Abstract
In the USA, university-based educational leadership programs, usually referred to as principal preparation programs, have traditionally been the sole source of preparing aspiring school leaders for the job. In response to criticisms from time to time, the programs have been reformed and redesigned. This research was an attempt to investigate the current status of educational leadership programs regarding their missions, goals, and objectives, the curriculum design, and the incorporation of standards. Findings indicated that the programs’ missions, goals, and objectives focused on the knowledge, skills, and dispositions as articulated in the Interstate School Leadership Licensure Consortium and Educational Leadership Constituent Council Standards in the form of expectations for school leaders. The courses aligned with the standards were designed to equip candidates with the basic knowledge and processes of administration and instructional leadership along with awareness of the current issues, application of research tools to make informed decisions, use of modern technology, and developmental and cultural understanding. Moreover, the internship component of the programs was meant to provide authentic opportunities for candidates to apply theory into practice and to devise and practice their own leadership style
Keywords
Introduction
With the No Child Left Behind policy, the school principal’s success is measured by the achievement of students on national- and state-level tests regardless of their background and language (Hilliard and Jackson, 2011). It has given rise to the belief that the efficiency of schools is based on the ability of principals (DiPaola and Tschannen-Moran, 2003; Huber, 2004).
The changing role of school leaders and the accountability policies have brought school leaders’ practices and hence their preparation into focus too (Orr, 2011). Educational leadership training is the foundation step in the careers of administrators and so the leadership success of principals is dependent on the quality of such preparation (Council of Chief State School Officers CCSSO, 2012).
The university-based educational leadership programs in the USA are the oldest as compared to other countries of the world (Murphy, 1998) and carry the sole responsibility of preparing school-level leaders (Briggs et al., 2013). Initially, the preparation programs came into focus when the University Council for Educational Administration and the National Commission on Excellence in Educational Administration published a report titled “Leaders for America’s Schools” (1987). The report criticized leadership preparation programs for several weaknesses. Further investigations into university- and college-based principal preparation programs proclaimed that the programs were inadequate for preparing aspiring principals to lead schools in the 21st century (Darling-Hammond, Meyerson, et al., 2009; Davis et al., 2005; Levine, 2005). Hess and Kelly (2007) raised questions on the content of educational leadership programs and found that aspiring principals received insufficient training in “important management scholarship or sophisticated inquiry on educational productivity and governance” (p. 36), in teacher evaluation as well as data statistics.
As a result of criticisms, a concerted effort started to improve the educational leadership programs at two levels: (a) policy and (b) research (Orr, 2011). On the policy level, efforts were made to standardize the knowledge-base and provide a common framework for preparation, which resulted in the formation of the Interstate School Leadership Licensure Consortium (ISLLC) and the Educational Leadership Constituent Council (ELCC) standards in 1996 (English, 2006). Most of the states in the USA have adopted the national standards and, since then, the ISLLC standards have been used to guide leadership preparation, practice, and evaluation, thus becoming the best source of producing exceptional future leaders (Canole and Young, 2013). The standards were revised and improved in 2008 and 2015, backed by extensive research and societal conditions such as changes in the demographics of student populations, the nature of families, technological advancement, and global changes (Young, 2015a).
Characteristics of successful educational leadership programs
It is well established now that certain leadership practices and dispositions result in student achievement (Leithwood et al., 1996). This notion leads to the presumption that effective principal preparation programs can produce such leadership qualities to ensure success for all students. There are several studies that established the importance of principal preparation for effective leadership (Barber et al., 2010; Braun et al., 2011; Darling-Hammond et al., 2009; Huber and West, 2002; Peterson, 2002; Pounder, 2011).
Those studies, along with establishing the important role of principal preparation programs in effective leadership, also identified several components that were known as innovative (Jackson and Kelly, 2002; Orr, 2011) and exemplary (Orr and Orphanos, 2011) due to their nature of being based on research and for their proved evidence of effectiveness. Among such components were the standards-based curriculum, a meticulous recruitment and selection process for candidates and faculty, strong partnerships with schools and districts to support intensive internships, cohort groups, and field-based internships with skilled supervision (Campanotta et al., 2018; Davis et al., 2005; Jackson and Kelly, 2002; Jacobson et al., 2015; McCarthy, 1999; Murphy et al., 2009; Orr, 2006; Young, 2015b).
The curriculum design of leadership programs was thought to be the cornerstone for developing a coherent program characterized by high-quality experiential learning opportunities for the candidates (Orr and Pounder, 2011). According to Jacobson et al. (2015), the curriculum and learning experiences should be clearly aligned to the programs’ missions and the standards. Moreover, the scope and sequence of the coursework should support the curriculum. Effective and aligned curriculum design necessitates deeply connected teaching and learning aligned to the program’s mission and goals, emphasizing critical self-reflection through activities in coursework, developing students’ intrapersonal and dispositional training(Jacobson et al., 2015; Waterson, 2015). Huber (2010) emphasized bonding theory to practice as the most important feature in designing educational leadership curricula.
Relevant internships that connect theory to practice have undeniably been the main focus of the principal preparation programs (Anast-May et al., 2011; Christian, 2011; Darling-Hammond et al., 2009). Authentic leadership experiences have been reported to have a positive impact on the administrative performance of school leaders (Jean and Evans, 1995; Milstein and Krueger, 1997). Researchers have also stressed the internships, which could develop professional leadership skills in candidates by providing the opportunity to apply theory into practice to contribute to constructing their leadership philosophies (Geer et al., 2014).
Based on the literature, very limited research studies examined how the curricula align program missions, goals, and objectives with multiple cases. The purpose of this study was to explore the status of three master’s programs of educational leadership and administration offered by institutions in the University System of Maryland from the perspectives of the program designers, such as the directors and the faculty, as well as the stakeholders, such as the students of the program. In other words, this study provided a holistic view of such programs based on the following research questions. (a) What are the missions, goals, and objectives of the selected educational leadership and administration master’s programs? (b) How do the curricula support the missions, goals, and objectives of the programs? (c) How do the programs meet the national standards for educational leaders? The results of this study will be useful for an international audience, especially those who intend to develop leadership training programs or who aim to improve already instituted ones.
Methods
Participants in the study
Participants for the collection of data included the following: the director and two teaching faculty from each program; ten senior candidates from each program.
Data collection procedures
The study employed multiple case methods to get a deep understanding of the selected three programs. In the first phase, document reviews were conducted to identify the characteristics of the curricula of each program. The document analyses incorporated reviews of artifacts, including the program handbooks, and online material on the school websites. The data from the documents review were used for constructing faculty interview questions and surveys of the program students.
The second stage of data collection consisted of semi-structured interviews with the programs’ directors and two teaching faculty members, and thus three faculties in total for each case program. Appropriate approval was obtained from the directors of each selected program and interview protocols were used prior to the interviews. Strict confidentiality was observed regarding all data. Apart from general questions about experience, specific questions about the programs’ features were asked in order to address the research questions. For example, in the faculty interview protocol questions 1–3 and 15 addressed research question 1; 4–10 addressed research question 2. Research question number 3, which was about standards, was directly addressed in interview protocol question number 13; other questions were also expected to provide a clue on the topic (Appendix A).
In the third stage, 30 senior program candidates, 10 from each of the three programs, were selected. Recommendation of the program directors was sought in selecting the candidates in order to select only those candidates who had completed and experienced all of the program components. The purpose of the survey was to get information about the candidates’ understanding of the features of individual programs regarding the knowledge, skills, and competencies and experiences that were offered by the programs. In the survey questionnaire (Appendix B), questions 1, 7, and 8 focused on research question 1, and survey questions 2 and 3 addressed research questions 2 and 3. Other than that, the survey questionnaire contained several other questions that shed light on the overall experiences of the program.
Data analysis and interpretations
The three programs taken as cases for this study were pseudo named as Program A, Program B, and Program C. In accordance with pseudonyms of the programs, the faculty of Program A was named as Faculty A1, Faculty A2, and so on, and the candidates were named as Candidate A1, Candidate A2, etc. The same naming criteria were used for the other programs. The faculty of university B was named as Faculty B1, Faculty B2, etc., and the candidates as Candidate B1, Candidate B2, etc. Participants of program C were named as Faculty C1, Faculty C2, etc., and the candidates as Candidate C1, Candidate C2, and so on.
Document analysis, interviews, and survey responses were used to collect data for this study. After all the pertinent data was collected a thematic analysis on the data ensued in order to analyze the information and produce meanings. The steps in the qualitative methodology of thematic analysis as proposed by Braun and Clark (2006) were used to find recurring patterns or themes across the entire data set and extract meaning out of them. Following the phases of thematic analysis, in the first phase the researcher transcribed the interviews and then read and re-read the interviews, documents, and candidate responses. In the second phase, codes were generated in the entire data, and collating codes were put together for potential themes in the third phase. In the fourth phase, themes were reviewed and collated together from all three sources. The fifth phase consisted of refining and defining themes and supporting themes with context and quotes, and gave a final shape. The final step consisted of reporting the final themes.
Triangulation and description were the main validation strategies adopted in this research. The term “triangulation” is used to refer to observation of the research issue from (at least) two different points “by applying different methodological approaches” (Flick, 2004: 178; Patton, 1999). In that connection, outside of the documents review, faculty interviews and candidate responses were analyzed to validate or add to the accuracy of themes. Moreover, an in-depth description was provided in order to develop a comprehensive understanding of the phenomena under study. This process gave rise to themes that in turn were used to answer the research questions.
Findings
Data analysis showed that standards, accreditation, and state laws determined the framework of educational leadership programs. Therefore, a general consensus was found among the programs regarding the programs’ missions and goals, courses, internships, and structures as a whole with slight variations.
Programs driven by standards
The analysis of data found that the three case programs were approved by the Maryland State Department of Education (MSDE) and accredited by the National Council for Accreditation and Teacher Education (NCATE). In connection with accreditation and approval the programs adhered to two sets of standards, such as ELCC and ISLLC standards. At the time of this study although the reformed standards known as National Educational Leadership Preparation Standards (NELP) and Professional Standards for Educational Leaders (PSELs) were already introduced, the case programs had not yet switched to the recent standards.
It was found that the programs’ curricula, missions, goals, objectives, and activities were constructed around those two sets of standards along with some local preferences. Faculty, in their interviews, expressed the dominant role of standards in the program design. For example, faculty A3 shared the following: The mission of our program is to develop leaders in order to lead K-12 schools. About how we design courses, it is to some extent driven by the standards that we follow. Basically, the way curriculum is designed is that we have a set of standards from our accreditation bodies to which we are held accountable. For example, the ELCC judges on these standards. So, when we are selecting courses, we have to look at what is required in the standards; and we also have to look at COMAR (Code of Maryland) laws, so those are the laws that govern. There are specific topics of courses. We have to have a law course, K-12 leadership, supervision, and assessment courses. So those four courses by name we have to have. Well that is the foundation. Next, we have to look at what are the institutional requirements. I have learned through the different assignments about the Educational Leadership Standards and the different ways that they could be implemented. Within those assignments, I was prompted to dig deeper and reach out to an assortment of different educational leaders in the county (as well as my administrators in my current and previous building). (Candidate B7)
Academic cum professional development
The selected educational leadership master’s programs conferred a master’s degree and advanced certification. In that connection, they were professional cum academic degree programs that contained both advanced knowledge and theory about the subject matter and aspects of practical application throughout the programs. The programs in accordance with state and institutional policies and accreditation regulations followed ISLLC and ELCC standards. Therefore, the programs’ entire frameworks were aligned to the two sets of standards.
The programs aimed to impart knowledge, skills, and competencies regarding administration, managerial processes, legal and financial procedures related to schools, and the use of modern technology for making data-based decisions for school improvement. Moreover, the programs offered knowledge on the best practices to lead diverse populations with equity and ethics in collaboration with community and other stakeholders. Most importantly, candidates were exposed to leadership theories, case studies, and practical experiences with emphasis on reflection, application of theory into practice, and discovering personal leadership style. Evidence for the discussed aims and goals were found in program documents, faculty interviews, and the candidate surveys.
Documents from Program A showed that the program emphasized five key areas: knowledge of subject matter; knowledge of effective pedagogy; knowledge of students and society; field-based experiences; and professional dispositions (Advisement Book: 10).
Program B was committed to provide “knowledge, application, analysis, and reflection of current practice in the field…provide background in theories appropriate to the field, and require student application…knowledge, recognition, and ability to work with individual differences and capabilities of children and adults” (Graduate Catalog, 2018-2020: 34).
Program C articulated its expectations as follows: “Graduates should be informed practitioners, possessing a full understanding of the theories that guide practice in school administration…. should demonstrate competence and skill as they apply knowledge to practice in educational organizations” (Online Program Introduction: 1).
Faculty also stressed the academic and professional development in the interview: We provide an academically rigorous and collaborative environment to inculcate academic knowledge, reflective practices, and interpersonal communication; but everything we do is aligned with the ISLLC standards. (Faculty A2) It [the program] allows you a text book version of what you will experience and the practicum experience allows you to sample what it would be like. The program gave opportunities to experience learning the behind the scenes things about what makes a building run, ways to talk to parents, how to have courageous conversations with staff members, things to consider when making public statements. (Candidate B4)
Moreover, candidates highlighted the knowledge, skills, and dispositions articulated in both sets of standards regarding the focus of educational leadership, such as school improvement, planning, classroom management, conflict resolution, facilities management, etc. “Within those assignments, I was prompted to dig deeper and reach out to an assortment of different educational leaders in the county” (Candidate B7). “The courses on Human Relations and School Law were the most helpful in that we had to read and respond to a variety of scenarios regarding teachers and students” (Candidate A1).
The programs were basically instituted to provide certification and professional development to candidates. The data indicated that the programs focused on equipping candidates with the knowledge of the job of an administrator at the school level. Candidates echoed an appreciation of the knowledge for their practical job experience.
Variations in curriculum structure
The programs’ missions and objectives were supported through offering a set of courses and a practicum. The courses and credit hours structure of the programs is tabulated in Table 1.
Course and credit hour structure of programs.
The programs, as shown in the Table 1, were composed of courses and a practicum component. Programs B and C were similar in terms of credit hour specification. Although the courses in Program B were specified as core and concentration, Program C itemized all nine courses as core. Analysis of the titles and course descriptions indicated that the courses were basically the same. Other than that, Program A specified more credit hours in their program and offered elective courses, which were due to institutional preferences. The curriculum design was explained by Faculty C1 as follows: Basically, the way curriculum designed is that we have a set of standards from our accreditation bodies we are held accountable for example ELCC they judge us on these standards. Next, we have to look at what are the institutional requirements. For example at the time our program was built we were not allowed to exceed 33 credits, so, we have to look at the standards, state law and institutional requirement and then we sit and think about what our students will need to be ready when they go on a job on the field.
Aligned curriculum framework
It was found that the curriculum framework was based on standards. Themes in the missions and objectives as articulated by individual programs reflected the two sets of standards. Moreover, courses were designed to meet the standards and the state law, and to some extent reflected the preferences of the curriculum committee. For example, Faculty B1 shared the following: So Maryland standards dictated that you should have a law course, a curriculum course finance, practical supervision, and assessment courses and leadership courses. So you have to go by the law while designing curriculum and let me tell you that the differences in programs are based on the personality differences and the skills and experiences professors bring to the class.
Alignment of missions, goals, and objectives of programs to Educational Leadership Constituent Council (ELCC) and Interstate School Leadership Licensure Consortium (ISLLC) standards.
As indicated in Table 2 the first group of interrelated themes consisted of school improvement, vision building, change management, and communication, which were addressed in ISLLC standard 1 and ELCC standard 1.
The second group consisted of curriculum, instruction, technology, and research and met ISLLC standard 2 and ELCC standards 2 and 4. The interrelated themes in group 3 addressed ELCC standard 3 and ISLLC standard 3 and the last group containing themes related to diversity and community addressed ELCC standard 5 and ISLLC standards 4 and 5.
The courses offered in the curriculum were also designed in accordance with the above-mentioned themes as evidently aligned to standards. Apart from meeting standards, the State of Maryland obligated educational leadership programs operating in the State of Maryland to have four compulsory courses, namely K-12 financial management, school law, human resource management, and K-12 leadership. Apart from offering the compulsory four courses, each university has a departmental committee to design curricula. The committee, while designing the curriculum, considered the institutional requirements, local preferences, and student needs.
It is important to note that the state law obligates the four aforementioned foundation courses for educational leadership programs, whereas for the rest of the course design programs have to meet the standards and each program strives to address the standards in its own way.
Table 3 summarizes the interconnection of standards, themes from missions, goals and objectives, and the courses, as indicated by the titles. It should be noted that inclusion of courses in theme groups was limited to the course descriptions. The courses offered in the curriculum were designed in accordance with the mentioned themes as evidently aligned to standards.
Mutual alignment of courses, missions, goals and objectives, and standards.
ELCC: Educational Leadership Constituent Council; ISLCC: Interstate School Leadership Licensure Consortium.
Each program offered the four courses as mandated by the state law. In the rest of the courses the titles indicated alignment to themes found in standards as well as slight personalization in the course titles.
In order to meet ELCC and ISLLC standard 1, which emphasized vision building, school improvement, and research, each of the three programs offered one course in research. In the USA, as a result of the No Child Left Behind policy, which highly emphasized scientifically based research, school principals must develop meticulous research skills, which could be applied to the daily challenges of successful school leadership (Bustamante and Combs, 2011). In that connection, Program B emphasized the provision of cutting edge research skills to be used in interpreting and evaluating preferred practices related to school administration and supervision (program guide).
The most recent form of education leadership is a combination of instructional leadership and management (Botha, 2004), where school leaders are expected to ensure quality curricula and successful implementation of programs (Shi, 2008). ELCC and ISLLC standard 2 emphasized the curriculum and instruction and standard 3 the knowledge and capacity regarding K-12 administration. In that connection, Program B offered one course, Program C offered three courses, and Program A offered five courses. An increased number of courses indicated an increased emphasis on curriculum and instruction. On the other hand, the selected programs offered several courses related to management in order to address standard 3. For example, Program A offered six, Program B offered five, and Program C offered four courses covering school law, human resource, administration, finance, etc.
Educational administrators are currently facing new challenges of social justice and equity. It was pointed out that skills to dispense with social and ethical challenges, such as poverty, gender, race, sexuality, etc., were not learnt through the teaching of traditional courses in the preparation programs (Furman and Shields, 2005; Marshall, 2004). One way to improve this issue was to produce educational leaders who uphold diversity and equity through ethics and cultural proficiency (Ezzani, 2014; Shah, 2006). ELCC and ISLLC standards 4 and 5, which emphasized that educational leaders should possess skills in administering the mentioned issues related to diversity, community relations, and ethics, were addressed by each program by offering one course for each standard, except Program C, which addressed both standards in one course.
A unique aspect that was revealed was that technology was an important theme found in the two sets of standards as well as in the missions and objectives of all the three programs; it was addressed in a course title by Programs B and C, whereas Program A did not mention the term in either the course title or description, although the program’s mission stated that “computer applications in all courses are stressed and various forms of technology are incorporated in the curriculum” (Program A student advisement book “Program Goals and Objectives”). The lack of technology theme was explained by Faculty A1 as follows: We may need to modify the course description again because technology is used a lot. Some may use technology in school finance because some school principals get their budget electronically and they have to maneuver the budget through computer. So the course today would not only be finance but also focused on using technology.
Theory into practice in internship
The internship was an important component in scaffolding theoretical themes as articulated in the missions and objectives of the programs and theoretical knowledge taught in the courses to practical application. It is important to note that the state law and the ELCC standards obligated educational leadership programs to provide a rigorous internship opportunity to aspiring principals. Regarding internships, Faculty A1 stated the following: Whatever the principal does every day in the school we would like to have the student (intern) has a hands-on experience for that so when in the classroom the student officially does writing on comments about instruction. Also, if a student has a disciplinary problem the student [intern] knows how to solve it by using the State of Maryland regulation. Also, we as a college will comment 2 or 3 times in a semester to see the students doing the internship. There are two levels of the internship and a lot of times the students go in on a level where they’re normally shadowing and following school leaders but in the other they develop a lot of problem solving that by a meeting and connecting to the individuals they have actually shadow with. So, they look and they follow the leadership skills of a person and then from there they take on a leadership issue that may develop and use in the place of same individual or place very similar in order to support the students of that process. If you are looking at student discipline the school law (course) relates to that if you are looking at the school budget the school administration (course) relates to that if you are looking at how the courses should be executed the school curriculum development (course) relates to that if you are looking how to work with people to improve the collaborative environment that would relate to dynamics of group behavior (course). If you are working with the principle to observe teacher teaching that’s school supervision (course) that’s how they all connect. Each intern is also assigned a university supervisor who goes to the site and sees and sits down with the principal and asks how things are going. In vast majority of cases things go very well and interns get rich experiences. We evaluate our interns based on observation, did they meet some of the goals or did they participate something to parents maybe at night there’s a PTA (Parent Teacher Association) meeting we also look at the notes that they have kept we look at the portfolio of the of entire experiences during the 2 semesters they have to turn in a digital portfolio (at one time it was a physical notebook) and we go online to evaluate their involvement with supervision, did they show involvement with law, curriculum also with families. We look at all of that in the notebook and evaluate them with a rubric that is a part of our task screen database system.
Candidates expressed highly the practical aspect of the internship opportunity; for example: “My internship allowed me to apply what I was learning to real time scenarios” (Candidate A4). Candidate A10 further elaborated on the benefits of internship by commenting, “By observing leaders serving in various leadership roles/capacities and engaging in aspects of the leadership role, I obtained a deeper-level understanding of the work I was about to embark upon. I was able to reflect on the work.”
It was evident from the candidates’ comments that the internship component was focused on preparing them for leadership success in several ways, such as “The internship helped me by providing me with real world experience and exposure to current school system leaders and the responsibilities they have. I was also able to improve my presentation skills by making presentations to key school system staff” (Candidate A10). “I learned a lot about how to effectively communicate with parents, students and colleagues” (Candidate C3). “It helped me see the various aspects of leadership both within the school building and outside of the school building (I did both) and how they work together” (Candidate A10).
Candidate A9 highlighted the application of theory into practice aspect of internship by saying the following: The internship allowed me to apply theoretical knowledge to the actual work of an educational leader. The internship was valuable because it is no longer just theory. It was also helpful to learn about school law, special education, and interacting with stakeholders.
Conclusion and discussion
In the USA, in order to secure a school leader position at the P-12 level, candidates must attain state certification (Anthes, 2004; Hilliard and Jackson, 2011, Mercer, 2016). Educational leadership master’s programs offered at universities are specialized programs that confer administrative certificates as well as master’s degrees. In that way, they are academic cum professional degrees that offer advanced content and theoretical knowledge about the field as well as application of that knowledge. The programs faced severe criticism some time ago but several years of ensuing research input and trials and tribulations have gone into maturing these programs into the present status. In that connection, it is always a point of interest to know the current status of those programs and, therefore, this research could become a reference point for others who wish to construct such programs or improve already existing ones.
Overall, the study and results show that the programs were meant for candidates to meet administrator certification requirements along with conferring a master’s degree. They aim to prepare effective school leaders to lead schools in the 21st century. The programs were regulated by state policies and regulations as well as judged against the national standards and accreditation, which could vary by state and institution. The programs under this study adhered to ISLLC and ELCC standards. Alignment to standards necessarily produces a coherent and robust curriculum (Cosner et al., 2015; Darling-Hammond et al., 2009; Ni et al., 2016; Orr and Orphanos, 2011; Young and Crow, 2016; Young et al., 2009). The programs’ missions, objectives, and courses addressed content related to the expectations of school leaders as articulated in the ISLLC and ELCC standards. The course content especially equipped candidates with the basic knowledge and processes of administration and leadership along with awareness of the current issues, application of research tools to make informed decisions, technology use, and developmental and cultural understanding. Therefore, the curriculum covered content related to management and instructional leadership. Moreover, the internship component was intended to provide the best authentic leadership experience to candidates for effective leadership. A two-way mentorship was provided to interns; firstly, from the school administrator that they had to shadow and, secondly, a university supervisor to ensure the best possible support to candidates. An important characteristic of the programs was their overall alignment to standards. Although there were slight variations in the structure of programs regarding credit requirements for graduation, course titles, and number of optional courses (in the case of one program), at the end everything went back to standards. Programs had to address what was required in standards and accreditation. Research has supported alignment to standards for ensuring quality in programs.
Owing to the increased complexity and accountability of school leadership, the preparation programs play a vital role in preparing aspiring leaders to get ready for the job. Recently the Council of Chief State School Officers (CCSSO, 2012) noted that educational leadership training is the first step in the careers of administrators, and the leadership success of principals essentially rests on “the quality of preparation” (p.3). Among other ways, scrutiny of the structure and design of such programs would also add to knowledge about the quality of programs.
Footnotes
Appendix A - Interview questions for the faculty
Appendix B – Candidates’ survey questionnaire
Declaration of conflicting interests
The authors have no conflicts of interest to declare.
Funding
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors
