ABSTRACT
This paper reports on the implementation of digital learning logs in the context of pre-service teacher training in a distance university in Madrid. The learning log, which had been previously implemented in the subject as a learning tool, has proven to be especially useful in Covid-19 times since the students had to work more independently and could use it to reflect upon their learning without the conventional teaching they were used to. The paper has a two-fold aim: first, to analyze whether the learning logs helped in promoting students' autonomy and self-reflection, and second, to observe whether they contribute to the development of their linguistic competence in English as a foreign language. Participants of the study (n=47) are students of the Primary and Infant Education degrees, specializing in English teaching, whose L2 level ranges between B1 and C2. At the end of half term, they were given the possibility of completing a learning log to record their learning process, review concepts and be aware of potential learning gaps and needs, and act accordingly. For this purpose, and to encourage participation, L1 or L2 could be chosen as vehicular languages. Participants were asked to complete an online questionnaire on their experience using the logs, answering questions regarding the suitability of this tool to enhance their language skills and promote effective strategies to become independent learners. The data drawn from the questionnaires submitted (n=29) were later analyzed through SPSS. In addition, individual semi-structured interviews were carried out to collect information on those participants who had not completed the learning log (n=11). The findings of the study show that the vast majority of participants agree on the potential of learning logs as a useful tool to keep track of their learning process and to develop metacognitive awareness and linguistic skills.
ABSTRACT
INTRODUCTION: The COVID-19 pandemic overwhelmed New York City hospitals. Shortages of ventilators and sedatives prompted tracheostomy earlier than recommended by professional societies. The objective of this study was to determine the impact of percutaneous dilational tracheostomy (PDT) in COVID-19 patients on critical care capacity. METHODS: This is a single-institution prospective case series of SARS-CoV-2 infected patients undergoing PDT from April 1-June 4, 2020 with follow-up through June 25, 2020 at a public tertiary care center. Clinical data were obtained through medical record review. Mechanically ventilated COVID-19 patients were screened for intervention based on the following criteria: ≥ 6 days of intubation with further need for mechanical ventilation, a fractional inspired oxygen concentration of ≤ 60%, positive end expiratory pressure ≤12, no significant organ dysfunction except acute kidney injury, and minimal pressor requirements. The main outcomes measured were change in 48-hour periprocedural sedative/analgesia requirements, liberation from the ventilator, rate of transfer from the ICU, decannulation, PDT-related complications, and in-hospital survival. RESULTS: Fifty-five patients met PDT criteria and underwent PDT a median of 13 days from intubation. Patient characteristics are found in Table 1. Intravenous midazolam equivalents, fentanyl equivalents and cisatracurium equivalents were significantly reduced post- PDT (Table 2). Thirty-five patients were transferred from the ICU and liberated from the ventilator. Median time from PDT to ventilator liberation and ICU discharge was 10 and 12 days respectively. Decannulation occurred in 45.5% and 52.7% were discharged from acute inpatient care. Median follow-up for the study was 62 days. Four patients had bleeding complications postoperatively and 11 died during the study period. Older age was associated with increased odds of complication (OR 1.12, 95% CI 1.04, 1.23) and death (OR=1.15, 95% CI 1.05, 1.30). CONCLUSIONS: Mechanically ventilated COVID-19 patients undergoing PDT using standard criteria improves ventilator and medication utilization in areas strained by the SARS-CoV-2 pandemic. Long term outcomes after PDT in this population deserve further study.