ABSTRACT
Educational technologies have experienced unprecedented prominence on university agendas with many institutions motivated to keep the lessons learned from the COVID-19 sparked transition with regard to online teaching. In response to this renewed interest in ensuring the longevity of educational technologies in higher education, this systematic review analysed the various organisational factors—for example, leadership, infrastructure, strategy—considered essential in the literature for the successful implementation of educational technologies. Specifically, we reviewed 1614 papers published in five prominent educational technology journals in the last decade. From this sample, we identified 47 papers that discussed organisational factors. Drawing on these studies, we constructed an organisational framework, which outlines the different organisational factors, actors and processes involved in implementing educational technologies. The identified organisational factors are structured into three main categories: (1) Leadership and Strategy, (2) Infrastructure and Resources and (3) Recognition and Motivation. Our aim was to further the scholarly understanding of the organisational layer involved in digital change as well as provide concrete recommendations for practitioners. Practitioner notes What is already known about this topic Previous research has stressed the importance of taking organisational factors such as infrastructure, leadership, strategy and staff commitment into account when implementing educational technologies. However, review papers have failed to systematically organise these studies to create a comprehensive understanding of the organisational factors involved in implementing educational technologies and ensuring their longevity at an institution. There is currently a high level of interest in how educational technologies can be implemented in the higher education landscape, as many institutions are facing the question of what lessons they can learn from the crisis and how they can continue on their path of digitalisation. What this paper adds This review paper addresses a gap in our scholarly understanding of the organisational layers involved in the implementation of educational technologies in higher education institutions (HEIs). This paper provides a framework on organisational factors, which influence the implementation of educational technologies in HEIs. This review paper demonstrates that bottom-up and opinion leadership, support structures tailored to the need and time of faculty as well as recognition and incentives have the largest impact on a sustainable implementation of educational technologies in HEIs. Implications for practice and/or policy Universities should create structures that enable innovation and creativity by promoting bottom-up and opinion leadership as well as shared decision-making processes as they are important for the successful implementation of educational technologies in HEIs. Besides providing a reliable and suitable infrastructure, institutional support and resources in terms of technical advice and training tailored to specific needs, should be in place when planning the implementation of educational technologies in HEIs. The additional workload instructors face when implementing digital teaching should be recognised and incentivised as it strengthens instructor engagement which is crucial for the implementation of educational technologies in HEIs. © 2022 The Authors. British Journal of Educational Technology published by John Wiley & Sons Ltd on behalf of British Educational Research Association.
ABSTRACT
INTRODUCTION: The patterns and hospital course of COVID-19 in children appears distinct from adult experience and requires clear delineation. The objective of this study is to describe the clinical course of children admitted with COVID-19 to a tertiary care pediatric center and to evaluate the frequency of MIS-C in various COVID-19 illness patterns. METHODS: Children (68) admitted with COVID-19 till June 2020 were included in an IRB approved, retrospective single center study. Serious COVID-19 illness was defined as any child requiring invasive respiratory or cardiovascular support or renal replacement therapy. COVID-related Kawasaki-like disease (CKLD) was defined as any patient with COVID-19, fever ≥5d, elevated inflammatory markers and mucocutaneous lesions. Remaining patients were mild to moderate illness. CDC criteria were used to identify multisystem inflammatory syndrome in children (MIS-C). RESULTS: The median age was 6.4Y. 31 (45.6%) were male. 60 (88.2%) were positive for SARS-CoV-2. Eight cases were antibody positive or epidemiologically linked. MIS-C was present in 39 (57.4%), serious COVID-19 illness in 11 (16.2%), CKLD in 9 (13.2%) and rest had mild to moderate illness (n=49;72%). MIS-C was present in all cases admitted to PICU (n=17) or who had severe illness and CKLD cases. Most common organs involved were hematologic (51.5%), hepatic (50%), respiratory (41.2%) and cardiac (23.5%). Children with serious illness were adolescents with elevated BMI (73%), premorbid conditions (82%) and ARDS (72%). Children with CKLD were 2-12 years old with no premorbid condition. Of PICU admissions, 11 needed supplemental oxygen, 6 non-invasive ventilation and 3 invasive ventilation. ARDS (S/ F≤264) was present in 8. The presence of lymphopenia, thrombocytopenia, CRP>3mg/dL, admission D-dimer>0.41μg/ mL or elevated BNP levels had a sensitivity of 0.84 and specificity of 0.75 for MIS-C diagnosis with COVID-19 (AUC:0.80;95%CI:0.68-0.91;p<0.001).One child died. CONCLUSIONS: The 3 patterns of COVID-19 in hospitalized children were (1) severe illness seen in obese adolescents with premorbidity (2) CKLD in 2-12-year-olds with varying cardiac involvement (3) mild to moderate illness in younger children. Children<2 years are generally spared from severe disease. MIS-C is present in all children with severe illness and CKLD.