- Pre-registration nursing students
- No definition of master’s degree in nursing described in the publication
After the search, we collated and uploaded all the identified records into EndNote v.X8 (Clarivate Analytics, Philadelphia, Pennsylvania) and removed any duplicates. Two independent reviewers (MCS and SA) screened the titles and abstracts for assessment in line with the inclusion criteria. They retrieved and assessed the full texts of the selected studies while applying the inclusion criteria. Any disagreements about the eligibility of studies were resolved by discussion or, if no consensus could be reached, by involving experienced researchers (MZ-S and RP).
The first reviewer (MCS) extracted data from the selected publications. For this purpose, an extraction tool developed by the authors was used. This tool comprised the following criteria: author(s), year of publication, country, research question, design, case definition, data sources, and methodologic and data-analysis triangulation. First, we extracted and summarized information about the case study design. Second, we narratively summarized the way in which the data and methodological triangulation were described. Finally, we summarized the information on within-case or cross-case analysis. This process was performed using Microsoft Excel. One reviewer (MCS) extracted data, whereas another reviewer (SA) cross-checked the data extraction, making suggestions for additions or edits. Any disagreements between the reviewers were resolved through discussion.
A total of 149 records were identified in 2 databases. We removed 20 duplicates and screened 129 reports by title and abstract. A total of 46 reports were assessed for eligibility. Through hand searches, we identified 117 additional records. Of these, we excluded 98 reports after title and abstract screening. A total of 17 reports were assessed for eligibility. From the 2 databases and the hand search, 63 reports were assessed for eligibility. Ultimately, we included 8 articles for data extraction. No further articles were included after the reference list screening of the included studies. A PRISMA flow diagram of the study selection and inclusion process is presented in Figure 1 . As shown in Tables 2 and and3, 3 , the articles included in this scoping review were published between 2010 and 2022 in Canada (n = 3), the United States (n = 2), Australia (n = 2), and Scotland (n = 1).
PRISMA flow diagram.
Characteristics of Articles Included.
Author | Contandriopoulos et al | Flinter | Hogan et al | Hungerford et al | O’Rourke | Roots and MacDonald | Schadewaldt et al | Strachan et al |
---|---|---|---|---|---|---|---|---|
Country | Canada | The United States | The United States | Australia | Canada | Canada | Australia | Scotland |
How or why research question | No information on the research question | Several how or why research questions | What and how research question | No information on the research question | Several how or why research questions | No information on the research question | What research question | What and why research questions |
Design and referenced author of methodological guidance | Six qualitative case studies Robert K. Yin | Multiple-case studies design Robert K. Yin | Multiple-case studies design Robert E. Stake | Case study design Robert K. Yin | Qualitative single-case study Robert K. Yin Robert E. Stake Sharan Merriam | Single-case study design Robert K. Yin Sharan Merriam | Multiple-case studies design Robert K. Yin Robert E. Stake | Multiple-case studies design |
Case definition | Team of health professionals (Small group) | Nurse practitioners (Individuals) | Primary care practices (Organization) | Community-based NP model of practice (Organization) | NP-led practice (Organization) | Primary care practices (Organization) | No information on case definition | Health board (Organization) |
Overview of Within-Method, Between/Across-Method, and Data-Analysis Triangulation.
Author | Contandriopoulos et al | Flinter | Hogan et al | Hungerford et al | O’Rourke | Roots and MacDonald | Schadewaldt et al | Strachan et al |
---|---|---|---|---|---|---|---|---|
Within-method triangulation (using within-method triangulation use at least 2 data-collection procedures from the same design approach) | ||||||||
: | ||||||||
Interviews | X | x | x | x | x | |||
Observations | x | x | ||||||
Public documents | x | x | x | |||||
Electronic health records | x | |||||||
Between/across-method (using both qualitative and quantitative data-collection procedures in the same study) | ||||||||
: | ||||||||
: | ||||||||
Interviews | x | x | x | |||||
Observations | x | x | ||||||
Public documents | x | x | ||||||
Electronic health records | x | |||||||
: | ||||||||
Self-assessment | x | |||||||
Service records | x | |||||||
Questionnaires | x | |||||||
Data-analysis triangulation (combination of 2 or more methods of analyzing data) | ||||||||
: | ||||||||
: | ||||||||
Deductive | x | x | x | |||||
Inductive | x | x | ||||||
Thematic | x | x | ||||||
Content | ||||||||
: | ||||||||
Descriptive analysis | x | x | x | |||||
: | ||||||||
: | ||||||||
Deductive | x | x | x | x | ||||
Inductive | x | x | ||||||
Thematic | x | |||||||
Content | x |
The following sections describe the research question, case definition, and case study design. Case studies are most appropriate when asking “how” or “why” questions. 1 According to Yin, 1 how and why questions are explanatory and lead to the use of case studies, histories, and experiments as the preferred research methods. In 1 study from Canada, eg, the following research question was presented: “How and why did stakeholders participate in the system change process that led to the introduction of the first nurse practitioner-led Clinic in Ontario?” (p7) 19 Once the research question has been formulated, the case should be defined and, subsequently, the case study design chosen. 1 In typical case studies with mixed methods, the 2 types of data are gathered concurrently in a convergent design and the results merged to examine a case and/or compare multiple cases. 10
“How” or “why” questions were found in 4 studies. 16 , 17 , 19 , 22 Two studies additionally asked “what” questions. Three studies described an exploratory approach, and 1 study presented an explanatory approach. Of these 4 studies, 3 studies chose a qualitative approach 17 , 19 , 22 and 1 opted for mixed methods with a convergent design. 16
In the remaining studies, either the research questions were not clearly stated or no “how” or “why” questions were formulated. For example, “what” questions were found in 1 study. 21 No information was provided on exploratory, descriptive, and explanatory approaches. Schadewaldt et al 21 chose mixed methods with a convergent design.
A total of 5 studies defined the case as an organizational unit. 17 , 18 - 20 , 22 Of the 8 articles, 4 reported multiple-case studies. 16 , 17 , 22 , 23 Another 2 publications involved single-case studies. 19 , 20 Moreover, 2 publications did not state the case study design explicitly.
This section describes within-method triangulation, which involves employing at least 2 data-collection procedures within the same design approach. 6 , 7 This can also be called data source triangulation. 8 Next, we present the single data-collection procedures in detail. In 5 studies, information on within-method triangulation was found. 15 , 17 - 19 , 22 Studies describing a quantitative approach and the triangulation of 2 or more quantitative data-collection procedures could not be included in this scoping review.
Five studies used qualitative data-collection procedures. Two studies combined face-to-face interviews and documents. 15 , 19 One study mixed in-depth interviews with observations, 18 and 1 study combined face-to-face interviews and documentation. 22 One study contained face-to-face interviews, observations, and documentation. 17 The combination of different qualitative data-collection procedures was used to present the case context in an authentic and complex way, to elicit the perspectives of the participants, and to obtain a holistic description and explanation of the cases under study.
All 5 studies used qualitative interviews as the primary data-collection procedure. 15 , 17 - 19 , 22 Face-to-face, in-depth, and semi-structured interviews were conducted. The topics covered in the interviews included processes in the introduction of new care services and experiences of barriers and facilitators to collaborative work in general practices. Two studies did not specify the type of interviews conducted and did not report sample questions. 15 , 18
In 2 studies, qualitative observations were carried out. 17 , 18 During the observations, the physical design of the clinical patients’ rooms and office spaces was examined. 17 Hungerford et al 18 did not explain what information was collected during the observations. In both studies, the type of observation was not specified. Observations were generally recorded as field notes.
In 3 studies, various qualitative public documents were studied. 15 , 19 , 22 These documents included role description, education curriculum, governance frameworks, websites, and newspapers with information about the implementation of the role and general practice. Only 1 study failed to specify the type of document and the collected data. 15
In 1 study, qualitative documentation was investigated. 17 This included a review of dashboards (eg, provider productivity reports or provider quality dashboards in the electronic health record) and quality performance reports (eg, practice-wide or co-management team-wide performance reports).
This section describes the between/across methods, which involve employing both qualitative and quantitative data-collection procedures in the same study. 6 , 7 This procedure can also be denoted “methodologic triangulation.” 8 Subsequently, we present the individual data-collection procedures. In 3 studies, information on between/across triangulation was found. 16 , 20 , 21
Three studies used qualitative and quantitative data-collection procedures. One study combined face-to-face interviews, documentation, and self-assessments. 16 One study employed semi-structured interviews, direct observation, documents, and service records, 20 and another study combined face-to-face interviews, non-participant observation, documents, and questionnaires. 23
All 3 studies used qualitative interviews as the primary data-collection procedure. 16 , 20 , 23 Face-to-face and semi-structured interviews were conducted. In the interviews, data were collected on the introduction of new care services and experiences of barriers to and facilitators of collaborative work in general practices.
In 2 studies, direct and non-participant qualitative observations were conducted. 20 , 23 During the observations, the interaction between health professionals or the organization and the clinical context was observed. Observations were generally recorded as field notes.
In 2 studies, various qualitative public documents were examined. 20 , 23 These documents included role description, newspapers, websites, and practice documents (eg, flyers). In the documents, information on the role implementation and role description of NPs was collected.
In 1 study, qualitative individual journals were studied. 16 These included reflective journals from NPs, who performed the role in primary health care.
Only 1 study involved quantitative service records. 20 These service records were obtained from the primary care practices and the respective health authorities. They were collected before and after the implementation of an NP role to identify changes in patients’ access to health care, the volume of patients served, and patients’ use of acute care services.
In 2 studies, quantitative questionnaires were used to gather information about the teams’ satisfaction with collaboration. 16 , 21 In 1 study, 3 validated scales were used. The scales measured experience, satisfaction, and belief in the benefits of collaboration. 21 Psychometric performance indicators of these scales were provided. However, the time points of data collection were not specified; similarly, whether the questionnaires were completed online or by hand was not mentioned. A competency self-assessment tool was used in another study. 16 The assessment comprised 70 items and included topics such as health promotion, protection, disease prevention and treatment, the NP-patient relationship, the teaching-coaching function, the professional role, managing and negotiating health care delivery systems, monitoring and ensuring the quality of health care practice, and cultural competence. Psychometric performance indicators were provided. The assessment was completed online with 2 measurement time points (pre self-assessment and post self-assessment).
This section describes data-analysis triangulation, which involves the combination of 2 or more methods of analyzing data. 6 Subsequently, we present within-case analysis and cross-case analysis.
Three studies combined qualitative and quantitative methods of analysis. 16 , 20 , 21 Two studies involved deductive and inductive qualitative analysis, and qualitative data were analyzed thematically. 20 , 21 One used deductive qualitative analysis. 16 The method of analysis was not specified in the studies. Quantitative data were analyzed using descriptive statistics in 3 studies. 16 , 20 , 23 The descriptive statistics comprised the calculation of the mean, median, and frequencies.
Two studies combined deductive and inductive qualitative analysis, 19 , 22 and 2 studies only used deductive qualitative analysis. 15 , 18 Qualitative data were analyzed thematically in 1 study, 22 and data were treated with content analysis in the other. 19 The method of analysis was not specified in the 2 studies.
In 7 studies, a within-case analysis was performed. 15 - 20 , 22 Six studies used qualitative data for the within-case analysis, and 1 study employed qualitative and quantitative data. Data were analyzed separately, consecutively, or in parallel. The themes generated from qualitative data were compared and then summarized. The individual cases were presented mostly as a narrative description. Quantitative data were integrated into the qualitative description with tables and graphs. Qualitative and quantitative data were also presented as a narrative description.
Of the multiple-case studies, 5 carried out cross-case analyses. 15 - 17 , 20 , 22 Three studies described the cross-case analysis using qualitative data. Two studies reported a combination of qualitative and quantitative data for the cross-case analysis. In each multiple-case study, the individual cases were contrasted to identify the differences and similarities between the cases. One study did not specify whether a within-case or a cross-case analysis was conducted. 23
This section describes confirmation or contradiction through qualitative and quantitative data. 1 , 4 Qualitative and quantitative data were reported separately, with little connection between them. As a result, the conclusions on neither the comparisons nor the contradictions could be clearly determined.
In 3 studies, the consistency of the results of different types of qualitative data was highlighted. 16 , 19 , 21 In particular, documentation and interviews or interviews and observations were contrasted:
Both types of data showed that NPs and general practitioners wanted to have more time in common to discuss patient cases and engage in personal exchanges. 21 In addition, the qualitative and quantitative data confirmed the individual progression of NPs from less competent to more competent. 16 One study pointed out that qualitative and quantitative data obtained similar results for the cases. 20 For example, integrating NPs improved patient access by increasing appointment availability.
Although questionnaire results indicated that NPs and general practitioners experienced high levels of collaboration and satisfaction with the collaborative relationship, the qualitative results drew a more ambivalent picture of NPs’ and general practitioners’ experiences with collaboration. 21
The studies included in this scoping review evidenced various research questions. The recommended formats (ie, how or why questions) were not applied consistently. Therefore, no case study design should be applied because the research question is the major guide for determining the research design. 2 Furthermore, case definitions and designs were applied variably. The lack of standardization is reflected in differences in the reporting of these case studies. Generally, case study research is viewed as allowing much more freedom and flexibility. 5 , 24 However, this flexibility and the lack of uniform specifications lead to confusion.
Methodologic triangulation, as described in the literature, can be somewhat confusing as it can refer to either data-collection methods or research designs. 6 , 8 For example, methodologic triangulation can allude to qualitative and quantitative methods, indicating a paradigmatic connection. Methodologic triangulation can also point to qualitative and quantitative data-collection methods, analysis, and interpretation without specific philosophical stances. 6 , 8 Regarding “data-collection methods with no philosophical stances,” we would recommend using the wording “data source triangulation” instead. Thus, the demarcation between the method and the data-collection procedures will be clearer.
Yin 1 advocated the use of multiple sources of evidence so that a case or cases can be investigated more comprehensively and accurately. Most studies included multiple data-collection procedures. Five studies employed a variety of qualitative data-collection procedures, and 3 studies used qualitative and quantitative data-collection procedures (mixed methods). In contrast, no study contained 2 or more quantitative data-collection procedures. In particular, quantitative data-collection procedures—such as validated, reliable questionnaires, scales, or assessments—were not used exhaustively. The prerequisites for using multiple data-collection procedures are availability, the knowledge and skill of the researcher, and sufficient financial funds. 1 To meet these prerequisites, research teams consisting of members with different levels of training and experience are necessary. Multidisciplinary research teams need to be aware of the strengths and weaknesses of different data sources and collection procedures. 1
When using multiple data sources and analysis methods, it is necessary to present the results in a coherent manner. Although the importance of multiple data sources and analysis has been emphasized, 1 , 5 the description of triangulation has tended to be brief. Thus, traceability of the research process is not always ensured. The sparse description of the data-analysis triangulation procedure may be due to the limited number of words in publications or the complexity involved in merging the different data sources.
Only a few concrete recommendations regarding the operationalization of the data-analysis triangulation with the qualitative data process were found. 25 A total of 3 approaches have been proposed 25 : (1) the intuitive approach, in which researchers intuitively connect information from different data sources; (2) the procedural approach, in which each comparative or contrasting step in triangulation is documented to ensure transparency and replicability; and (3) the intersubjective approach, which necessitates a group of researchers agreeing on the steps in the triangulation process. For each case study, one of these 3 approaches needs to be selected, carefully carried out, and documented. Thus, in-depth examination of the data can take place. Farmer et al 25 concluded that most researchers take the intuitive approach; therefore, triangulation is not clearly articulated. This trend is also evident in our scoping review.
Few studies in this scoping review used a combination of qualitative and quantitative analysis. However, creating a comprehensive stand-alone picture of a case from both qualitative and quantitative methods is challenging. Findings derived from different data types may not automatically coalesce into a coherent whole. 4 O’Cathain et al 26 described 3 techniques for combining the results of qualitative and quantitative methods: (1) developing a triangulation protocol; (2) following a thread by selecting a theme from 1 component and following it across the other components; and (3) developing a mixed-methods matrix.
The most detailed description of the conducting of triangulation is the triangulation protocol. The triangulation protocol takes place at the interpretation stage of the research process. 26 This protocol was developed for multiple qualitative data but can also be applied to a combination of qualitative and quantitative data. 25 , 26 It is possible to determine agreement, partial agreement, “silence,” or dissonance between the results of qualitative and quantitative data. The protocol is intended to bring together the various themes from the qualitative and quantitative results and identify overarching meta-themes. 25 , 26
The “following a thread” technique is used in the analysis stage of the research process. To begin, each data source is analyzed to identify the most important themes that need further investigation. Subsequently, the research team selects 1 theme from 1 data source and follows it up in the other data source, thereby creating a thread. The individual steps of this technique are not specified. 26 , 27
A mixed-methods matrix is used at the end of the analysis. 26 All the data collected on a defined case are examined together in 1 large matrix, paying attention to cases rather than variables or themes. In a mixed-methods matrix (eg, a table), the rows represent the cases for which both qualitative and quantitative data exist. The columns show the findings for each case. This technique allows the research team to look for congruency, surprises, and paradoxes among the findings as well as patterns across multiple cases. In our review, we identified only one of these 3 approaches in the study by Roots and MacDonald. 20 These authors mentioned that a causal network analysis was performed using a matrix. However, no further details were given, and reference was made to a later publication. We could not find this publication.
Because it focused on the implementation of NPs in primary health care, the setting of this scoping review was narrow. However, triangulation is essential for research in this area. This type of research was found to provide a good basis for understanding methodologic and data-analysis triangulation. Despite the lack of traceability in the description of the data and methodological triangulation, we believe that case studies are an appropriate design for exploring new nursing roles in existing health care systems. This is evidenced by the fact that case study research is widely used in many social science disciplines as well as in professional practice. 1 To strengthen this research method and increase the traceability in the research process, we recommend using the reporting guideline and reporting checklist by Rodgers et al. 9 This reporting checklist needs to be complemented with methodologic and data-analysis triangulation. A procedural approach needs to be followed in which each comparative step of the triangulation is documented. 25 A triangulation protocol or a mixed-methods matrix can be used for this purpose. 26 If there is a word limit in a publication, the triangulation protocol or mixed-methods matrix needs to be identified. A schematic representation of methodologic and data-analysis triangulation in case studies can be found in Figure 2 .
Schematic representation of methodologic and data-analysis triangulation in case studies (own work).
This study suffered from several limitations that must be acknowledged. Given the nature of scoping reviews, we did not analyze the evidence reported in the studies. However, 2 reviewers independently reviewed all the full-text reports with respect to the inclusion criteria. The focus on the primary care setting with NPs (master’s degree) was very narrow, and only a few studies qualified. Thus, possible important methodological aspects that would have contributed to answering the questions were omitted. Studies describing the triangulation of 2 or more quantitative data-collection procedures could not be included in this scoping review due to the inclusion and exclusion criteria.
Given the various processes described for methodologic and data-analysis triangulation, we can conclude that triangulation in case studies is poorly standardized. Consequently, the traceability of the research process is not always given. Triangulation is complicated by the confusion of terminology. To advance case study research in nursing, we encourage authors to reflect critically on methodologic and data-analysis triangulation and use existing tools, such as the triangulation protocol or mixed-methods matrix and the reporting guideline checklist by Rodgers et al, 9 to ensure more transparent reporting.
Acknowledgments.
The authors thank Simona Aeschlimann for her support during the screening process.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Supplemental Material: Supplemental material for this article is available online.
Definition of double jeopardy, criminal cases and double jeopardy law, eligibility for double jeopardy protection, state vs. federal double jeopardy protection, attachment of double jeopardy, termination of double jeopardy, double jeopardy after acquittal.
In the 1932 case of Blockburger v United States , the defendant had been indicted on five separate counts of drug trafficking , all of which involved the sale of morphine to a single purchaser. The jury found the defendant guilty only on counts two, three, and five. Count two charged the defendant with the sale of ten grains of morphine not in the original form or package; count three involved the sale of eight grains of morphine not in the original form or packaging on a different day; and the sale in count five did not involve a written order. The defendant was sentenced to serve five years in prison for each conviction, to be served consecutively.
Police officer Scott was indicted on three counts of distribution of narcotics . During the trial, Scott asked that the case be dismissed, claiming his defense had been hindered by a pre- indictment delay. The court agreed and dismissed the first two counts, submitting the third count to the jury, which returned a verdict of not guilty.
State of Georgia v James Arthur Williams
Dual sovereignty doctrine, related legal terms and issues.
Original Author: Rebecca Mastey
HPI: 8 year old female brought in by mother for evaluation of wandering eye and double vision. She was noted to have eye misalignment at age 1 and age 2 but exams were limited at that time. The patient had not followed with ophthalmology since then. Recently, the right eye has been wandering more frequently and has been noticed by teachers and students at school. She also gets double vision when she looks up and has adapted a slight chin up posture.
Past Ocular History: Intermittent exotropia noted at age 1 and 2
Ocular Medications: None
Past Medical History: None
Surgical History: None
Past Family Ocular History: None
Social History: Lives with parents and older sister. Normal growth and development for age.
Medications: Allegra
Allergies: NKDA, seasonal allergies
ROS: Denied headache, denied recent illness Ocular Exam
Visual Acuity (cc): OD: 20/50 +1 OS: 20/50 +3
OD: Dark 8, Light 6, Round, Risk, No APD OS: Dark 8, Light 6, Round, Risk, No APD
Extraocular Movements: OD: -3 to supraduction, otherwise full OS: Full
Confrontational Visual Fields: OD: Full OS: Full Slit Lamp Exam:
External | Normal | Normal |
Lids and Lashes | Normal | Normal |
Conjunctiva/Sclera | White and quiet | White and quiet |
Cornea | Clear | Clear |
Anterior Chamber | Deep and quiet | Deep and quiet |
Iris | Normal | Normal |
Lens | Clear | Clear |
Anterior Vitreous | Normal | Normal |
Disc | Normal | Normal |
C/D Ratio | 0.2 | 0.2 |
Macula | Normal | Normal |
Vessels | Normal | Normal |
Periphery |
Imaging/additional tests: Sensorimotor exam:
Diagnosis: Monocular elevation deficiency
Differential Diagnoses: The patient has monocular elevation deficiency (MED) in which there is a deficiency of one eye to elevate in all directions. It is likely congenital although not diagnosed until this visit due to limited exams on prior visits due to age. Other diagnoses on the differential include Brown syndrome, Duane syndrome, acquired elevation deficiency, Superior division of CN3 palsy, and congenital fibrosis of EOM. The patient history, as well as the sensorimotor exam and ductions help better understand the pattern and assist in narrowing the diagnosis to MED as the elevation deficit is the same in both abduction and adduction.
Definition: Moncular elevation deficiency (MED) is defined as a limitation of elevation in one eye with normal movements in all other gazes. The superior limitation must be similar in both abduction and adduction. MED is relatively rare. The incidence of strabismus overall is about 5% and of these patients the incidence of MED is 0.5%. It is most commonly congenital although can be acquired. MED was formerly called “double elevator palsy” referring to the two ipsilateral elevator muscles (inferior oblique and superior rectus), however, this is becoming less widely used and replaced with MED. The pathophysiology is still poorly understood but leading theories include: superior rectus paresis, inferior rectus restriction, and/or unilateral supranuclear abnormality.
Examination: MED often presents with vertical misalignment of the eyes which can cause an abnormal head posture (AHP), binocular diplopia, or amblyopia. Patients often adapt an AHP to offset diplopia that they notice. This adaptation helps the patient use both eyes together and therefore can prevent amblyopia. MED is a clinical diagnosis that is most notable on ductions and sensorimotor exam. There will be a limitation of elevation in the affected eye that is similar in all areas of upgaze. There can be ptosis and amblyopia in the affected eye although this is not required for the diagnosis. CT/MRI can rule out other etiologies since imaging is usually normal in MED.
Treatment: As with any misalignment of the eyes, any underlying refractive error should be corrected with glasses and if there is amblyopia this should be addressed as well. This patient does not have diplopia or significant misalignment in primary gaze and therefore monitoring is sufficient for now. Close monitoring for any change in these symptoms (ie worsening diplopia, worsening alignment in primary, worsening head position, or loss of stereovision) would warrant surgical intervention. Surgically, the goal would be to improve the position of the affected eye in primary gaze and increase the field of binocular vision.
How do you differentiate between MED and Brown Syndrome? b. Brown Syndrome has elevation deficit in adduction and MED has elevation deficit in adduction and abduction Correct answer is B. MED has elevation deficit that is comparable in all fields of upgaze (abduction and adduction) whereas Brown syndrome has an elevation deficit only in adduction. True or False: Patients with MED who adapt a head up posture is a sign of amblyopia This statement is false. Patients who adapt a head up posture are doing so in order to use both eyes together. This is actually a reassuring sign of fusion, preserving stereovision, and avoiding amblyopia. If the affected eye is amblyopic, the patient may not adapt a head up posture as they are not using the eyes together. Which is a suggested cause of MED? d. All the above Correct answer is D. The pathophysiology is still poorly understood and all of the above causes could be the underlying reason for MED in a given patient. If the patient warrants surgical intervention, it is especially important to try and further evaluate which of these three is the cause in order to perform the correct surgerical intervention.
References/Resources:
Ophthalmic case study 1, ophthalmic case study 10, ophthalmic case study 2, ophthalmic case study 11, ophthalmic case study 3, ophthalmic case study 12, ophthalmic case study 4, ophthalmic case study 13, ophthalmic case study 5, ophthalmic case study 14, ophthalmic case study 6, ophthalmic case study 15, ophthalmic case study 7, ophthalmic case study 16, ophthalmic case study 8, ophthalmic case study 17, ophthalmic case study 9, ophthalmic case study 18.
https://educationhub.blog.gov.uk/2024/08/20/gcse-results-day-2024-number-grading-system/
Thousands of students across the country will soon be finding out their GCSE results and thinking about the next steps in their education.
Here we explain everything you need to know about the big day, from when results day is, to the current 9-1 grading scale, to what your options are if your results aren’t what you’re expecting.
GCSE results day will be taking place on Thursday the 22 August.
The results will be made available to schools on Wednesday and available to pick up from your school by 8am on Thursday morning.
Schools will issue their own instructions on how and when to collect your results.
The shift to the numerical grading system was introduced in England in 2017 firstly in English language, English literature, and maths.
By 2020 all subjects were shifted to number grades. This means anyone with GCSE results from 2017-2020 will have a combination of both letters and numbers.
The numerical grading system was to signal more challenging GCSEs and to better differentiate between students’ abilities - particularly at higher grades between the A *-C grades. There only used to be 4 grades between A* and C, now with the numerical grading scale there are 6.
The grades are ranked from 1, the lowest, to 9, the highest.
The grades don’t exactly translate, but the two grading scales meet at three points as illustrated below.
The bottom of grade 7 is aligned with the bottom of grade A, while the bottom of grade 4 is aligned to the bottom of grade C.
Meanwhile, the bottom of grade 1 is aligned to the bottom of grade G.
If your results weren’t what you were expecting, firstly don’t panic. You have options.
First things first, speak to your school or college – they could be flexible on entry requirements if you’ve just missed your grades.
They’ll also be able to give you the best tailored advice on whether re-sitting while studying for your next qualifications is a possibility.
If you’re really unhappy with your results you can enter to resit all GCSE subjects in summer 2025. You can also take autumn exams in GCSE English language and maths.
Speak to your sixth form or college to decide when it’s the best time for you to resit a GCSE exam.
Entry requirements vary depending on the college and course. Ask your school for advice, and call your college or another one in your area to see if there’s a space on a course you’re interested in.
Apprenticeships combine a practical training job with study too. They’re open to you if you’re 16 or over, living in England, and not in full time education.
As an apprentice you’ll be a paid employee, have the opportunity to work alongside experienced staff, gain job-specific skills, and get time set aside for training and study related to your role.
You can find out more about how to apply here .
The National Career Service is a free resource that can help you with your career planning. Give them a call to discuss potential routes into higher education, further education, or the workplace.
Whatever your results, if you want to find out more about all your education and training options, as well as get practical advice about your exam results, visit the National Careers Service page and Skills for Careers to explore your study and work choices.
You may also be interested in:
Tags: GCSE grade equivalent , gcse number grades , GCSE results , gcse results day 2024 , gsce grades old and new , new gcse grades
Share this page, related content and links, about the education hub.
The Education Hub is a site for parents, pupils, education professionals and the media that captures all you need to know about the education system. You’ll find accessible, straightforward information on popular topics, Q&As, interviews, case studies, and more.
Please note that for media enquiries, journalists should call our central Newsdesk on 020 7783 8300. This media-only line operates from Monday to Friday, 8am to 7pm. Outside of these hours the number will divert to the duty media officer.
Members of the public should call our general enquiries line on 0370 000 2288.
Follow us on social media, search by date.
M | T | W | T | F | S | S |
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | |||
5 | 7 | 8 | 9 | 10 | 11 | |
13 | 14 | 15 | 16 | 17 | 18 | |
21 | 22 | 23 | 24 | 25 | ||
26 | 27 | 29 | 30 | 31 |
COMMENTS
A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.
In this type of research design, a case can be an individual, an event, or an entity, as determined by the research questions. There are two variants of the case study: the single-case study and the multiple-case study. The former design can be used to study and understand an unusual case, a critical case, a longitudinal case, or a revelatory case.
Case study methodology can entail the study of one or more "cases," that could be described as instances, examples, or settings where the problem or phenomenon can be examined. The researcher is tasked with defining the parameters of the case, that is, what is included and excluded.
Abstract Qualitative case study methodology enables researchers to conduct an in-depth exploration of intricate phenomena within some specific context. By keeping in mind research students, this article presents a systematic step-by-step guide to conduct a case study in the business discipline. Research students belonging to said discipline face issues in terms of clarity, selection, and ...
What is a case study? Whereas quantitative methods look at phenomena at scale, case study research looks at a concept or phenomenon in considerable detail. While analyzing a single case can help understand one perspective regarding the object of research inquiry, analyzing multiple cases can help obtain a more holistic sense of the topic or issue.
A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.
A case study is a detailed study of a specific subject, such as a person, group, place, event, organisation, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research. A case study research design usually involves qualitative methods, but quantitative methods are sometimes also used.
The multiple case study design is a valuable qualitative research tool in studying the links between the personal, social, behavioral, psychological, organizational, cultural, and environmental factors that guide organizational and leadership development. Case study research is essential for the in-depth study of participants' perspectives on ...
Résumé. Case study is a common methodology in the social sciences (management, psychology, science of education, political science, sociology). A lot of methodological papers have been dedicated to case study but, paradoxically, the question "what is a case?" has been less studied.
Researchers, economists, and others frequently use case studies to answer questions across a wide spectrum of disciplines, from analyzing decades of climate data for conservation efforts to developing new theoretical frameworks in psychology. Learn about the different types of case studies, their benefits, and examples of successful case studies.
Abstract A case study is one of the most commonly used methodologies of social research. This article attempts to look into the various dimensions of a case study research strategy, the different epistemological strands which determine the particular case study type and approach adopted in the field, discusses the factors which can enhance the effectiveness of a case study research, and the ...
What is a case study? Read here to learn the case study definition, find case study examples, and understand how to write a case study.
A case study is defined as an in-depth analysis of a particular subject, often a real-world situation, individual, group, or organization. It is a research method that involves the comprehensive examination of a specific instance to gain a better understanding of its complexities, dynamics, and context.
Abstract This article presents a reconstructed definition of the case study approach to research. This definition emphasizes comparative politics, which has been closely linked to this method since its creation. The article uses this definition as a basis to explore a series of contrasts between cross-case study and case study research.
In social work research, case study is an empowering initiative to understand and enable the participant or partner or collaborator to understand in their context, and gain right perspective of the person, event, or situation. It provides stronger inputs to bring effective outputs in person/s or situations.
The Encyclopedia of Case Study Research provides a compendium on the important methodological issues in conducting case study research and explores both the strengths and weaknesses of different paradigmatic approaches. These two volumes focus on the distinctive characteristics of case study research and its place within and alongside other research methodologies.
A case study is an in-depth analysis of one individual or group. Learn more about how to write a case study, including tips and examples, and its importance in psychology.
A case study is a detailed description and assessment of a specific situation in the real world, often for the purpose of deriving generalizations and other insights about the subject of the case study. Case studies can be about an individual, a group of people, an organization, or an event, and they are used in multiple fields, including business, health care, anthropology, political science ...
A double-blind study withholds each subject's group assignment from both the participant and the researcher performing the experiment. If participants know which group they are assigned to, there is a risk that they might change their behavior in a way that would influence the results. This can lead to a few types of research bias ...
We also propose a more precise and encompassing definition that reconciles various definitions of case study research: case study is a transparadigmatic and transdisciplinary heuristic that involves the careful delineation of the phenomena for which evidence is being collected (event, concept, program, process, etc.).
Case studies are recommended to evaluate the implementation of new roles in (primary) health care, such as that of NPs. 1,5 Case studies on new role implementation can generate a unique and in-depth understanding of specific roles (individual), teams (smaller groups), family practices or similar institutions (organization), and social and ...
However, the use of case studies as research methodology entails certain challenges. We argue that one of the biggest challenges is the case selection bias when conducting multiple-case studies.
Definition of a Double-Blind Study. In scientific research, participants are often randomly assigned to one of two groups. In the treatment or experimental group, participants are given a ...
Double jeopardy defined and explained with examples. Double jeopardy is subjecting a person to a second trial or punishment for the same offence or crime.
MCW Ophthalmic Case Study 19: An 8-year-old female brought in by mother for evaluation of wandering eye and double vision. ... Case Study 19 - CC: Wandering Eye and Double Vision. Original Author: Rebecca Mastey. all. Patient Visit. ... Definition: Moncular elevation deficiency (MED) is defined as a limitation of elevation in one eye with ...
Giggle's legal team argued throughout the case that sex is a biological concept. They freely concede that Tickle was discriminated against - but on the grounds of sex, rather than gender identity.
You'll find accessible, straightforward information on popular topics, Q&As, interviews, case studies, and more. Please note that for media enquiries, journalists should call our central Newsdesk on 020 7783 8300. This media-only line operates from Monday to Friday, 8am to 7pm. Outside of these hours the number will divert to the duty media ...