inventive production that had a stronger association with learning from PF than pre-existing differences in math achievement. These findings, consistent across both topics, demonstrate the value of engaging students in opportunities for inventive production while learning math, regardless of prior math achievement.

Background Outpatient Parenteral Antimicrobial Therapy (OPAT) programs aim to facilitate early discharge and improve patient care; however, rates of readmission remain high. After discharge, safe monitoring and follow-up is logistically heterogenous and prone to error. We aimed to utilize a Six Sigma framework to evaluate our OPAT process and define opportunities for improvement in patient care. Methods A define, measure, analyze, improve, control (DMAIC) approach was used by a multidisciplinary group to evaluate errors and opportunities in the OPAT discharge process (Fig 1). Baseline analysis of 6-months of OPAT discharges revealed an all cause 30-day readmission rate of 19.7%, and less than half of all patients (45%) were seen in the infectious diseases (ID) clinic within 28-days. The group created a process map and identified potential opportunities for error and heterogeneity in the process. A define, measure, analyze, improve, control (DMAIC) approach was used by a multidisciplinary group to evaluate errors and opportunities in the OPAT discharge process Results Process mapping revealed process heterogeneity depending on patient discharge location (Fig 2). Reliability of ordering labs and transporting patients to appointments varied by location (Skilled nursing facility (SNF) versus home infusion, etc.). Furthermore, the OPAT note was not included in the discharge summary and the process was reliant on an ID team member emailing the clinic to request follow-up. An Ishikawa diagram identified numerous factors contributing to OPAT related adverse events (Fig 3). Main opportunities for improvement included (1) the OPAT note, (2) delegation of laboratory ordering for monitoring patient after discharge, (3) patient follow-up scheduling and monitoring, and (4) skilled nursing facility (SNF) communication and expectations. Interventions resulting included working with information technology to update the OPAT note to include appointment dates, attaching OPAT note to discharge summary, and bridging communication and ensuring task completion by delegating certain reliable SNFs as centers of excellence. Process mapping revealed significant process heterogeneity depending on patient discharge location, that the OPAT note was not included in the discharge summary, and the process was heavily reliant on an ID team member emailing the clinic to request follow-up and ensure future laboratory tracking. An Ishikawa diagram identified numerous factors contributing to OPAT related adverse events including numerous system and individual factors Conclusion The DMAIC approach was useful in identifying opportunities to improve transitions of care in patients discharged on OPAT and developing interventions for targeted process improvement. Other centers may use a similar strategy to analyze and improve the care of OPAT patients. Disclosures All Authors: No reported disclosures.