The impact of curricular changes on BSCN students' clinical learning outcomes

Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Nurse education in practice 2016-11, Vol.21, p.51-58
Hauptverfasser: Landeen, Janet, Carr, Donna, Culver, Kirsten, Martin, Lynn, Matthew-Maich, Nancy, Noesgaard, Charlotte, Beney-Gadsby, Larissa
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 58
container_issue
container_start_page 51
container_title Nurse education in practice
container_volume 21
creator Landeen, Janet
Carr, Donna
Culver, Kirsten
Martin, Lynn
Matthew-Maich, Nancy
Noesgaard, Charlotte
Beney-Gadsby, Larissa
description Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology. Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.
doi_str_mv 10.1016/j.nepr.2016.09.010
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1866658844</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1471595316301032</els_id><sourcerecordid>1866658844</sourcerecordid><originalsourceid>FETCH-LOGICAL-c461t-a510d2e6417ec521b479c96476274bf12dba0d2e38e91bde6aa13c81f06f867c3</originalsourceid><addsrcrecordid>eNqN0U1v1DAQBmALgegH_IEekCUO9JLgsR07kbiUFbRIpT1QzpbjTFqvEnuxEyT-PV5t6YED4uQ5PPNK45eQM2A1MFDvt3XAXap5mWvW1QzYM3IMrRZVw7l4XmapoWq6RhyRk5y3rECm1UtyxLWWINvumHy9e0Dq5511C40jdWtK3q2TTdQ92HCPmcZAP37b3NC8rAOGJb-jbvLBOzvRCW0KPtzTuC4uzphfkRejnTK-fnxPyffPn-42V9X17eWXzcV15aSCpbINsIGjkqDRNRx6qTvXKakV17IfgQ-93QPRYgf9gMpaEK6FkamxVdqJU3J-yN2l-GPFvJjZZ4fTZAPGNRtolVJN20r5H1Q0EhhrRKFv_6LbuKZQDilKask7LnhR_KBcijknHM0u-dmmXwaY2fditmbfi9n3YlhnSi9l6c1j9NrPODyt_CmigA8HgOXbfnpMJjuPweHgE7rFDNH_K_8330-ctg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1847429232</pqid></control><display><type>article</type><title>The impact of curricular changes on BSCN students' clinical learning outcomes</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Applied Social Sciences Index &amp; Abstracts (ASSIA)</source><source>ProQuest Central UK/Ireland</source><creator>Landeen, Janet ; Carr, Donna ; Culver, Kirsten ; Martin, Lynn ; Matthew-Maich, Nancy ; Noesgaard, Charlotte ; Beney-Gadsby, Larissa</creator><creatorcontrib>Landeen, Janet ; Carr, Donna ; Culver, Kirsten ; Martin, Lynn ; Matthew-Maich, Nancy ; Noesgaard, Charlotte ; Beney-Gadsby, Larissa</creatorcontrib><description>Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology. Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.</description><identifier>ISSN: 1471-5953</identifier><identifier>EISSN: 1873-5223</identifier><identifier>DOI: 10.1016/j.nepr.2016.09.010</identifier><identifier>PMID: 27741489</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Canada ; Changes ; Clinical decision making ; Clinical nursing ; Clinical placements ; Clinical training ; College professors ; College students ; Court decisions ; Curricula ; Curriculum - trends ; Curriculum change ; Curriculum evaluation ; Decision making ; Education, Nursing, Baccalaureate - methods ; Education, Nursing, Baccalaureate - standards ; Educational Innovation ; Faculty Development ; Focus Groups ; Humans ; Learning ; Learning Curve ; Learning Processes ; Medical education ; Nursing ; Nursing education ; Outcome and Process Assessment (Health Care) - methods ; Outcomes of Education ; Pathophysiology ; Patient-centered care ; Perceptions ; Problem based learning ; Professional practice ; Qualitative Research ; Quality of education ; Renewal ; Student Attitudes ; Students, Nursing - psychology ; Studies ; Teaching ; Teaching Methods</subject><ispartof>Nurse education in practice, 2016-11, Vol.21, p.51-58</ispartof><rights>2016 The Authors</rights><rights>Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><rights>2016. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-a510d2e6417ec521b479c96476274bf12dba0d2e38e91bde6aa13c81f06f867c3</citedby><cites>FETCH-LOGICAL-c461t-a510d2e6417ec521b479c96476274bf12dba0d2e38e91bde6aa13c81f06f867c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1847429232?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,12827,27905,27906,30980,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27741489$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Landeen, Janet</creatorcontrib><creatorcontrib>Carr, Donna</creatorcontrib><creatorcontrib>Culver, Kirsten</creatorcontrib><creatorcontrib>Martin, Lynn</creatorcontrib><creatorcontrib>Matthew-Maich, Nancy</creatorcontrib><creatorcontrib>Noesgaard, Charlotte</creatorcontrib><creatorcontrib>Beney-Gadsby, Larissa</creatorcontrib><title>The impact of curricular changes on BSCN students' clinical learning outcomes</title><title>Nurse education in practice</title><addtitle>Nurse Educ Pract</addtitle><description>Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology. Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.</description><subject>Canada</subject><subject>Changes</subject><subject>Clinical decision making</subject><subject>Clinical nursing</subject><subject>Clinical placements</subject><subject>Clinical training</subject><subject>College professors</subject><subject>College students</subject><subject>Court decisions</subject><subject>Curricula</subject><subject>Curriculum - trends</subject><subject>Curriculum change</subject><subject>Curriculum evaluation</subject><subject>Decision making</subject><subject>Education, Nursing, Baccalaureate - methods</subject><subject>Education, Nursing, Baccalaureate - standards</subject><subject>Educational Innovation</subject><subject>Faculty Development</subject><subject>Focus Groups</subject><subject>Humans</subject><subject>Learning</subject><subject>Learning Curve</subject><subject>Learning Processes</subject><subject>Medical education</subject><subject>Nursing</subject><subject>Nursing education</subject><subject>Outcome and Process Assessment (Health Care) - methods</subject><subject>Outcomes of Education</subject><subject>Pathophysiology</subject><subject>Patient-centered care</subject><subject>Perceptions</subject><subject>Problem based learning</subject><subject>Professional practice</subject><subject>Qualitative Research</subject><subject>Quality of education</subject><subject>Renewal</subject><subject>Student Attitudes</subject><subject>Students, Nursing - psychology</subject><subject>Studies</subject><subject>Teaching</subject><subject>Teaching Methods</subject><issn>1471-5953</issn><issn>1873-5223</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqN0U1v1DAQBmALgegH_IEekCUO9JLgsR07kbiUFbRIpT1QzpbjTFqvEnuxEyT-PV5t6YED4uQ5PPNK45eQM2A1MFDvt3XAXap5mWvW1QzYM3IMrRZVw7l4XmapoWq6RhyRk5y3rECm1UtyxLWWINvumHy9e0Dq5511C40jdWtK3q2TTdQ92HCPmcZAP37b3NC8rAOGJb-jbvLBOzvRCW0KPtzTuC4uzphfkRejnTK-fnxPyffPn-42V9X17eWXzcV15aSCpbINsIGjkqDRNRx6qTvXKakV17IfgQ-93QPRYgf9gMpaEK6FkamxVdqJU3J-yN2l-GPFvJjZZ4fTZAPGNRtolVJN20r5H1Q0EhhrRKFv_6LbuKZQDilKask7LnhR_KBcijknHM0u-dmmXwaY2fditmbfi9n3YlhnSi9l6c1j9NrPODyt_CmigA8HgOXbfnpMJjuPweHgE7rFDNH_K_8330-ctg</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Landeen, Janet</creator><creator>Carr, Donna</creator><creator>Culver, Kirsten</creator><creator>Martin, Lynn</creator><creator>Matthew-Maich, Nancy</creator><creator>Noesgaard, Charlotte</creator><creator>Beney-Gadsby, Larissa</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201611</creationdate><title>The impact of curricular changes on BSCN students' clinical learning outcomes</title><author>Landeen, Janet ; Carr, Donna ; Culver, Kirsten ; Martin, Lynn ; Matthew-Maich, Nancy ; Noesgaard, Charlotte ; Beney-Gadsby, Larissa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-a510d2e6417ec521b479c96476274bf12dba0d2e38e91bde6aa13c81f06f867c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Canada</topic><topic>Changes</topic><topic>Clinical decision making</topic><topic>Clinical nursing</topic><topic>Clinical placements</topic><topic>Clinical training</topic><topic>College professors</topic><topic>College students</topic><topic>Court decisions</topic><topic>Curricula</topic><topic>Curriculum - trends</topic><topic>Curriculum change</topic><topic>Curriculum evaluation</topic><topic>Decision making</topic><topic>Education, Nursing, Baccalaureate - methods</topic><topic>Education, Nursing, Baccalaureate - standards</topic><topic>Educational Innovation</topic><topic>Faculty Development</topic><topic>Focus Groups</topic><topic>Humans</topic><topic>Learning</topic><topic>Learning Curve</topic><topic>Learning Processes</topic><topic>Medical education</topic><topic>Nursing</topic><topic>Nursing education</topic><topic>Outcome and Process Assessment (Health Care) - methods</topic><topic>Outcomes of Education</topic><topic>Pathophysiology</topic><topic>Patient-centered care</topic><topic>Perceptions</topic><topic>Problem based learning</topic><topic>Professional practice</topic><topic>Qualitative Research</topic><topic>Quality of education</topic><topic>Renewal</topic><topic>Student Attitudes</topic><topic>Students, Nursing - psychology</topic><topic>Studies</topic><topic>Teaching</topic><topic>Teaching Methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Landeen, Janet</creatorcontrib><creatorcontrib>Carr, Donna</creatorcontrib><creatorcontrib>Culver, Kirsten</creatorcontrib><creatorcontrib>Martin, Lynn</creatorcontrib><creatorcontrib>Matthew-Maich, Nancy</creatorcontrib><creatorcontrib>Noesgaard, Charlotte</creatorcontrib><creatorcontrib>Beney-Gadsby, Larissa</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index &amp; Abstracts (ASSIA)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Education Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Nurse education in practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Landeen, Janet</au><au>Carr, Donna</au><au>Culver, Kirsten</au><au>Martin, Lynn</au><au>Matthew-Maich, Nancy</au><au>Noesgaard, Charlotte</au><au>Beney-Gadsby, Larissa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of curricular changes on BSCN students' clinical learning outcomes</atitle><jtitle>Nurse education in practice</jtitle><addtitle>Nurse Educ Pract</addtitle><date>2016-11</date><risdate>2016</risdate><volume>21</volume><spage>51</spage><epage>58</epage><pages>51-58</pages><issn>1471-5953</issn><eissn>1873-5223</eissn><abstract>Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology. Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>27741489</pmid><doi>10.1016/j.nepr.2016.09.010</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1471-5953
ispartof Nurse education in practice, 2016-11, Vol.21, p.51-58
issn 1471-5953
1873-5223
language eng
recordid cdi_proquest_miscellaneous_1866658844
source MEDLINE; Elsevier ScienceDirect Journals; Applied Social Sciences Index & Abstracts (ASSIA); ProQuest Central UK/Ireland
subjects Canada
Changes
Clinical decision making
Clinical nursing
Clinical placements
Clinical training
College professors
College students
Court decisions
Curricula
Curriculum - trends
Curriculum change
Curriculum evaluation
Decision making
Education, Nursing, Baccalaureate - methods
Education, Nursing, Baccalaureate - standards
Educational Innovation
Faculty Development
Focus Groups
Humans
Learning
Learning Curve
Learning Processes
Medical education
Nursing
Nursing education
Outcome and Process Assessment (Health Care) - methods
Outcomes of Education
Pathophysiology
Patient-centered care
Perceptions
Problem based learning
Professional practice
Qualitative Research
Quality of education
Renewal
Student Attitudes
Students, Nursing - psychology
Studies
Teaching
Teaching Methods
title The impact of curricular changes on BSCN students' clinical learning outcomes
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T14%3A01%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20impact%20of%20curricular%20changes%20on%20BSCN%20students'%20clinical%20learning%20outcomes&rft.jtitle=Nurse%20education%20in%20practice&rft.au=Landeen,%20Janet&rft.date=2016-11&rft.volume=21&rft.spage=51&rft.epage=58&rft.pages=51-58&rft.issn=1471-5953&rft.eissn=1873-5223&rft_id=info:doi/10.1016/j.nepr.2016.09.010&rft_dat=%3Cproquest_cross%3E1866658844%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1847429232&rft_id=info:pmid/27741489&rft_els_id=S1471595316301032&rfr_iscdi=true