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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

Abstract:

During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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Authors: Natalia Podkhodova, Olga Sheremeteva, Mariia Soldaeva

Abstract:

Creating favourable conditions for students’ comprehension of mathematical content is one of the primary problems in teaching mathematics in secondary school. The fact of comprehension includes the ability to build a working situational model and thus becomes an important means of solving mathematical problems. This paper describes a holistic approach to teaching mathematics designed to address the primary challenges of such teaching; specifically, the challenge of students’ comprehension. Essentially, this approach consists of (1) establishing links between the attributes of the notion: the sense, the meaning, and the term; (2) taking into account the components of student’s subjective experience—value-based emotions, contextual, procedural and communicative—during the educational process; (3) linking together different ways to present mathematical information; (4) identifying and leveraging the relationships between real, perceptual and conceptual (scientific) mathematical spaces by applying real-life situational modelling. The article describes approaches to the practical use of these foundational concepts. Identifying how proposed methods and techniques influence understanding of material used in teaching mathematics was the primary goal. The study included an experiment in which 256 secondary school students took part: 142 in the study group and 114 in the control group. All students in these groups had similar levels of achievement in math and studied math under the same curriculum. In the course of the experiment, comprehension of two topics — “Derivative” and “Trigonometric functions”—was evaluated. Control group participants were taught using traditional methods. Students in the study group were taught using the holistic method: under teacher’s guidance, they carried out assignments designed to establish linkages between notion’s characteristics, to convert information from one mode of presentation to another, as well as assignments that required the ability to operate with all modes of presentation. Identification, accounting for and transformation of subjective experience were associated with methods of stimulating the emotional value component of the studied mathematical content (discussions of lesson titles, assignments aimed to create study dominants, performing theme-related physical exercise ...) The use of techniques that forms inter-subject notions based on linkages between, perceptual real and mathematical conceptual spaces proved to be of special interest to the students. Results of the experiment were analysed by presenting students in each of the groups with a final test in each of the studied topics. The test included assignments that required building real situational models. Statistical analysis was used to aggregate test results. Pierson criterion x2 was used to reveal statistics significance of results (pass-fail the modelling test). Significant difference of results was revealed (p < 0.001), which allowed to conclude that students in the study group showed better comprehension of mathematical information than those in the control group. The total number of completed assignments of each student was analysed as well, with average results calculated for each group. Statistical significance of result differences against the quantitative criterion (number of completed assignments) was determined using Student’s t-test, which showed that students in the study group completed significantly more assignments than those in the control group (p = 0.0001). Authors thus come to the conclusion that suggested increase in the level of comprehension of study material took place as a result of applying implemented methods and techniques.

Keywords: Comprehension of mathematical content, holistic approach to teaching mathematics in secondary school, subjective experience, technology of the formation of inter-subject notions.

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