s2fieldsofstudy: Education Psychology

text:
PRESCHOOL EDUCATORS’ VIEWS ON SUPPORTING CHILDREN WITH MENTAL HEALTH ISSUES IN EARLY CHILDHOOD EDUCATION

Schools are considered the ideal place to provide mental health services. International literature highlights the importance of early detection of mental health problems and the implementation of preventive interventions in school context. The present study aims to explore preschool teachers’ views regarding the involvement of the school in the prevention and treatment of students' mental health problems in preschool education and the ways in which the school can assist in supporting students. The sample of the research consisted of 115 preschool teachers. The method of data collection was a questionnaire. The results of the research showed that the majority of teachers believe that the school should be involved in the prevention and treatment of children's mental health problems. In addition, they defined the characteristics of mental health in preschool children. Simultaneously, they argue that enhancing a child's self-confidence, developing positive interpersonal relationships between teachers and students and collaborative relationships with parents are the main ways in which the school can support students with mental health problems. Research findings could be utilized in designing mental health promotion interventions.

Introduction
The school environment is an important area for promoting children's mental health. Simultaneously, the relevant literature emphasizes the importance of teachers' active role in promoting mental health (Elias & Weissberg, 2000). Mental health is defined as a state of emotional and social well-being in which the individuals are aware of their potential, can cope and manage the normal stresses of life, can work productively and efficiently, i Correspondence: email enikolaou@aegean.gr and are able to contribute to the community (WHO, 2004). Mental health is directly related to health and quality of life.
According to World Health Organization, mental health promotion is a broader concept than the prevention of mental disorders. Within the context of mental health promotion, the factors and processes that protect mental health and reduce risk factors are strengthened. Mental health promotion often refers to "positive mental health rather than poor mental health". Positive mental health is the desired result of mental health promotion interventions. Promoting mental health is related to quality of life rather than the absence of mental illness and the emphasis on deficits (WHO, 2001).
The World Health Organization (WHO, 2004) defines mental health promotion as the actions, conditions and environment that support mental health and allow individuals to adopt and maintain a lifestyle characterized by health. It includes actions that increase the chances of mental health experiences. In addition, the World Health Organization considers fundamental actions that facilitate the development of an environment that respects their rights at the socio-economic, political, and cultural level. Prevention is related to disease prevention while promotion is related to improving health and well-being. The World Health Organization links prevention to the reduction of mental disorders and relapse. It also focuses on high-risk groups in order to prevent the occurrence of mental disorders.

Literature Review
According to Reinke, Stormont, Herman, Puri, & Goel (2011), the vast majority of teachers argued that the school should be involved in addressing students' mental health problems. Teachers maintained that it is the school's responsibility to support students' mental health needs and that teachers could play a significant role. However, they feel that they do not have the necessary knowledge and skills to support children with mental health issues. In addition, the majority of teachers asserted that the implementation of socio-emotional learning programs is more in line with the role of school psychologists. Moon, Williford, & Mendenhall (2017) contended that teachers and principals are willing to enhance the school's capacity to meet the mental health needs of students. A key mechanism for achieving the above goal is the knowledge, awareness and ability to meet the mental health needs of children. The majority responded that they desire to be trained in understanding the concept of mental health, behavioural management as well as social skills. Mental health literacy training is a key tool in promoting students' mental health and consequently their educational achievements. Teacher training is related to the prevention of externalizing and internalizing problems through the timely detection and referral of students.
In the research of Cefai & Askell-Williams (2017), teachers argued that the involvement of school community in promoting children's mental health and well-being is essential. They were in favour of a holistic approach which includes the development of skills, inclusion, the development of cooperative relationships with parents and the development of positive relationships with students. In addition, Ekornes (2015) asserted that teachers acknowledge their crucial role in identifying students' mental health problems and making referrals in mental health services. They also highlighted the need for inter-professional collaboration. Holt (2019) argued that teachers consider the promotion of students' mental health and the creation of a positive climate in the classroom as an important dimension of their role. They stressed the importance of forming positive interpersonal relationships between teachers and students. Moreover, they highlighted the importance of their own mental health in order to be able to properly perform their role, the importance of their ability to manage their emotions and the need to be positive role models. They also referred to their contribution to cultivating students' interpersonal skills and to creating an environment where students receive respect and acceptance.
Danby & Hamilton (2016) explored how teachers perceive the concept of mental health. Their descriptions included social functioning and the absence of mental illness. They also mentioned the ability of expressing emotions, the ability of coping with life's difficulties and positive self-esteem. Moreover, they argued that the school should provide a safe and supportive environment and they stressed the need to collaborate parents and mental health professionals to ensure early intervention. In addition, they mentioned the empowerment of parents through the organization of seminars in order to raise awareness of the needs of their children.
Nikolaou, Moustakas & Markogiannakis (2017) explored teachers' perceptions regarding supporting children with depression in school context. They argued that supporting children, a positive interpersonal relationship with these children, a positive climate in the classroom, cooperation with parents and mental health professionals are considered effective strategies for addressing the mental health issues of children with depression. Moreover, they contended that the implementation of socio-emotional programs by teachers in cooperation with mental health professionals, as well as the implementation of mental health prevention programs aiming at all children by mental health specialists are effective strategies. In addition, the collaboration between school and family is vital to addressing the needs of students (Stamatis & Nikolaou, 2016). Finally, teachers' role in mental health promotion is highlighted and is vital to students' adaptation to school Stamatis & Nikolaou, 2020).

Methodology
The present sample research aims to explore the views of preschool teachers regarding their role in the prevention and treatment of mental health problems. Expanding knowledge on this topic can contribute to early diagnosis of children's difficulties, to mental health promotion as well as prevention.
This research attempts to fill gaps in existing knowledge and provide information for the adoption of new practices in an issue that is associated with children's well-being and their adaptation to school environment. The sample of the research was consisted of 115 preschool teachers. Data were collected by a questionnaire based on previous research. In relation to the educational level of the teachers of the sample, 74.8% were university graduates, while 25.2% were holders of a postgraduate degree, master or doctorate. Regarding the studies of teachers in special education (S.E.), the largest percentage of the sample 56.1% (f = 64) was without studies in S.E., 29.8% (f = 34) of the participants had attended a seminar or training in S.E., 11.4% (f = 13) held a master's degree and only 2.6% (f = 3) were graduates of a Department of Special Education. One teacher did not answer this question (f = 1).
Specifically, 29.6% (f = 34) had 1-5 years of service, 26.1% (f = 30) of teachers had 13-18 years of service, 25.2% (f = 29) had 6-12 years, 5.2% (f = 6) ranged from 19 to 25 years and the same percentage (5.2%) had from 31 years of service and over. 4.3% (f = 5) of the sample had 26 to 30 years of service. In relation to the previous service of teachers in special education, 86.1% (f = 99) of teachers in the sample did not have any relevant service. Cumulatively, 10.4% of the sample had 1 to 4 years of service (f = 12).

Results
The data in Table 1   The absence of mental health disorder is the dimension that most characterizes the mentally healthy child of preschool age according to the answers of the teachers.   Table 3 shows that the majority of teachers (82,6%) believe that the school is important to participate in the prevention of students' mental health problems. According to Table 4, the vast majority of teachers, 82.6% (cumulative percentage of teacher responses placed in the categories "to a very great extent" and "to a great extent") argue that the school should be involved in addressing mental health problems of the students.  Table 5 shows that 41.7% of the sample believes that supporting students with mental health problems is included in the role of teacher "to a great extent", 14.8% believe that it is included in the role of teacher "to a very great extent", while 39,1 % of the sample has a neutral view.  Table 6 shows that the teachers of the sample believe that enhancing students' selfconfidence is an important part of the role of teachers in supporting students with mental health issues (M = 4.70, S.D = 0.533). The above dimension gathered the highest average compared to the other dimensions studied. This is followed by the development  The above results indicate that teachers are willing to contribute to the prevention of mental health disorders, to mental health promotion in general as well as to providing support to children with mental health issues. These findings align with relevant literature (Reinke et al., 2011. Moon et al., 2017. Teacher support is regarded as a significant protective factor for promoting students' psychological resilience (Nikolaou et al., 2021). In addition, the definition of mental health is associated mainly with the absence of mental health disorder and social functioning as indicated by the means of their responses in relation to the characteristics of mentally healthy children. The way they perceive mental health is consistent with Danby & Hamilton (2016) research's findings. Moreover, the fact that they related mental health with the absence of mental health disorder conveys a pathology-oriented definition which was also found in previous research (Graham et al., 2011). Teachers' perceptions regarding supporting children with mental health issues are crucial as they are key stakeholders in mental health promotion. Their active participation is linked to the effectiveness of school mental health promotion programs (Rowling, 2008). Further research could explore the research questions of the present study employing a larger sample or by conducting interviews.

Conclusions
The educators of the present study argue that Attention Deficit Hyperactivity Disorder and Anxiety Disorders are the most common disorders in preschool education. There follows the developmental delay of children. Selective mutism and depression are less common than the mental health issues mentioned above. In relation to the characteristics that define the mentally healthy child in preschool education, it was found that the absence of mental disorder, the ability to form interpersonal relationships with classmates and sociability are the dimensions that are most attributed to the mentally healthy child. In addition, the vast majority of teachers considered that school's involvement in the prevention and treatment of mental health problems is important. In addition, supporting students with mental health problems is largely part of the role of the teacher according to the research findings. In particular, teachers expressed the view that strengthening students' self-confidence, developing interpersonal relationships between teachers and students are part of the role of teachers to support students with mental health problems. Simultaneously, the detection of students 'mental health problems and the implementation of programs in the classroom for students' behaviour problems in collaboration with experts was considered crucial.


DOES DENTAL STUDENTS' ATTENDANCE IN CLASSROOM LECTURES DEPEND ON THE MODE OF ATTENDANCE TRACKING?

Purpose: The necessity to attend classroom lectures is a disputable topic among dental schools globally. Since there is an ongoing debate on different aspects of this problem in literature, the purpose of this study was to compare students’ attitudes toward classroom attendance and investigate if stricter attendance tracking methods could lead to better classroom attendance at two dental schools utilising different modes of tracking students’ attendance. Method: This was an observational, cross-sectional survey distributed among dental students enrolled at King Abdul-Aziz University (KAU) and King Saud University (KSU) in Saudi Arabia. The survey included questions on demographics, average travel time, student's attitudes toward classroom lectures and common reasons for absenteeism. Collected data were analysed and summarised as frequencies and percentages and then compared using the Chi-square test for statistical significance. Findings: The study involved 678 participants from KAU and 475 participants from KSU. In general, there was a significant difference in students’ attendance between both schools in which 26.8% of KAU dental students skipped 5 or more lectures/month compared to 11.5% of students at KSU. Among the factors affecting classroom lecture attendance, commuting time was a major one reported by students (44.8% of students at KSU and 51.4% at KAU needed 30-60 min to reach their schools). The availability of lectures through online resources and the necessity to study for exams were additional factors reported by students of both schools. Implications for research and practices: Based on the current data, the school’s method to track students’ attendance may have a role in the pattern of classroom absenteeism.

Introduction
The necessity to attend in-class lectures has been a controversial topic among dental educators triggered by the change in dental students' generational change and attitudes combined with the recent schools' investments and shift toward virtual learning during the time of COVID-19 outbreak (Stewart, Stott, & Nuttall, 2011). Student' absenteeism patterns vary between dental institutes with no official data or literature to assess the magnitude of this phenomenon and its impact on dental education (Desalegn, Berhan, & Berhan, 2014). Factors such as the school adopted curriculum, lecturer's attitude, students' lack of motivation or interest towards specific subject have been linked to classroom absence reported in the medical literature (Alhabi et al., 2017;Moore, Armstrong, & Pearson, 2008). In the study by Waleed et al. (unpublished data), the experience of a single dental school was reported which showed that daily travel time and early morning classes are the two major reasons for dental students to skip classroom lectures. Several recommendations were suggested to address this issue which included modifications to the academic timetable, improvement of educators' presentation skills and wider implementation of technological advancement in teaching (Alhabi, 2017;Cook, 2005).
As of today, many dental schools continue to mandate students' traditional presence in-class. However, implementing optional attendance can also be viewed as a possible alternative. On the one hand, a more flexible students` attendance policy could have a negative effect on the educational process with the compromised learning experience, lack of in-class interactive discussions and use of educational resources posing an impact on the overall academic performance (Massingham P, 2006). On the other hand, due to а steady increase in а number of accepted students annually in a single class internationally, optional attendance may help to decrease the student/lecturer ratio in classrooms. Portals for distant learning with video recordings of lectures can provide an access to them at a later time. This option may work best as a coping tool for students with psychological challenges such as social anxiety and for those who spend much time commuting to university. However, educators in health-related specialities, including dentistry, are likely to support physical attendance of

Demographics of respondents
The study was structured following the STROBE initiative on reporting observational studies (von Elm et al., 2008). A total of 678 dental students at KAU and 475 dental students at KSU participated and completed the survey. The KAU data was previously reported and will only be compared to KSU data in this study. All demographics of participating students can be found in Table 1.

Students' attitude towards classroom attendance at KSU
In order to understand the prevalence of students' absenteeism, study participants at KSU were first asked about their likelihood to skip a classroom lecture. Overall, 60.0% of students (285/475) were more likely to skip 0-2 lectures, 28.6% (136/475) would skip 3-4 lectures, and 11.4% (54/475) would skip 5 or more lectures/month. Among all years of study, 2 nd year students were the most likely to skip 5 or more lectures/month (18/110 (18.2%)) and 3 rd year students were the least likely to skip lectures in general (1/61 (1.6%)). As for gender, 71.5% of female students (149/210) were likely to skip classroom lectures once or twice/month compared to 51.3% (136/265) of male students. At the same time, 8.3% of male students (22/265) were likely to skip more than 6 classroom lectures/month compared to 1.9% of female students (4/210) ( Table 2).
When asked about the number of times they were late to classroom lectures, almost half of the students were more likely to be late 0-2 times/month (235/475 (49.5%)), followed by 3-4 times/month (126/475 (26.5%)), 5-6 times/month (48/475 (10.1%)) and more than 6 times/month (66/475 (13.9%)). When asked about an option for classroom lectures to be streamed live or recorded and made available at а later time, 39% of students (188/475) were more likely to skip classroom lectures and utilise this option, while, 23% of students (113/475) expressed interest in attending classroom lectures even if they were available online and 36% of students (174/475) had no preference.
Of all participants, 81.7% (388/475) of students preferred classroom attendance to be non-compulsory. This was more evident in 1 st and 2 nd year students (106/121 (87.6%) and 89/110 (89.1%) respectively). The majority of respondents (307/475 (64.6%)) agreed that attending classroom lectures would have a positive impact on their academic progress and 70.5% of female students (148/210) strongly believed in its positive correlation with the overall GPA (Table 2). To investigate if travel time contributes to students' absenteeism, study participants were asked about their commuting time. In total, 44.4% of students (211/475) needed less than 30 minutes and 44.8% (213/475) needed between 30-60 minutes on average to reach their dental schools.
Comparing KAU to KSU data The collected data from students at both KAU with KSU were compared to better understand if the implemented method for students' attendance tracking has an impact on overall students' attitude toward attending classroom lectures. In general, no statistically significant differences were noted between KAU and KSU in terms of students' marital status or a number of children. However, there were more male students responses at KAU in comparison to KSU; and more students with a GPA of >4.5/5 at KSU compared to KAU (68.0% vs 55.5%; P<0.001). On average, 60.0% of KSU students (285/475) would skip classroom lectures 0-2 times/month compared to 44.5% at KAU (298/671), which was statistically significant (P<0.001) (Figure 1). However, 44.90% of KAU students were likely to skip 3-6 lectures/month compared to 36.60% of KSU students. 55.3% of female students at KAU (208/379) skipped 0-2 classes /month compared to 71.2% of female students at KSU (149/210). At the same time, 14.4% of female students at KAU (54/379) missed more than 5 classes/month compared to 6.7% of female students at KSU (14/210). In total, 39.4% of male students at KAU skipped 5 or more classes/ month (116/299) compared to 15% (40/256) at KSU.
Comparing factors affecting student attendance among KAU and KSU, several differences were noted ( Figure 2). Commuting time was one factor of major impact as 44.8% (213/475) of students at KSU needed 30-60 min and 10.7% (51/475) needed more than 60 minutes to reach the dental school. However, 51.4% (343/678) of students at KAU required 30-60 min and 16.8% (112/678) required more than 60 minutes. The availability of recorded lectures online was more attractive to KSU students in general as 39.6% of students expressed their intention to skip or be late for a classroom lecture compared to 48.4% of KAU students (312/678). Studying for exams came 2nd for 51.6% of KSU students (245/475) as a reason to skip classroom lectures compared to 42.9% of KAU students (291/678). In addition, early morning lectures were reported as а major factor for student absenteeism at both KAU and KSU (353/678 (52.1%) and 215/475 (45.3%), respectively). However, 88.8% (422/475) of KSU students are more likely to attend late-day classroom lectures compared to 31.4% (213/678) of KAU students. The lecturer's personality and lecturing skills were similarly reported as factors to influence students' attendance; however, it had more impact on KAU students (284/678 (41.9%)) compared to KSU students (44/475 (9.3%)).

Discussion
Mandating students' attendance in classrooms has been, and continues to be a disputable issue, particularly for dental schools. Available literature on students' attendance patterns is scarce and there is no agreement between scientists about the potential impact, if any, on the academic performance of students (Alghamdi et al., 2016;Credé et al., 2010;Demir et al., 2017). А significant number of studies supported inclass attendance and demonstrated its importance for academic success. For instance, Demir et al. (2017) evaluated the academic performance of a group of 2 nd year medical students based on their attendance rate and revealed that those who attended in-class lectures had а significantly higher number of correct exam answers. Similar to the current study, Moore et al. (2008) reported the following reasons to skip in-class lectures stated by students: lecture timing, lecturer's skills and the availability of the learning material online. However, Van Walbeek (2004) supposed that the relationship between attendance compliance and better academic performance is weaker than anticipated, which was in line with Chan (2009) who revealed that at the end of the 4-month block of diagnostic radiology course there was no difference between the academic achievement of medical students who were present and absent at 6 randomly selected lectures and that classroom attendees retained knowledge only for a short period of time.
As the debate stands, classroom attendance of dental students continues to be mandatory in all schools in Saudi Arabia. However, several schools in the country reported variable absenteeism rates among dental students and proposed continuing education sessions and workshops for schools' administrations to better understand this phenomenon and suggest proper solutions. One approach was the implementation of a students' attendance tracking mechanism which varied among different schools. For instance, KAU adopted manual sign-in sheets before, during or after lectures to capture students' attendance. However, KSU had implemented a fingerprint tracking method for students' attendance in classrooms. Using this method, students are required to register this attendance prior to and at the end of each lecture. As such, the aim of this study is to compare dental students' attendance attitudes and patterns at KAU and KSU dental schools considering the difference in tracking daily attendance.
The current data have demonstrated that students from both KAU and KSU in general, are inclined to skip classroom lectures. However, KAU students were likely to skip more lectures compared to KSU students (3-6 Vs 0-2 lectures). This difference could be caused by several factors, such as differences in commuting time, lecture scheduling and attendance tracking methods. Due to the lack of official data on local daily traffic in the areas around both schools, the role of transportation time cannot be assessed in this report. Other factors such as lectures' day timings and individual interests in attending classroom lectures were also reported by both groups (Figure 2). However, the fact that KSU has implemented a fingerprint tracking method may have encouraged better students' attendance in classrooms to avoid academic warnings and potential suspensions or disqualification from exams which is yet to be confirmed. The available literature has discussed attendance tracking policies in fields other than dentistry. A retrospective study included medical students who spent 2.5 years at Melaka Manipal Medical College (India) and demonstrated the impact of changing attendance policy on students' GPA and absenteeism. The study reported classroom attendance rate to improve from 4% to 11% of the total number of students who never skipped classes when the school expanded its mandatory attendance from 75% to 90% of total classes (Subramaniam, Hande, & Komattil, 2013). In addition, students' academic performances were positively related to increased attendance rate.
Other factors with an impact on dental students' attitude toward classroom attendance were addressed in this study. The students' academic performance track record is one of them as study participants from KSU had on average higher GPA compared to KAU students (68.0% vs 55.5%), although these GPA figures may not be totally comparable due to lack of national examination programme for all dental students. Similar outcomes were reported in a prospective study which included 126 students enrolled in different programmes at 3 South African Universities (Wadesango, 2011). This study demonstrated that students who did not attend classroom lectures had lower academic performance record compared to those who attended them. Our research is also in line with the study by Hidayat, Vansal, Kim, Sullivan and Salbu (2012) which evaluated the relationship between attendance and academic performance of 135 pharmacy school students. The study concluded that low performing students had missed more classes than their peers with higher performance records (34.7% vs 15%). However, our results are contrary to those obtained by Azab et al. (2016) who failed to show a significant relationship between overall academic performance and attendance of preclinical courses by 2nd year dental students of Tuft School of Dental Medicine in Boston, MA.
The lecture timing was reported by study participants as the main reason to influence their decision to attend specific lectures at both KAU and KSU. In total, 45.3% of KSU students and 52.1% of KAU students were more likely to skip early morning classes. One explanation could be the individual lifestyles when staying up late is a common behaviour among certain groups of students. As a result, attending early classes become a challenge. In addition, poor time management and the inability to prioritise daily tasks are other factors to consider. Longer travel time was also reported by participants to impact the attendance rate of classroom lectures. In total, 10.7% of KSU students and 16.5% of KAU students had to commute for more than 60 minutes to reach their designated schools on daily basis. As such, heavy road traffic jams combined with a lack of proper time management are expected to result in more frequent tardiness or absence from classroom lectures. Similar data were reported by Monash University (Australia) for pharmacology and biochemistry students as early morning lectures were more likely to be skipped (Davis, Hodgson, & Macaulay, 2012) This factor is more likely to be a worldwide challenge especially in heavy-populated metropolitans as in case of the cities of Jeddah (KAU) and Riyadh (KSU) and is not equally important for other students in Saudi Arabia. Time management in these settings are pivotal, and should be reinforced by faculty members and academic advisors on a regular basis. Even with the study being conducted at 2 dental schools in Saudi Arabia, variable components may still be applicable to other dental schools worldwide.
Overall, no specific pattern was noted among students of different levels in terms of classroom attendance between KAU and KSU. However, both schools have incorporated an online learning portal through Blackboard Inc® (Washington, D.C.) to provide study material for students which may have negatively affected students' attendance at both dental schools. Similar observations were reported in the literature, particularly in the study by Schnee et al (2019) which showed the decrease of students' attendance rate when lecture materials were provided via online resources. At the end of the study, students attending lectures earned higher grades compared to their peers who were relying on online videos only (Schnee et al., 2019).
Multiple factors with potential influence on students' attitude toward classroom attendance have been considered in this report. However, the impact of these factors on the overall academic performance has to be further investigated. This study comes at a special time of COVID-19 global outbreak which forced the closure of almost all schools around the world with concurrent switching to virtual learning and cancellation of student physical attendance in classrooms. Different types of lectures, webinars and exams were conducted via online applications such as Zoom, MicrosoftTeams and Google Hangouts to ensure delivery of knowledge and maintain the educational process, yet maintaining the safety of students and educators. A survey of a group of European dental schools has demonstrated that more than 90% have adopted online learning with limited clinical services during the time of pandemic (Quinn et al., 2020). Further recommendations included encouragements to use online resources and engagement in self-learning processes as well as providing mental health support to students and academic staff (Meng, Hua, & Bian, 2020) In addition, formative and summative assessments were postponed and examinations had to be organised online. It is anticipated that COVID-19 outbreak will change the student learning paradigm and reveal the true potential of distant online learning to become a strategic option for educational authorities (Quinn et al., 2020). However, the efficiency of virtual learning, students' experiences and associated challenges are aspects yet to be explored and reported in the near future by researchers in the field of education.
The current data have highlighted certain aspects of attitudes and patterns of student attendance. Considering the changing world of dental education combined with the current impact of COVID-19 pandemic, in-class lectures may be a challenging option though playing an integral part of students' academic development and attainment which are less likely to be gained outside the classroom. Students who often skip classes are perhaps those who are more likely to work less, lack interest in dental subjects and may not rise to academic challenges. It can be argued that the online teaching could be a helpful tool or a coping mechanism for a particular group of students with psychological challenges, which justifies making classroom lecture attendance optional. Based on the current report, we can also conclude that the best approach to supporting students' academic performance is to combine in-class learning with the use of online resources.
This study has several limitations. Firstly, self-reported attendance may have affected the validity of this study as no official attendance records were available. It is not uncommon for students to report more favourable answers to survey questions even if not completely true to improve their academic image among school administration. Keppens et al compared self-reported and official attendance records at 57 schools in Flanders (Belgium) and indicated that students are likely to report better daily attendance than what was registered by the school administration (Keppens, Spruyt, & Dockx, 2019). Secondly, the cross-sectional design of this study and the lack of long-term follow-up data to correlate students' attendance with their academic performance may not allow for а complete assessment of the available data. Thirdly, а comparison of several parameters between the two schools, such as GPA, was not possible due to the nature of the study and lack of national exam for all enrolled dental students. Our research group is currently planning a future study to address these limitations and attempt to analyse deeper the students' attendance records and their correlation with academic performance. In addition, the next study will explore potential solutions within focus groups.

Conclusion
The current study reported students' attitudes toward absenteeism at two governmental dental schools in Saudi Arabia with different attendance tracking methods. Reasons such as the time of lecture, commuting time and lecturers' skills were reported to influence dental students' decision to skip or be late for a classroom lecture. The current data shed light on the role of students' attendance tracking method adopted by a particular school in the encouragement of better classroom attendance and can be considered by other schools in the future based on curriculum and factors such as students' population and attitudes. Further long-term studies to understand the impact of classroom lecture absenteeism on academic performance are needed.

Conflict of Interest:
All authors declare that they have no conflict of interest related to this study.


The implementation of guided discovery learning model to improve students’ characters of responsibility and academic skills

The low level of responsibility and academic skills can hinder students in developing all their potentials to obtain more meaningful information and stay on one’s memory. Thus, research was conducted to improve the character of responsibility and the academic skills of Grade XI Science 1 students at SMA Negeri 12 Banjarmasin. This type of research is a class action model adapted from Kemmis and Mc Taggart, consisting of 2 cycles. Each cycle includes planning, implementation/observation, and reflection. The research subjects involved were 23 pupils. Observation and tests were conducted to collect the data needed. The instruments used were observation sheets on the implementation of the Learning Implementation Plan. Observation sheets were utilized to analyze student responsibility characters, science process skills tests, and cognitive ability tests. Data were analyzed descriptively. The findings of the research instruments from cycle I to cycle II stated: (1) the implementation of the Learning Implementation Plan in the first cycle of the first meeting obtained a score of 79.43% (good), and the second meeting received 85.36% (very good). In the second cycle, the first meeting got 91.73% (excellent) and the second meeting achieved 93.17% (very good); (2) The average level of student responsibility in cycle I and cycle II increased from 65.81% (high) to 81.42% (very high); (3) Students’ science process skills in cycle I and cycle II also increased from 0.58 (quite skilled) to 0.92 (very professional); (4) The classical cognitive ability of students in cycle I and cycle II increased from 78.26% (completed) to 100% (completed). It was concluded that the guided discovery learning model helped improve students’ responsibility and academic skills.

Introduction
Learning must be comprehensive, covering all aspects of affective, psychomotor, and cognitive. Responsibility is one branch of the affective element that schools must teach [1][2][3]. Humans who have a responsible character can be aware of their behavior and actions, whether intentional or unintentional [4,5]. Therefore, the nature of responsibility is a person's attitude and efforts to do what should be done for oneself, society, environment, the State, and God Almighty. Hence, the character of responsibility is needed by every individual in everyday life [6].
One aspect directly related to the learning process that greatly determines student success in school is cognitive development. Cognitive development relates to the perception, way of thinking, memory, language skills, and information processing which all enable a person to acquire knowledge, solve problems, and plan for the future-in other words; it is all psychological processes related to how individuals learn, pay attention, observe, imagine, estimate, assess, and think about the environment [7].
Learning in schools is not only taught by delivering information from teachers or other learning resources, such as books. However, it must also be integrated through activities that emphasize actual activities, including observations, experiments, or trials. These activities are a means of transferring information/knowledge and training various process skills. Science process skills are used to understand what phenomena have occurred. These process skills are needed to acquire, discover, develop, and apply scientific concepts, principles, laws, or theories [8][9][10].
In general, the primary source of information during the learning process in the classroom tends to be dominated by the teacher, which results in students becoming less actively involved in the learning process [11]. As a result, students have difficulty understanding the concepts and principles of physics (cognitive domain). In addition, students' lack of courage to take the opportunity to ask questions is also a problem that causes them to have difficulties in understanding the lesson. It can be seen from the results of the physics tests given to students of grade XI Science 1 SMA Negeri 12 Banjarmasin in the 2016/2017 academic year during the odd semester. The tests showed that as many as 82.60% of students obtained scores below the minimum completeness criteria that have been set, which was 75. In addition, the average final exam scores of the 23 students in grade XI Science 1 SMA Negeri 12 Banjarmasin was 58.76. These results indicated that students' cognitive abilities in XI Science 1 SMA Negeri 12 Banjarmasin are still relatively low.
The absence of attention on character education (affective domain) in learning activities raises concerns regarding the long-term impact on students. This is supported by the results of the researcher's observations on the level of student responsibility when the teacher teaches. The data indicated that: 2 people were categorized in the very high category, four people were in the high category, six people were included in the reasonably high category, nine people in the low category, and two were categorized in the deficient category. This indicates that the character of student responsibility at the time of learning is still relatively low. Therefore, the researchers aim to increase student responsibility during the learning activities.
Another problem in learning physics that was not focused on was the weakness of students' science process skills. This was reflected in the results of TIMSS (Third International in Mathematics and Science Study), which indicated the ability of Indonesian students in the science field to rank 45th out of 48 countries [12]. One of the reasons is that science learning has been more oriented to the content of science materially rather than the process of science itself. Based on the initial data collection results carried out in grade XI Science 1, the students' science process skills were very low, with an average of only 20%. Therefore, this research also aimed to improve students' science process skills. Thus, to overcome the problems above, an appropriate learning model is needed to develop character and improve science process skills and students' cognitive abilities. One of the learning models that can be used is the guided discovery learning model.
Several existing studies have proven that discovery learning models could develop responsibility, effectively improve students' cognitive learning outcomes, and improve students' science process skills [13][14][15]. Therefore, research was conducted on applying the guided discovery learning model to enhance students' character of responsibility and academic skills. This study aimed to describe the application of the guided discovery learning model to improve students' character of responsibility and academic skills.

Method
The type of this research is Classroom Action Research which was adapted from the Kemmis and Mc Taggart model. The model consists of 2 cycles, in which each cycle is carried out in 2 meetings. Each cycle consists of three stages, namely planning, implementing and observing, and reflecting.
The research subjects involved in this study were 23 students of grade XI Science 1 SMA Negeri 12 Banjarmasin. The techniques used to collect data in this study were observation and tests. Observations were conducted to obtain data on the implementation of guided discovery learning model lesson plans and the character of students' responsibility. Partner teachers and one research colleague carried out observations of the performance of the lesson plans. Three research colleagues carried out words of the character of responsibility. The test was conducted to collect data on science process skills and cognitive abilities.
The tools and instruments used in this research are Learning Implementation Plans, teaching materials, Student Activity Sheets, observation sheets, science process skills tests, and cognitive ability tests.
The lesson plan implementation data were analyzed descriptively quantitatively with the percentage technique. The percentages obtained are further categorized according to the criteria [16] shown in Table  1. To calculate the reliability of the lesson plan implementation between two observers, Cronbach's Alpha formula is used (Ratumanan and Laurens, 2011). 60 < ≤ 80 Good 5.
> 80 Very Good The assessment of the level of student responsibility observed during the learning process is expressed in a percentage. The percentages obtained are further categorized according to the criteria shown in Table 1.
The data of students' science process skills were analyzed descriptively quantitatively. The data were expressed in the form of scores. The science process skill scores obtained were further categorized according to the criteria [16] in Table 2. Cognitive ability test data were analyzed individually and classically. Mastery learning individually seen from the achievement of scores obtained according to the Minimum Completeness Criteria set by SMA Negeri 12 Banjarmasin was ≥75. This action research is considered successful if the implementation of the lesson plans at least results in the excellent category, the character of the minimum responsibility are categorized in the reasonably high category, the science process skills are at least included in the quite skilled in the category, and the classical completeness of the cognitive ability test is at least 75%.

The Implementation of the Lesson Plan
The data recapitulation of the lesson plan implementation for each meeting is based on the observation sheet as shown in Figure 1.  Figure 1. Implementation of the Learning Implementation Plan for each meeting Overall, the implementation of the lesson plan has increased from the good category to the outstanding category. Although each phase has been carried out under the very good category, in phase 1, during Stage 3 and 4, Meeting 1, which focused on motivating students and reminding students of previous learning, was still categorized as good. This was due to the lack of preparation made before the learning activities took place. In addition, phases 2 and 3 were not following the time allocation previously determined in the Lesson Plan. The teacher took too much time in phases 2 and 3 to guide students who were still having difficulties collecting data, analyzing data based on experimental data obtained, and making conclusions based on the results of data analysis. Students were still in the adjustment phase with learning activities that integrated the guided discovery learning model, which was the first time it was applied in the class. Actions taken by the researchers as an effort to improve in cycle II, namely preparing as well as possible, and during the time of motivating and reminding students of the previous meeting, researchers should pose problems related to the material discussed through simple questions related to everyday life. In addition, the researchers should try to improve their time management, primarily during phases 2 and 3. Each stage in the Lesson Plan could be carried out by the time allocation that was previously planned in the Lesson Plan and enable the learning activities to run smoothly.
Overall, the average score of the implementation of the lesson plans in cycle II increased from 91.72% (meeting 1) to 93.16% (meeting 2), which was categorized in the outstanding category. All phases in cycle II were carried out under the scale of the outstanding category, following the time allocation specified in the lesson plan, and met the indicators of success. The average implementation of the lesson plans as a whole in cycle I and cycle II have increased. Thus, the efforts made by researchers according to the results of the reflection of the cycle I succeeded in expanding the implementation of the lesson plan cycle II as a whole, and the performance of all phases in the lesson plan in cycle II had met the indicators of success.
The efforts made by the researchers in preparing the lesson plans in cycle II were based on the results of the reflection conducted during the process I. It resulted in an increase in the implementation of each phase in the lesson plan and helped to achieve the established success indicators. This was in accordance with the statement of Suprihatiningrum [17], in which the learning process would run smoothly, learning objectives could be achieved optimally, and the success of learning itself could be described if it is planned as well as possible. Sumantri [18] also stated that good learning planning would result in a good learning process. The description above showed that the implementation of the lesson plans always  increases at each meeting in the research cycle. In addition, in cycles, I and II, all phases in the lesson plan had been implemented in an excellent category and met the indicators of research success.

Character of Responsibility
The data recapitulation based on the student responsibility level observation sheet in each cycle is shown in Figure 2.

Figure 2. The Student Responsibility Level in Each Cycle
The recapitulation of the achievement of each responsibility criterion in cycles I and II is shown in Table  3.  Table 3, it appears that the achievement of all responsibility criteria meets the indicators of success. In addition, the description above shows that learning by applying the guided discovery learning model has succeeded in increasing the character of students' responsibility, following several research results that state that using physics learning tools oriented to the guided discovery learning approach is proven to develop the level of commitment [14,19,20]. In addition, this was also by the opinion of Carin [21], which stated, "…through discovery learning students are guided and encouraged to become more independent, self-directed, and responsible for their learning…".

Students' science process skills
The recapitulation of the students' science process skills achievement in cycles I and II for each category is shown in Table 4.  Table 4 above, it appears that the achievement of all aspects of students' science process skills in cycle I for each category has met the indicators of success, namely at least categorized in the category of quite skilled, except for the skills of analyzing data and making conclusions. There are still skills classified as less experienced, namely analyzing data and making conclusions, which received 100% and 43.48%, respectively.
Based on the deficiencies that occur, the efforts made by researchers as improvements in cycle II are needed to improve students' abilities in analyzing data and concluding experimental data. These efforts provided guidance and emphasized the steps that students must consider and carry out before studying and completing experimental data. Skills in analyzing data, the teacher said, was what needs to be done to investigate the practical data table, describe the experimental data into sentences that explain the influence of the manipulation variable on the response variable following the problem formulation, hypothesis formulation, and guiding questions that have been provided, relate the data description using the appropriate mathematical equation, and explain the mathematical equation while connecting it to the manipulation, response, and control variables. Skills in concluding data, the teacher conveys, were that the data is completed to data analysis and the formulation of hypotheses. It must answer the formulation of the problem.
Aspects of science process skills that have met the indicators of success need to be further improved. Therefore, in cycle II, the researcher reduces the guidance when students formulate hypotheses and identify variables. It aims to make students more proficient in developing hypotheses and identifying variables.
Based on Table 4, the achievement of all aspects of students' science process skills in cycle II for each category has met the indicators of success. In addition, the percentage of achievement of all aspects of students' science process skills in cycle II for each category also increased.
Based on the results obtained, it indicates that the efforts made by the researchers by trying to guide the form of direction and emphasis on the steps that must be taken by students before analyzing data and making conclusions inflicted a positive impact, namely the achievement of aspects of data analysis skills and making conclusions, that have finally met the indicators of success. Biggs [22], which stat if teachers want students to understand the information they have learned, teachers must help students build their meanings from the information they have learned. This is following the results of research, which states that through discovery learning, students are encouraged to order to be able to find information or knowledge based on the materials that have been provided. The teacher acts as a facilitator to guide until the students can use the ideas, ideas, and skills learned to find new information or knowledge [23].
Efforts made by researchers by reducing guidance when students formulate hypotheses and identify variables also positively impacted students. Students become more proficient in developing ideas and identifying variables, as seen from the increase in the percentage of skill aspect achievement. This is following Lev Vygotsky's constructivist learning theory, namely scaffolding, which describes that students are given a large amount of guidance and assistance during the early stages of learning, then reduce the advice and assistance to provide opportunities for students to take on greater responsibility as soon as they can do something. The task independently [24].
Referring to the above explanations, it can be concluded that the application of the guided discovery learning model has succeeded in improving students' science process skills. This is aligned with the research results, which states that the application of physics learning tools oriented to guided discovery learning has proven to improve students' science process skills [13,[25][26][27][28].

Student cognitive abilities
The recapitulation of student cognitive abilities for each cycle is shown in Figure 3. The mastery of students' cognitive abilities in the first cycle can be seen in Figure 3. The cognitivStudents' cognitive abilities cycle have met the indicators of success with the percentage of students who have completed with a score of 78.26%. Based on the data in Figure 3, the cognitive abilities of students in cycle II have met the indicators of success with the percentage of students who completed classically at 100%. The classical students' cognitive skills in cycle I and cycle II increased from 78.26% (completed) to 100% (completed). Thus, the application of the guided discovery learning model succeeded in improving students' cognitive abilities. This follows Bruner's opinion, which states that through discovery learning, a person has broad opportunities to build their knowledge so that their intellectual potential will increase. Bruner claims that students are not mere listeners. He believes that children learn best when they are actively involved in hands-on and mind-on activities. The discovery approach provides broad opportunities for students to organize and manage the information found through their investigations so that the information obtained or the concepts built are more meaningful, which ultimately affects students' cognitive abilities [21].
Thus, through discovery learning, students are allowed to learn deeper so that the facts/concepts/principles/theories/laws learned through the discovery process become more meaningful and can be understood in-depth to ensure that they can last a long time in the students' memories. The learning process using the guided discovery learning model effectively improved cognitive learning outcomes [15]. Several other studies also show that the application of discovery learning impacts student learning outcomes that are getting better [29][30][31][32].
The researchers' efforts to immediately share the results of cognitive ability tests to students, provide feedback and reinforcement, and distribute prizes to students who have passed contribute positively to improving students' cognitive ability test results. In accordance with the results of research by Dwiantoro and Kartiko [33]) which states that gift-giving has a significant effect on student learning outcomes. In addition, Hosnan [34] suggests that informing student learning outcomes and giving awards in the form of prizes or praise is one of the efforts to increase student learning motivation.
Efforts to provide feedback and reinforcement are intended to acknowledge and remember which steps are proper and which actions are wrong to avoid making the same mistakes in cycle II. According to Sabriani [35], giving feedback aims to make students realize the strengths and weaknesses of their tasks. In addition, Sulistyaningsih and Cahyani [36] stated that reinforcement seeks to make students follow or not follow specific behavior.

Conclusion
It can be concluded that the application of the guided discovery learning model can be used to improve the character of responsibility and academic skills of students in Grade XI Science 1 SMA Negeri 12 Banjarmasin. This statement was supported by the findings of the research on the application of guided discovery learning models in Grade XI Science 1 SMA Negeri 12 Banjarmasin as follows: (1)  implementation of the guided discovery learning model lesson plans at the first meeting of the first cycle was carried out with the score of 79.73% which belonged in the excellent category, the second meeting of the first cycle was carried out at 85.36% in the very good category, the first meeting in the second cycle was 91.72% in the very good category, and the second meeting in the second cycle was 93.16% in the very good category; (2) The level of student responsibility after the guided discovery learning model was applied had met the indicators of success and increased from cycle I to cycle II; (3) Students' science process skills applied by guided discovery learning model met the indicators of success and increased from cycle I to cycle II; and (4) classical students' cognitive abilities in cycle I and cycle II increased from 78.26% to 100%.


Faculty Perceptions on Accessibility in Online Learning: Knowledge, Practice and Professional Development

This study examined the level of readiness of faculty in designing and delivering accessible online courses to meet the needs of all learners, including students with disabilities. A total of 182 tenured/non-tenured full time, part-time, adjunct and clinical faculty from three public universities of different sizes were surveyed to gauge their awareness, understanding, and practices related to disability laws, quality standards, utilization of tools, and professional development support. Results from the study indicated an uneven level of readiness by faculty regarding online learning accessibility. Results from the study showed that professional development training in online learning had a very significant influence on accessibility knowledge and practice. Also, high perceptions of knowledge for institutional policy and terminology and low perception of accessibility laws and standards were found. It is also found that training on disability-related laws and regulations provided by higher education institutions was insufficient and at times, does not align with the faculty’s schedule. Given the results of the study, it is recommended that higher education institutions reorient their approach to supporting faculty who teach online and develop a comprehensive strategy to reach the goal of helping all students, including students with disabilities, to fully engage online learning. The findings from this study have implications for course development and implementation to support students with disabilities.

Figure 1
Structure of Literature Review (Guilbaud, 2019) As part of the Macro domain, the research explores current issues related to the rise of online learning in higher education focusing on some of the factors driving increased online presence by the vast majority of colleges and universities in the U.S. (Allen & Seaman, 2017;Gladhart, 2010;Lederman, 2018).
The Meso domain of research looks specifically at some of the key reasons higher education institutions have been dedicating resources and personnel to support learners with disabilities who take online courses (Center for Educational Innovation, n.d.; Loftus, 2019;Rothstein, 2010;Perez& Ali, 2010). Laws and regulations related to campus accessibility, in general, and accessible online education, in particular, are examined (deMaine, 2017;Federal Communications Commission, 2017;Helland, 2017;Huss & Eastep, 2016;U.S. General Services Administration, n.d.). Key activities and endeavors undertaken by higher education institutions in response to accessibility-related laws and regulations are appraised and discussed (Seale, 2014;Yuknis & Bernstein, 2017). This domain also examines the organizational structure of higher education institutions to gauge its impact on responses and reactions by those institutions to accessibility-related laws and regulations (Cohen & Kisker, 2010;deMaine, 2014;Higher Education Compliance Alliance, n.d.;Manning, 2013).

Learners with Disabilities and Online Education
According to the Americans with Disabilities Act (ADA) of 1990, amended 2008, the term disability refers to an individual: (a) with a physical or mental impairment that substantially limits one or more major life activities of the individual; (b) who has a record of the impairment; or (c) as regarded as having such an impairment (U.S. Department of Justice, 2009). Major life activities involve limitations in caring for oneself, performing physical activities, seeing, hearing, speaking, learning, reading, and concentrating (National Center for Education Statistics, 2019). Students with disabilities taking online courses can have one or more impairments that affect their ability to have equal access. Section 504 of the Rehabilitation Act of 1973 is a federal law that protects the rights of individuals with disabilities from discrimination solely on the basis of the disability from programs that receive federal assistance.
The National Center for Education Statistics (2019) reports that psychological disabilities such as depression, anxiety, and post-traumatic stress can additionally pose significant barriers to learning for the student. Despite the many challenges, the enrollment numbers for students with disabilities at post-secondary institutions continue to rise (Patton et al., 2016). Online learning presents increased opportunities for students with disabilities to complete their post-secondary education, especially for students who are less inclined to navigate the on-campus landscape (Basham, Stahl, Ortiz, Rice & Smith, 2015;Case & Davidson, 2011).
While online learning offers many opportunities for access to higher learning, when courses do not take into consideration students with disabilities, this can create many challenges, concerns, and some uncertainties for the academy. According to Vasek (2005), faculty members at most institutions are not always prepared to provide the necessary accommodations to assist students with disabilities who take online courses. Seale (2014) argues that some faculty members believe that student support services such as disability offices are the sole entities that are responsible for making sure the student receives the appropriate accommodations.
As a result, at many institutions the Office of Accessibility is often seen as the main entity or sole entry point for students who need accommodations due to disabilities. Yet, many online courses are not designed to be adjusted in a post-hoc fashion to facilitate the complete integration of learners with disabilities. Thus, given the reactive approach to accommodate the needs of students with disabilities, faculty and staff are challenged when trying to retrofit the learning contents and assessments used in those courses to make them more accessible (Case & Davidson, 2011). Alternatively, Burgstahler (2015) and Oswal and Meloncon (2014) advocate for designing online courses with accessibility at the onset; thus, taking a proactive approach.
The Universal Design for Learning (UDL) framework can facilitate proactive design and development of instruction thereby making online content accessible for a wider range of students with various abilities (Burgstahler, 2015;Tobin, 2014;Wynants & Dennis, 2017). Research has found that faculty who implement UDL principles enhance the quality of the learning experiences for all learners by ensuring content is delivered through multiple modalities which provides multiple means to engage in learning, while also giving the learner opportunities to demonstrate their knowledge in multiple ways (Dell, Dell & Blackwell, 2015;Hollingshead, 2017).
When courses are offered solely online, students with disabilities, like all students, find they must take online courses to progress in their programs of study. Given that students with disabilities are a diverse population, they are challenged in many ways in trying to navigate online courses that do not consider accessibility (Burgstahler, 2015;Gladhart, 2010;World Health Organization, 2011). In addition to the diversity of disability, these students also have demographic characteristics with differences in gender, age, socioeconomic status, sexuality, ethnicity, and culture. Therefore, supporting the student has to focus not only on the disability but on the whole person, as is the case in designing for non-disabled students.

Legal Requirements Issues
Academic institutions in the U.S. must determine ways to ensure compliance to the disability laws based on their understanding of the laws to ensure student needs are being addressed through their various internal offices such as accessibility, legal, risk management, and student support services, instructional design, and faculty professional development. While there have been several high-profile disability court cases (Helland, 2017;Loftus, 2019; U.S. Dept. of Education, Office of Civil Rights, 2014), few provide the precedent to assist higher education institutions on how to meet the legal requirements for designing accessible online courses (Helland, 2017;Loftus, 2019;Rothstein, 2010). However, there is enough information for higher education institutions to take proactive measures in the design and delivery of their online courses (Perez & Ali, 2010 There are several federal and state laws and statutes in place regarding individuals with disabilities. Table 2 includes laws and statutes that require equity in accommodation and offer protection against discrimination to those individuals and have an impact on Higher Education. Although higher education institutions must comply with the aforementioned laws and statutes, Betts et al. (2013) state that "accessibility is the right thing to do and training should be focused on students, their engagement online, and program completion" (p.52), and therefore, go beyond the need to comply with laws. In fact, the laws alone do not provide sufficient guidance to ensure compliance. This is because they do not explicitly specify online courses in higher education. The lack of specific mention of online education in these laws has presented some challenges for those involved in delivering content to students with disabilities because there are no clear guidelines or standards on exactly how accessibility compliance is to be accomplished.

Faculty Development to Support Online Learners with Disabilities
As teaching online requires designing and delivering instruction that is very different from how it is delivered in face-to-face settings, designing instruction that is considerate of the needs of students with disabilities adds complexity to the online environment. The key issue that remains to be resolved is how to best support faculty to gain the change in perspective and mind-set needed to have accessibility concepts at the onset when designing online instruction (Rogers-Shaw, Carr-Chellman, & Choi, 2018). Many higher education faculty members are not often aware of the need to consider students with disabilities in the design of online learning courses (Burgstahler, 2015). This research argues that faculty need to undergo a challenge to their established perceptions or have a transformative experience that can serve as a catalyst for them to create inclusive, engaging and interactive online learning courses that are accessible for all students. Burgstahler (2015) and McQuiggan (2012) propose that faculty would need this kind of experience to understand the online context of learning of their students and their broad range of abilities. Professional development provides tremendous opportunity to introduce proactive frameworks such as Quality Matters (QM) and Universal Design for Learning (UDL) in designing online courses (Craig, Smith & Frey, 2019). Therefore, given the need, professional development and training should help faculty position themselves in the context of their students with disabilities (National Center on Disability and Access to Education [NCDAE], n.d.). Incorporating UDL into professional development would assist faculty in designing equitable and inclusive experiences to promote learning for all students (Wynants & Dennis, 2017).
To meet the challenges of time and scheduling conflicts, individualized, flexible, multimodal training should be offered to accommodate different teaching schedules and the ebb and flow in the seasonal cycles of a semester (Herman, 2012). Seale (2014) argues that faculty prefer training experiences that are less time-intensive and more portable. Because faculty have heavy teaching loads, faculty training should be in the form of just-in-time formats, as such an approach permits a quick refresher or answer to a specific question (NCDAE, n.d.). Support and training activities should be faculty-centered and customized to their specific learning needs and adapted to teaching discipline (Gappa, Austin & Trice, 2007). To accommodate the differences in faculty schedules, online videos should be available to watch at convenient times.

Purpose of this Study and Research Questions
Academic progression of students with disabilities taking online courses through traditional higher education institutions is of significant concern as it relates to the high attrition rate among this population. Review of literature reveals that course content that is not accessible and usable to students with disabilities is a hindrance to their progress and retention. Research also reveals that faculty are often unaware of how to develop accessible online content (Huss & Eastep, 2016;Schmidt, Tschida & Hodge, 2016;Terras, Leggio & Phillips, 2015;Wynants & Dennis, 2018). 3. Do faculty perceptions vary by key background factors for their capacity to design and implement accessible online tools for students with disabilities?

Research Design
We followed a quantitative survey-based research approach with two open-ended questions. Because the objective of this study is to make inferences about faculty perceptions of their knowledge of laws, institutional policies, online pedagogical practices, and professional development support at a single point in time, a survey was the preferred method of data collection due to the potential for rapid turnaround and capacity for wide coverage and broad application.

Survey Instrument
The survey instrument for the study had three major content areas that are constructed to accommodate various faculty responses to items on the questionnaire. These are 1) Accessibility knowledge, 2) Accessibility Application/Practice, and 3) Accessibility Professional Development and have 66 fixed-choice items combined with two open-ended questions to provide additional insights. The survey requires responses to five-point Likert scales to measure faculty awareness and perception of their knowledge and practices in their online courses. The Likert-scale question for the subcategories address the level of awareness (24 items) for each item on a range: 1= Not at all aware, 2= Slightly aware, 3= Somewhat aware, 4= Moderately aware, and 5= Very aware. The Likert-scale question for the subcategories on practice (31 items) address the degree of use for each item on a range: 1= Never, 2= Rarely, 3= Sometimes, 4= Very often, and 5= Always. The Likert-scale question for the subcategory, Professional development (17 items), addresses the level of agreement for each item on a range: 1= Strongly Disagree, 2= Disagree, 3= Neither agree or disagree, 4= Agree, and 5= Strongly agree. A few of the items on the level of importance for each item on a range: 1= Not important, 2= Slightly important, 3= Moderately important, 4= Important, and 5= Very important. Open-ended questions at the end of the survey provided additional input from respondents regarding what support would be helpful to achieve accessible design in their courses.
After an initial draft of the survey was created, it was assessed for content validity by four expert reviewers in higher education including 1) Director of Disability Services, 2) Assistive Technology Specialist, 3) Instructional Designer at the Center for Teaching and Learning and 4) specialist in Quality Matters and Online Learning. In addition, the survey was piloted for usability and content accuracy with six online faculty representing the three institutions. These faculty provided feedback on various aspects of the instrument, which led to the inclusion of several questions regarding demographics and a wording change from accommodation to accessibility on online courses.

Setting
Three universities representing four-year public universities were invited to participate in this study. These three universities were chosen primarily by convenience. All three institutions are located in the southeastern region of the United States. The universities have different size enrollments, and due to their size and scope of activities, provide different experiences in offering distance courses and programs. All three are primarily residential with a significant undergraduate student population. The universities offer various courses, certificates, and degree programs online. An electronic survey was administered to the campuses through their distance education divisions to the faculty who teach online.

Participants
A total of 182 faculty responded to the survey. The study had a 17% response rate. The respondents were mostly female (n = 103, 56.6%), male (n= 67, 36.8%), and those who preferred not to answer (n=12, 6.6%). Table 3 presents a description of the participants, including age, rank, primary online delivery method, level of teaching, years teaching, years teaching online, support received to teach online and funds used for training and development.

Data Analysis
In this survey-based research study, descriptive statistics (means and standard deviations) are reported at the category and subcategory levels. Cronbach's alpha was used to check the internal consistency of the responses to the survey items and was found to be .943 for all items. A 4 X 4 X 2 between-subjects factorial ANOVA was conducted for professional development of participants who are grouped in one of four age ranges and teaching online in one of four ranges by year, and who received some training for online teaching versus no training for online teaching. The qualitative data was open coded using content analysis as described by Creswell (2013). Themes were identified based on the patterns identified from the categories. Then, relationships between themes were consolidated and assigned a label based on findings that emerged.

Faculty Perception of Knowledge, Practice and Professional Development Supports for Online Accessibility
Descriptive statistics (means and standard deviations) for each of the three categories knowledge, application/practice, and professional development and subcategories are reported in Table 4. The Knowledge category (M=2.99) rated level of awareness of standards and law, institutional policy, design guidelines, terminology, and accessibility checking protocols of tools. The Accessibility Application and Practice category (M=2.93) rated level of use and practices with Word and PDF documents, LMS, and audio and video. The Professional Development category (M=3.74) rated faculty's perceptions on challenges to practice, importance of training on standards and policies, technologies, and knowledge of specific learner disabilities.

Faculty Perceptions and Key Background Factors
A 4 (age) X 4 (years teaching online) X 2 (received training for online teaching or not) between-subjects factorial ANOVA was conducted comparing accessibility knowledge, application and practice, and professional development for participants who are grouped in one of four age ranges [21-40, 41-50, 51-60, 61+] and teaching online in one of four-year ranges, and who received some training for online teaching versus no training for online teaching. Assumptions of the factorial ANOVA were met. The descriptive statistics based on key background factors is reported in Table 5.

Background Factors and Knowledge of Accessibility
While the main effect for age was not significant (p >.05) and the main effect for a number of years teaching online was also not significant (p > .05), a significant main effect for training for online teaching received was found (F (1,107) = 17.5, p < .05). Instructors who received some training for online teaching did slightly better (M = 3.33) than those who had none (M =2.45) in their responses on their knowledge of accessibility. The interactions were not significant:

Background Factors and Accessibility Application and Practice
The main effect for age was not significant (p >.05). However, a significant main effect for number of years teaching online (F (3,99) = 7.374, p < .05) and for training received for online teaching (F (1,99) = 27.751, p < .05) was found. Those who had training had higher perception (M =3.14) than those who had no training for online teaching (M =2.57). The interactions were not significant: Tukey Post hoc test was performed for examining difference in experience of online teaching. It was found that those who taught online for 6-10 years (M= 3.16), p> .009 had significantly higher perception on their responses for application and practice than those who taught two years or less (M=2.66).

Background Factors and Professional Development
The main effect for age was not significant (p >.05). The main effect for the number of years teaching online (p > .05) and for training received for online teaching or not, were also not significant (p > .05). The interactions were not significant.

Accessible Design in Online Courses from Open-Ended Data
A total of 85 faculty instructors provided additional feedback by responding to the openended question on the survey. The themes that resulted based on the patterns identified from the categories is reported in Table 6. Training. Faculty mentioned the need for training on disability laws (n = 9), standards (n = 7), students with disabilities (n = 8), and accessibility features of tools (n = 9) to be beneficial in creating accessible design in their courses. For example, one faculty member wrote, "Canvas specific accessibility trainings are needed and periodic refreshers or professional development on the policies and standards." And another faculty member wrote "...More workshops on Autism and cognitively impaired. We have no idea on specific accessibility issues to assist these populations." Regarding tools, one faculty member wrote, "I had no idea there were already features built into the software I regularly use to make documents, PDFs, videos, etc." Type of Training. Some faculty members reported a need for flexible training (n = 8) and just-in-time training (n = 5) as important to consider. One faculty member stated, "The time to develop a course makes it so hard even before accessibility and accommodations are addressed, and as a faculty member, I would develop a much stronger course if I had assistance throughout the process." Another wrote, "Workshops or help chats online when I'm not able to physically attend a seminar or workshop" as helpful. Some faculty stated that support could come in the form of, "Ongoing workshops on QM standards and universal principles, and accessibility." Several faculty members state the need for coaching (n = 9) as a benefit. As one faculty member wrote, "It also would be helpful to have 'coaches' who could assist faculty in redesigning online courses to be more accessible." Another faculty member stated, "It would be helpful to have one-on-one consultations where someone with broad training could sit down with me to make my materials and LMS site more accessible." Challenges to Accessible Design. Some faculty members perceived that it takes too much time to design courses (n = 14) and that they lack time for training (n = 13). Some faculty stated that they would consider a reactive approach (n= 6) to incorporating accessibility into their course design. One faculty member wrote that, "Given the limited time I have as an instructor, I have been reactive rather than proactive in addressing accessibility in my online courses, when I have a student that has a requirement." Also, faculty stated that captioning and transcription support services (n = 7) would be very helpful in alleviating some of the workload.

Discussion
The survey findings yielded important insights regarding faculty knowledge of laws and standards as well as their responsibility to accessibility practices and professional development support they find beneficial. The results of this study indicate that there is a need to promote education and access to information on disability and the faculty role in the accommodation of students online.

Knowledge
Faculty reported being very knowledgeable on various accessibility terms and in their legal responsibility in providing accommodations to students with disabilities. They also reported being very knowledgeable about their institution's legal obligation. However, faculty are much less aware of the laws and standards that formed the basis of institutional policies. For instance, faculty are moderately aware of the Americans with Disabilities Act of 1990. However, they were only slightly aware of Section 504 of the Rehabilitation Act of 1973. They are less aware of how these laws impact their design and delivery of online courses. This was also reinforced in the open-ended comments where faculty requested knowledge and training on laws and standards. Nonetheless, higher education institutions are legally bound to adhere to both laws which prohibit discrimination and guarantee equal access to all individuals with disabilities (United States Department of Education, 2018). Thus, higher education institutions must continue to take proactive steps to close the gap in faculty knowledge regarding how federal laws impact the design of online courses.
In addition, in the open-ended comment, faculty also requested training on the disabilities students have and tools that can be used to support students with disabilities. Early studies indicate links between faculty awareness and knowledge of disability laws and being disposed to accommodating the needs of students (Bowman & Marzouk, 1990;Rao & Garten, 2003). The implications are that lack of awareness and knowledge are impediments to faculty accessibility practices. This establishes the need for faculty education on disability laws, standards, needs of students, and accessibility of tools and applications.

Practice
Findings reveal that faculty infrequently apply practices that facilitate accessibility. Their perceptions of the use of videos, Word and PDF documents were high, and perception of the use of Google Apps and audio in online courses was low. Faculty perception of their need to provide a statement on their respective syllabi regarding disability accommodations was also high. However, faculty perception of use was low in regard to providing transcripts and captions for video. In the open-ended survey responses, faculty reported that captioning the videos themselves was a very time-intensive process and that it would be beneficial to them for a specific department within the university to provide those services or even outsource that task to an external vendor. Yet, faculty frequently use videos in their courses as they serve as an alternative to text-only instruction. A key advantage of video-enhanced instruction is that it allows students to learn at their own pace and view material as often as needed. As Kay (2012) noted, the integration of videos in instruction helps enhance students' engagement with course materials. Also, videos are beneficial to those with cognitive challenges and different learning styles (Linder, 2016).
Nonetheless, research shows that a reactive approach to course design can cost more and requires more time than a proactive approach to course design (deMaine, 2014). This is because with a reactive design, key sections of the course often need to be altered and adjusted to meet the new user needs and requirements and this takes additional time and effort from the faculty and other support staff of the university. With proactive design, potential changes are anticipated and thus embedded in the initial course development process. Furthermore, as it is already a common practice for faculty to include a statement on the syllabus regarding accessibility, this studentfaculty relationship and commitment to inclusiveness is only a first step in a move beyond a legal obligation.

Professional Development
Participants reported that professional development on accessibility is very important. The data collected show that faculty perception was high for support using technology to teach students with disabilities and the need for assistance from internal units and resources like the Office of Online Programs, Center for Teaching and Learning, Instructional Designer, etc. in adapting their online courses. Further, when faculty were asked about their knowledge in developing accessible online courses, they reported a high perception for support in training and knowledge on how to improve accessibility application and practices, and on overcoming the challenges to meeting the time commitment involved in designing online content.
Faculty also rated the need for support in video captioning and training on the policies and procedures for students with disabilities as very important. Faculty rated the need for training on using WCAG Guidelines and Section 508 of the Rehabilitation Act regarding technology use as moderately important. From the open-ended responses, faculty preferred periodic refreshers, as well as professional development on policies and standards. They also specifically requested workshops on autism and cognitive impairments. Research also supports that students with disabilities find few of the faculty who are familiar with their disability and need for accommodations (Stevens, Schneider & Bederman-Miller, 2018;Terras, Leggio & Phillips, 2015).
Due to the nature of faculty work and the diversity of needs and teaching schedules, faculty have limited time to attend traditional workshops that require they attend at a specific time and location (Gappa, Austin & Trice, 2007;Lombardi & Adam, 2017). Some faculty reported an alternative training program could be beneficial. They requested online workshops, one-to-one workshops, coaching, and flexibility in scheduling workshops based on their schedule. When professional development on accessibility is offered, it is important to keep these types of training in mind. In addition, faculty reported challenges to negotiating their time with professional and disciplinary criteria of tenure and promotion, which rewards scholarly productivity ahead of teaching and other activities such as student advising and community involvement. Faculty have challenging teaching loads and are expected to integrate new technologies when designing and developing learning experiences for their students.
Challenges to Designing Accessible Courses. There were four themes that emerged as challenges which include, designing accessible courses takes too much time, lack of time to attend training, captioning/transcription services are not provided by universities, and faculty use a reactive approach to instruction instead of being proactive. Given these challenges, it is important for administrators to provide the support that faculty need in terms of time, also training opportunities, and captioning/transitioning services. Quality assurance certification programs such as Quality Matters include accessibility as an essential standard that requires the faculty to be more proactive than reactive.

Key Background Factors
Statistically significant differences were noted with respect to perceptions of knowledge and practices with accessibility in online courses. Results revealed faculty with online teaching experience between 6-10 years performed slightly better with practice than those who had been teaching two years or less. Research on expertise explains how experience and practice allow people to excel in domain-related tasks. Therefore, the difference in practice with regards to accessibility in online courses between the two groups appears to be linked to expertise. It can be expected that the scores of the participants who fall in the novice category (i.e., 2 years or less experience teaching online), will most likely improve as they teach longer and thus achieve expertlevel performance in the field.
Results also showed that faculty who received professional development training in online learning had a very significant influence on accessibility knowledge and practice than those who had not received any training. These findings are comparable to Wynants and Dennis' (2017) findings that training improves faculty accessibility knowledge and practice in online courses. Although faculty perceptions regarding professional development were very important, 37% of survey participants reported that they had not received any training for online teaching in the past year.

Limitations
There were some methodological limitations with the study. First, the response rate of the survey was only 17%. Also, 182 faculty members from three institutions participated in the survey, 51% of the responses came from one institution. Second, all the data collected were self-reported. This could result in a response bias. Third, the domain of faculty expertise was not a factor that was examined in the study. Fourth, the data collected did not convey the types and level of training faculty receive at their institutions. Consequently, the reader may interpret the results of the study with caution because they may have limited generalizability in different contexts and settings.

Recommendations for Future Research
Areas for future research may include an examination of the impact faculty background has on their knowledge and competency regarding supporting learners with disabilities who take online courses. The availability, type, and scope of resources and activities related to faculty training, e.g., Center of Teaching of Learning, Online Education Office, and financial allocation, may be explored to determine their impact on faculty knowledge and practice. Future research may likewise explore the connection between faculty's background and experience with disabilityrelated issues and their academic practice. It will also be worthwhile to examine the perspective of faculty without prior experience teaching online or teaching only in hybrid formats on accessibility issues related to learners with disabilities.

Implications and Conclusion
Many students with disabilities are now taking online courses to fulfill their degree program requirements. Consequently, higher education institutions, no matter their size or enrollment level, must take the appropriate steps to ensure that their online courses are legally compliant with all disability-related laws, rules, and ordinances. As the results of this study show, higher education institutions must make greater efforts to ensure that their faculty members are adequately trained and supported to teach effectively and efficiently in the online learning environment. Moreover, higher education institutions must ensure that their level of investments in both academic tools and personnel resources are in congruence with their focus on increasing their online offerings.
It is recommended that accessibility training provided by higher education institutions includes a focus on disability-related laws and specific disabilities and designing instruction with accessibility in mind. Institutions should also emphasize proactive strategies for online course design in their training. This is to avoid having to retrofit online courses to meet legal requirements and the educational needs of learners with disabilities. As important, professional development support needs also to incorporate a transformational learning framework that scaffolds critical reflection and reflective discourse. Such an approach will help provoke reflection on beliefs and practices regarding inclusive teaching approaches in online courses for all students, including those with disabilities.