Spiritual_Wellness_Holistic_Health_and_the_Practic

176 Philosophical Foundations of Health Education
an understanding of the challenge and its impact. Stated more simply, the need is to
become aware and informed. Both methodological approaches, demonstrating statistical
significance, addressed and emphasized both the “ why ” and “ how ” of lifestyle
issues. In doing so, they seemed to have provided relevant and adequate information
to raise the awareness of participants initially in stages 1 and 2. This, by itself, may
have precipitated the observed alterations (Robbins et al., 1997). However, comparatively,
problem - based learning places a greater emphasis for learning on the student,
has the instructor function as a facilitator rather than a provider of knowledge, and
requires the student to develop and refine critical thinking, creative problem - solving,
analytical skills and other desirable learning characteristics (Garman, 1999). By working
through the process of problem - based learning and refining these aforementioned
straits, students may develop a better understanding of issues, of available resources
supporting enhanced behavior, and may have greater opportunities for self - evaluation
and reflection. Consequently, by engaging in more numerous elements of the “ processes
of change ” (Prochaska, DiClemente et al., 1994), effectiveness of the instructional
methodology may be comparatively stronger. With the growing emphasis, in
higher education, on “ learning ” rather than simply “ teaching ” (Barr & Tagg, 1995),
this may warrant additional investigation.
While these data suggest both lecture recitation and problem - based methodological
approaches to instruction can influence early stage of change position, the presence
of several confounding factors necessitates a conservative approach to conclusions.
While the use of self reported data has been supported in similar research (Curry et al.,
1992; Mhurchu, Margetts, & Speller, 1997), the recognition that its use may interject
a bias into the findings cannot be discounted. Also potentially influencing results may
be the impact of unacknowledged personal exposure to evolving or active lifestyle
related illness, which served as a major catharsis for change. Data (Burton, Shapiro, &
German, 1999) suggested that these experiences frequently provide significant impetus
for behavioral change. These variables were not assessed within the scope of the
investigation. Though not acknowledged by any of the subjects, the potential influence
of these occurrences can ’ t be ignored as a strong impetus for altering behavior.
Additionally, concluding that “ distance learning ” lacks the ability to impact position
in the initial levels of the “ stage of change ” model needs to be viewed cautiously due
to the small number of participants ( n 21) engaged with that instructional approach.
While conventional practice frequently accepts an experimental cell of 20 (Bruning &
Kintz, 1977), reduced numbers will affect the power of the statistical tests to a degree
that differences may not be detected (Bruning & Kintz, 1977). A post hoc evaluation
of the sample size within the distance learning cell, utilizing a desired power of 0.95
and both a moderate (0.50) and conservative (0.80) estimation of the “ standard effect
size ” (Cohen, 1988) suggests a cautious approach to interpreting distance learning
ineffectiveness may be warranted. Finally, the most frequently occurring post intervention
foci differed from initial data with 75.9 percent (PBL) and 78.6 percent (DL)
concluding the inquiry by addressing tobacco usage habits. Though not statistically
significant, these changes suggest two possible occurrences: either participants engaged