Muianga, Custodio; Rice, Carol; Lentz, Thomas; Lockey, James; Niemeier, Richard; Succop, Paul
2012-01-01
A systematic approach was developed to review, revise and adapt existing exposure control guidance used in developed countries for use in developing countries. One-page employee and multiple-page supervisor guidance sheets were adapted from existing documents using a logic framework and workers were trained to use the information to improve work practices. Interactive, hands-on training was delivered to 26 workers at five small-scale demolition projects in Maputo City, Mozambique, and evaluated. A pre-and-post walkthrough survey used by trained observers documented work practice changes. Worker feedback indicated that the training was effective and useful. Workers acquired knowledge (84% increase, p < 0.01) and applied the work practice guidance. The difference of proportions between use of work practice components before and after the intervention was statistically significant (p < 0.05). Changes in work practices following training included preplanning, use of wet methods and natural ventilation and end-of-task review. Respirable dust measurements indicated a reduction in exposure following training. Consistency in observer ratings and observations support the reliability and validity of the instruments. This approach demonstrated the short-term benefit of training in changing work practices; follow-up is required to determine the long-term impact on changes in work practices, and to evaluate the need for refresher training. PMID:22470296
New systems of work organization and workers' health.
Kompier, Michiel A J
2006-12-01
This paper aims at identifying major changes in and around work organizations, their effects upon job characteristics and the health and well-being of today's employees, and related research challenges. Increased internationalization and competition, increased utilization of information and communication technology, the changing workforce configuration, and flexibility and new organizational practices are considered. As work has changed from physical to mental in nature, job characteristics have changed significantly. Meanwhile work and family life have blended. New systems of work organization have become more prevalent, but they do not represent a radical change across the whole economy. New practices may have an adverse impact upon job characteristics, but their effects depend on their design, implementation, and management. Research recommendations include improved monitoring of changes in work organization and studies into their health and safety consequences, intervention studies, studies into the motivating potential of modern work practices, studies of marginalized workers and workers in less developed countries, and "mechanism studies".
Understanding and Representing Changing Work Structures and Practices through Art
ERIC Educational Resources Information Center
Wieland, Stacey M. B.
2018-01-01
Courses: Organizational Communication, Advanced Organizational Communication, Organizing Work, Management/Organizational History. Objectives: This activity will help students to understand major shifts in the organization of work and creatively represent changing work structures and practices. An optional follow-up assignment is included. A…
Tuomi, Kaija; Vanhala, Sinikka; Nykyri, Erkki; Janhonen, Minna
2004-03-01
Rapid technological change and increased international competition have changed working life and work organizations. These changes may not be considered when researching employee work ability and well-being. This study investigates the impact of organizational practices, work demands and individual factors on work ability, organizational commitment and mental well-being of employees in the metal industry and retail trade. A follow-up study was conducted to examine these connections among 1389 employees (mean age 42 years at baseline) in 91 organizations. The first survey was conducted in 1998 and was repeated in 2000. Changes in organizational practices and the demands of work were strongly associated with changes in employee well-being. Work ability, organizational commitment and the mental well-being of employees were increased most if the opportunities for development and influence and the promotion of employee well-being were increased and if the supervisory support and organization of work were improved. Well-being also improved with less uncertainty at work and with decreasing mental and physical work demands. In addition physical exercise and affluence also had favourable effects. The results confirm that several features of organizational practices are strongly associated with employees' well-being. Organizational development is an important method of improving employees' work ability, commitment and well-being.
ERIC Educational Resources Information Center
Noesgaard, Signe Schack
2016-01-01
Purpose: The paper aims to discuss the effectiveness of e-Learning in advancing work practices. The paper investigates the assumption that e-Learning is as effective as face-to-face interventions when stimulating change. It also examines the assumption that well-designed and well-executed instructional interventions will advance work practices.…
Williams, Caroline
2010-09-01
To critically review the work-based learning literature and explore the implications of the findings for the development of work-based learning programmes. With NHS budgets under increasing pressure, and challenges to the impact of classroom-based learning on patient outcomes, work-based learning is likely to come under increased scrutiny as a potential solution. Evidence from higher education institutions suggests that work-based learning can improve practice, but in many cases it is perceived as little more than on-the-job training to perform tasks. The CINAHL database was searched using the keywords work-based learning, work-place learning and practice-based learning. Those articles that had a focus on post-registration nursing were selected and critically reviewed. Using the review of the literature, three key issues were explored. Work-based learning has the potential to change practice. Learning how to learn and critical reflection are key features. For effective work-based learning nurses need to take control of their own learning, receive support to critically reflect on their practice and be empowered to make changes to that practice. A critical review of the literature has identified essential considerations for the implementation of work-based learning. A change in culture from classroom to work-based learning requires careful planning and consideration of learning cultures. To enable effective work-based learning, nurse managers need to develop a learning culture in their workplace. They should ensure that skilled facilitation is provided to support staff with critical reflection and effecting changes in practice. CONTRIBUTION TO NEW KNOWLEDGE: This paper has identified three key issues that need to be considered in the development of work-based learning programmes. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Pascaris, Alysia; Shields, Leslie Reed; Wolf, Jessica
2008-01-01
Complex and multiple barriers confront out-patient programs in promoting recovery and addressing mental health recipients' work-related goals. This article describes a focused organizational change project utilizing intensive consultation and technical assistance within five New York City outpatient psychiatric services. The project aimed to increase staff exposure to, understanding and use of work-related and recovery-based concepts to promote consumers' recovery and attainment of employment goals. Tailored assessment, curriculum delivery, and identification and implementation of change objectives were useful strategies in promoting change. This change model can serve to assist programs in their efforts to integrate new approaches and to better understand changes among leadership, staff and consumers, and changes in organizational culture and practice required to support a work and recovery-oriented service paradigm. The project experience suggests that adopting and embracing new practices takes time. Varied and incremental steps toward programmatic and operational changes can be significant and can reap authentic sustainable change occurring in the process of learning, experiencing, internalizing and adjusting to new methods of practice.
Responding to Global Shifts: Meta-Practice as a Relevant Social Work Practice Paradigm
ERIC Educational Resources Information Center
Grise-Owens, Erlene; Miller, J. Jay; Owens, Larry W.
2014-01-01
In response to increasing global changes, this article proposes that social work education add meta-practice to traditional micro-, mezzo-, and macro-practice curriculum areas. Drawing on pertinent literature, the authors conceptualize meta-practice as a necessary paradigm shift for competent and relevant social work practice. Further, the authors…
Morténius, Helena; Fridlund, Bengt; Marklund, Bertil; Palm, Lars; Baigi, Amir
2012-04-01
To evaluate the long-term utilisation of strategic communication as a factor of importance when changing work practices among primary care staff. In many health care organisations, there is a gap between theory and practice. This gap hinders the provision of optimal evidence-based practice and, in the long term, is unfavourable for patient care. One way of overcoming this barrier is systematically structured communication between the scientific theoretical platform and clinical practice. This longitudinal evaluative study was conducted among a primary care staff cohort. Strategic communication was considered to be the intervention platform and included a network of ambassadors who acted as a component of the implementation. Measurements occurred 7 and 12 years after formation of the cohort. A questionnaire was used to obtain information from participants. In total, 846 employees (70%) agreed to take part in the study. After 12 years, the 352 individuals (60%) who had remained in the organisation were identified and followed up. Descriptive statistics and multivariate analysis were used to analyse the data. Continuous information contributed to significant improvements over time with respect to new ideas and the intention to change work practices. There was a statistically significant synergistic effect on the new way of thinking, that is, willingness to change work practices. During the final two years, the network of ambassadors had created a distinctive image for itself in the sense that primary care staff members were aware of it and its activities. This awareness was associated with a positive change with regard to new ways of thinking. More years of practice was inversely associated with willingness to change work practices. Strategic communication may lead to a scientific platform that promotes high-quality patient care by means of new methods and research findings.
Breaking the silence: nurses' understandings of change in clinical practice.
Copnell, Beverley; Bruni, Nina
2006-08-01
This paper reports a study exploring critical care nurses' understandings of change in their practice. In contemporary nursing literature, change in clinical nursing practice is generally understood to be a rational process, synonymous with progress. It is seen as invariably contested, and hence difficult to achieve. It is represented as occurring infrequently. This literature effectively silences clinicians as this discourse of change does not recognize or incorporate their views or practices. This study was informed by a Foucauldian poststructuralist framework. The participants were 12 critical care nurses who engaged in three individual in-depth, focused interviews. The transcripts were deconstructed to reveal participants' discourses of change and the implications of these discourses for nursing work. The data were generated between 1996 and 1998 as part of a study whose in-depth analysis was completed in 2003. Change was revealed as a highly complex phenomenon, closely intertwined with understandings of clinical nursing work. Participants showed difficulty in identifying or recalling clinical changes. Several dichotomies shaped their understandings of change, including change/stasis, formal/informal and dramatic/subtle. Their experiences of change frequently conflicted with prevailing dominant understandings, but they did not openly challenge them. Rather, they employed dichotomies, such as abstract/concrete and other/self, to enable them to work with these conflicts. As a result, they engaged in practices such as naming other nurses as 'irrational'. The data provide new understandings of change in clinical nursing practice, some of which challenge many widely held views (for example, that such change is a rare occurrence). It is argued that a lack of open challenge by clinical nurses contributes to their silencing, promotes disharmony amongst nurses and, hence, works against a collaborative approach to decisions about clinical practice.
ERIC Educational Resources Information Center
Pring, Tim; Flood, Emma; Dodd, Barbara; Joffe, Victoria
2012-01-01
Background: The majority of speech and language therapists (SLTs) work with children who have speech, language and communication needs. There is limited information about their working practices and clinical experience and their views of how changes to healthcare may impact upon their practice. Aims: To investigate the working practices and…
NASA Astrophysics Data System (ADS)
Abrahams, Ian; Reiss, Michael J.; Sharpe, Rachael
2014-09-01
Background:Despite the widespread use of practical work in school it has been recognised that more needs to be done to improve its effectiveness in developing conceptual understanding. The 'Getting Practical' CPD (Continuing Professional Development) programme was designed to contribute towards an improvement in the effectiveness of practical work through initiating changes in teachers' predominantly 'hands-on' approach to practical work to one which manifests a more equitable balance between 'hands-on' and 'minds-on'. Purpose:To evaluate the impact of the Getting Practical: Improving Practical Work in Science CPD programme on teachers' ideas and practice in science practical work in primary and secondary schools in England. Programme description:The CPD programme was designed to improve the effectiveness of science practical work in developing conceptual understanding in primary and secondary schools in England. Sample:Ten teachers of primary science and 20 secondary science teachers. Design and methods:The study employed a condensed fieldwork strategy with data collected using interviews, observational field notes and pre- and post-CPD training observations in practical lessons within 30 schools. Results:Whilst the CPD programme was effective in getting teachers to reflect on the ideas associated with the Getting Practical programme, it was much less effective in bringing about changes in actual teaching practice.
Work-based learning: making a difference in practice.
Chapman, Linda; Howkins, Elizabeth
Nurses play an increasingly crucial role in ensuring that patients receive the best possible care, and strive to lead innovations in health care. Changing practice is not easy and many nurses do not have the leadership skills or confidence to push for change. Therefore, they need to know that they are supported and encouraged to bring about change in nursing practice. Primary care trusts in the west of Berkshire and a university based in Reading have worked together to respond to this challenge by developing and implementing a flexible, accredited, work-based educational programme. The programme ensures that patients remain at the heart of learning by enabling nurses to lead and influence practice.
Can E-Learning Change Work Practices?
ERIC Educational Resources Information Center
Noesgaard, Signe Schack
2016-01-01
Stand-alone e-learning is unlikely to change work practices. This claim contrasts with a comprehensive body of research arguing that e-learning is at least as effective as face-to-face instruction in improving work performance. Such a comparison is, however, problematic. On the one hand, it relies on the premise that face-to-face instruction is…
ERIC Educational Resources Information Center
Gazi, Zehra A.
2009-01-01
Change and development in work settings for better working practice through projects has become essential. And, in this context, learning through working practice is constructed by participatory action research. This work-based research has a significant role to contribute innovative practice of Distance Education Institute at Eastern…
Changes in Financial Practices: Southeast Asian Refugees.
ERIC Educational Resources Information Center
Johnson, Phyllis J.
1989-01-01
Presents research on changes over a two-year period in the use of new, Western financial practices by Southeast Asian refugees and in variables affecting those changes. Significant interaction effects showed that increased use of new practices was affected by age, education, work experience, and changes in English ability. (JOW)
29 CFR 1910.1047 - Ethylene oxide.
Code of Federal Regulations, 2011 CFR
2011-07-01
..., rupture of containers, or failure of control equipment that is likely to or does result in an unexpected... there has been a change in the production, process, control equipment, personnel or work practices that... controls and work practices. (i) The employer shall institute engineering controls and work practices to...
Leading the Charge in Changing Times: 21st Century Learning and Leading
ERIC Educational Resources Information Center
Jones, Amanda Criswell
2016-01-01
Throughout history educational practices have typically been modeled after economic work practices. During the agrarian-age, educational practices modeled agrarian practices. Likewise, in the industrial-age, education became standardized and was modeled after industrial practices to prepare students for work in factories and industrial settings.…
ERIC Educational Resources Information Center
Wilson, Frances; Wade, Neil; Evans, Steve
2016-01-01
As part of a wider qualification reform at upper secondary level in England, the assessment of practical work is changing, following concerns that the legacy model of assessment was having a negative impact on teaching and learning. The OCR examination board is running a longitudinal survey of teachers' views on practical work, focusing on the…
Guevara, Edilma B; Mendias, Elnora P
2002-11-01
To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nurses about their perceptions of nursing practice and changes in work environments. Descriptions of characteristics and trends in nursing practice in the study sites were also obtained. Reorganization of health services has occurred in all five of the countries, responding to health sector reform initiatives and affecting nursing practice in each country. Respondents from all five countries mentioned an emphasis on private enterprise, changes in payment systems for patients and providers, redistributions in the nursing workforce, changes in the personnel mix and nursing-practice functions, work shifting from the hospital to the community, and greater emphasis on cost control and prevention in practice settings. The study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries. Nurses maintain their core values despite increased work stress and greater patient care needs in all the countries as well as economic crises in the Latin American countries.
Ethical preferences for the clinical practice of empowerment social work.
Miley, Karla; DuBois, Brenda
2007-01-01
Social workers in health care and mental health benefit from interventions that integrate principles of contextual social work practice with standards for clinical practice. The authors articulate a conceptual framework for the ethical practice of social work that complements the social justice purpose. The sixteen ethical preferences in this framework are the ethics of care, autonomy, power, change, respect, critical thinking, praxis, discourse, critique, justice, contextual practice, inclusion, anti-oppression, advocacy, collaboration, and politicized practice.
Grant, Bettyanne; Colello, Sandra; Riehle, Martha; Dende, Denise
2010-04-01
To discuss the new Magnet Model as it relates to the successful implementation of a practice change. There is growing international interest in the Magnet Recognition Programme. The latest generation of the Magnet Model has been designed not only as a road map for organizations seeking to achieve Magnet recognition but also as a framework for nursing practice and research in the future. The Magnet Model was used to identify success factors related to a practice change and to evaluate the nursing practice environment. Even when proposed changes to practice are evidence based and thoughtfully considered, the nurses' work environment must be supportive and empowering in order to yield successful and sustainable implementation of new practice. Success factors for implementation of a practice change can be illuminated by aligning environmental characteristics to the components of the new Magnet Model. The Magnet Model provides an exceptional framework for building an agile and dynamic work force. Thoughtful consideration of the components and inter-relationships represented in the new model can help to both predict and ensure organizational vitality.
Foundations of Social Work Practice: A Graduate Text.
ERIC Educational Resources Information Center
Mattaini, Mark A., Ed.; Lowery, Christine T., Ed.; Meyer, Carol H., Ed.
As social work enters its second century, dynamic developments in practice and theory, the richness offered by multiple cultures and groups, and changing political and economic climates are potent forces driving advances in social work knowledge and practice. In the context of this professional evolution, this textbook wrestles with and builds on…
Practice development: implementing a change of practice as a team.
Covill, Carl; Hope, Angela
2012-08-01
Practice development (PD), as a framework for multiprofessional working, has immense potential, specifically within change management and the clinical governance agenda. It has been acknowledged as a vehicle for 'continuous improvement'. This article discusses PD through collaborative working using the example of a case study on change of practice in falls reduction within a localised community setting. The process is underpinned by a PD framework and facilitated by leaders of PD within a university setting. The article identifies that PD frameworks are conducive to developing leadership and management roles within a democratic process. The article discusses the potential for multiprofessional PD within the locality and further afield.
ERIC Educational Resources Information Center
Reisch, Michael
2016-01-01
This article asserts that macro practice is increasingly important in today's rapidly changing and complex practice environment. It briefly explores the history of macro practice in U.S. social work, summarizes its major contributions to the profession and to U.S. society, and provides some suggestions for how social work programs can expand…
Green shoots of recovery: a realist evaluation of a team to support change in general practice.
Bartlett, Maggie; Basten, Ruth; McKinley, Robert K
2017-02-08
A multidisciplinary support team for general practice was established in April 2014 by a local National Health Service (NHS) England management team. This work evaluates the team's effectiveness in supporting and promoting change in its first 2 years, using realist methodology. Primary care in one area of England. Semistructured interviews were conducted with staff from 14 practices, 3 key senior NHS England personnel and 5 members of the support team. Sampling of practice staff was purposive to include representatives from relevant professional groups. The team worked with practices to identify areas for change, construct action plans and implement them. While there was no specified timescale for the team's work with practices, it was tailored to each. In realist evaluations, outcomes are contingent on mechanisms acting in contexts, and both an understanding of how an intervention leads to change in a socially constructed system and the resultant changes are outcomes. The principal positive mechanisms leading to change were the support team's expertise and its relationships with practice staff. The 'external view' provided by the team via its corroborative and normalising effects was an important mechanism for increasing morale in some practice contexts. A powerful negative mechanism was related to perceptions of 'being seen as a failing practice' which included expressions of 'shame'. Outcomes for practices as perceived by their staff were better communication, improvements in patients' access to appointments resulting from better clinical and managerial skill mix, and improvements in workload management. The support team promoted change within practices leading to signs of the 'green shoots of recovery' within the time frame of the evaluation. Such interventions need to be tailored and responsive to practices' needs. The team's expertise and relationships between team members and practice staff are central to success. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
The management of advanced practitioner preparation: a work-based challenge.
Livesley, Joan; Waters, Karen; Tarbuck, Paul
2009-07-01
This paper explores the collaborative development of a Master's level advanced practice programme in the context of the radical reform and remodelling of the UK's National Health Service. Some of the educational, managerial and practice challenges are discussed. Changes to education and training in response to key strategic reviews undertaken by the Greater Manchester Strategic Health Authority (North West of England) established a need to develop nurses and allied health care practitioners to advanced practitioner level. This paper considers how employers, commissioners and educationalists worked together to produce a Master's level programme to prepare nurses and other health care practitioners for sustainable advanced practice roles. Developing innovative and effective curricula to meet the needs of post graduate students from varied backgrounds preparing to practice in different contexts with different client groups is challenging. However, the development of individual learning pathways and work-based learning ensures that the student's work and intended advanced practice role remains at the centre of their learning. Analysis of each student's knowledge and skill deficits alongside an analysis of the organization's readiness to support them as qualified advanced practitioners (APs) is instrumental in ensuring that organizations are ready to support practitioners in new roles. Work-based learning and collaboration between students, employers and higher education institutions can be used to enable managers and students to unravel the network of factors which affect advanced practice in health and social care. Additionally, collaborative working can help to create opportunities to develop strategies that will facilitate change. Implications for nursing management Sustainable change concerned with the introduction of advanced practitioner roles present a real challenge for managers at a strategic and operational level. Commissioning flexible, collaborative and service-led educational programmes can assist in ensuring that change is sustainable and produce practitioners who are fit for practice, purpose and award.
Practice Change in Child Welfare: The Interface of Training and Social Work Education
ERIC Educational Resources Information Center
Deglau, Ericka; Ray, Anasuya; Conway, Fiona; Carre-Lee, Nancy; Waldman, William; Cunningham, Katelyn; Harrison, Talisah; Bales, Heather; Powell, Tedecia
2015-01-01
This article examines perceptions of the relationship between professional education and workplace training among a select group of public child welfare employees who pursued graduate social work education during a period of major practice change at their agency. Focus groups were conducted with representative members of graduating cohorts as…
The Impact of Patient Suicide on the Professional Practice of Swiss Psychiatrists and Psychologists.
Gulfi, Alida; Castelli Dransart, Dolores Angela; Heeb, Jean-Luc; Gutjahr, Elisabeth
2016-02-01
Many psychiatrists and psychologists are likely to experience a patient suicide at a point in their professional career. The present paper examines the effects of patient suicide on psychiatrists' and psychologists' professional reactions and working practices and investigates factors that may affect the severity of repercussions on their professional lives. Data from 271 psychiatrists and psychologists working in various institutional settings and in private practice in French-speaking Switzerland were collected by a written questionnaire. Psychiatrists and psychologists reported a range of professional reactions and changes in working practices following a patient suicide. Professional reactions and changes in working practices were more significant among women. The length of therapy and the emotional closeness with the deceased patient were predictive of a greater impact. In contrast, social and psychological support served as a protective factor by reducing negative repercussions on professional practice. Finally, the impact of losing a patient to suicide did not differ between psychiatrists and psychologists in institutional settings and those in private practice. Although patient suicide affected the professional life of psychiatrists and psychologists, it also encouraged them to review and adjust their working practices.
Practicing Policy, Pursuing Change, and Promoting Social Justice: A Policy Instructional Approach
ERIC Educational Resources Information Center
Heidemann, Gretchen; Fertig, Ralph; Jansson, Bruce; Kim, Hansung
2011-01-01
Schools of social work are mandated to train students for policy practice. A new instructional approach is needed so that social workers skillfully engage in policy change to address the growing economic, social, and cultural problems that affect our clients. This article presents the Practicing Policy, Pursuing Change, and Promoting Social…
Empowerment in Social Work Practice. A Sourcebook.
ERIC Educational Resources Information Center
Gutierrez, Lorraine M., Ed.; Parsons, Ruth J., Ed.; Cox, Enid Opal, Ed.
Empowerment as a philosophy, approach, or method of practice provides a way to rethink social work practice and to achieve needed social change, personally and politically, in ways that meet human needs. Part One, "An Introduction to Empowerment Practice," written by the editors, describes the elements and process of the model in the first…
ERIC Educational Resources Information Center
Limb, Gordon E.; Organista, Kurt C.
2006-01-01
The current study builds on a previous study that examined change in student views on social work's traditional mission, career motivations, and practice preferences between entry into and graduation from master of social work programs. Results from 6,987 students at entry and 3,451 students at graduation showed that students at graduation…
Evans, Jamie; Fitch, Christopher; Collard, Sharon; Henderson, Claire
2018-04-27
In recent years, the UK debt collection industry has taken steps to improve its policies and practices in relation to customers with mental health problems. Little data, however, have been collected to evidence change. This paper examines whether the reported attitudes and practices of debt collection staff when working with customers with mental health problems have changed between 2010 and 2016. This paper draws on descriptive and regression analyses of two cross-sectional surveys of debt collection staff: one conducted in 2010 and one conducted in 2016. All variables analysed show statistically significant changes between 2010 and 2016 indicative of improved reported attitudes and practices. While results suggest an improvement in attitudes and practice may have occurred between 2010 and 2016, research is required to understand this potential shift, its likely causes, and concrete impact on customers.
Theoretical Issues in Clinical Social Group Work.
ERIC Educational Resources Information Center
Randall, Elizabeth; Wodarski, John S.
1989-01-01
Reviews relevant issues in clinical social group practice including group versus individual treatment, group work advantages, approach rationale, group conditions for change, worker role in group, group composition, group practice technique and method, time as group work dimension, pretherapy training, group therapy precautions, and group work…
The Place of Community in Social Work Practice Research: Conceptual and Methodological Developments
ERIC Educational Resources Information Center
Coulton, Claudia
2005-01-01
Community is widely acknowledged as a fundamental aspect of social work practice, and this formulation distinguishes social work from other professions. Because of this long-standing tradition, social work needs to make a greater investment in producing scientific knowledge to enable community change and to incorporate community context into…
ERIC Educational Resources Information Center
Stratton, Mary; Levine, Barbara
A preliminary study explored how Canadian practitioners who are engaged in community economic development (CED) that includes or is specific to women gain new information relevant to their work and how they incorporate that new learning into their daily practice. Interview questions focused on sources of information, learning opportunities and…
Improving patient care through work-based learning.
Chapman, Linda
To record post-registration community nurses' perceptions of the impact of work-based learning on the quality of patient care. Ten nurses were interviewed. Each interviewee, who had successfully completed work-based learning programmes, was asked to describe their impact on the quality of patient care. The participants valued work-based learning. Four themes emerged where work-based learning contributed to improving the quality of care: increased health promotion, increased access to services, increased patient choice and reduced risk of infection. The relevance of studies and distance learning materials were perceived to be the main aspects that influenced changes in practice. The study provides insight into how work-based learning helped staff develop practice. It highlights that time for learning and mentoring are paramount for changes in practice to occur through work-based learning. Further studies are required to establish the best structure and style of distance learning materials needed to meet the needs of post-registration community nurses.
Practice settings and dentists' job satisfaction.
Lo Sasso, Anthony T; Starkel, Rebecca L; Warren, Matthew N; Guay, Albert H; Vujicic, Marko
2015-08-01
The nature and organization of dental practice is changing. The aim of this study was to explore how job satisfaction among dentists is associated with dental practice setting. A survey measured satisfaction with income, benefits, hours worked, clinical autonomy, work-life balance, emotional exhaustion, and overall satisfaction among dentists working in large group, small group, and solo practice settings; 2,171 dentists responded. The authors used logistic regression to measure differences in reported levels of satisfaction across practice settings. Dentists working in small group settings reported the most satisfaction overall. Dentists working in large group settings reported more satisfaction with income and benefits than dentists in solo practice, as well as having the least stress. Findings suggest possible advantages and disadvantages of working in different types of practice settings. Dentists working in different practice settings reported differences in satisfaction. These results may help dentists decide which practice setting is best for them. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.
A Study of Teachers' Views on Practical Work in Secondary Schools in England and Wales
ERIC Educational Resources Information Center
Abrahams, Ian; Saglam, M.
2010-01-01
Many teachers view practical work as an essential feature of science education. This study examined whether there had been any changes in the relative importance of the aims science teachers assign to the use of practical work, across the full secondary age range (11-18), since the last such national survey undertaken by Kerr 46 years ago. A…
Wainer, Jo
2004-04-01
To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are not well represented in policies and programs for rural doctors. The incoming cohort of rural general practitioners has a majority of women and it is essential that the practice styles and needs of women doctors are understood in order to attract and retain women in rural medicine. This survey identifies some of the effects of family responsibilities on the work practices of female rural doctors and the changes needed to the structure of rural practice to include the way women work.
Improving compliance with requirements on junior doctors' hours
Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E
2003-01-01
Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942
Using the Behaviour Change Wheel in infection prevention and control practice
Atkins, Lou
2015-01-01
The Centre for Behaviour Change at University College London (UCL) is a new venture that has grown out of the work that we have been doing in the Health Psychology Research Group at UCL and seeks to harness the different pockets of behaviour change work in different disciplines across UCL. A lot of our work in health focuses on the adoption of evidence-based guidelines in practice; not just designing and evaluating interventions, but also developing usable tools for people who are tasked with changing behaviours. These tools aim to enable those who do not necessarily have a background in behavioural science to understand the behaviours they are trying to change and design appropriate interventions. PMID:28989457
ERIC Educational Resources Information Center
Youens, Bernadette; Gordon, Jules; Newton, Len
2014-01-01
Practical work has a long history in science education in the UK. This article explores how the influences of curriculum and assessment policy have shaped practical work over recent years. We argue that, together with changes in teacher training programmes, these influences have weakened science teachers' capacity to meet the challenge of calls…
Trends of Empirical Research in South Korean Mental Health Social Work
ERIC Educational Resources Information Center
Song, In Han; Lee, Eun Jung
2017-01-01
Since the introduction of evidence-based practice in South Korea, it has gained significant attention for its potential to promote the efficacy of social work services and to integrate knowledge and practice in mental health social work. In order to see how empirical research in South Korean mental health social work has changed, we examined…
School Social Work in Louisiana: A Model of Practice
ERIC Educational Resources Information Center
Richard, Laura A.; Villarreal Sosa, Leticia
2014-01-01
Although the role of the school social worker has historically been inconsistent, fragmented, and contextual, concerns about the need to advocate for school social work positions, demonstrate the effectiveness of school social work practice, understand the consequences of role ambiguity, and respond in a proactive way to policy changes has…
Integrating Women's Issues in the Social Work Curriculum: A Proposal.
ERIC Educational Resources Information Center
Carter, Carolyn; And Others
1994-01-01
Social work faculty revising courses at Arizona State University's School of Social Work attempting to integrate content on women propose that development of new models reflecting women's experiences are required. Examples of curricular changes made using this approach are offered. They address direct practice, family practice,…
Work and Family. Policies for a Changing Work Force.
ERIC Educational Resources Information Center
Ferber, Marianne A., Ed.; And Others
This book reviews changes in work and family structures and their effects on worker productivity and employer practices. The first two chapters introduce the topic and trace the history of family structure and composition in the United States, the changing nature of employment, and the central role of the employment relationship to the social…
High-performance workplace practices in nursing homes: an economic perspective.
Bishop, Christine E
2014-02-01
To develop implications for research, practice and policy, selected economics and human resources management research literature was reviewed to compare and contrast nursing home culture change work practices with high-performance human resource management systems in other industries. The organization of nursing home work under culture change has much in common with high-performance work systems, which are characterized by increased autonomy for front-line workers, self-managed teams, flattened supervisory hierarchy, and the aspiration that workers use specific knowledge gained on the job to enhance quality and customization. However, successful high-performance work systems also entail intensive recruitment, screening, and on-going training of workers, and compensation that supports selective hiring and worker commitment; these features are not usual in the nursing home sector. Thus despite many parallels with high-performance work systems, culture change work systems are missing essential elements: those that require higher compensation. If purchasers, including public payers, were willing to pay for customized, resident-centered care, productivity gains could be shared with workers, and the nursing home sector could move from a low-road to a high-road employment system.
ERIC Educational Resources Information Center
Smith, Beatrice Quarshie
2006-01-01
Drawing on an ongoing project examining the literacies prevalent at an outsourcing site, this article explores the changing nature of workplace practices enabled by new information and communication technologies. It also examines the complex geopolitical dynamics of these practices, the discourses of development, and globalization. The author…
2014-01-01
Background The shortage of physicians is an evolving problem throughout the world. In this study we aimed to identify to what extent junior doctors’ training and working conditions determine their intention to leave clinical practice after residency training. Methods A prospective cohort study was conducted in 557 junior doctors undergoing residency training in German hospitals. Self-reported specialty training conditions, working conditions and intention to leave clinical practice were measured over three time points. Scales covering training conditions were assessed by structured residency training, professional support, and dealing with lack of knowledge; working conditions were evaluated by work overload, job autonomy and social support, based on the Demand–Control–Support model. Multivariate ordinal logistic regression analyses with random intercept for longitudinal data were applied to determine the odds ratio of having a higher level of intention to leave clinical practice. Results In the models that considered training and working conditions separately to predict intention to leave clinical practice we found significant baseline effects and change effects. After modelling training and working conditions simultaneously, we found evidence that the change effect of job autonomy (OR 0.77, p = .005) was associated with intention to leave clinical practice, whereas for the training conditions, only the baseline effects of structured residency training (OR 0.74, p = .017) and dealing with lack of knowledge (OR 0.74, p = .026) predicted intention to leave clinical practice. Conclusions Junior doctors undergoing specialty training experience high workload in hospital practice and intense requirements in terms of specialty training. Our study indicates that simultaneously improving working conditions over time and establishing a high standard of specialty training conditions may prevent junior doctors from considering leaving clinical practice after residency training. PMID:24942360
ERIC Educational Resources Information Center
Pellegrino, James W.
2014-01-01
This article summarizes major points about the transformation of educational assessment that emerged from the work of Gordon Commission and it presents recommendations to different stakeholders as to needed changes in policy, practice, and research and development.
Measuring Changes in the Economics of Medical Practice.
Fleming, Christopher; Rich, Eugene; DesRoches, Catherine; Reschovsky, James; Kogan, Rachel
2015-08-01
For the latter third of the twentieth century, researchers have estimated production and cost functions for physician practices. Today, those attempting to measure the inputs and outputs of physician practice must account for many recent changes in models of care delivery. In this paper, we review practice inputs and outputs as typically described in research on the economics of medical practice, and consider the implications of the changing organization of medical practice and nature of physician work. This evolving environment has created conceptual challenges in what are the appropriate measures of output from physician work, as well as what inputs should be measured. Likewise, the increasing complexity of physician practice organizations has introduced challenges to finding the appropriate data sources for measuring these constructs. Both these conceptual and data challenges pose measurement issues that must be overcome to study the economics of modern medical practice. Despite these challenges, there are several promising initiatives involving data sharing at the organizational level that could provide a starting point for developing the needed new data sources and metrics for physician inputs and outputs. However, additional efforts will be required to establish data collection approaches and measurements applicable to smaller and single specialty practices. Overcoming these measurement and data challenges will be key to supporting policy-relevant research on the changing economics of medical practice.
Pedersen, Line Bjørnskov; Gyrd-Hansen, Dorte
2014-07-01
This study examines the preferences of general practitioners (GPs) in training for organizational characteristics in general practice with focus on aspects that can mitigate problems with GP shortages. A discrete choice experiment was used to investigate preferences for the attributes practice type, number of GPs in general practice, collaboration with other practices, change in weekly working hours (administrative versus patient related), and change in yearly surplus. In May 2011, all doctors actively engaged in the family medicine program in Denmark were invited to participate in a web-based survey. A total of 485 GPs in training responded to the questionnaire, resulting in a response rate of 56%. A mixed logit model showed that GPs in training prefer to work in smaller shared practices (2 GPs). This stands in contrast to the preferences of current GPs. Hence, a generational change in the GP population is likely to introduce more productive practice forms, and problems with GP shortages are likely to be mitigated over the coming years. Results further showed that a majority of the respondents are willing to work in larger shared practices (with 3-4 GPs) if they receive an increase in surplus (approximately 50,000 DKK/6,719 EUR per year) and that they may be willing to take in more patient-related work if the increase in surplus is sufficient (approximately 200,000 DKK/26,875 EUR per year for 5 extra hours per week). Monetary incentives may therefore be an effective tool for further improving productivity.
Doing more with less in nursing work: a review of the literature.
Bradley, C
1999-09-01
The paper explores the literature on changes in nursing work. It examines the suggestion that changes in work practices are management responses to cost cutting imperatives. Nursing labour force issues such as staffing roles and staffing mix, the push for flexibility in the workforce and casualisation are discussed. The paper concludes that given the rise of casual work in the general Australian workforce, research needs to be conducted on the extent of casualisation of nursing, and the implications this may have for nursing practice, professional development and on the nursing labour market.
Teacher Compensation: Standard Practices and Changes in Wisconsin. WCER Working Paper No. 2016-5
ERIC Educational Resources Information Center
Kimball, Steven M.; Heneman, Herbert G., III.; Worth, Robin; Arrigoni, Jessica; Marlin, Daniel
2016-01-01
Over many decades, teachers' compensation has been determined through standard practices, commonly represented by the single salary schedule. While these practices served districts well in a number of respects, many argue that new forms of teacher pay could provide powerful levers for changing teacher performance and improving student achievement…
The Social Work Ethics Audit: A Risk-Management Strategy.
ERIC Educational Resources Information Center
Reamer, Frederic G.
2000-01-01
Article integrates current knowledge on social work ethics and introduces the concept of a social work ethics audit to aid social workers in their efforts to identify pertinent ethical issues; review and assess the adequacy of their current ethics-related practices; modify their practices as needed; and monitor the implementation of these changes.…
Kodama, Tomoko; Koike, Soichi; Matsumoto, Shinya; Ide, Hiroo; Yasunaga, Hideo; Imamura, Tomoaki
2012-05-01
The percentage of females in the physician workforce is increasing in Japan, as in other countries; however, the working status of female physicians has not been sufficiently investigated. Original data were obtained from the National Survey of Physicians (NSP) conducted by the Ministry of Health, Labour and Welfare, Japan, from 1984 to 2004. We examined the trend of female physicians' areas of practice and analyzed their leave, return to work, and change in areas of practice using cohort data. The percentage of female physicians has increased significantly in recent generations, especially in surgery, surgical subareas of practice, and obstetrics and gynecology. A remarkable increase was found in obstetrics and gynecology among women under 29 years old from 15.4 to 66.2%. The total number of female physicians on leave has been higher than the number of female physicians returning since 1998. The average percentage of those who changed their area of practice was high in surgery (20.7%) and low in pediatrics (5.0%) and obstetrics and gynecology (1.7%). A strategic plan is needed for future health policy to plan for the physician workforce, especially for the areas of practice with increasing proportions of young female physicians. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Trends in a changing vascular practice environment for members of the Society for Vascular Surgery
Matthews, Mika A. B.; Satiani, Bhagwan; Lohr, Joann M.
2013-01-01
Objective To survey the Society for Vascular Surgery (SVS) membership with regard to practice trends related to work effort, employment status, practice ownership, endovascular cases, and anticipated changes in practice in the near future. Methods A survey questionnaire was developed to gather information about member demographics and practice, hours worked, full-time (FT) or part-time status, employment status, practice ownership, competition for referrals, proportion of endovascular vs open procedures, and anticipated changes in practice in the next 3 years. We used SurveyMonkey and distributed the survey to all active vascular surgeon (VS) members of the SVS. Results The response rate was 207 of 2230 (10.7%). Two thirds were in private practice, and 21% were in solo practice. Twenty-four percent were employed by hospitals/health systems. Those VS under the age of 50 years were more likely to exclusively practice vascular surgery compared with VS over the age of 50 years (P = .0003). Sixty-eight of the physicians (32.7%) were between 50 and 59 years old, 186 (90.3%) were men, 192 (92.8%) worked FT (>36 hours of patient care per week), and almost two thirds worked >60 hours per week. Those in physician-owned practices worked >40 hours of patient care per week more often than did FT employed VS (P = .012). Younger VS (age <50 years) more frequently reported >50% of their workload being endovascular compared with older VS (age ≥50 years; P < .001). Eighty percent of FT VS planned to continue their current practice over the next 3 years. Of the 43.6% indicating loss of referrals, 82% pointed to cardiologists as the competition. Conclusions The current workforce is predominately male and works FT; one-third is between the ages of 50 and 59 years. Younger VS (age <50 years) are more likely to exclusively practice VS and have a higher caseload of endovascular procedures. Those in physician-owned practices are more likely to put in >40 hours of patient care per week than are FT employed VS. Longitudinal surveys of SVS members are imperative to help tailor educational, training, and practice management offerings, guide governmental activities, advocate for issues important to members, improve branding initiatives, and sponsor workforce analyses. PMID:23254185
Hunter, Cheryl; Chew-Graham, Carolyn A; Langer, Susanne; Drinkwater, Jessica; Stenhoff, Alexandra; Guthrie, Elspeth A; Salmon, Peter
2015-12-01
Health outcomes for long-term conditions (LTCs) can be improved by lifestyle, dietary and condition management-related behaviour change. Primary care is an important setting for behaviour change work. Practitioners have identified barriers to this work, but there is little evidence examining practices of behaviour change in primary care consultations and how patients and practitioners perceive these practices. To examine how behaviour change is engaged with in primary care consultations for LTCs and investigate how behaviour change is perceived by patients and practitioners. Multiperspective, longitudinal qualitative research involving six primary health-care practices in England. Consultations between patients with LTCs and health-care practitioners were audio-recorded. Semi-structured interviews were completed with patients and practitioners, using stimulated recall. Patients were re-interviewed 3 months later. Framework analysis was applied to all data. Thirty-two people with at least one LTC (chronic obstructive pulmonary disease, diabetes, asthma and coronary heart disease) and 10 practitioners. Behaviour change talk in consultations was rare and, when it occurred, was characterized by deflection and diffidence on the part of practitioners. Patient motivation tended to be unaddressed. While practitioners positioned behaviour change work as outside their remit, patients felt uncertain about, yet responsible for, this work. Practitioners raised concerns that this work could damage other aspects of care, particularly the patient-practitioner relationship. Behaviour change work is often deflected or deferred by practitioners in consultations, who nevertheless vocalize support for its importance in interviews. This discrepancy between practitioners' accounts and behaviours needs to be addressed within primary health-care organizations. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.
Teaching mathematics remotely: changed practices in distance education
NASA Astrophysics Data System (ADS)
Lowrie, Tom; Jorgensen, Robyn
2012-09-01
This investigation explored the challenges of creating meaningful mathematics practices for a community engaged in Distance Education (DE). Specifically, the study maps the influence of new technologies on the practices of a learning community where mathematics was taught remotely. The theoretical framework of this study utilised Bourdieu's work on practice to consider the changed nature of the field, in this case, remote education provision, over time. By using Bourdieu's notion of field, we are better able to understand the ways in which practices and discourses shape particular ways of working in rural education provision. The results of the study show that Field 1 was innovative and beyond the non-school world, while Field 2 lagged behind the technological resources of the non-school world.
Cameron, Shona; Rutherford, Ishbel; Mountain, Kristina
2012-01-01
The context of primary care in the UK is changing rapidly, underpinned by continuing policy drivers to ensure person-centred safe and effective practice. Undergraduate and postgraduate programmes for healthcare practitioners are increasingly using interprofessional education (IPE) as one route to engender greater understanding of others' roles and contributions to health care, with the suggestion that IPE leads to better integration and teamwork, and thus stronger collaborative practice. Access to education and professional development for those working in primary care is difficult, and individuals need the focus of learning to be clearly relevant to their practice. To review and debate the evidence on the role of work-based learning and IPE in enhancing collaborative practice in primary care. Literature search and critique of key papers relevant to primary care practice. The three themes emerged of IPE, workbased learning (WBL) and collaborative practice. There is a growing body of literature to support the positive outcomes of IPE and the utilisation of WBL in developing practice. A range of practitioners in a variety of work settings have used WBL approaches in the implementation of innovations and the development of communities of practice. However, little evidence exists to support these approaches in primary care. The application of WBL across primary care teams can support a positive and collaborative learning culture, resulting in changes to professional practice.
Balancing your personal and professional lives: help for busy medical practice employees.
Hills, Laura Sachs
2008-01-01
It is extremely difficult for most people to balance work and home life. This is especially true of employees who work in fast-paced medical practices where they are on the go all day. Each medical practice employee must find his or her own way to balance work and life, but fortunately, the process can usually be boiled down to some basics. This article outlines a strategy for establishing the top five priorities in the medical practice employee's life. It suggests that medical practice personnel can develop and use a personal mission statement as a life guide. This article also suggests specific strategies medical practice employees can use to protect and make the best use of their private time. It provides examples of how medical practice personnel have changed their lives by dropping unnecessary activities from their daily schedules. Finally, this article offers guidance about getting children to help working parents balance their work and private lives, 10 additional tips for work/life balance, a work/life balance self-assessment quiz, and a template the medical practice employee can use to create a customized personal mission statement.
Simulating Real Life: Enhancing Social Work Education on Alcohol Screening and Brief Intervention
ERIC Educational Resources Information Center
Osborne, Victoria A.; Benner, Kalea; Sprague, Debra J.; Cleveland, Ivy N.
2016-01-01
Social work students typically use role play with student colleagues to practice clinical intervention skills. Practice with simulated clients (SCs) rather than classmates changes the dynamics of the role play and may improve learning. This is the first known study to employ the SC model in substance use assessment in social work education. Social…
Landstrom, Bjorn; Mattsson, Bengt; Nordin, Per; Rudebeck, Carl E
2014-03-15
The aim of the study was to investigate medical students' views on general practice based on their experiences in training, and to find out whether there were certain views associated with the intention to become a GP. A questionnaire, based on our earlier studies about GP working behaviour, was handed out to medical students in terms 1, 3, 5, 7, 10 and 11 of undergraduate studies in Gothenburg, Sweden. The analysis comprised statistical descriptions and comparisons. The students regarded general practice positively. They found the work environment good, the GP's awareness of patients' living conditions necessary, and that GP work requires medical breadth. The status of the GP in the medical profession was not considered high. One-fourth of the students strongly agreed with the possibility of a future as a GP. This attitude was statistically associated with support to the statements that general practice offers a good work environment and should be a major component in undergraduate training. Students with a negative attitude to working as GPs were also negative to having a major component of general practice in undergraduate training. Medical students with a positive stated attitude towards becoming GPs support changes in undergraduate training to include more general practice. The risk of increasing a negative attitude should be considered when changes are discussed.
Lopez, Amy
2014-10-01
Information and communication technologies (ICTs) are becoming essential to social work practice by providing increased treatment possibilities and reducing barriers to service. While recognizing the importance of ICTs in practice, social work practitioners have had concerns about ethical use. In response, NASW compiled the Standards for Technology and Social Work Practice. While the guidelines set the groundwork, they were not embedded in a process that would allow them to adapt to the swift pace of ICT changes. This article reviews the current Standards, evaluates how these have been implemented by practitioners, and offers suggestions for updates.
Managing the Right Projects: Best Practices to Align Project and Corporate Strategies
NASA Technical Reports Server (NTRS)
Watkins, Bobby
2012-01-01
If there's a human endeavor that exemplifies teamwork, it is space exploration. And that teamwork absolutely cannot happen effectively if the boots on the ground the people doing the work - don't understand how their work aligns with the larger goal. This presentation will discuss some best management practices from NASA's Marshall Space Flight Center that have succeeded in helping employees become informed, engaged and committed to the space agency's important missions. Specific topics include: Alignment Criteria: Linking Projects To Corporate Strategy. Resource Management: Best Practices For Resource Management. Strategic Analysis: Supporting Decision Making In A Changing Environment. Communication Strategies: Best Practices To Communicate Change. Benefits Achieved And Lessons Learned.
How behavioural science can contribute to health partnerships: the case of The Change Exchange.
Byrne-Davis, Lucie M T; Bull, Eleanor R; Burton, Amy; Dharni, Nimarta; Gillison, Fiona; Maltinsky, Wendy; Mason, Corina; Sharma, Nisha; Armitage, Christopher J; Johnston, Marie; Byrne, Ged J; Hart, Jo K
2017-06-12
Health partnerships often use health professional training to change practice with the aim of improving quality of care. Interventions to change practice can learn from behavioural science and focus not only on improving the competence and capability of health professionals but also their opportunity and motivation to make changes in practice. We describe a project that used behavioural scientist volunteers to enable health partnerships to understand and use the theories, techniques and assessments of behavioural science. This paper outlines how The Change Exchange, a collective of volunteer behavioural scientists, worked with health partnerships to strengthen their projects by translating behavioural science in situ. We describe three case studies in which behavioural scientists, embedded in health partnerships in Uganda, Sierra Leone and Mozambique, explored the behaviour change techniques used by educators, supported knowledge and skill development in behaviour change, monitored the impact of projects on psychological determinants of behaviour and made recommendations for future project developments. Challenges in the work included having time and space for behavioural science in already very busy health partnership schedules and the difficulties in using certain methods in other cultures. Future work could explore other modes of translation and further develop methods to make them more culturally applicable. Behavioural scientists could translate behavioural science which was understood and used by the health partnerships to strengthen their project work.
"I Do and I Understand?" Practical Work and Laboratory Use in United Kingdom Schools
ERIC Educational Resources Information Center
Toplis, Rob; Allen, Michael
2012-01-01
This paper provides a critical review of the changes to the role of practical work in the science curriculum in England over the last forty years. The science curriculum over this period appears to place an emphasis on an approach to practical enquiry that suggests school students can act like "real" scientists. This paper provides a…
"Working with COW": Social Work Supporting Older Women Living in the Community.
Rawsthorne, Margot; Ellis, Kayleigh; de Pree, Alison
2017-01-01
Australia, like all developed Western countries, is experiencing a demographic shift resulting in an increasing proportion of the population being over the age of 65 years. Contrary to stereotypes, the vast majority of older people live independently in communities. This article explores the potential of social work practice informed by community development principles to enable socially disadvantaged older women to live in vibrant and supportive communities, in which they feel safe and are able to access the support services they need. It argues that participation in social action not only builds older women's well-being but also enables them to become (or continue to be) agents for social change in local communities. Adopting a community-based research methodology, this article draws on a decade of community development practice with the Concerned Older Women's (COW) Group. This data suggests that community development practice based on participation, empowerment, and social action founded on respectful relationships may accrue significant benefits to individuals and the broader community. This social work practice creates the social conditions to facilitate older women's capacity to work collectively to achieve social change, challenging ageist stereotypes.
Manthorpe, Jill; Hussein, Shereen; Moriarty, Jo
2005-07-01
Social work education in England underwent significant change in its move to degree status in 2003. It is hoped that the result will be increased professional standing for social workers, an improvement in the current widespread problems with recruitment, and assurance that all newly qualified social workers meet the National Occupational Standards for Social Work (Available from: http://www.topssengland.net/files/cd/). This change has pre-occupied social work educators and debate within the profession has concentrated on the practicalities and expectations of reform. This paper suggests that those working in nurse education may observe a number of similarities with its own earlier reforms and with current debates on whether nursing should move to an all-graduate profession. It then highlights three aspects of the new requirements for social work training: service user involvement, the place of research-minded practice, and the primacy of practice--that may be of interest and relevance to nursing colleagues.
Zhao, Hongyu; Zhang, Xiaohui
2017-01-01
The current study used mixed methods to research pre-service teachers' professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers' professional identity increased after the field teaching practice-specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers' professional identity. Moreover, the development of pre-service teachers' professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies.
Understanding work contextual factors: a short-cut to evidence-based practice?
Wallin, Lars; Ewald, Uwe; Wikblad, Karin; Scott-Findlay, Shannon; Arnetz, Bengt B
2006-01-01
It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors. The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors. The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden. Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion. These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.
Faith-Based Human Services Initiatives: Considerations for Social Work Practice and Theory
ERIC Educational Resources Information Center
Tangenberg, Kathleen M.
2005-01-01
Faith-based human services initiatives present numerous challenges to professional social work. This article explores ways a theoretical integration of ecosystems and structuration perspectives may help social workers navigate complex ideological and practical implications of changing service delivery policies. The article highlights diversity…
ERIC Educational Resources Information Center
Gysbers, Norman C.; And Others
This seventh chapter in "Elementary School Counseling in a Changing World" discusses theoretical and practical issues related to career development and offers suggestions to help elementary school counselors promote students' career exploration. Four journal articles are included. "Major Trends in Career Development Theory and Practice" by Norman…
ERIC Educational Resources Information Center
Ramberg, Magnus R.
2014-01-01
Educational change initiatives, whether they involve the implementation of new policies or curriculum reforms, often fail to reach the level of teachers' classroom practices. In the search for explanations, numerous studies have either characterized teachers as resistant to change or focused on how schools' workplace conditions have failed to…
The Continued Relevance of "Teaching to Transgress: Education as the Practice of Freedom"
ERIC Educational Resources Information Center
Bullen, Pauline E.
2012-01-01
In 1994, bell hooks' work, Teaching to Transgress--Education as the Practice of Freedom was first published and this work re-examines it for its intent to counter the devaluation of teaching and on the basis that it addresses the urgent need for changes in teaching practices. Because of the intransience of racism and the various "isms" that are…
Building Basic Therapeutic Skills: A Practical Guide for Current Mental Health Practice.
ERIC Educational Resources Information Center
Heaton, Jeanne Albronda
Each therapeutic contact provides unique opportunities to ameliorate suffering and cultivate change. This volume addresses the inherent struggle in therapy to create a therapeutic relationship and make the work compassionate, efficient, and effective. It provides assistance to students, supervisors, and educators in doing therapeutic work while…
Work, Disability, and the Future: Promoting Employment for People with Disabilities.
ERIC Educational Resources Information Center
Roessler, Richard T.
1987-01-01
Statistical data on unemployment emphasize problems experienced by people with disabilities in seeking work. Advocates changes in public policies, institutional practices, rehabilitation practices, and employer benefits to ensure people with disabilities a share in the prosperity anticipated in view of brighter economic prospects. (Author/KS)
Antibiotic stewardship: does it work in hospital practice? A review of the evidence base.
Hulscher, M E J L; Prins, J M
2017-11-01
Guidelines for developing and implementing stewardship programmes include recommendations on appropriate antibiotic use to guide the stewardship team's choice of potential stewardship objectives. They also include recommendations on behavioural change interventions to guide the team's choice of potential interventions to ensure that professionals actually use antibiotics appropriately in daily practice. To summarize the evidence base of both appropriate antibiotic use recommendations (the 'what') and behavioural change interventions (the 'how') in hospital practice. Published systematic reviews/Medline. The literature shows low-quality evidence of the positive effects of appropriate antibiotic use in hospital patients. The literature shows that any behavioural change intervention might work to ensure that professionals actually perform appropriate antibiotic use recommendations in daily practice. Although effects were overall positive, there were large differences in improvement between studies that tested similar change interventions. The literature showed a clear need for studies that apply appropriate study designs- (randomized) controlled designs-to test the effectiveness of appropriate antibiotic use on achieving meaningful outcomes. Most current studies used designs prone to confounding by indication. In the process of selecting behavioural change interventions that might work best in a chosen setting, much should be learned from behavioural sciences. The challenge for stewardship teams lies in selecting change interventions on the careful assessment of barriers and facilitators, and on a theoretical base while linking determinants to change interventions. Future studies should apply more robust designs and evaluations when assessing behavioural change interventions. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Challenges and Opportunities for Advancing Work on Climate Change and Public Health.
Gould, Solange; Rudolph, Linda
2015-12-09
Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.
Educational Change, Baldrige, and Schlechty
ERIC Educational Resources Information Center
Vaszauskas, Jim
2011-01-01
This article explores the relationship between research on educational change, the Baldrige continuous improvement framework, and Schlechty's (2002) WOW school standards articulated in "Working on the Work". Each of Schlechty's standards are examined and examples from practicing educators who have been trained in continuous improvement…
The Teacher Leadership Process: Attempting Change within Embedded Systems
ERIC Educational Resources Information Center
Cooper, Kristy S.; Stanulis, Randi N.; Brondyk, Susan K.; Hamilton, Erica R.; Macaluso, Michael; Meier, Jessica A.
2016-01-01
This embedded case study examines the leadership practices of eleven teacher leaders in three urban schools to identify how these teacher leaders attempt to change the teaching practice of their colleagues while working as professional learning community leaders and as mentors for new teachers. Using a theoretical framework integrating complex…
Price, John M.; Colflesh, Gregory J. H.; Cerella, John; Verhaeghen, Paul
2014-01-01
We investigated the effects of 10 hours of practice on variations of the N-Back task to investigate the processes underlying possible expansion of the focus of attention within working memory. Using subtractive logic, we showed that random access (i.e., Sternberg-like search) yielded a modest effect (a 50% increase in speed) whereas the processes of forward access (i.e., retrieval in order, as in a standard N-Back task) and updating (i.e., changing the contents of working memory) were executed about 5 times faster after extended practice. We additionally found that extended practice increased working memory capacity as measured by the size of the focus of attention for the forward-access task, but not for variations where probing was in random order. This suggests that working memory capacity may depend on the type of search process engaged, and that certain working-memory-related cognitive processes are more amenable to practice than others. PMID:24486803
Challenges and Opportunities for Advancing Work on Climate Change and Public Health
Gould, Solange; Rudolph, Linda
2015-01-01
Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194
The Role of Radical Imagination in Social Work Education, Practice, and Research
ERIC Educational Resources Information Center
Barnetz, Zion
2015-01-01
This article addresses the role of imagination in social work education, practice, and research. Following a brief discussion of terms, the author attempts to identify the various contributions of human imagination to social change processes. The second part presents the argument that the cultural structure known as Social Darwinism significantly…
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-10
... control measures (e.g., engineering controls, work practices, personal protective equipment) that are... controls, work practices, personal protective equipment) being taken to minimize worker exposure to 2,3... request. NIOSH includes all comments received without change in the docket, including any personal...
Zhao, Hongyu; Zhang, Xiaohui
2017-01-01
The current study used mixed methods to research pre-service teachers’ professional identity. Ninety-eight pre-service teachers were investigated and twelve teachers were interviewed in China. The results were as follows: (1) The results of quantitative data showed that compared with before the field teaching practice, pre-service teachers’ professional identity increased after the field teaching practice—specifically, intrinsic value identity increased, and extrinsic value identity did not significantly change; (2) The results of qualitative data validated and elaborated the results of quantitative data in more detail with regard to changes in professional identity. Specifically, compared with before the field teaching practice, intrinsic value identity including work content, work pattern, etc., increased and extrinsic value identity including work environment, income, and social status, etc., did not significantly change after experiencing teaching practice; (3) The results of qualitative data also showed that mentor support at field school promoted the development of pre-service teachers’ professional identity. Moreover, the development of pre-service teachers’ professional identity during field teaching practice further promoted their professional commitment; that is, it promoted their emotional evaluation and belief in the teaching profession. The study discussed these results and proposed solutions and suggestions for future studies. PMID:28790956
Assessing and changing medical practice culture.
Hills, Laura
2011-01-01
Your medical practice has an existing culture that manifests itself daily in literally hundreds of ways. Some aspects of your culture likely support your practice's growth; others may be impeding your progress. This article describes the characteristics of medical practice culture and provides numerous examples of how culture influences behavior. It describes how culture is expressed in a medical practice through objects and artifacts, language, emotions, interactions, practice management systems, and daily work habits. It offers three techniques for assessing an existing medical practice culture and a checklist for conducting culture observations. This article also provides guidelines for identifying a desired medical practice culture and explores why changing culture is so difficult. It describes five reasons employees are likely to resist culture change and provides 12 fundamental changes that will enable a practice to improve its culture. Finally, this article explores how medical practice cultures are formed and perpetuated and provides more than a dozen questions to ask employees in a culture survey.
Work and Family: The Crucial Balance = Travail et la Famille: Un Equilibre Delicat.
ERIC Educational Resources Information Center
Ontario Ministry of Community and Social Services, Toronto.
The dynamics of the Canadian workforce have changed. Demographic, social and employment trends, coupled with the changing face of the Canadian family, will increasingly challenge business and industry in the '90s. This practical resource guide for employers explores the changing relationship between family and paid work, and how that new…
From boundaries to boundary work: middle managers creating inter-organizational change.
Oldenhof, Lieke; Stoopendaal, Annemiek; Putters, Kim
2016-11-21
Purpose In healthcare, organizational boundaries are often viewed as barriers to change. The purpose of this paper is to show how middle managers create inter-organizational change by doing boundary work: the dual act of redrawing boundaries and coordinating work in new ways. Design/methodology/approach Theoretically, the paper draws on the concept of boundary work from Science and Technology Studies. Empirically, the paper is based on an ethnographic investigation of middle managers that participate in a Dutch reform program across health, social care, and housing. Findings The findings show how middle managers create a sense of urgency for inter-organizational change by emphasizing "fragmented" service provision due to professional, sectoral, financial, and geographical boundaries. Rather than eradicating these boundaries, middle managers change the status quo gradually by redrawing composite boundaries. They use boundary objects and a boundary-transcending vocabulary emphasizing the need for societal gains that go beyond production targets of individual organizations. As a result, work is coordinated in new ways in neighborhood teams and professional expertise is being reconfigured. Research limitations/implications Since boundary workers create incremental change, it is necessary to follow their work for a longer period to assess whether boundary work contributes to paradigm change. Practical implications Organizations should pay attention to conditions for boundary work, such as legitimacy of boundary workers and the availability of boundary spaces that function as communities of practice. Originality/value By shifting the focus from boundaries to boundary work, this paper gives valuable insights into "how" boundaries are redrawn and embodied in objects and language.
Connolly, Sarah
2012-01-01
In pediatric hospitals, social work plays a central role in the prevention, identification, and management of child abuse. Children who are suspected of having been abused or neglected require an evaluation of their psychosocial situation. As an integral member of the health care team, the social worker is well placed to undertake comprehensive psychosocial assessments including information on the child's development, parental capacity, family, and community supports. Current practice approaches have seen a shift away from a narrow, "expert" approach to child protection. This article describes the development of an integrated model of social work service delivery to better respond to vulnerable and at-risk children in a pediatric hospital setting. Developing a new model of service required strategic planning, consultation, and endorsement from senior hospital management. The new model aimed to ensure a high quality, responsive social work service to children at risk of physical abuse, neglect, or cumulative harm. The change necessitated understanding of current research evidence, development of best practice guidelines, and effective communication with staff and external stakeholders. Policy development, implementation of practice guidelines, staff training, data collection, and service evaluation are described. The role of social work management and leadership were central in creating change. Visionary leadership is widely regarded as key to successful organizational change. The management approach included consultation with staff, building commitment to the need for change, addressing staff concerns, and providing a vision of enhanced client outcomes as a result of the change process. This article provides a candid overview of challenges and barriers to change. Change strategies described are easily transferable to other social work settings. Copyright © Taylor & Francis Group, LLC
McCabe, Patricia J
2018-06-01
Evidence-based practice (EBP) is a well-accepted theoretical framework around which speech-language pathologists strive to build their clinical decisions. The profession's conceptualisation of EBP has been evolving over the last 20 years with the practice of EBP now needing to balance research evidence, clinical data and informed patient choices. However, although EBP is not a new concept, as a profession, we seem to be no closer to closing the gap between research evidence and practice than we were at the start of the movement toward EBP in the late 1990s. This paper examines why speech-language pathologists find it difficult to change our own practice when we are experts in changing the behaviour of others. Using the lens of behavioural economics to examine the heuristics and cognitive processes which facilitate and inhibit change, the paper explores research showing how inconsistency of belief and action, or cognitive dissonance, is inevitable unless we act reflectively instead of automatically. The paper argues that heuristics that prevent us changing our practice toward EBP include the sunk cost fallacy, loss aversion, social desirability bias, choice overload and inertia. These automatic cognitive processes work to inhibit change and may partially account for the slow translation of research into practice. Fortunately, understanding and using other heuristics such as the framing effect, reciprocity, social proof, consistency and commitment may help us to understand our own behaviour as speech-language pathologists and help the profession, and those we work with, move towards EBP.
ERIC Educational Resources Information Center
Hargreaves, Andy
This book examines the personal, moral, cultural, and political dimensions of teaching in the context of rapid and far-reaching change within teachers' work and in the world beyond it. The chapters in Part One examine the powerful forces for change in society and how those forces are exerting pressure on existing institutions. Issues such as the…
Volker, Nerida; Williams, Lauren T; Davey, Rachel C; Cochrane, Thomas; Clancy, Tanya
2017-02-24
The reorientation of primary health care towards prevention is fundamental to addressing the rising burden of chronic disease. However, in Australia, cardiovascular disease prevention practice in primary health care is not generally consistent with existing guidelines. The Model for Prevention study was a whole-of-system cardiovascular disease prevention intervention, with one component being enhanced lifestyle modification support and addition of a health coaching service in the general practice setting. To determine the feasibility of translating intervention outcomes into real world practice, implementation work done by stakeholders was examined using Normalisation Process Theory as a framework. Data was collected through interviews with 40 intervention participants and included general practitioners, practice nurses, practice managers, lifestyle advisors and participants. Data analysis was informed by normalisation process theory constructs. Stakeholders were in agreement that, while prevention is a key function of general practice, it was not their usual work. There were varying levels of engagement with the intervention by practice staff due to staff interest, capacity and turnover, but most staff reconfigured their work for required activities. The Lifestyle Advisors believed staff had varied levels of interest in and understanding of, their service, but most staff felt their role was useful. Patients expanded their existing relationships with their general practice, and most achieved their lifestyle modification goals. While the study highlighted the complex nature of the change required, many of the new or enhanced processes implemented as part of the intervention could be scaled up to improve the systems approach to prevention. Overcoming the barriers to change, such as the perception of CVD prevention as a 'hard sell', is going to rely on improving the value proposition for all stakeholders. The study provided a detailed understanding of the work required to implement a complex cardiovascular disease prevention intervention within general practice. The findings highlighted the need for multiple strategies that engage all stakeholders. Normalisation process theory was a useful framework for guiding change implementation.
Work and retirement preferences of practicing radiologists as a predictor of workforce needs.
Moriarity, Andrew K; Brown, Manuel L; Schultz, Lonni R
2014-08-01
The radiology job market has been described as highly variable, and recent practice hiring surveys predict that the number of available jobs will remain flat. Radiologists may be working more hours and retiring later than desired, activities that influence overall job availability. A national survey was performed to determine the desired work rate and retirement preferences of practicing radiologists, and the responses are used to estimate current and potential future work output and future workforce needs. Practicing radiologists were surveyed regarding current and preferred work level and desired and expected retirement age. A model incorporating these preferences and stratified by age was developed using survey responses and American Medical Association full-time equivalent (FTE) estimates. Available FTE radiologists are estimated under four scenarios from 2016 to 2031 in 5-year intervals. The model predicts a total of 26,362 FTE radiologists available in 2011, which corresponds to previous estimates. Participants reported working more hours and expecting to retire later than desired, with younger radiologists and women reporting the greatest desired decrease in FTE hours worked. Under each scenario, there is an initial FTE availability in 2016 ranging from 21,156 to 24,537, which increases to between 27,753 and 31,435 FTE by 2031 depending on work rate and retirement patterns. Practicing radiologists report that they currently work more hours than desired and expect to retire later than they would prefer. If radiologists changed current personal work rate and expected retirement age to meet these preferences, there would be an immediate shortage of FTE radiologists continuing until at least 2020 assuming no other workforce needs changes. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.
[Changing to a career in general practice - a qualitative study reveals motives of specialists].
Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth
2016-12-01
In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of the challenges of ageing and family life. A major finding was that without the slim-lined program, the majority of participants would not have changed their career. The slim-lined training program in general practice attracts experienced medical doctors. Specialists decide to change career because of the particular ways of working in general practice and with the intention to improve their daily work as a physician, either to improve individual working conditions and/or to improve their individual curative work profile. In addition, specialists are attracted by the concept of self-employment in general practice. Therefore, appreciation of the specific ways of working in general practice as well as management skills are most important during the reduced 2-year training. Further studies should investigate if facilitating a career switch to general practice is a good way to improve the shortage of general practitioners. Copyright © 2016. Published by Elsevier GmbH.
Elvey, Rebecca; Voorhees, Jennifer; Bailey, Simon; Burns, Taylor; Hodgson, Damian
2018-06-01
Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine. A qualitative 'netnography' was undertaken of readers' comments to PulseToday. METHOD: A sample of readers' comments on articles published in PulseToday was collated and subjected to thematic analysis. Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using 'access to care' as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs' underlying feelings about their work and place in the NHS; constraints to GPs' control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership. This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs' roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown. © British Journal of General Practice 2018.
Is anybody listening? A qualitative study of nurses' reflections on practice.
Huntington, Annette; Gilmour, Jean; Tuckett, Anthony; Neville, Stephen; Wilson, Denise; Turner, Catherine
2011-05-01
To explore nurses' perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work-life balance and health of nurses. Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint. Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses. Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around 'care' as the organising construct. Four themes emerged: 'embodied care' which discusses the impact of work on the nurse's physical and emotional health; 'quantity/quality care' which addresses increasing pressures of work and ability to provide quality care; 'organisational (non)care' raising the seeming lack of support from management; and '(un)collegial/self care' where bullying and professional relationships were raised. Issues raised by participants have been discussed in the nursing literature for several years yet nurses still experience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory-practice gap, resulting in nurses intending to leave the profession. Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care. © 2011 Blackwell Publishing Ltd.
ERIC Educational Resources Information Center
Olesen, Henning Salling
An analysis of office work (OW) highlights the relationship between formal vocational qualifications and tacit knowledge gained through experience. In OW, "abstracted" skills (typewriting, correspondence) and theory are taught in schools out of their practical context and can become obsolete because of technological change. Some types of…
Phillips, Christine; Dwan, Kathryn; Pearce, Christopher; Hall, Sally; Porritt, Julie; Yates, Rachel; Sibbald, Bonnie
2007-08-01
In Australia, more nurses are entering general practice, and nurses' work is being funded in increasingly complex ways through Medicare. Little research has explored the ways doctors and nurses realign their priorities and activities when working together in general practice. We undertook rapid, intensive multimethod studies of 25 general practices to explore the ways in which the labour of nurses and doctors was structured, and the implicit decisions made by both professions about the values placed on different ways of working and on their time. Data collected included photographs, floor-plans, interviews with 37 nurses, 24 doctors and 22 practice managers, and 50 hours of structured observation. Nursing time was constructed by both nurses and doctors as being fluid and non-contingent; they were regarded as being 'available' to patients in a way that doctors were not. Compared to medical time, nursing time could be disposed more flexibly, underpinning a valorized attribute of nursing: deep clinical and personal contact with patients. The location of practice nurses' desks in areas of traffic, such as administrative stations, or in the treatment room, underpinned this valuable unstructured contact with patients. Changes to the practice nurse role through direct fee-for-service items for nurses may lead to greater congruence between the microeconomies of nursing and medicine in general practice. In a time of pressure upon a primary care workforce, this is likely to lead to more independent clinical work by nurses, but may also lead to a decrease in flexible contact with patients.
Complexity and the Beginning Principal in the United States: Perspectives on Socialization
ERIC Educational Resources Information Center
Crow, Gary M.
2006-01-01
Purpose: This paper aims to contribute to the literature and practice on beginning principal socialization by identifying the features of post-industrial work that create a more complex work environment for the practice and learning of the principalship in the USA. Design/methodology/approach: Based on recent literature on the changing nature of…
NASA Astrophysics Data System (ADS)
Walsh, E.; McGowan, V. C.
2015-12-01
The Next Generation Science Standards promote a vision in which learners engage in authentic knowledge in practice to tackle personally consequential science problems in the classroom. However, there is not yet a clear understanding amongst researchers and educators of what authentic practice looks like in a classroom and how this can be accomplished. This study explores these questions by examining interactions between scientists and students on a social media platform during two pilot enactments of a project-based curriculum focusing on the ecological impacts of climate change. During this unit, scientists provided feedback to students on infographics, visual representations of scientific information meant to communicate to an audience about climate change. We conceptualize the feedback and student work as boundary objects co-created by students and scientists moving between the school and scientific contexts, and analyze the structure and content of the scientists' feedback. We find that when giving feedback on a particular practice (e.g. argumentation), scientists would provide avenues, critiques and questions that incorporated many other practices (e.g. data analysis, visual communication); thus, scientists encouraged students to participate systemically in practices instead of isolating one particular practice. In addition, scientists drew attention to particular habits of mind that are valued in the scientific community and noted when students' work aligned with scientific values. In this way, scientists positioned students as capable of participating "scientifically." While traditionally, incorporating scientific inquiry in a classroom has emphasized student experimentation and data generation, in this work, we found that engaging with scientists around established scientific texts and data sets provided students with a platform for developing expertise in other important scientific practices during argment construction.
Advancing knowledge on practice change: linking facilitation to the senses framework.
Cooper, Julie; Meyer, Julienne; Holman, Cheryl
2013-06-01
To explore the facilitating factors that enabled staff on a rehabilitation ward for older people engage in change activities. The importance of facilitation in practice change is widely acknowledged; however, little nursing research has taken place in relation to its nature. Following identification in the early phases of an action research study that learned helplessness states and the use of socially structured defence techniques were preventing staff on a rehabilitation ward for older people from engaging in practice development, some change was achieved. What facilitated this to take place needed to be explored. An action research approach was used. Data gained from 13 in-depth interviews with staff and managers together with three years of researcher field notes were analysed using thematic analysis. The continuous presence and neutrality of the researcher who worked together with staff on their issues of concern using a flexible ward-based approach, combined with giving staff the opportunity to explore what it was like for them working in this area, were considered key in helping staff to engage with change. Analysis of findings suggests that the senses framework presents a theoretical approach to facilitation that can help staff move out of learned helplessness states and reduce the need for the use of socially structured defence techniques. This study identifies a facilitation approach that enabled staff to engage with practice change. Although carried out in the UK, its findings have wider relevance through the application of a theoretical perspective for practice change facilitation that has not before been considered in this literature, and which is likely to be of interest to those involved in practice change internationally. © 2013 Blackwell Publishing Ltd.
Price, John M; Colflesh, Gregory J H; Cerella, John; Verhaeghen, Paul
2014-05-01
We investigated the effects of 10h of practice on variations of the N-Back task to investigate the processes underlying possible expansion of the focus of attention within working memory. Using subtractive logic, we showed that random access (i.e., Sternberg-like search) yielded a modest effect (a 50% increase in speed) whereas the processes of forward access (i.e., retrieval in order, as in a standard N-Back task) and updating (i.e., changing the contents of working memory) were executed about 5 times faster after extended practice. We additionally found that extended practice increased working memory capacity as measured by the size of the focus of attention for the forward-access task, but not for variations where probing was in random order. This suggests that working memory capacity may depend on the type of search process engaged, and that certain working-memory-related cognitive processes are more amenable to practice than others. Copyright © 2014 Elsevier B.V. All rights reserved.
Full practice authority--effecting change and improving access to care: the Nevada journey.
VanBeuge, Susan S; Walker, Tomas
2014-06-01
In 2013, Nevada shifted from a collaborative practice model to full practice authority. Given the challenges many states still face, this article provides an outline of the evolution of the "nurse practitioner" (NP) in Nevada. Reviewing the path Nevada took toward full practice authority, we hope to provide insight including lessons learned and opposition encountered to assist other states working toward full practice authority. Literature searches were conducted on PubMed and MEDLINE. Search terms included "autonomous practice," "nurse practitioner," and "full practice authority." Healthcare reform will require nurse practitioners committed to legislative change. Nurse practitioners have the knowledge and ability to affect the legislative process and improve patients' access to care. With careful planning, full engagement, and team building, making a statute change is possible and should be seriously considered in states still struggling with collaborative relationships. Nurse practitioners are well situated to provide primary care in the United States. Removing barriers to practice through statute change will empower NPs to effect positive change in our struggling healthcare system. ©2014 The Author(s) ©2014 American Association of Nurse Practitioners.
Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.
Galbany-Estragués, Paola; Comas-d'Argemir, Dolors
2017-10-01
Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.
Bunn, Christopher; Wyke, Sally; Gray, Cindy M; Maclean, Alice; Hunt, Kate
2016-06-01
In this paper we use a social practice approach to explore men's experience of Football Fans in Training (FFIT), a group-based weight management programme for men that harnesses men's symbolic attachment to professional football clubs to engage them in lifestyle change. FFIT is delivered by community coaches in clubs' stadia and is gender-sensitised in relation to context, content and style of delivery. Using a 'toolkit' of concepts from the work of Bourdieu, Goffman and Durkheim we analysed data from 13 focus group discussions with participants, and fieldwork notes from programme observations to investigate the appeal and success of FFIT, and how it worked to support change. Our analysis builds on our work on the importance of shared symbolic commitment to the football club and being with 'men like me' to understand how the interaction context facilitated 'effervescent' experiences. These experiences encouraged men to make changes to their diet and physical activity, talk about them, practice performing them and implement them in their lives. Thus a social practice approach illuminated the social processes through which lifestyle change was achieved, and we argue that it can deepen and enrich both intervention design and evaluation. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.
Filter Backwash Recycling Rule Documents
The purpose of the FBRR is to require (PWSs) to review their recycle practices and, where appropriate, work with the state Primacy Agency to make any necessary changes to recycle practices that may compromise microbial control.
Dickinson, L Miriam; Dickinson, W Perry; Nutting, Paul A; Fisher, Lawrence; Harbrecht, Marjie; Crabtree, Benjamin F; Glasgow, Russell E; West, David R
2015-04-01
Efforts to improve primary care diabetes management have assessed strategies across heterogeneous groups of patients and practices. However, there is substantial variability in how well practices implement interventions and achieve desired outcomes. To examine practice contextual features that moderate intervention effectiveness. Secondary analysis of data from a cluster randomized trial of three approaches for implementing the Chronic Care Model to improve diabetes care. Forty small to mid-sized primary care practices participated, with 522 clinician and staff member surveys. Outcomes were assessed for 822 established patients with a diagnosis of type 2 diabetes who had at least one visit to the practice in the 18 months following enrollment. The primary outcome was a composite measure of diabetes process of care, ascertained by chart audit, regarding nine quality measures from the American Diabetes Association Physician Recognition Program: HgA1c, foot exam, blood pressure, dilated eye exam, cholesterol, nephropathy screen, flu shot, nutrition counseling, and self-management support. Data from practices included structural and demographic characteristics and Practice Culture Assessment survey subscales (Change Culture, Work Culture, Chaos). Across the three implementation approaches, demographic/structural characteristics (rural vs. urban + .70(p = .006), +2.44(p < .001), -.75(p = .004)); Medicaid: < 20 % vs. ≥ 20 % (-.20(p = .48), +.75 (p = .08), +.60(p = .02)); practice size: < 4 clinicians vs. ≥ 4 clinicians (+.56(p = .02), +1.96(p < .001), +.02(p = .91)); practice Change Culture (high vs. low: -.86(p = .048), +1.71(p = .005), +.34(p = .22)), Work Culture (high vs. low: -.67(p = .18), +2.41(p < .001), +.67(p = .005)) and variability in practice Change Culture (high vs. low: -.24(p = .006), -.20(p = .0771), -.44(p = .0019) and Work Culture (high vs. low: +.56(p = .3160), -1.0(p = .008), -.25 (p = .0216) were associated with trajectories of change in diabetes process of care, either directly or differentially by study arm. This study supports the need for broader use of methodological approaches to better examine contextual effects on implementation and effectiveness of quality improvement interventions in primary care settings.
Changing Teacher Practices: Proceedings of a National Conference (Austin, Texas, October 1981).
ERIC Educational Resources Information Center
Defino, Maria E., Ed.; Carter, Heather, Ed.
In this report of a working conference, experts in the teacher education field considered the adequacy of current research on teaching practices and obstacles in the implementation of changes based on research findings. In "How Useful Are the Findings from the Research on Teaching," Jane A. Stallings discussed findings from research on teaching…
Disallowing Recommendations for Practice and Policy: A Proposal that Is Both Too Much and Too Little
ERIC Educational Resources Information Center
Harris, Karen R.
2013-01-01
Robinson et al. ("Educ Psychol Rev" 25(2):291-302, 2013) offer a thoughtful and powerful argument for a policy change for primary educational research journals. This policy change would "disallow recommendations for practice" (p. 10) in primary educational research journals. They provided compelling examples of works in which…
ERIC Educational Resources Information Center
Fetsch, Robert J.; Jackman, Danielle M.
2015-01-01
Disability rates resulting from work-related injuries remain steadily high among farmers and ranchers. To address the gap in services within this population, USDA implemented AgrAbility nationally. Using part of Bennett's hierarchical model, the current study evaluated the KASA and practice change levels of 401 farmers and ranchers and compared…
Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise
2009-11-08
Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider explorations of ICT's potential benefits, yet firm evidence of the effects of role changes on health service outcomes is limited. This project will provide important evidence about the role of ICT in supporting new models of care delivery across multiple healthcare organizations and about the ways in which innovative work practice change is diffused.
Ziegler, Stine; van den Bussche, Hendrik; Römer, Farina; Krause-Solberg, Lea; Scherer, Martin
2017-06-01
Introduction We investigated the preferences of medical residents in Germany with regard to future working place (hospital or private practice) and position (employment/self-employment in private practice; resp. specialist/senior or chief physician in the hospital). This is analysed in a gender comparative perspective, including the influence of parenthood. Methods Annual postal surveys among graduates of seven medical faculties in Germany from their last year ("Practical Year") until after four years of postgraduate training. The return rate at baseline was 48 % and the four surveys after reached rates from 85 % up. In all samples about two thirds were women, which corresponds to the actual gender differentiation in under- and postgraduate training. Descriptive statistics and regression analyses were performed. Results Compared to private practice the hospital is clearly preferred, although the attraction of hospital jobs decreased over the years. The decision for or against the hospital is connected to the discipline. Working in private practice is seen as possibility for part time work. Men prefer self-employment whereas women prefer to work under an employment contract. In the hospital, male doctors prefer to work in leading positions. Those positions are associated with full-time work. Leadership training especially takes place in university hospitals. Discussion Three trends are recognized: Reluctance against leading positions, growing interest for part time work and rising popularity of work as an employee in private practice. Those trends can be understood as a rejection of traditional professional role models. The realization of these preferences is easily feasible because of the current labour market situation. Therefore, emerging problems have to be faced in another way. A change of gender-typical role models was rarely detected. © Georg Thieme Verlag KG Stuttgart · New York.
Huang, Yingying; Pan, Suiming
2014-01-01
The Chinese Government periodically enforces anti-prostitution laws through regular police presence in red light districts and through the arrests of brothel managers and sex workers. One of the most intense crackdowns on prostitution occurred throughout China in 2010. Using the 'structure-agency' framework and ethnographic approach, this paper examines the influence of the 2010 government anti-prostitution crackdown on female sex workers (FSWs). We observed 10 red light districts (6 cities and 2 counties) and interviewed 107 FSWs, 26 managers and 37 outreach workers working with FSWs. The findings describe variations in police practices and diverse strategies adopted by FSWs in response to police actions. The strategies include: soliciting sex outside of establishments in less visible channels, increasing the mobility and flexibility of sex work, changing sexual practices, sharing knowledge of how to identify policemen disguised as male clients and building personal relationships with local police. Our study suggests that, rather than disappearing as a result of crackdowns, the terms and content of sex work changed as a result of the FSWs' responses to police practices. Some of these responses potentially increased the health risks associated with sex work, but others laid the foundation for an effective response to police practices.
Huang, Yingying; Pan, Suiming
2015-01-01
The Chinese Government periodically enforces anti-prostitution laws through regular police presence in red light districts and through the arrests of brothel managers and sex workers. One of the most intense crackdowns on prostitution occurred throughout China in 2010. Using the ‘structure-agency’ framework and ethnographic approach, this paper examines the influence of the 2010 government anti-prostitution crackdown on female sex workers (FSWs). We observed 10 red light districts (6 cities and 2 counties) and interviewed 107 FSWs, 26 managers and 37 outreach workers working with FSWs. The findings describe variations in police practices and diverse strategies adopted by FSWs in response to police actions. The strategies include: soliciting sex outside of establishments in less visible channels, increasing the mobility and flexibility of sex work, changing sexual practices, sharing knowledge of how to identify policemen disguised as male clients and building personal relationships with local police. Our study suggests that, rather than disappearing as a result of crackdowns, the terms and content of sex work changed as a result of the FSWs’ responses to police practices. Some of these responses potentially increased the health risks associated with sex work, but others laid the foundation for an effective response to police practices. PMID:25226069
Insight, working through, and practice: the role of procedural knowledge.
Rosenblatt, Allan
2004-01-01
A conception of insight is proposed, based on a systems and information-processing framework and using current neuroscience concepts, as an integration of information that results in a new symbolization of experience with a significant change in self-image and a transformation of non-declarative procedural knowledge into declarative knowledge. Since procedural memory and knowledge, seen to include emotional and relationship issues, is slow to change, durable emotional and behavioral change often requires repeated practice, a need not explicitly addressed in standard psychoanalytic technique. Working through is thus seen as also encompassing nondynamic factors. The application of these ideas to therapeutic technique suggests possible therapeutic interventions beyond interpretation. An illustrative clinical vignette is presented.
Rojo, Elena; Oruña, Clara; Sierra, Dolores; García, Gema; Del Moral, Ignacio; Maestre, Jose M
2016-04-01
We analyzed the impact of simulation-based training on clinical practice and work processes on teams caring for patients with possible Ebola virus disease (EVD) in Cantabria, Spain. The Government of Spain set up a special committee for the management of EVD, and the Spanish Ministry of Health and foreign health services created an action protocol. Each region is responsible for selecting a reference hospital and an in-house care team to care for patients under investigation. Laboratory-confirmed cases of EVD have to be transferred to the Carlos III Health Institute in Madrid. Predeployment training and follow-up support are required to help personnel work safely and effectively. Simulation-based scenarios were designed to give staff the opportunity to practice before encountering a real-life situation. Lessons learned by each team during debriefings were listed, and a survey administered 3 months later assessed the implementation of practice and system changes. Implemented changes were related to clinical practice (eg, teamwork principles application), protocol implementation (eg, addition of new processes and rewriting of confusing parts), and system and workflow (eg, change of shift schedule and rearrangement of room equipment). Simulation can be used to detect needed changes in protocol or guidelines or can be adapted to meet the needs of a specific team.
Developing Collaborative and Innovative Leadership: Practices for Fostering a New Mindset
ERIC Educational Resources Information Center
Paxton, Doug; Van Stralen, Suzanne
2015-01-01
"We live at a hinge time in history, a threshold time when societies and cultures are being recomposed. We are learning that the way life used to work--or the way we thought it should-- doesn't work any longer" (Parks, 2009, p. 15). This article is about learning, culture change, practice and leadership. Many wise minds have articulated…
Knowledges and Practices of Successful Literacy Teachers (Brazil, 1950-1980)
ERIC Educational Resources Information Center
Monteiro, Maria Iolanda; Bueno, Belmira Oliveira
2008-01-01
Significant changes have marked Brazilian education in the period focused on by this research. Aiming to understand the configurations of the teaching profession in that period, this work focuses on the issue of the school success in the area of literacy by means of an analysis of the practices of literacy teachers who were at work between the…
Learning organisations: the challenge of finding a safe space in a climate of accountability.
McKee, Anne
2017-03-01
The effects of health policy reforms over a twenty-five year period have changed the NHS as a place in which to work and learn. Some of these changes have had unintentional consequences for learning in the workplace. A recent King's Fund contribution to quality improvement debates included an extensive review of NHS policies encouraging change 'from within' the NHS and renewed calls to develop learning organisations there. I draw upon an action research project designed to develop learning organisations in primary care to locate quality improvement debates amid the realities of practice. The project identified key challenges primary care practices encountered to protect time and space for this form of work based learning, even when they recognised the need for it and wanted to engage in it. Implications for policy makers, primary care practices and health professional educationalists are identified.
Litaker, David; Ruhe, Mary; Weyer, Sharon; Stange, Kurt C
2008-01-01
Background The relationship between health care practices' capacity for change and the results and sustainability of interventions to improve health care delivery is unclear. Methods In the setting of an intervention to increase preventive service delivery (PSD), we assessed practice capacity for change by rating motivation to change and instrumental ability to change on a one to four scale. After combining these ratings into a single score, random effects models tested its association with change in PSD rates from baseline to immediately after intervention completion and 12 months later. Results Our measure of practices' capacity for change varied widely at baseline (range 2–8; mean 4.8 ± 1.6). Practices with greater capacity for change delivered preventive services to eligible patients at higher rates after completion of the intervention (2.7% per unit increase in the combined effort score, p < 0.001). This relationship persisted for 12 months after the intervention ended (3.1%, p < 0.001). Conclusion Greater capacity for change is associated with a higher probability that a practice will attain and sustain desired outcomes. Future work to refine measures of this practice characteristic may be useful in planning and implementing interventions that result in sustained, evidence-based improvements in health care delivery. PMID:18485216
Deutsch, Tobias; Hönigschmid, Petra; Frese, Thomas; Sandholzer, Hagen
2013-02-21
Demographic change and recruitment problems in family practice are increasingly threatening an adequate primary care workforce in many countries. Thus, it is important to attract young physicians to the field. The purpose of the present study was to examine the effect of an early community-based 28-h family practice elective with one-to-one mentoring on medical students' consideration of family practice as a career option, their interest in working office-based, and several perceptions with regard to specific aspects of a family physician's work. First- and second-year medical students completed questionnaires before and after a short community-based family practice elective, consisting of a preparatory course and a community-based practical experience with one-to-one mentoring by trained family physicians. We found a significantly higher rate of students favoring family practice as a career option after the elective (32.7% vs. 26.0%, p = 0.039). Furthermore, the ranking of family practice among other considered career options improved (p = 0.002). Considerations to work office-based in the future did not change significantly. Perceptions regarding a family physician's job changed positively with regard to the possibility of long-term doctor-patient relationships and treatment of complex disease patterns. The majority of the students described identification with the respective family physician tutor as a professional role model and an increased interest in the specialty. Our results indicate that a short community-based family practice elective early in medical education may positively influence medical students' considerations of a career in family practice. Furthermore, perceptions regarding the specialty with significant impact on its attractiveness may be positively adjusted. Further research is needed to evaluate the influence of different components of a family practice curriculum on the de facto career decisions of young physicians after graduation.
Motivation, Work Satisfaction, and Teacher Change among Early Childhood Teachers
ERIC Educational Resources Information Center
Wagner, Brigid Daly; French, Lucia
2010-01-01
This study tests the explanatory power of Deci and Ryan's (1985) self-determination theory as a framework for describing how interactions between early childhood teachers and the systems within which their work is embedded influence motivation for professional growth and change in teaching practice. Fifty-four early childhood teachers and teacher…
Understanding general practice: a conceptual framework developed from case studies in the UK NHS.
Checkland, Kath
2007-01-01
General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Five general practices in England, selected using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.
Reid, Anne-Marie; Ledger, Alison; Kilminster, Sue; Fuller, Richard
2015-08-01
Continued changes to healthcare delivery in the UK, and an increasing focus on patient safety and quality improvement, require a radical rethink on how we enable graduates to begin work in challenging, complex environments. Professional regulatory bodies now require undergraduate medical schools to implement an 'assistantship' period in the final year of study, where senior medical students 'shadow' the work of junior doctors, with an expectation that they will be better 'prepared' for work. However, there is little guidance about what an 'assistantship' entails and the current emphasis on preparedness of students arguably underplays the importance of contextualised learning within the workplace environment. This paper will describe a modified Development Work Research (DWR) (Engeström in Developmental work research: activity theory in practice. Lehmanns Media, Berlin, 2005) approach to organisational change, enabling academic, clinical and administrative partners to develop assistantship placements in different hospitals. Our findings indicate that a modified DWR approach can reveal factors indicating organisational readiness to support change within a locally contextualised framework. The process has significant practical applications across a range of healthcare disciplines, as all professions seek to engage with the challenge of enabling successful transitions of graduates to the workplace.
Dreischulte, Tobias; Guthrie, Bruce
2017-01-01
Objective To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Design Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Setting Ten (30%) primary care practices participating in the trial from Scotland, UK. Results Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Conclusions Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. Trial registration number NCT01425502. PMID:28283493
Grant, Aileen; Dreischulte, Tobias; Guthrie, Bruce
2017-03-10
To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Ten (30%) primary care practices participating in the trial from Scotland, UK. Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. NCT01425502. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
ERIC Educational Resources Information Center
Geber, Beverly
1990-01-01
Demographic trends imply that organizations must learn to manage a diverse work force. Ways to change organizational systems, structures, and practices to eliminate subtle barriers are awareness training, attitude change, and valuing diversity. (SK)
Work-based learning in health care environments.
Spouse, J
2001-03-01
In reviewing contemporary literature and theories about work-based learning, this paper explores recent trends promoting life-long learning. In the process the paper reviews and discusses some implications of implementing recent policies and fostering le arning in health care practice settings. Recent Government policies designed to provide quality health care services and to improve staffing levels in the nursing workforce, have emphasized the importance of life-long learning whilst learning-on-the-job and the need to recognize and credit experiential learning. Such calls include negotiation of personal development plans tailored to individual educational need and context-sensitive learning activities. To be implemented effectively, this policy cann ot be seen as a cheap option but requires considerable financial resourcing for preparation of staff and the conduct of such activities. Successful work-based learning requires investment in staff at all levels as well as changes to staffing structures in organizations and trusts; changes designed to free people up to work and learn collaboratively. Creating an organizational environment where learning is prized depends upon a climate of trust; a climate where investigation and speculation are fostered and where time is protected for engaging in discussions about practice. Such a change may be radical for many health care organizations and may require a review of current policies and practices ensuring that they include education at all levels. The nature of such education also requires reconceptualizing. In the past, learning in practice settings was seen as formal lecturing or demonstration, and relied upon behaviourist principles of learning. Contemporary thinking suggests effective learning in work-settings is multi-faceted and draws on previously acquired formal knowledge, contextualizes it and moulds it according to situations at hand. Thinking about work-based learning in this way raises questions about how such learning can be supported and facilitated.
Education Research Australia: A Changing Ecology of Knowledge and Practice
ERIC Educational Resources Information Center
Seddon, Terri; Bennett, Dawn; Bennett, Sue; Bobis, Janette; Chan, Philip; Harrison, Neil; Shore, Sue
2013-01-01
Processes of national research assessment, such as Excellence in Research for Australia (ERA) are a type of audit technology that confronts and steers established institutional identities and traditions. This nexus between policy and practice drives boundary work that diffracts prevailing policy logics, organisational practices, and habits of…
From Planning to Action: Government Initiatives for Improving School-Level Practice.
ERIC Educational Resources Information Center
Chapman, David W., Ed.; Mahlck, Lars O., Ed.; Smulders, Anna E. M., Ed.
This work examines ways central and regional education ministries can influence practices at the school level. Chapter 1, "Changing What Happens in Schools: Central-Level Initiatives to Improve School Practice," reviews common themes, concerns, problems, and emphases. Chapter 2, "Knowledge Utilization and the Process of Policy…
Attitudes toward working mothers: accommodating the needs of mothers in the work force.
Albright, A
1992-10-01
More women, including mothers, are part of the work force than ever before. In the workplace, barriers often exist that restrict promotion and advancement of mothers. Mothers often are penalized in attempting to meet the demands of parent and worker roles. Parenting practices have been considered primarily the domain of mothers. However, nurturing may be done effectively by fathers or other motivated adults. Policies of employers must change to accommodate needs of families. Examples of supportive practices may include flexible working hours, parental leave, and on-site child care.
Machin, Alison I; Machin, Tony; Pearson, Pauline
2012-07-01
This article reports the study of a group of United Kingdom health visitors' interactions with their changing practice context, focusing on role identity and influences on its stability. United Kingdom policies have urged health visitors to refocus their role as key public health nurses. Reduced role identity clarity precipitated the emergence of different models of health visiting public health work. An inconsistent role standard can lead to role identity fragmentation and conflict across a group. It may precipitate individual role crisis, affecting optimum role performance. Seventeen health visitors in two United Kingdom community healthcare organizations participated in a grounded theory study, incorporating constant comparative analysis. Direct observations and individual interviews were undertaken between 2002 and 2008. Four interlinked categories emerged: professional role identity (core category); professional role in action; interprofessional working; and local micro-systems for practice; each influencing participants' sense of identity and self-worth. The Role Identity Equilibrium Process explains interactive processes occurring at different levels of participants' practice. Re-establishing equilibrium and consistency in health visiting identity is a priority. This study's findings have significance for other nurses and health professionals working in complex systems, affected by role change and challenges to role identity. © 2011 Blackwell Publishing Ltd.
National Service Frameworks and UK general practitioners: street-level bureaucrats at work?
Checkland, Kath
2004-11-01
This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.
Focus First on Outcomes: When Planning Change, Improved Student Learning Is the Ultimate Goal
ERIC Educational Resources Information Center
Bradley, Janice; Munger, Linda; Hord, Shirley
2015-01-01
Educators working to achieve changes in classroom teaching practices that lead to improvement in student learning need to gain clarity in where they are going--what they want to accomplish. Teachers in a professional learning community need a road map as they begin learning and applying a new practice to ensure they reach their intended goal…
ERIC Educational Resources Information Center
Lorencatto, Fabiana; West, Robert; Seymour, Natalie; Michie, Susan
2013-01-01
Objective: There is a difference between interventions as planned and as delivered in practice. Unless we know what was actually delivered, we cannot understand "what worked" in effective interventions. This study aimed to (a) assess whether an established taxonomy of 53 smoking cessation behavior change techniques (BCTs) may be applied…
ERIC Educational Resources Information Center
McMunn, Nancy; Schenck, Patricia; McColskey, Wendy
Whether school district support and training in standards-based assessment, grading, and reporting in classrooms can change teacher practice in these areas was studied in a Florida school district. This district, Bay District Schools of Panama City, has been working with the SERVE Regional Educational Laboratory on a project that involves teachers…
ERIC Educational Resources Information Center
Gault, Stanley C.; Brock, William E.; Donahue, Thomas R.
Three conference papers explore issues related to work and the American family. The first, by Stanley C. Gault, Chairman of th Board of the National Association of Manufacturers, discusses recent changes in business practices that accommodate changes in the structure of the modern American family. The second, by Secretary of Labor, William E.…
Bourdieu's theory of practice and its potential in nursing research.
Rhynas, Sarah J
2005-04-01
This paper seeks to consider the utility of Bourdieu's "Theory of Practice" in nursing, and considers specifically its use as a framework for research exploring nurses' conceptualizations of illness and the patients in their care. Bourdieu's work uses the concepts of field, capital and habitus to explain interactions within the social world. This paper describes these concepts and their relationship with nursing is discussed using dementia care as an example. The work of French scholar Pierre Bourdieu has contributed to debates throughout the social sciences, but has had relatively little attention in the nursing literature. Pierre Bourdieu's work developed against a backdrop of change in the academic world. The emergence of the social sciences and the debate around objective and subjective styles of research were influential in the development of his "Theory of Practice". The importance of the conceptualization process is discussed, and the considerable potential influence of conceptualization on patient care is highlighted. Reflexivity is a cornerstone of Bourdieu's work, and is an important feature of nursing research. Examples of health care research using his work as a framework are discussed, and some of the challenges of the approach are outlined. The use of Bourdieu's "Theory of Practice" as a research framework could allow nurse researchers to explore the interactions of nurses with the structures, agents and symbols of illness within the field of care. This work could enhance understanding of how nurses view and react to patients in their care, and promote the development of practice innovations and policy change. The theory may, therefore, have much to offer future nursing research.
ERIC Educational Resources Information Center
Castleton, Geraldine; Ovens, Carolyn; Ralston, Deborah
The nature and effects of current common understandings of the relationship between work and literacy were examined along with the typical design and objectives of workplace literacy programs for members of Australia's work force. Special attention was paid to the following topics: changing demands of work and literacy at work; discourses of…
The BGR Contingency Model for Leading Change
ERIC Educational Resources Information Center
Brown, Derek R.; Gordon, Raymond; Rose, Dennis Michael
2012-01-01
The continuing failure rates of change initiatives, combined with an increasingly complex business environment, have created significant challenges for the practice of change management. High failure rates suggest that existing change models are not working, or are being incorrectly used. A different mindset to change is required. The BGR…
Lyons, Tara; Krüsi, Andrea; Pierre, Leslie; Small, Will; Shannon, Kate
2017-12-01
The objective of this study was to investigate how environmental and structural changes to a trans outdoor work environment impacted sex workers in Vancouver, Canada. The issue of changes to the work area arose during qualitative interviews with 33 trans sex workers. In response, ethnographic walks that incorporated photography were undertaken with trans sex workers. Changes to the work environment were found to increase vulnerabilities to client violence, displace trans sex workers, and affect policing practices. Within a criminalized context, construction and gentrification enhanced vulnerabilities to violence and harassment from police and residents.
Vocational training courses as an intervention on change of work practice among immigrant cleaners.
Jensen, Flemming W; Frydendall, Karen B; Flyvholm, Mari-Ann
2011-11-01
The aim of the study was to examine how knowledge and skills from vocational training courses on working techniques modified for immigrant cleaners are applied in practice and to identify factors that influence the implementation. The modifications of the standard course included language support with possibilities for translation and an extension of the duration of the course. The study is a prospective intervention study based on qualitative data. Data were collected as structured interviews and observations were carried out at the workplaces before and after the course. The study population included 31 immigrant cleaners from five different workplaces. Changes were observed in the use of working techniques (i.e., positioning of hands when using the floor mop). In some cases the use of the taught techniques was incorrect, partial, or only used part of the time. Interactions between individual factors (i.e., knowledge, awareness, capability, or work orientation) and environmental factors (i.e., equipment, time, workload, or physical surroundings) influenced the use of the techniques in practice. The course provided the participants with new working techniques through which some were able to reduce work related pain. However, with regard to incorrect and partial use of the working techniques, follow-up and post-training support is recommended. Copyright © 2011 Wiley Periodicals, Inc.
Teachers Reflecting on Their Work: Articulating What Is Said about What Is Done
ERIC Educational Resources Information Center
Mena Marcos, Juan Jose; Sanchez, Emilio; Tillema, Harm
2008-01-01
Teachers' written reflections on their work, which report on a change in their practice, were the object of this research. Taking teachers' articulation of their plans and actions in teacher journals as our source, this study's aim is twofold: (1) to describe how teacher reflect in a self-initiated and non-framed way on their own practice, and (2)…
ERIC Educational Resources Information Center
Walker, Thomas J.; Johnson, Scott D.
1993-01-01
The Eastern Pennsylvania Lead Teacher Consortium, a regional network for professional development of vocational teachers, demonstrates that lead teachers' work must be tied to student learning outcomes, ideas and practices must be communicated to building-level staff, and regional consortia need a dedicated funding source. (SK)
[Motivating health education-based change].
Puerto-Guerrero, Ana H
2012-06-01
The following work refers to academic experience regarding the training of nurses concerning primary prevention and child nursing within the area of public health. The target population consisted of children. Accumulated experience was systematized for identifying epistemological, theoretical and practical elements developed over five years in basic primary education institutions, in line with the educational proposal Experience sexuality with dignity. It was found that this type of work managed to develop special motivation in the scholastic community whilst allowing academics to approach the social reality which they must confront in their professional practice. The work emphasised strengthening children's awareness of the need for family, state and civil society participation. Motivating health education-based change did involve the systematisation of experience as a methodological tool.
CASH--an innovative approach to sustainable OSH improvement at workplace.
Pingle, S; Shanbhag, S
2006-01-01
Occupational health department of a large private enterprise located in India launched Project CASH--Change Agents for Safety and Health, at manufacturing units of the enterprise to bring about a positive change in work environment and improvement in work practices to reduce occupational health risk. Multidisciplinary teams of change agents were constituted and were given intensive training inputs. Reduction in exposure to noise, dust and heat stress were identified as specific objectives after a baseline survey of the work environment. Occupational safety and health knowledge and training was imparted to all field personnel to improve their work practices and attitudes. The focus of the actions was on engineering control measures and process engineering changes necessary for workplace improvement. Noise levels were reduced by an average of more than 9dBA in most of the top ten high noise locations. Out of two locations identified for dust exposure, one was fully eliminated and dust levels at other location were significantly reduced. Heat stress was reduced in all three identified locations with an average reduction of more than 3 degrees C in WBGT levels. Thus, final evaluation of workplace environments revealed significant reduction in exposure to all identified agents, viz noise, dust and heat fulfilling the project objectives. Educating and empowering the team led to reduction of occupational health risks in the work environment. There was positive attitudinal and behavioural change in safety and occupational health awareness & practices among employees. The monetary savings resulting from improvements far outweighed the investments. Success of this pilot project was followed up with further similar projects and their number has grown in geometric proportion for the last three years indicating the sustainability of the project.
eLearning, knowledge brokering, and nursing: strengthening collaborative practice in long-term care.
Halabisky, Brenda; Humbert, Jennie; Stodel, Emma J; MacDonald, Colla J; Chambers, Larry W; Doucette, Suzanne; Dalziel, William B; Conklin, James
2010-01-01
Interprofessional collaboration is vital to the delivery of quality care in long-term care settings; however, caregivers in long-term care face barriers to participating in training programs to improve collaborative practices. Consequently, eLearning can be used to create an environment that combines convenient, individual learning with collaborative experiential learning. Findings of this study revealed that learners enjoyed the flexibility of the Working Together learning resource. They acquired new knowledge and skills that they were able to use in their practice setting to achieve higher levels of collaborative practice. Nurses were identified as team leaders because of their pivotal role in the long-term care home and collaboration with all patient care providers. Nurses are ideal as knowledge brokers for the collaborative practice team. Quantitative findings showed no change in learner's attitudes regarding collaborative practice; however, interviews provided examples of positive changes experienced. Face-to-face collaboration was found to be a challenge, and changes to organizations, systems, and technology need to be made to facilitate this process. The Working Together learning resource is an important first step toward strengthening collaboration in long-term care, and the pilot implementation provides insights that further our understanding of both interprofessional collaboration and effective eLearning.
Whay, Helen R; Dikshit, Amit K; Hockenhull, Jo; Parker, Richard M A; Banerjee, Anindo; Hughes, Sue I; Pritchard, Joy C; Reix, Christine E
2015-01-01
Previous studies have found the prevalence of lameness in working horses to be 90-100%. Risk factors for lameness in this important equine population, together with risk-reduction strategies adopted by their owners, are poorly understood. The objective was to uncover risk factors for lameness and limb abnormalities in working horses, by associating clinical lameness examination findings on three occasions over two years with owner reported changes in equine management and work practices over this period. Twenty-one communities of horse owners in Jaipur, India, took part in a participatory intervention (PI) project aiming to reduce risk factors for poor welfare, particularly lameness and limb problems. Associations between quantitative measures of equine lameness/limb abnormalities and reported changes in management and work practices were compared with 21 control (C) communities of owners where no intervention had taken place. Key findings from 'complete cases', where the same horse stayed with the same owner for the whole study period (PI group = 73 owners of 83 horses, C group = 58 owners of 66 horses), were that more positive statements of change in equine management and work practices were made by PI group owners than C group owners. A mixed picture of potential risk factors emerged: some reported management improvements, for example reducing the weight of the load for cart animals, were associated with improved limbs and lameness, and others, such as making improvements in shoeing and increasing the age at which their animals started work, with negative outcomes. This study illustrates the complexity and interacting nature of risk factors for lameness in working horses, and highlights the importance of longitudinal investigations that recognise and address this. PI group owners found the project useful and requested similar inputs in future. Our findings demonstrate the value of exploratory and participatory research methodology in the field of working horse welfare.
Women Urologists: Changing Trends in the Workforce.
Saltzman, Amanda; Hebert, Kristi; Richman, Ashley; Prats, Samantha; Togami, Joanna; Rickey, Leslie; Montgomery, Melissa
2016-05-01
To characterize the current workforce of women urologists in the United States. An anonymous electronic survey was sent to all members of the Society of Women in Urology and all female non-Society of Women in Urology members of the American Urologic Association. The survey was distributed in January of 2015. Demographic, work, and personal life data were collected. Of 1563 e-mails with a link to our survey sent to women urologists in the United States, 365 surveys were completed for a 23% response rate. The average age of all participants was 39 years (range 25-73 years). Practicing women urologists had an average age of 44 years (range 32-65 years) compared to the average age (53 years) of all practicing urologists reported in the 2014 American Urologic Association Census. The majority of practicing female urologists live and work in a population of >1 million whereas a few live and work in rural areas. Practicing women urologists are most likely to work academic or group practice. Twenty percent of practicing women urologists reported working part-time, but almost 70% report working >50 hours/week. Women urologists in the United States are younger than their male counterparts and most work full-time in urban academic centers. Copyright © 2016 Elsevier Inc. All rights reserved.
Andersen, Rikke Sand; Aarhus, Rikke
2017-07-31
Health care systems as well as bodies of medical knowledge are dynamic and change as the result of political and social transformations. In recent decades, health care systems have been subjected to a whole assemblage of regulatory practices. The local changes undertaken in Denmark that are being explored here are indicative of a long-term shift that has occurred in many welfare states intended to make public services in the Global North more efficient and transparent. Departing in prolonged field work in Danish general practice and the anthropological literature on audit culture, this paper suggests that the introduction of regulatory practices has enhanced the need for triage as a key organising principle. The term triage literally means separating out and refers to the process of sorting and placing patients in time and space. The paper suggests that an increasing introduction of triage feeds into a reconfiguration of diagnostic work, where the clinical setting is gradually becoming more intertwined with the governing domains of policy, and the work of the secretary is gradually becoming more intertwined with that of the doctor. Finally, the paper argues that an increasing regulation of general practice poses an ethically charged challenge to existing welfare politics of responsibility between the state and the public, as it makes it increasingly difficult to negotiate access to care.
Teaching Note--Integrating Prevention Content into Clinical Social Work Practice Courses
ERIC Educational Resources Information Center
Rishel, Carrie W.
2014-01-01
Rapid changes in health care services and delivery suggest an upcoming paradigm shift in the field of mental health. Recent national reports, health care policy changes, and growing evidence support a shift toward prevention-focused mental health care. The social work profession is uniquely positioned to act as leaders in this shift as the…
How to build the practice you want, not just the practice that walks through the door.
Jackson, Rem
2013-01-01
The first step in transforming your patient mix is to recognize that it is appropriate to prefer to see a specific type of patient over other types. You may enjoy working in a particular practice niche more than others, and there may be financial considerations as well. The second step is to change your marketing so that it focuses on your preferred, or "perfect," patient. This strategy will allow you to build a patient database that will enable you to change, over time, the type of patients you are seeing in your practice.
Motivational Interviewing: An Evidence-Based Practice for Improving Student Practice Skills
ERIC Educational Resources Information Center
Hohman, Melinda; Pierce, Paloma; Barnett, Elizabeth
2015-01-01
Motivational interviewing (MI) is an evidence-based communication method to assist clients in resolving their ambivalence regarding change. With a school emphasis on evidence-based practice and learning outcomes, a social work department implemented a semester-long course on MI. The purpose of this study was to determine baseline skills and…
Working to Full Scope: The Reorganization of Nursing Work in Two Canadian Community Hospitals
MacKinnon, Karen; Butcher, Diane L.; Bruce, Anne
2018-01-01
Work relationships between registered nurses (RNs) and practical nurses (LPNs) are changing as new models of nursing care delivery are introduced to create more flexibility for employers. In Canada, a team-based, hospital nursing care delivery model, known as Care Delivery Model Redesign (CDMR), redesigned a predominantly RN-based staffing model to a functional team consisting of fewer RNs and more LPNs. The scope of practice for LPNs was expanded, and unregulated health care assistants introduced. This study began from the standpoint of RNs and LPNs to understand their experiences working on redesigned teams by focusing on discourses activated in social settings. Guided by institutional ethnography, the conceptual and textual resources nurses are drawing on to understand these changing work relationships are explicated. We show how the institutional goals embedded in CDMR not only mediate how nurses work together, but how they subordinate holistic standards of nursing toward fragmented, task-oriented, divisions of care. PMID:29410976
Working to Full Scope: The Reorganization of Nursing Work in Two Canadian Community Hospitals.
MacKinnon, Karen; Butcher, Diane L; Bruce, Anne
2018-01-01
Work relationships between registered nurses (RNs) and practical nurses (LPNs) are changing as new models of nursing care delivery are introduced to create more flexibility for employers. In Canada, a team-based, hospital nursing care delivery model, known as Care Delivery Model Redesign (CDMR), redesigned a predominantly RN-based staffing model to a functional team consisting of fewer RNs and more LPNs. The scope of practice for LPNs was expanded, and unregulated health care assistants introduced. This study began from the standpoint of RNs and LPNs to understand their experiences working on redesigned teams by focusing on discourses activated in social settings. Guided by institutional ethnography, the conceptual and textual resources nurses are drawing on to understand these changing work relationships are explicated. We show how the institutional goals embedded in CDMR not only mediate how nurses work together, but how they subordinate holistic standards of nursing toward fragmented, task-oriented, divisions of care.
ERIC Educational Resources Information Center
Stanhope, Clare
2011-01-01
This article examines a case study of an A-Level student's work and how the inclusion and integration of my own practice as artist-teacher into the classroom has changed the teacher-student relationship, resulting in a more collaborative environment. It investigates how the mutual sharing of practice supports opportunities for pupils to discuss…
Physicians’ leadership styles in rural primary medical care: How are they perceived by staff?
Kirkhaug, Rudi
2014-01-01
Abstract Aim. This study investigates which leadership styles can be identified among general practice lead physicians and how they are associated with and predicted by staff and context characteristics like profession, gender, age, work experience, and team size. Method/material. In a cross-sectional study self-administered questionnaires were distributed to staff physicians (42% females) and support staff (98% females) at 101 primary health care centres in North Norway. A total of 127 and 222, respectively, responded (response rate 59%). Items were ranked on Likert scales (range 1–5). Results. Analysis revealed three significantly different styles (mean scores/Cronbach's alpha): change style (3.36/0.898), task style (3.17/0.885), and relation style (2.88/0.900). The lead physicians were perceived as practising change style the most and relation style the least. Males experienced significantly more of all three styles. Support staff scored lowest for all styles. Age was negatively correlated with relation style and change style, while work experience was negatively correlated with change style. No significant association was found between styles and team size. Conclusion. Leadership in rural general practice can be identified in terms of task, relation, and change styles. Change style is the most perceived style. Males seem to be most attentive to leadership styles. However, within the staff physician group, there is less difference between genders. Support staff scores lowest for all styles; this might indicate either less need for leadership or dissatisfaction with leadership. Age and work experience seem to reduce employees’ attention to relation and change styles, indicating that maturity reduces needs for these leadership styles. Due to growing demands for leaders to take care of efficiency and change in general practice, more young female physicians, and more diverse staff groups, these findings may be useful to understand leadership and leadership training for general practice. PMID:24533846
Physicians' leadership styles in rural primary medical care: how are they perceived by staff?
Hana, Jan; Kirkhaug, Rudi
2014-03-01
This study investigates which leadership styles can be identified among general practice lead physicians and how they are associated with and predicted by staff and context characteristics like profession, gender, age, work experience, and team size. METHOD/MATERIAL: In a cross-sectional study self-administered questionnaires were distributed to staff physicians (42% females) and support staff (98% females) at 101 primary health care centres in North Norway. A total of 127 and 222, respectively, responded (response rate 59%). Items were ranked on Likert scales (range 1-5). Analysis revealed three significantly different styles (mean scores/Cronbach's alpha): change style (3.36/0.898), task style (3.17/0.885), and relation style (2.88/0.900). The lead physicians were perceived as practising change style the most and relation style the least. Males experienced significantly more of all three styles. Support staff scored lowest for all styles. Age was negatively correlated with relation style and change style, while work experience was negatively correlated with change style. No significant association was found between styles and team size. Leadership in rural general practice can be identified in terms of task, relation, and change styles. Change style is the most perceived style. Males seem to be most attentive to leadership styles. However, within the staff physician group, there is less difference between genders. Support staff scores lowest for all styles; this might indicate either less need for leadership or dissatisfaction with leadership. Age and work experience seem to reduce employees' attention to relation and change styles, indicating that maturity reduces needs for these leadership styles. Due to growing demands for leaders to take care of efficiency and change in general practice, more young female physicians, and more diverse staff groups, these findings may be useful to understand leadership and leadership training for general practice.
Schroeder, Krista; Kulage, Kristine M.; Lucero, Robert
2016-01-01
Purpose We apply Critical Theory to examine menu labeling with the aim of uncovering important implications for nursing practice, research, and policy. Conclusions Our critical analysis uncovers barriers to menu labeling's effectiveness, particularly for vulnerable populations. Nurses must work to minimize the impact of these barriers and optimize the effectiveness of menu labeling, in order to strengthen the fight against obesity. Practice implications We suggest changes, guided by this critical analysis,that can be implemented by nurses working in clinical practice, research, and policy. PMID:26112774
Organisational support for evidence-based practice: occupational therapists perceptions.
Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth
2016-02-01
Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.
ERIC Educational Resources Information Center
Barton, Roy
2005-01-01
There continues to be a gulf between what have been identified from the literature as the potential benefits of using computer-aided practical work and the difficulties of realizing them as reported by practising teachers, even from those who are committed to the use of Information and Communication Technology (ICT). This article reports on a…
Changing Professional Practice Requires Changing Beliefs
ERIC Educational Resources Information Center
Guerra, Patricia L.; Nelson, Sarah W.
2009-01-01
Creating schools that are culturally responsive and successful with all students requires doing basic work with educators to uncover their beliefs about children. If school leaders believe, like many people do, that changed behavior will result in changed beliefs, they are mistaken. Leaders must be proactive in identifying what teachers believe…
Hospital culture--why create one?
Sovie, M D
1993-01-01
Hospitals, to survive, must be transformed into responsive, participative organizations capable of new practices that produce improved results in both quality of care and service at reduced costs. Creating, managing, and changing the culture are critical leadership functions that will enable the hospital to succeed. Strategic planning and effective implementation of planned change will produce the desired culture. Work restructuring, a focus on quality management along with changes in clinical practices, as well as the care and support processes, are all a part of the necessary hospital cultural revolution.
The scope of private practice nursing in an Australian sample.
Wilson, Anne; Averis, Andrea; Walsh, Ken
2004-01-01
The changing Australian health care system is creating new opportunities for nurses who work directly with clients in private practice settings. This study examines the scope of practice of a cohort of nurses in private practice. In a questionnaire sent to 106 self-employed nurse entrepreneurs, questions were asked pertaining to the participants' scope of practice, their clients, the types of services offered, and their fee structures. Questions about scope of practice were divided into domains of clinical practice, business consultancy, education, and research. Quantitative and qualitative data were collected for a final sample 54 eligible responses. Participants had been in private practice for an average of 7.6 years (range: 1-20) and reported a mean of 21 years of nursing experience (range: 4-42) before entering private practice. Over half held diplomas in specialty areas. Most participants reported clinical practice, consultancy, or education as the primary work domain; research was much less important as a work activity. Nurses reported difficulties with building client base and receiving adequate fees for service, particularly in clinical practice. Increasing awareness within the nursing profession and health sector about various aspects of private practice nursing could improve service quality for their clients.
Nielsen, Karina; Randall, Raymond
2012-01-01
The powerful positive results of implementing teamwork are not always achieved. It has been suggested that attempts to implement theories regarding teamwork do not always lead to those theories being put into practice, and as a result positive outcomes are not always found. The participation of employees in the development and implementation of an intervention may help to ensure that changes take place. In this longitudinal study (N = 583) of teamwork implementation in Denmark we examined the links between pre-intervention working conditions and well-being, levels of participation in planning and implementation, employees’ reports of changes in procedures, and intervention outcomes. Pre-intervention levels of autonomy and job satisfaction predicted the degree of employee participation in the planning and implementation of the intervention. Pre-intervention well-being and social support were linked directly to the degree to which employees reported changes in existing work practices concerning teamwork. In addition, participation and changes in work procedures were significantly associated with post-intervention autonomy, social support and well-being. The results indicate that employee participation in intervention processes is crucial in what appears to be an important association with perceived changes in procedures and, therefore, in intervention outcomes. PMID:22745519
Reframing Teachers' Work for Educational Innovation
ERIC Educational Resources Information Center
Kunnari, Irma; Ilomäki, Liisa
2016-01-01
The universities of applied sciences in Finland aim to support students in achieving work life competences by integrating authentic research, development and innovation (RDI) practices into learning. However, pursuing an educational change from a traditional higher education culture to a networked model of working is challenging for teachers. This…
Crowther, Andrew John; Ragusa, Angela Theresa
2014-10-01
This paper explores the effects of mental policy changes and the curtailment of mental health nursing education on the realities of working as a mental health nurse in rural and remote locations in New South Wales, Australia. Using the twin lenses of mental health nursing and the sociology of work and social change, the experiences of mental health nurses are explored and set in the context of the evolution of the mental health nurse into non-specialist mental health worker. At the same time, mental health nurses are challenged to adapt to new practice realities.
Shaw, William S; Findley, Patricia A; Feuerstein, Michael
2011-12-01
Early research of work disability in the 1980s showed a complexity of factors influencing pain and health-related functional limitation at work; hence, multidisciplinary perspectives were necessary to understand the complex interplay between biomechanical, organizational, social, and psychological factors impacting work disability. To address this need, the Journal of Occupational Rehabilitation was founded in 1991 with the goal of providing a scientific, yet practical forum for presenting multidisciplinary research and practice in work disability. Now, the 20-year collection of articles in the Journal reflects important trends and directions in the field of occupational rehabilitation. We conducted a retrospective summary of the past 20 years of the Journal of Occupational Rehabilitation, including its inaugural goals and intent, rates of submission and acceptance, trends in the types of articles published, study topics, global distribution of authors, and future directions. The original goal of providing a multidisciplinary scientific and practical forum has been met, but current trends reflect a maturing scientific evidence base, with less representation of employer-based case studies and practical innovations. There has been a dramatic increase in the international representation of studies, authors, and peer reviewers outside of the US. Also, published studies now address work disability for a larger number of health concerns. Contributions to the Journal continue to reflect a multidisciplinary perspective, but the Journal has seen significant changes with respect to international representation, the expanding study of non-musculoskeletal sources of work disability, and the maturing scientific evidence base in the field of occupational rehabilitation. Future volumes of the Journal will likely reflect continuing changes in the global economy, workforce fitness, and job demands.
Adams, Mary; Robert, Glenn; Maben, Jill
2013-07-01
This article examines the importance of some informal work practices among community nurses during a period of significant organizational change. Ethnographic fieldwork in two purposively selected adult community nursing services in England comprised 79 hours of observation of routine practice, 21 interviews with staff and 23 interviews with patients. We identified the informal work practice of 'catching up', informal work conversations between immediate colleagues, as an important but often invisible aspect of satisfying work relationships and of the relational care of patients. Drawing on anthropological literatures on 'communities of practice' the article examines two central issues concerning the practices of 'catching up': (1) how informal learning processes shape community nursing work; (2) how this informal learning is shaped both in relation to the ideals of community nursing work and the wider political and organizational contexts of community nursing practice. Our findings highlight the distinctive value of informal workplace 'catch ups' for nurses to manage the inherent challenges of good home care for patients and to develop a shared ethic of care and professional identity. Our findings also indicate the decline of 'catching up' between nurses along with diminishing time and opportunity for staff to care holistically for patients in present service climates.
Best practices for preventing musculoskeletal disorders in masonry: stakeholder perspectives.
Entzel, Pamela; Albers, Jim; Welch, Laura
2007-09-01
Brick masons and mason tenders report a high prevalence of work-related musculoskeletal disorders (WMSDs), many of which can be prevented with changes in materials, work equipment or work practices. To explore the use of "best practices" in the masonry industry, NIOSH organized a 2-day meeting of masonry stakeholders. Attendees included 30 industry representatives, 5 health and safety researchers, 4 health/safety specialists, 2 ergonomic consultants, and 2 representatives of state workers' compensation programs. Small groups discussed ergonomic interventions currently utilized in the masonry industry, including factors affecting intervention implementation and ways to promote diffusion of interventions. Meeting participants also identified various barriers to intervention implementation, including business considerations, quality concerns, design issues, supply problems, jobsite conditions and management practices that can slow or limit intervention diffusion. To be successful, future diffusion efforts must not only raise awareness of available solutions but also address these practical concerns.
The Alternative Workplace: Changing Where and How People Work.
ERIC Educational Resources Information Center
Apgar, Mahlon, IV
1998-01-01
Discusses the alternative workplace, the combination of nontraditional work practices, settings, and locations that is beginning to supplement traditional offices. Looks at myths and realities, options, advantages and disadvantages, and implementation of alternative workplaces. (JOW)
The medicalization of addiction treatment professionals.
Roy, A Kenison; Miller, Michael M
2012-01-01
In a previous article, the authors described the changes initiated by recent health care legislation, and how those changes might affect the practice of medicine and the delivery of addiction services. This article reviews the same changes with respect to how they have the potential to change the practice activities of addiction physicians, addiction therapists, addiction counselors and addiction nurses, as well as the activities of administrators and service delivery financial personnel. Developments in delivery systems and the impact of those developments on professionals who work in addiction treatment are considered; current problems, potential solutions, and opportunities for clinicians under health reform are addressed. The goals envisioned for health system reform and the potential for realization of those goals via changes in addiction service delivery design and clinical practice are discussed.
Achieving organizational change in pediatric pain management
Dowden, Stephanie; McCarthy, Maria; Chalkiadis, George
2008-01-01
BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices. OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital. DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party. RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described. CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement. PMID:18719714
Exploring the role of children's dreams in psychoanalytic practice today: a pilot study.
Lempen, Olivia; Midgley, Nick
2006-01-01
The aim of this research study was to investigate the role of children's dreams in the practice of child psychoanalysis today, and to explore contemporary psychoanalytic understanding of children's dreams. This pilot study consisted of two stages. The first involved a document analysis of published articles in The Psychoanalytic Study of the Child, making a comparison between those of the early 1950s and the 1990s, in order to see in what way the discourse around children's dreams within the psychoanalytic literature has changed over time. The second stage, based on questionnaires and in-depth interviews, attempted to understand in more detail the way contemporary child analysts, working in the Anna Freudian tradition, think about dreams and use them in their clinical practice. Results suggest that there has been a decreased focus on dreams in a clinical context over time, and that this may partly be a consequence of changing theoretical models and changes in training. When work with dreams does take place, it appears that child analysts have
Understanding general practice: a conceptual framework developed from case studies in the UK NHS
Checkland, Kath
2007-01-01
Background General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. Aim To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. Design of study In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Setting Five general practices in England, selected using purposeful sampling. Method Semi-structured interviews with all clinical and managerial personnel in each practice, participant and non-participant observation, and examination of documents. Results A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Conclusion Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality. PMID:17244426
Ideas of and Attitudes towards Projects and Changing Practices: Voices of Four Teachers
ERIC Educational Resources Information Center
Shome, Saurav; Natarajan, Chitra
2013-01-01
The paper reports a study of the project practices of four Indian middle school teachers, elicited through semi-structured interviews of individual teachers. The teachers also responded to a proposal to modify four aspects of existing project practices, viz. subject integration, assessment, group work, and management of resources. The aspects were…
The Role of Action Research in Empowering Teachers to Change Their Practice
ERIC Educational Resources Information Center
Bradley-Levine, Jill; Smith, Joshua; Carr, Kari
2009-01-01
Universities need to work with teachers to dispel the belief that research is disconnected from practice and teachers must be open to the benefits of action inquiry. This study examined the process and impact of conducting action research on teachers' perceptions of practice and professionalism. Twelve teachers enrolled in a master's level course…
Fiery Spirits in the context of institutional entrepreneurship in Swedish healthcare.
Eriksson, Nomie; Ujvari, Sandor
2015-01-01
Clinical governance and leadership concepts can lead to more or less successful implementations of new clinical practice. The purpose of this paper is to examine how Fiery Spirits, as institutional entrepreneurs can, working in a team, implement sustained change in hospital clinical practice. This paper describes two case studies, conducted at two Swedish hospitals over a period of two years, in which changes in clinical practice were implemented. In both cases, key-actors, termed Fiery Spirits, played critical roles in these changes. The authors use a qualitative approach and take an intra-organizational perspective with semi-structured in-depth interviews and document analysis. The new clinical practices were successfully implemented with a considerable influence of the Fiery Spirits who played a pivotal role in the change efforts. The Fiery Spirits persuasively, based on their structural and normative legitimacy and the adoption of learning processes, advocated, and supported change. Fiery Spirits, given flexibility and opportunity, can be powerful forces for change outside the trajectory of management-inspired and management-directed change. Team members, when inspired and encouraged by Fiery Spirits, are less resistant to change and more willing to test new clinical practices. The paper complements literature on how the Fiery Spirit concept aligns with concepts of clinical governance and leadership and how change can be achieved. Additionally, the findings show the effects of legitimacy and learning processes on change in clinical practice.
Primary Care Practice Transformation Is Hard Work
Crabtree, Benjamin F.; Nutting, Paul A.; Miller, William L.; McDaniel, Reuben R.; Stange, Kurt C.; Jaén, Carlos Roberto; Stewart, Elizabeth
2010-01-01
Background Serious shortcomings remain in clinical care in the United States despite widespread use of improvement strategies for enhancing clinical performance based on knowledge transfer approaches. Recent calls to transform primary care practice to a patient-centered medical home present even greater challenges and require more effective approaches. Methods Our research team conducted a series of National Institutes of Health funded descriptive and intervention projects to understand organizational change in primary care practice settings, emphasizing a complexity science perspective. The result was a developmental research effort that enabled the identification of critical lessons relevant to enabling practice change. Results A summary of findings from a 15-year program of research highlights the limitations of viewing primary care practices in the mechanistic terms that underlie current or traditional approaches to quality improvement. A theoretical perspective that views primary care practices as dynamic complex adaptive systems with “agents” who have the capacity to learn, and the freedom to act in unpredictable ways provides a better framework for grounding quality improvement strategies. This framework strongly emphasizes that quality improvement interventions should not only use a complexity systems perspective, but also there is a need for continual reflection, careful tailoring of interventions, and ongoing attention to the quality of interactions among agents in the practice. Conclusions It is unlikely that current strategies for quality improvement will be successful in transforming current primary care practice to a patient-centered medical home without a stronger guiding theoretical foundation. Our work suggests that a theoretical framework guided by complexity science can help in the development of quality improvement strategies that will more effectively facilitate practice change. PMID:20856145
Measures for assessing practice change in medical practitioners
Hakkennes, Sharon; Green, Sally
2006-01-01
Background There are increasing numbers of randomised trials and systematic reviews examining the efficacy of interventions designed to bring about a change in clinical practice. The findings of this research are being used to guide strategies to increase the uptake of evidence into clinical practice. Knowledge of the outcomes measured by these trials is vital not only for the interpretation and application of the work done to date, but also to inform future research in this expanding area of endeavour and to assist in collation of results in systematic reviews and meta-analyses. Methods The objective of this review was to identify methods used to measure change in the clinical practices of health professionals following an intervention aimed at increasing the uptake of evidence into practice. All published trials included in a recent, comprehensive Health Technology Assessment of interventions to implement clinical practice guidelines and change clinical practice (n = 228) formed the sample for this study. Using a standardised data extraction form, one reviewer (SH), extracted the relevant information from the methods and/or results sections of the trials. Results Measures of a change of health practitioner behaviour were the most common, with 88.8% of trials using these as outcome measures. Measures that assessed change at a patient level, either actual measures of change or surrogate measures of change, were used in 28.8% and 36.7% of studies (respectively). Health practitioners' knowledge and attitudes were assessed in 22.8% of the studies and changes at an organisational level were assessed in 17.6%. Conclusion Most trials of interventions aimed at changing clinical practice measured the effect of the intervention at the level of the practitioner, i.e. did the practitioner change what they do, or has their knowledge of and/or attitude toward that practice changed? Less than one-third of the trials measured, whether or not any change in practice, resulted in a change in the ultimate end-point of patient health status. PMID:17150111
Measures for assessing practice change in medical practitioners.
Hakkennes, Sharon; Green, Sally
2006-12-06
There are increasing numbers of randomised trials and systematic reviews examining the efficacy of interventions designed to bring about a change in clinical practice. The findings of this research are being used to guide strategies to increase the uptake of evidence into clinical practice. Knowledge of the outcomes measured by these trials is vital not only for the interpretation and application of the work done to date, but also to inform future research in this expanding area of endeavour and to assist in collation of results in systematic reviews and meta-analyses. The objective of this review was to identify methods used to measure change in the clinical practices of health professionals following an intervention aimed at increasing the uptake of evidence into practice. All published trials included in a recent, comprehensive Health Technology Assessment of interventions to implement clinical practice guidelines and change clinical practice (n = 228) formed the sample for this study. Using a standardised data extraction form, one reviewer (SH), extracted the relevant information from the methods and/or results sections of the trials. Measures of a change of health practitioner behaviour were the most common, with 88.8% of trials using these as outcome measures. Measures that assessed change at a patient level, either actual measures of change or surrogate measures of change, were used in 28.8% and 36.7% of studies (respectively). Health practitioners' knowledge and attitudes were assessed in 22.8% of the studies and changes at an organisational level were assessed in 17.6%. Most trials of interventions aimed at changing clinical practice measured the effect of the intervention at the level of the practitioner, i.e. did the practitioner change what they do, or has their knowledge of and/or attitude toward that practice changed? Less than one-third of the trials measured, whether or not any change in practice, resulted in a change in the ultimate end-point of patient health status.
Watt, R; McGlone, P; Evans, D; Boulton, S; Jacobs, J; Graham, S; Appleton, T; Perry, S; Sheiham, A
2004-10-09
To determine the extent and types of change in seven domains of dental practice in a sample of English general dental practitioners (GDPs). A postal questionnaire was sent to 561 GDPs on the dental lists of three health authorities in diverse regions of England. Information collected included demographic details on personal and practice characteristics, self-rating of amount of change in the seven domains of practice and factors influencing change. The response rate was 60%. Fifty-six per cent of the sample were under 40 years old. Over a third of respondents reported "changing a lot or completely" certain clinical activities, practice management arrangements and practice amenities. The highest self-reported level of change was in clinical activities. Of the GDPs who reported changing their clinical activities, 56% reported an increase in preventive care, followed by crown and bridge (44%), periodontics (44%) and endodontics (43%). Practice management rated second in the mean rank scores for self-reported change. The main changes reported were the introduction of computer systems and employment of practice managers. A sizeable percentage (66%) reported increasing the amount of information they provided to patients and the time spent discussing care. Quality assurance activities were the area of practice least likely to have changed over a 5-year period. Over half the sample reported not being involved in any quality assurance activities in the previous 5 years. Those respondents who were younger, had a postgraduate qualification and earned more than 20% of their income from private practice reported higher levels of change. General dental practitioners' work patterns are dynamic and appear to be responding to changing needs and demands on their service. The main changes were in the types of clinical procedures being carried out. The low prevalence of changes reported in auditing and peer review activities needs to be investigated further.
Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.
Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine
2011-12-01
The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices. © 2011 Blackwell Publishing Ltd.
Vijayasingham, Lavanya; Jogulu, Uma; Allotey, Pascale
2017-01-01
Individuals with multiple sclerosis have a tendency to make early decisions for work change, even in reversible, episodic, or mild disease stages. To better understand how a multiple sclerosis (MS) diagnosis influences perceptions of work and motivations for work changes, we conducted a hermeneutic phenomenology study to explore the work lives of ten individuals with MS in Malaysia. The interpretive analysis and cumulative narratives depict an overarching change in their concept of ideal work and life aspirations and how participants make preemptive work changes to manage illness-work-life futures in subjectively meaningful ways. Discussions on their integrated pursuit of finding dynamic and subjective illness-work-life balance include reconciling the problem of hard work and stress on disease activity and progress, making positive lifestyle changes as health management behaviour, and the motivational influence of their own life and family roles: the consideration of their spouses, parents, and children. At an action level, work change was seen as moral and necessary for the management of illness futures. Our findings contribute insights on how individual perceptions and holistic life management decisions contribute to on-going and disrupted work trajectories, which can inform practice and policy on early interventions to support continued employment.
Jogulu, Uma
2017-01-01
Individuals with multiple sclerosis have a tendency to make early decisions for work change, even in reversible, episodic, or mild disease stages. To better understand how a multiple sclerosis (MS) diagnosis influences perceptions of work and motivations for work changes, we conducted a hermeneutic phenomenology study to explore the work lives of ten individuals with MS in Malaysia. The interpretive analysis and cumulative narratives depict an overarching change in their concept of ideal work and life aspirations and how participants make preemptive work changes to manage illness-work-life futures in subjectively meaningful ways. Discussions on their integrated pursuit of finding dynamic and subjective illness-work-life balance include reconciling the problem of hard work and stress on disease activity and progress, making positive lifestyle changes as health management behaviour, and the motivational influence of their own life and family roles: the consideration of their spouses, parents, and children. At an action level, work change was seen as moral and necessary for the management of illness futures. Our findings contribute insights on how individual perceptions and holistic life management decisions contribute to on-going and disrupted work trajectories, which can inform practice and policy on early interventions to support continued employment. PMID:29348937
The reliability and stability of visual working memory capacity.
Xu, Z; Adam, K C S; Fang, X; Vogel, E K
2018-04-01
Because of the central role of working memory capacity in cognition, many studies have used short measures of working memory capacity to examine its relationship to other domains. Here, we measured the reliability and stability of visual working memory capacity, measured using a single-probe change detection task. In Experiment 1, the participants (N = 135) completed a large number of trials of a change detection task (540 in total, 180 each of set sizes 4, 6, and 8). With large numbers of both trials and participants, reliability estimates were high (α > .9). We then used an iterative down-sampling procedure to create a look-up table for expected reliability in experiments with small sample sizes. In Experiment 2, the participants (N = 79) completed 31 sessions of single-probe change detection. The first 30 sessions took place over 30 consecutive days, and the last session took place 30 days later. This unprecedented number of sessions allowed us to examine the effects of practice on stability and internal reliability. Even after much practice, individual differences were stable over time (average between-session r = .76).
A Historical Perspective on the Future of Innovation in Social Work
ERIC Educational Resources Information Center
Okpych, Nathanael J.
2017-01-01
Changing social work from a profession with innovators to a profession that innovates will likely require an innovation movement. This article draws on lessons from a prior movement in social work to suggest implications for a future innovation movement. Empirical clinical practice (ECP), a movement in social work in the 1970-1990s, sought to…
Olander, Ellinor; Coates, Rose; Brook, Judy; Ayers, Susan; Salmon, Debra
2018-02-09
This multi-method evaluation assessed the perceived impact of interprofessional workshops targeting enhanced collaboration between healthcare professionals who care for women during and after pregnancy. Current policy recommends partnership working to improve care for women and babies, however, there is little interprofessional education in this area. Five one-day workshops were delivered to 18 healthcare professionals (47.4% of the 38 healthcare professionals registered). The workshop was evaluated through questionnaires before and after the workshop measuring attitudes and willingness towards collaboration; observations of the workshops by a researcher and follow-up interviews 2 months' post-workshop to explore changes in practice. Workshops were attended by midwives, health visitors (trained nurses specialising in community care for children 0-5 years), dietitians, nurses, a general practitioner and a breastfeeding specialist. Attitudes and willingness to participate in interprofessional collaborative practice improved after the workshop. Observations made at the workshop included engaged participants who reported numerous barriers towards collaboration. Follow-up contact with 12 participants identified several examples of collaboration in practice resulting from workshop attendance. These findings suggest that the workshops influenced attendees to change their practice towards more collaborative working. Future work needs to confirm these results with more participants.
Technology Enhanced Learning: Best Practices
ERIC Educational Resources Information Center
Lytras, Miltiadis D., Ed.; Gasevic, Dragan, Ed.; Ordonez de Pablos, Patricia, Ed.; Huang, Weihong, Ed.
2008-01-01
With the shift towards the knowledge society, the change of working conditions, and the high-speed evolution of information and communication technologies, peoples' knowledge and skills need continuous updating. Learning based on collaborative working, creativity, multidisciplinarity, adaptiveness, intercultural communication, and problem solving…
Constancy and Change in Work Practice in Schools: The Role of Organizational Routines
ERIC Educational Resources Information Center
Sherer, Jennifer Zoltners; Spillane, James
2011-01-01
Background/Context: Though change is constant in organizations, determining how to successfully implement planned change has been a perennial challenge for both organizational scholars and practitioners. While the empirical knowledge base on planned change in schools and other organizations offers numerous insights, the inattention to activity, or…
A comparison of Canadian pediatric resident career plans in 1998 and 2006.
Shamseer, Larissa; Roth, Daniel E; Tallett, Susan; Hilliard, Robert; Vohra, Sunita
2008-12-01
Studies of pediatric resident career plans and preferences help to forecast changes in the demographic profile and practice patterns of North American pediatricians, providing insights that can guide child health care and medical education policy making. With this study we aimed to compare 4 aspects of Canadian pediatric resident career plans in 1998 and 2006: (1) weekly work hours; (2) scope of practice; (3) professional activities; and (4) community size. Canadian pediatric residents were invited to participate in a national cross-sectional survey to explore career plans and preferences in 1998 (mailing) and 2006 (on-line). Response rates were 69% in 1998 and 52% in 2006. In both survey years, the majority of respondents were female (69% and 73%, respectively). Overall, residents planned to work a similar number of weekly hours in both survey years (47.8 vs 48.8). Women planned to work significantly fewer hours than men; this gap was wider in 2006 than in 1998 (1998: 2.8 fewer hours; 2006: 7.8 fewer hours). After adjusted analysis, the association between proportion of time in primary care and study year became significant; however, time in consultant general or subspecialty pediatrics remained nonsignificantly changed. Residents planned to spend less time in clinical work in 2006 than 1998 (64.4% vs 58.1%), and more planned to work and reside in metropolitan areas (68% vs 78% of decided respondents). Between 1998 and 2006, there was no overall change in the number of hours that Canadian pediatric residents planned to work, but the gender gap widened because of an increase in planned weekly work hours among men. The results also suggest that new strategies may be needed to improve future pediatrician availability in small communities by addressing barriers to nonmetropolitan practice, especially for women.
Disturbing Practices: Training Workers to Be Lean
ERIC Educational Resources Information Center
Yasukawa, Keiko; Brown, Tony; Black, Stephen
2014-01-01
Purpose: The purpose of this paper is to explore the possibilities for expansive learning during organisational change. It considers the introduction of "lean production" as a disturbance to the existing work practices. Design/methodology/approach: The paper considers two case studies of "lean production" training with…
Sharing Practice through Socratic Seminars
ERIC Educational Resources Information Center
Mangrum, Jennifer R.
2010-01-01
Developing systems and opportunities for effective dialogue is critical if schools wish to help teachers work collectively. One school used Socratic seminars, structured conversations about selected texts. These seminars helped teachers to build relationships, share practice, and change curriculum and policy. The seminars also were critical to…
Climate Change Adaptation Practices in Various Countries
NASA Astrophysics Data System (ADS)
Tanik, A.; Tekten, D.
2017-08-01
The paper will be a review work on the recent strategies of EU in general, and will underline the inspected sectoral based adaptation practices and action plans of 7 countries; namely Germany, France, Spain, Italy, Denmark, USA and Kenya from Africa continent. Although every countries’ action plan have some similarities on sectoral analysis, each country in accordance with the specific nature of the problem seems to create its own sectoral analysis. Within this context, green and white documents of EU adaptation to climate change, EU strategy on climate change, EU targets of 2020 on climate change and EU adaptation support tools are investigated.
Map Changes and Theme Evolution in Work Hours: A Co-Word Analysis
Liu, Bei; Chen, Hong; Huang, Xinru
2018-01-01
(1) Background: Work hours are the basic carrier impacting employees’ work–life experience and organizational performance, and employees have greater anxiety in relation to work hours as new technology requires an increasingly faster work rhythm. However, scientific research on this topic lags far behind the practice, calling to attention the need for research on work hours from the perspective of historical evolution; (2) Methods: The Bibliometric method is used to analyze the 6364 articles and their contained 77 high-frequency keywords related to work hours from the Web of Science published between 1901 and 2017. Additionally, an individual–organization–society integrative perspective was adopted to describe the map changes and theme evolution of work hours; (3) Results and conclusions: The hot spots of research at the organizational level changed significantly around 1990, with the theme of “long work hours” becoming the core issue in recent years. Studies on the individual level have gradually moved from physiological aspects to the issues of burnout and psychological distress. Research topics related to the social level are somewhat loose, and mainly focused on work–life conflict areas. In addition, the cluster analysis based on the high-frequency keywords classifies six research types according to their research themes. Based on these findings, future trends are proposed to provide theoretical and practical reference for future studies. PMID:29789455
Women in medicine: a four-nation comparison.
McMurray, Julia E; Cohen, May; Angus, Graham; Harding, John; Gavel, Paul; Horvath, John; Paice, Elisabeth; Schmittdiel, Julie; Grumbach, Kevin
2002-01-01
to determine the impact of increasing numbers of women in medicine on the physician work force in Australia, Canada, England, and the United States. We collected data on physician work force issues from professional organizations and government agencies in each of the 4 nations. Women now make up nearly half of all medical students in all 4 countries and 20% to 30% of all practicing physicians. Most are concentrated in primary care specialties and obstetrics/gynecology and are underrepresented in surgical training programs. Women physicians practice largely in urban settings and work 7 to 11 fewer hours per week than men do, for lower pay. Twenty percent to 50% of women primary care physicians are in part-time practice. Work force planners should anticipate larger decreases in physician full-time equivalencies than previously expected because of the increased number of women in practice and their tendency to work fewer hours and to be in part-time practice, especially in primary care. Responses to these changes vary among the 4 countries. Canada has developed a detailed database of work/family issues; England has pioneered flexible training schemes and reentry training programs; and Australia has joined consumers, physicians, and educators in improving training opportunities and the work climate for women. Improved access to surgical and subspecialty fields, training and practice settings that provide balance for work/family issues, and improved recruitment and retention of women physicians in rural areas will increase the contributions of women physicians.
Nicholls, Emily; Robinson, Victoria; Farndon, Lisa; Vernon, Wesley
2018-01-01
This narrative review explores the ways in which drawing on theories and methods used in sociological work on footwear and identity can contribute to healthcare research with podiatrists and their patients, highlighting recent research in this field, implications for practice and potential areas for future development.Traditionally, research within Podiatry Services has tended to adopt a quantitative, positivist focus, developing separately from a growing body of sociological work exploring the importance of shoes in constructing identity and self-image. Bringing qualitative research drawing on sociological theory and methods to the clinical encounter has real potential to increase our understanding of patient values, motivations and - crucially - any barriers to adopting 'healthier' footwear that they may encounter. Such work can help practitioners to understand why patients may resist making changes to their footwear practices, and help us to devise new ways for practitioners to explore and ultimately break down individual barriers to change (including their own preconceptions as practitioners). This, in turn, may lead to long-term, sustainable changes to footwear practices and improvements in foot health for those with complex health conditions and the wider population. A recognition of the complex links between shoes and identity is opening up space for discussion of patient resistance to footwear changes, and paving the way for future research in this field beyond the temporary 'moment' of the clinical encounter.
Berry, Anne S; Zanto, Theodore P; Rutman, Aaron M; Clapp, Wesley C; Gazzaley, Adam
2009-09-01
Working memory (WM) performance is impaired by the presence of external interference. Accordingly, more efficient processing of intervening stimuli with practice may lead to enhanced WM performance. To explore the role of practice on the impact that interference has on WM performance, we studied young adults with electroencephalographic (EEG) recordings as they performed three motion-direction, delayed-recognition tasks. One task was presented without interference, whereas two tasks introduced different types of interference during the interval of memory maintenance: distractors and interruptors. Distractors were to be ignored, whereas interruptors demanded attention based on task instructions for a perceptual discrimination. We show that WM performance was disrupted by both types of interference, but interference-induced disruption abated across a single experimental session through rapid learning. WM accuracy and response time improved in a manner that was correlated with changes in early neural measures of interference processing in visual cortex (i.e., P1 suppression and N1 enhancement). These results suggest practice-related changes in processing interference exert a positive influence on WM performance, highlighting the importance of filtering irrelevant information and the dynamic interactions that exist between neural processes of perception, attention, and WM during learning.
Cohen, Elaine V; Hagestuen, Ruth; González-Ramos, Gladys; Cohen, Hillel W; Bassich, Celia; Book, Elaine; Bradley, Kathy P; Carter, Julie H; Di Minno, Mariann; Gardner, Joan; Giroux, Monique; González, Manny J; Holten, Sandra; Joseph, Ricky; Kornegay, Denise D; Simpson, Patricia A; Tomaino, Concetta M; Vandendolder, Richard P; Walde-Douglas, Maria; Wichmann, Rosemary; Morgan, John C
2016-01-01
Examine outcomes for the National Parkinson Foundation (NPF) Allied Team Training for Parkinson (ATTP), an interprofessional education (IPE) program in Parkinson's disease (PD) and team-based care for medicine, nursing, occupational, physical and music therapies, physician assistant, social work and speech-language pathology disciplines. Healthcare professionals need education in evidence-based PD practices and working effectively in teams. Few evidence-based models of IPE in PD exist. Knowledge about PD, team-based care, the role of other disciplines and attitudes towards healthcare teams were measured before and after a protocol-driven training program. Knowledge, attitudes and practice changes were again measured at 6-month post-training. Trainee results were compared to results of controls. Twenty-six NPF-ATTP trainings were held across the U.S. (2003-2013). Compared to control participants (n = 100), trainees (n = 1468) showed statistically significant posttest improvement in all major outcomes, including self-perceived (p < 0.001) and objective knowledge (p < 0.001), Understanding Role of Other Disciplines (p < 0.001), Attitudes Toward Health Care Teams Scale (p < 0.001), and the Attitudes Toward Value of Teams (p < 0.001) subscale. Despite some decline, significant improvements were largely sustained at six-month post-training. Qualitative analyses confirmed post-training practice changes. The NPF-ATTP model IPE program showed sustained positive gains in knowledge of PD, team strategies and role of other disciplines, team attitudes, and important practice improvements. Further research should examine longer-term outcomes, objectively measure practice changes and mediators, and determine impact on patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane
2016-09-06
Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.
Morténius, Helena; Marklund, Bertil; Palm, Lars; Björkelund, Cecilia; Baigi, Amir
2012-06-01
To bridge the gap between theory and practice, methods are needed that promote a positive attitude to change among health care professionals and facilitate the incorporation of new research findings. In this context, communication plays a significant role. The aim of this study was to analyse primary care staff members' readiness to adopt new ways of thinking and willingness to change their work practices by means of strategic communication. An evaluative design was used to study a primary care staff cohort for 7 years. The study population comprised all primary care staff in a region of Sweden (n = 1206). The strategic communication encompassed managerial impact, planning and implementation of reflexive communication processes, in addition to activities in three established communication channels (oral, written and digital). A questionnaire was used, and bivariate and multivariate statistical analyses were performed. A total of 846 individuals participated in the evaluation (70%). Strategic communication had a significant effect on staff members' new way of thinking (61%) and willingness to change daily work practices (33%). The communication channels had a significant synergy effect on the adoption of new ideas and willingness to change attitudes. Oral and digital communication had a significant impact on staff members' readiness to change. Strategic communication plays an important role in the process of creating innovative attitudes and behaviour among primary care professionals. The willingness to change attitudes enhances primary care staff's readiness to change everyday practices, thus facilitating the implementation of evidence-based care. © 2011 Blackwell Publishing Ltd.
Self-employed nurses as change agents in healthcare: strategies, consequences, and possibilities.
Wall, Sarah
2014-01-01
The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare. Focussed ethnography was used to explore self-employed nurses' work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system. These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice. Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing's professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.
[Working Education Program in Health: transforming experience of nursing teaching and practice].
Santos, Débora de Souza; Santos de Almeida, Lenira Maria Wanderley; Reis, Renata Karina
2013-12-01
This is an experience report of tutors from nursing Working Education Program in Health ( PET- Saúde ) from the Federal University of Alagoas, from May 2009 to April 2010. The objective of the nursing PET-Saúde was to develop health education actions aimed at the needs of the communities attended by the Family Health Units in Maceio, Alagoas. We conducted a health planning guided by the problem-based methodology. The activities resulted in changes in student learning and in the practice of nurses PET-Saúde , indicating the importance of this program for teaching and practice of nursing.
ERIC Educational Resources Information Center
Vickers, Caroline H.; Deckert, Sharon K.
2013-01-01
This article demonstrates how one woman's identity changed as she was empowered through her participation in a sewing cooperative community of practice. A community of practice framework allows examination of participation in ongoing negotiated interactions in which people construct expert and novice identities as they work together. Identity, as…
Practice and professional development plans (PPDPs): results of a feasibility study.
Elwyn, G; Carlisle, S; Hocking, P; Smail, S
2001-01-01
Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Qualitative observational study. All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. This work supports the view that organisational development has considerable potential for bringing about effective change, and individual contributions could form a valuable component of personal portfolios. We believe that the existing structures in education and management in the health service are not yet able to support these processes. Evidence from the fields of risk management and quality improvement all point to the need to develop effective organisational systems and the results of this feasibility study indicate that alternative models of sustaining organisational development need careful evaluation.
Practice and professional development plans (PPDPs): results of a feasibility study
Elwyn, Glyn; Carlisle, Sandra; Hocking, Paul; Smail, Simon
2001-01-01
Background Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Aims Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Design Qualitative observational study. Study sample All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Method Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Results Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. Conclusions This work supports the view that organisational development has considerable potential for bringing about effective change, and individual contributions could form a valuable component of personal portfolios. We believe that the existing structures in education and management in the health service are not yet able to support these processes. Evidence from the fields of risk management and quality improvement all point to the need to develop effective organisational systems and the results of this feasibility study indicate that alternative models of sustaining organisational development need careful evaluation. PMID:11299046
Shea, Christopher M; Reiter, Kristin L; Weaver, Mark A; McIntyre, Molly; Mose, Jason; Thornhill, Jonathan; Malone, Robb; Weiner, Bryan J
2014-12-14
Meaningful Use (MU) provides financial incentives for electronic health record (EHR) implementation. EHR implementation holds promise for improving healthcare delivery, but also requires substantial changes for providers and staff. Establishing readiness for these changes may be important for realizing potential EHR benefits. Our study assesses whether provider/staff perceptions about the appropriateness of MU and their departments' ability to support MU-related changes are associated with their reported readiness for MU-related changes. We surveyed providers and staff representing 47 ambulatory practices within an integrated delivery system. We assessed whether respondent's role and practice-setting type (primary versus specialty care) were associated with reported readiness for MU (i.e., willingness to change practice behavior and ability to document actions for MU) and hypothesized predictors of readiness (i.e., perceived appropriateness of MU and department support for MU). We then assessed associations between reported readiness and the hypothesized predictors of readiness. In total, 400 providers/staff responded (response rate approximately 25%). Individuals working in specialty settings were more likely to report that MU will divert attention from other patient-care priorities (12.6% vs. 4.4%, p = 0.019), as compared to those in primary-care settings. As compared to advanced-practice providers and nursing staff, physicians were less likely to have strong confidence in their department's ability to solve MU implementation problems (28.4% vs. 47.1% vs. 42.6%, p = 0.023) and to report strong willingness to change their work practices for MU (57.9% vs. 83.3% vs. 82.0%, p < 0.001). Finally, provider/staff perceptions about whether MU aligns with departmental goals (OR = 3.99, 95% confidence interval (CI) = 2.13 to 7.48); MU will divert attention from other patient-care priorities (OR = 2.26, 95% CI = 1.26 to 4.06); their department will support MU-related change efforts (OR = 3.99, 95% CI = 2.13 to 7.48); and their department will be able to solve MU implementation problems (OR = 2.26, 95% CI = 1.26 to 4.06) were associated with their willingness to change practice behavior for MU. Organizational leaders should gauge provider/staff perceptions about appropriateness and management support of MU-related change, as these perceptions might be related to subsequent implementation.
Implications of Preparing School Administrators for Knowledge Work Organizations: A Case Study.
ERIC Educational Resources Information Center
Mulkeen, Thomas A.; Cooper, Bruce S.
1992-01-01
The Executive Leadership Program at Fordham University presents a model for practicing school administrators' continuing education that reflects a changing society and schools' changing needs. The program is based on four innovations: an intellectual/change agent approach; a clinical, field-based research experience; an instructional agenda…
ERIC Educational Resources Information Center
Edwards, Frances
2012-01-01
Increasingly school change processes are being facilitated through the formation and operation of groups of teachers working together for improved student outcomes. These groupings are variously referred to as networks, networked learning communities, communities of practice, professional learning communities, learning circles or clusters. The…
Motivating the Potential Social Worker.
ERIC Educational Resources Information Center
Clavner, Jerry B.; Clavner, Catherine
Recently, there have been some major changes in the theory and practice of social services, social welfare, and social work. However, instead of the major educational modifications necessary to accompany these changes, minor curriculum changes have taken place. The need to modify education programs is severe at the undergraduate level, and…
10 CFR 850.27 - Hygiene facilities and practices.
Code of Federal Regulations, 2012 CFR
2012-01-01
... or their personal clothing. (b) Change rooms or areas. The responsible employer must provide clean change rooms or areas for beryllium workers who work in regulated areas. (1) Separate facilities free of... change rooms or areas and shower facilities required under paragraphs (b) and (c) of this section; and (3...
10 CFR 850.27 - Hygiene facilities and practices.
Code of Federal Regulations, 2014 CFR
2014-01-01
... or their personal clothing. (b) Change rooms or areas. The responsible employer must provide clean change rooms or areas for beryllium workers who work in regulated areas. (1) Separate facilities free of... change rooms or areas and shower facilities required under paragraphs (b) and (c) of this section; and (3...
10 CFR 850.27 - Hygiene facilities and practices.
Code of Federal Regulations, 2011 CFR
2011-01-01
... or their personal clothing. (b) Change rooms or areas. The responsible employer must provide clean change rooms or areas for beryllium workers who work in regulated areas. (1) Separate facilities free of... change rooms or areas and shower facilities required under paragraphs (b) and (c) of this section; and (3...
10 CFR 850.27 - Hygiene facilities and practices.
Code of Federal Regulations, 2013 CFR
2013-01-01
... or their personal clothing. (b) Change rooms or areas. The responsible employer must provide clean change rooms or areas for beryllium workers who work in regulated areas. (1) Separate facilities free of... change rooms or areas and shower facilities required under paragraphs (b) and (c) of this section; and (3...
The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.
Schoonover, Heather
The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.
Changing policy and practice: making sense of national guidelines for osteoarthritis.
Ong, Bie Nio; Morden, Andrew; Brooks, Lauren; Porcheret, Mark; Edwards, John J; Sanders, Tom; Jinks, Clare; Dziedzic, Krysia
2014-04-01
Understanding uptake of complex interventions is an increasingly prominent area of research. The interplay of macro (such as changing health policy), meso (re-organisation of professional work) and micro (rationalisation of clinical care) factors upon uptake of complex interventions has rarely been explored. This study focuses on how English General Practitioners and practice nurses make sense of a complex intervention for the management of osteoarthritis, using the macro-meso-micro contextual approach and Normalisation Process Theory (NPT), specifically the construct of coherence. It is embedded in a cluster RCT comprising four control practices and four intervention practices. In order to study sense-making by professionals introduction and planning meetings (N = 14) between researchers and the practices were observed. Three group interviews were carried out with 10 GPs and 5 practice nurses after they had received training in the intervention. Transcripts were thematically analysed before comparison with NPT constructs. We found that: first, most GPs and all nurses distinguished the intervention from current ways of working. Second, from the introduction meeting to the completion of the training the purpose of the intervention increased in clarity. Third, GPs varied in their understanding of their remit, while the practice nurses felt that the intervention builds on their holistic care approach. Fourth, the intervention was valued by practice nurses as it strengthened their expert status. GPs saw its value as work substitution, but felt that a positive conceptualisation of OA enhanced the consultation. When introducing new interventions in healthcare settings the interaction between macro, meso and micro factors, as well as the means of engaging new clinical practices and their sense-making by clinicians needs to be considered. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Pressure ulcer prevention program: a journey.
Delmore, Barbara; Lebovits, Sarah; Baldock, Philip; Suggs, Barbara; Ayello, Elizabeth A
2011-01-01
The Centers for Medicare & Medicaid Services' regulations regarding nonpayment for hospital-acquired conditions such as pressure ulcers have prompted a marked increase in focus on preventive care. Our hospital also used this change in payment policy as an opportunity to strengthen our pressure ulcer prevention practices. We used an 8-spoke prevention wheel to develop and implement practice changes that reduced pressure ulcer incidence from 7.3% to 1.3% in 3 years. Because it is about the journey, we will describe the mechanisms we designed and implemented, and identify strategies that worked or did not work as we promulgated a quality improvement process for pressure ulcer prevention in our large urban hospital center.
Yu, Ann T W; Poon, C S; Wong, Agnes; Yip, Robin; Jaillon, Lara
2013-01-01
Waste management in the building industry in Hong Kong has become an important environmental issue. Particularly, an increasing amount of construction and demolition (C&D) waste is being disposed at landfill sites. In order to reduce waste generation and encourage reuse and recycling, the Hong Kong Government has implemented the Construction Waste Disposal Charging Scheme (CWDCS) to levy charges on C&D waste disposal to landfills. In order to provide information on the changes in reducing waste generation practice among construction participants in various work trades, a study was conducted after 3 years of implementation of the CWDCS via a structured questionnaire survey in the building industry in Hong Kong. The study result has revealed changes with work flows of the major trades as well as differentiating the levels of waste reduced. Three building projects in the public and private sectors were selected as case studies to demonstrate the changes in work flows and the reduction of waste achieved. The research findings reveal that a significant reduction of construction waste was achieved at the first 3 years (2006-2008) of CWDCS implementation. However, the reduction cannot be sustained. The major trades have been influenced to a certain extent by the implementation of the CWDCS. Slight improvement in waste management practices was observed, but reduction of construction waste in the wet-finishing and dry-finishing trades has undergone little improvement. Implementation of the CWDCS has not yet motivated subcontractors to change their methods of construction so as to reduce C&D waste. Copyright © 2012 Elsevier Ltd. All rights reserved.
2020 Workplace and the Evolution of Business Intelligence
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hollis Henry; Troy Hiltbrand
The work place is rapidly changing and will continue to change as the decade proceeds to 2020. Business Intelligence (BI) has many of the tools that will ensure that employees in this future work place can be successful and deal with these environmental changes. Ideas such as “swarming”, “hyper-connectedness”, “de-routinization of work” and “the collective” will morph employee engagement and those organizations with mature Business Intelligence practices will be prepared to support the success of their employees.
Using Gemba Boards to Facilitate Evidence-Based Practice in Critical Care.
Bourgault, Annette M; Upvall, Michele J; Graham, Alison
2018-06-01
Tradition-based practices lack supporting research evidence and may be harmful or ineffective. Engagement of key stakeholders is a critical step toward facilitating evidence-based practice change. Gemba , derived from Japanese, refers to the real place where work is done. Gemba boards (visual management tools) appear to be an innovative method to engage stakeholders and facilitate evidence-based practice. To explore the use of gemba boards and gemba huddles to facilitate practice change. Twenty-two critical care nurses participated in interviews in this qualitative, descriptive study. Thematic analysis was used to code and categorize interview data. Two researchers reached consensus on coding and derived themes. Data were managed with qualitative analysis software. The code gemba occurred most frequently; a secondary analysis was performed to explore its impact on practice change. Four themes were derived from the gemba code: (1) facilitation of staff, leadership, and interdisciplinary communication, (2) transparency of outcome data, (3) solicitation of staff ideas and feedback, and (4) dissemination of practice changes. Gemba boards and gemba huddles became part of the organizational culture for promoting and disseminating evidence-based practices. Unit-based, publicly located gemba boards and huddles have become key components of evidence-based practice culture. Gemba is both a tool and a process to engage team members and the public to generate clinical questions and to plan, implement, and evaluate practice changes. Future research on the effectiveness of gemba boards to facilitate evidence-based practice is warranted. ©2018 American Association of Critical-Care Nurses.
From Narratives to Numbers: Data Work and Patient-Generated Health Data in Consultations.
Lindroth, Tomas; Islind, Anna Sigridur; Steineck, Gunnar; Lundin, Johan
2018-01-01
This article presents preliminary findings on how the introduction of patient-generated health data (PGHD) triggers changes during patient-nurse consultations. This article builds on a two-year case study, examining the work practice at a cancer rehabilitation clinic at a Swedish Hospital using PGHD. The study focuses on how nurses' use data, gathered by patients with a mobile phone app, during consultations. The use of PGHD introduce a change in the translation work, the work of turning rich patient descriptions and transform them into data, during the consultation for documentation and clinical decision-making. This change affects precision, questions asked and the use of visualizations as well as the patient-nurse decision making.
ERIC Educational Resources Information Center
Kutnick, Peter; Fung, Dennis C. L.; Mok, Ida. A. C.; Leung, Frederick K. S.; Li, Johnson C. H.; Lee, Betty P.-Y.; Lai, Veronica K. W.
2017-01-01
The Hong Kong Education Bureau recommends that primary school pupils' mathematical achievement be enhanced via collaborative discussions engendered by group work. This pedagogic change may be hindered by Confucian heritage classroom practices and Western-dominated group work approaches that predominate in Hong Kong. To overcome these obstacles, we…
Language and Literacy in Workplace Education: Learning at Work. Language in Social Life Series.
ERIC Educational Resources Information Center
Mawer, Giselle; Fletcher, Lee; McCall, Julia; O'Grady, Catherine; Ong, Bee Jong
Interweaving theory and commentary with case studies, this book explores a multifaceted approach to workplace education that develops workers' skills and integrates learning, language, and cross-cultural issues into work, communication, and management practices. Chapter 1 explores the changing world of work and implications for workforce skill…
Cultures of Work-Life Balance in Higher Education: A Case of Fragmentation
ERIC Educational Resources Information Center
Lester, Jaime
2015-01-01
In response to demographic shifts, colleges and universities implemented new policies, adopted new practices, and created professional development opportunities to gain support for work-life balance. Research on work-life balance reveals gender disparities, lack of policy usage, and a lack of cultural change with little understanding of the ways…
A Harsh and Challenging World of Work: Implications for Counselors.
ERIC Educational Resources Information Center
Jones, Lawrence K.
1996-01-01
Presents some of the health risks and economic and job insecurities involved in working in the United States. Suggests ways for counselors to amend their practices to accommodate the changing work environment and to help clients prepare for and deal with the economic and physical realities of the job market. (Author)
Strict Slaves of Slogans: Response to ''The Social Work Cartel''
ERIC Educational Resources Information Center
Epstein, William M.
2016-01-01
The corruption of the social work enterprise is not simply episodic but systemic and long-standing including education, research, governance, and practice. Reform is unlikely since the constituency within the field and outside of it that wishes to change the situation is small and ineffective. The corruption of social work reflects the unfortunate…
Activity Theory and the Transformation of Pedagogic Practice
ERIC Educational Resources Information Center
Yamazumi, Katsuhiro
2006-01-01
Today, work and other societal practices are experiencing accelerating paradigm shifts from mass-production-based systems toward new systems based on networking between organizations, collaboration, and partnerships. This shift requires new paradigms in the fields of education, learning, and development. As human activity quickly changes to…
Future trends in health and health care: implications for social work practice in an aging society.
Spitzer, William J; Davidson, Kay W
2013-01-01
Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.
Why a disaster is not just normal business ramped up: Disaster response among ED nurses.
Hammad, Karen S; Arbon, Paul; Gebbie, Kristine; Hutton, Alison
2017-11-15
The emergency department (ED) is a familiar place for the emergency nurse who spends their working days inside it. A disaster threatens that familiarity and creates changes that make working in the ED during a disaster response different from the everyday experience of working in the ED. This research reports on an aspect of the findings from a larger study about the experience of working as a nurse in the ED during a disaster response. Thirteen nurses from 8 different countries were interviewed about their experience. The findings from this research demonstrate that a disaster event leads to a chain reaction of changes in process, space and practice. Nurses' respond to the news of a disaster event with shock and disbelief. The ED may change as a result of the event requiring nurses to work in an altered environment or a completely different setting. These changes provoke nurses to alter their behaviour and practice and reflect on the experience after the response. Emergency nurses have a high likelihood of participating in disaster response and as such should be adequately prepared. This highlights how disaster response is different and leads to recommendations to enhance training for emergency nurses which will better prepare them Disasterresponse is not normal business ramped up. There are a number of challenges and changes that should be considered when preparing emergency nurses for the realities of disaster response. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.
Mullola, Sari; Hakulinen, Christian; Presseau, Justin; Gimeno Ruiz de Porras, David; Jokela, Markus; Hintsa, Taina; Elovainio, Marko
2018-03-27
Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with patients. The results showed distinctive personality traits to be associated with physicians' career and specialty choices after medical school independent of known confounding factors. Openness was the most consistent personality trait associated with physicians' career choices in terms of employment sector, amount of clinical patient contact, specialty choice and change of specialty. Personality-conscious medical career counseling and career guidance during and after medical education might enhance the person-job fit among physicians.
NASA Technical Reports Server (NTRS)
Wales, Roxana C.; Shalin, Valerie L.; Bass, Deborah S.
2004-01-01
This paper focuses on the development and use of the abbreviated names as well as an emergent ontology associated with making requests for action of a distant robotic rover during the 2003-2004 NASA Mars Exploration Rover (MER) mission, run by the Jet Propulsion Laboratory. The infancy of the domain of Martian telerobotic science, in which specialists request work from a rover moving through the landscape, as well as the need to consider the interdisciplinary teams involved in the work required an empirical approach. The formulation of this ontology is grounded in human behavior and work practice. The purpose of this paper is to identify general issues for an ontology of action (specifically for requests for action), while maintaining sensitivity to the users, tools and the work system within a specific technical domain. We found that this ontology of action must take into account a dynamic environment, changing in response to the movement of the rover, changes on the rover itself, as well as be responsive to the purposeful intent of the science requestors. Analysis of MER mission events demonstrates that the work practice and even robotic tool usage changes over time. Therefore, an ontology must adapt and represent both incremental change and revolutionary change, and the ontology can never be more than a partial agreement on the conceptualizations involved. Although examined in a rather unique technical domain, the general issues pertain to the control of any complex, distributed work system as well as the archival record of its accomplishments.
Social work in health care: do practitioners' writings suggest an applied social science?
Rehr, H; Rosenberg, G; Showers, N; Blumenfield, S
1998-01-01
There are two sources of literature in social work-one from academics and the other from practitioners. Each group is driven by different motivations to write. Academics seek a 'scientific rationality' for the field, while practitioners assume practical and intuitive reasoning, experience aligned with theory, and the 'art of practice' to guide them. It has been said that practitioners do not write and that 'faculty' are the trustees of the knowledge base of the profession, and are responsible for its promulgation via publication. Practitioners, however, do write about their practice and their programs, and analyze both, but publish much of their work in non-social work media. Their work tends not to be referenced by academic writers. One department's social workers' publications are described. We learn, from their practice writings, what concerns clinicians. Theirs is case-based learning, theoretically supported, in which the organization of services calls for their participation in multi-professional decision-making. There is the growing realization among social workers that practice wisdom and scientific technologies need to be reassessed together to find ways to enhance social work services. Clinicians' knowledge can lead to continuing refinement of practice and enhanced institutional services. If practitioners' writings can be assessed, they may lead to a written practice knowledge base, subject to timely change. Academic and practitioner separateness hampers progress in the field. They need each other, and a shared professional literature. There is beginning indication they are getting together.
Promoting Change in Schools: Ground Level Practices That Work.
ERIC Educational Resources Information Center
Wiles, Jon W.
This book rests on two major tenets. First, our way of looking at change in schools governs our ability to approach the process of changing. Second, most schools fail miserably at managing change, resulting in the pulling of many chains without much progress. The first of six chapters, "Understanding the Uniqueness of Schools," discusses the…
Human Rights: Its Meaning and Practice in Social Work Field Settings.
Steen, Julie A; Mann, Mary; Restivo, Nichole; Mazany, Shellene; Chapple, Reshawna
2017-01-01
The goal of the study reported in this article was to explore the conceptualizations of human rights and human rights practice among students and supervisors in social work field settings. Data were collected from 35 students and 48 supervisors through an online survey system that featured two open-ended questions regarding human rights issues in their agency and human rights practice tasks. Responses suggest that participants encountered human rights issues related to poverty, discrimination, participation/self-determination/autonomy, violence, dignity/respect, privacy, and freedom/liberty. They saw human rights practice as encompassing advocacy, service provision, assessment, awareness of threats to clients' rights, and the nature of the worker-client relationship. These results have implications for the social work profession, which has an opportunity to focus more intently on change efforts that support clients' rights. The study points to the possibilities of expanding the scope of the human rights competency within social work education and addressing the key human rights issues in field education. © 2016 National Association of Social Workers.
Women, Poverty, and Trauma: An Empowerment Practice Approach.
East, Jean Francis; Roll, Susan J
2015-10-01
This article describes an empowerment approach for working with diverse women who experience poverty, trauma, and multiple structural oppressions. The approach is the result of 20 years of experience developing, implementing, and evaluating this practice in a metropolitan community, and is grounded in women's empowerment theory and relational-cultural theory. The interventions combine social work's clinical interventions with community organizing strategies to promote personal and collective empowerment, supporting the "personal is political" tenet of feminist practice. The interventions, including nonclinical interviews, story circles, and leadership and advocacy education and training, can guide practitioners in providing services and programs that create a space for women to make changes in their personal lives and in their community. Program outcomes report successful changes for women in improving symptoms, increasing self-efficacy, and engaging in community advocacy. Women who participated also reported an increased sense of power, balancing commonality and difference among women, and a sense of hope for their future.
Facilitators of transforming primary care: a look under the hood at practice leadership.
Donahue, Katrina E; Halladay, Jacqueline R; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat
2013-01-01
This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41-4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08-1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement.
Facilitators of Transforming Primary Care: A Look Under the Hood at Practice Leadership
Donahue, Katrina E.; Halladay, Jacqueline R.; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat
2013-01-01
PURPOSE This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. METHODS We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. RESULTS Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41–4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08–1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. CONCLUSIONS In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement. PMID:23690383
Hashizume, Cary T; Woloschuk, Wayne; Hecker, Kent G
2015-01-01
There is a paucity of research regarding veterinary students' attitudes toward the rural environment and rural veterinary practice and how these attitudes might change over the course of a veterinary medicine program that includes rural clinical experience. Using a 23-item questionnaire, attitudes toward rural lifestyle, rural work-life balance, opportunities for career and skill development in rural veterinary practice, and inter-professional teamwork in the rural environment were assessed at the beginning and completion of a four-year veterinary medicine program. Eighty-six students (74.4% female) were included in this Canadian study over a six-year period. Thirty-one participants (36.1%) were rural students. Overall, students' attitudes toward the rural lifestyle, rural work-life balance, and inter-professional teamwork in rural veterinary practice all significantly decreased (p<.001) over the course of the program. As compared to urban students, rural students had significantly higher rural lifestyle scores at both the beginning (p<.001) and end (p<.01) of the veterinary medicine program. A less positive attitude toward living and working in a rural environment could influence students to exclude rural veterinary practice as a career choice. Rural clinical experiences designed to sustain or increase veterinary student interest in rural practice may not be sufficient to support positive rural attitudes. Given the demand for rural veterinary services in developed countries, the implications of this study may extend beyond Canada.
National Tech Prep Conference Review--Best Practices for Changing Times.
ERIC Educational Resources Information Center
Vandenberg, Victoria
1995-01-01
Provides an overview of the National Tech Prep Network Annual Conference in Atlanta, Georgia, October 5-7, 1995. Issues addressed include changes in funding for vocational education, new block grants, marketing programs, partnerships, and school to work. (JOW)
1988-01-25
to vote in a booth but the obligation) are questions on which work is continuing. If the proposed plans for changes are accepted, after dis...areas. Representative Imre Kiss of Borsod County described the practical outcome of changes in legal provisions affecting domestic commerce, and
Breast health educational interventions. Changes in beliefs and practices of working women.
Thomas, Barbara; Stamler, Lynnette Leeseberg; Lafreniere, Kathryn D; Delahunt, Tabitha D
2002-10-01
Health education programs supported by women's groups or workplaces have been successful in reaching large populations and changing intentions to perform breast health behaviors. This study examined the responses women working in the automotive industry had to two health education interventions, mailed pamphlets, and a combination of mailed material and classes at the worksite compared to a control group. A quasi-experimental design was used. Of the 948 women completing the pre-test, 437 also completed the post-test and were highly representative of the initial sample. The findings suggest that although the mailed information produced some change in practices and intentions, the classes in combination with the mailed pamphlets produced greater change. In addition, confidence in breast self examination as a method of detecting an existing breast lump increased from pre-test to post-test across all age groups. The reported influences on the women's decisions related to breast health varied across the life span. The results of this study can be used to support the development of effective health promotion programs for use at workplaces to increase the likelihood of women engaging in healthy breast practices.
Magill, Molly
2012-01-01
Summary Evidence-based practice involves the consistent and critical consumption of the social work research literature. As methodologies advance, primers to guide such efforts are often needed. In the present work, common statistical methods for testing moderation and mediation are identified, summarized, and corresponding examples, drawn from the substance abuse, domestic violence, and mental health literature, are provided. Findings While methodologically complex, analyses of these third variable effects can provide an optimal fit for the complexity involved in the provision of evidence-based social work services. While a moderator may identify the trait or state requirement for a causal relationship to occur, a mediator is concerned with the transmission of that relationship. In social work practice, these are questions of “under what conditions and for whom?” and of the “how?” of behavior change. Implications Implications include a need for greater attention to these methods among practitioners and evaluation researchers. With knowledge gained through the present review, social workers can benefit from a more ecologically valid evidence base for practice. PMID:22833701
Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective.
Winter, Karen; Cree, Viviene E
2016-07-01
The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an 'invisible trade': it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice.
Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective
Winter, Karen; Cree, Viviene E.
2016-01-01
The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an ‘invisible trade’: it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice. PMID:27559221
ERIC Educational Resources Information Center
Norton, Kent; Rafferty, Mike
2010-01-01
Work practices in the meat-processing industry have changed in recent years. The industry has moved away from workers dressing a whole carcass towards a chain-based system, with each worker performing a single task along a moving production line. The nature of the meat-processing workforce has also changed. It is no longer dominated by seasonal…
Basu, Sanjay; Landon, Bruce E; Song, Zirui; Bitton, Asaf; Phillips, Russell S
2015-02-01
Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation model estimating clinic-level utilization, revenues, and expenses using user-specified or public input data detailing practice staffing levels, salaries and overhead expenditures, patient characteristics, clinic workload, and reimbursements. We assessed whether the model could accurately estimate clinic utilization, revenues, and expenses across the nation using labor compensation, medical expenditure, and reimbursements databases, as well as cost and revenue data from independent practices of varying size. We demonstrated the model's utility in a simulation of how utilization, revenue, and expenses would change after hiring a nurse practitioner (NP) compared with hiring a part-time physician. Modeled practice utilization and revenue closely matched independent national utilization and reimbursement data, disaggregated by patient age, sex, race/ethnicity, insurance status, and ICD diagnostic group; the model was able to estimate independent revenue and cost estimates, with highest accuracy among larger practices. A demonstration analysis revealed that hiring an NP to work independently with a subset of patients diagnosed with diabetes or hypertension could increase net revenues, if NP visits involve limited MD consultation or if NP reimbursement rates increase. A model of utilization, revenue, and expenses in primary care practices may help policymakers and managers understand the implications of workforce and financing changes.
International profiles of dental hygiene 1987 to 1998: a 19-nation comparative study.
Johnson, P M
2001-08-01
Development of an international longitudinal database to examine patterns, trends and changes in dental hygiene. Three surveys of national dental hygienists' associations, mainly members of the International Federation of Dental Hygienists. Data were collected by mail in 1987, 1992 and 1998, using a 40-item questionnaire. Sample size increased over time; results presented are based on responses for 13, 15 and 19 countries respectively. Preliminary tabulations were circulated to respondents for validation. Overall, characteristics of the profession were remarkably similar; most noteworthy was the scope of dental hygiene clinical practice. Regarding historical development, education and professional organisation, the profession was more similar than dissimilar. Greater variation was evident in terms of numbers, distribution, workforce behaviour, predominant work setting and remuneration. While apparent change over the relatively short period 1987 to 1998 was viewed with caution, several observations were of particular interest: marked increases in the supply of dental hygienists, scope of practice and range of practice settings, accompanied by a decline in mandated level of work supervision. A slight but gradual increase in independent dental hygiene practice also was noted. By 1998 the profiles reflected the vast majority of the world's population of dental hygienists. While rate of change varied across the countries examined, the nature of the change tended to be consistent, resulting in a continuing homogeneity in the profession worldwide. Changes and emerging trends should continue to be monitored in terms of improved access to quality oral health services and technical efficiency in the provision of those services.
NASA Astrophysics Data System (ADS)
Ware, Molly Noelle
2015-03-01
In this piece, I begin by reviewing and summarizing the book John Dewey and Education Outdoors by John Quay and Jayson Seaman. After an overview of the authors' work, I use nuanced presumptions within the authors' work to explore how principles of ecology (complexity theory), principles of embodied movement practices such as yoga and five Rhythms Dance, and a poststructural both/and perspective might create opportunities for re-imagining and transforming the cultural institution of education. Questions explored in this review include: What sort of relationship might allow us to remain open and engaged within a dynamic environment where change is the norm? What sort of relationship to difference allows us to remain open to the creative potential found in what is oppositional? Through exploring these questions, I hope to clarify a vision of transformation and change as a creative practice that grows out of learning to both work with, accept, and honor ourselves and strengthen connection with others, communities, the planet and the environment.
Theorising Practice in Single-Sex Work.
ERIC Educational Resources Information Center
Tett, Lyn
1996-01-01
The practice of adult educators in single-sex settings is directed by "theories-in-use" about the social construction of gender, such as gender is culturally constructed but people internalize gender stereotypes; gender stereotypes can be challenged and changed; and power to define gender roles lies in patriarchy, but it can be contested…
Essays on Learning through Practice
ERIC Educational Resources Information Center
Feng, Junchen
2017-01-01
The future of education is human expertise and artificial intelligence working in conjunction, a revolution that will change the education as we know it. The Intelligent Tutoring System is a key component of this future. A quantitative measurement of efficacies of practice to heterogeneous learners is the cornerstone of building an effective…
Teachers' Experiences with the Transition to a Career Academy
ERIC Educational Resources Information Center
Spurlock, Charlene Denise
2010-01-01
Career academies, schools within schools that concentrate on career fields, require the intentional efforts of teachers working collaboratively and sharing best practices to increase students' achievement and employability. Little is known of the perceptions of career academies' teachers, however, as they attempt to make changes in practice. The…
45 CFR 680.11 - Staff involvement with NSF proposals and awards.
Code of Federal Regulations, 2014 CFR
2014-10-01
... SCIENCE FOUNDATION NATIONAL SCIENCE FOUNDATION RULES OF PRACTICE Rules of Practice for the National Science Foundation § 680.11 Staff involvement with NSF proposals and awards. (a)(1) Many scientists... field of science, engineering, or education, notwithstanding that the focus of the work may change in...
45 CFR 680.11 - Staff involvement with NSF proposals and awards.
Code of Federal Regulations, 2011 CFR
2011-10-01
... SCIENCE FOUNDATION NATIONAL SCIENCE FOUNDATION RULES OF PRACTICE Rules of Practice for the National Science Foundation § 680.11 Staff involvement with NSF proposals and awards. (a)(1) Many scientists... field of science, engineering, or education, notwithstanding that the focus of the work may change in...
45 CFR 680.11 - Staff involvement with NSF proposals and awards.
Code of Federal Regulations, 2013 CFR
2013-10-01
... SCIENCE FOUNDATION NATIONAL SCIENCE FOUNDATION RULES OF PRACTICE Rules of Practice for the National Science Foundation § 680.11 Staff involvement with NSF proposals and awards. (a)(1) Many scientists... field of science, engineering, or education, notwithstanding that the focus of the work may change in...
45 CFR 680.11 - Staff involvement with NSF proposals and awards.
Code of Federal Regulations, 2012 CFR
2012-10-01
... SCIENCE FOUNDATION NATIONAL SCIENCE FOUNDATION RULES OF PRACTICE Rules of Practice for the National Science Foundation § 680.11 Staff involvement with NSF proposals and awards. (a)(1) Many scientists... field of science, engineering, or education, notwithstanding that the focus of the work may change in...
Establishing Benchmarks and Measuring Progress at "HSTW" Sites.
ERIC Educational Resources Information Center
Southern Regional Education Board (SREB), 2010
2010-01-01
Schools that join the "High Schools That Work (HSTW)" network are expected to show progress in changing school and classroom practices in ways that improve student achievement and readiness for postsecondary studies and careers. They are expected to focus on practices that have proven most effective in advancing student achievement.…
Foster, Michele; Burridge, Letitia; Donald, Maria; Zhang, Jianzhen; Jackson, Claire
2016-01-14
Service delivery innovation is at the heart of efforts to combat the growing burden of chronic disease and escalating healthcare expenditure. Small-scale, locally-led service delivery innovation is a valuable source of learning about the complexities of change and the actions of local change agents. This exploratory qualitative study captures the perspectives of clinicians and managers involved in a general practitioner-led integrated diabetes care innovation. Data on these change agents' perspectives on the local innovation and how it works in the local context were collected through focus groups and semi-structured interviews at two primary health care sites. Transcribed data were analysed thematically. Normalization Process Theory provided a framework to explore perspectives on the individual and collective work involved in putting the innovation into practice in local service delivery contexts. Twelve primary health care clinicians, hospital-based medical specialists and practice managers participated in the study, which represented the majority involved in the innovation at the two sites. The thematic analysis highlighted three main themes of local innovation work: 1) trusting and embedding new professional relationships; 2) synchronizing services and resources; and 3) reconciling realities of innovation work. As a whole, the findings show that while locally-led service delivery innovation is designed to respond to local problems, convincing others to trust change and managing the boundary tensions is core to local work, particularly when it challenges taken-for-granted practices and relationships. Despite this, the findings also show that local innovators can and do act in both discretionary and creative ways to progress the innovation. The use of Normalization Process Theory uncovered some critical professional, organizational and structural factors early in the progression of the innovation. The key to local service delivery innovation lies in building coalitions of trust at the point of service delivery and persuading organizational and institutional mindsets to consider the opportunities of locally-led innovation.
The art and science of political advocacy.
Kosiorowski, Donna
2014-01-01
School nurses throughout the nation, individually and collectively, work to bring about change for the school nursing profession and to safeguard the health of children and the public. School nurses practice amidst education reform, health care reform, changes in society, and medical and technological advancements. School nurses must be active in decisions that affect their daily practice by involvement in the local, state, and federal political process. School nurses must craft the art and develop the science of political advocacy.
Broken Voices or a Broken Curriculum? The Impact of Research on UK School Choral Practice with Boys
ERIC Educational Resources Information Center
Ashley, Martin R.
2013-01-01
Work such as that of John Cooksey on boys' changing voices has influenced choral practice in the USA and in certain UK youth choirs, but has hitherto had little impact in UK schools where many teachers continue to believe that boys' voices "break". Different practices are found across the independent and maintained sectors of secondary…
Lean and leadership practices: development of an initial realist program theory.
Goodridge, Donna; Westhorp, Gill; Rotter, Thomas; Dobson, Roy; Bath, Brenna
2015-09-07
Lean as a management system has been increasingly adopted in health care settings in an effort to enhance quality, capacity and safety, while simultaneously containing or reducing costs. The Ministry of Health in the province of Saskatchewan, Canada has made a multi-million dollar investment in Lean initiatives to create "better health, better value, better care, and better teams", affording a unique opportunity to advance our understanding of the way in which Lean philosophy, principles and tools work in health care. In order to address the questions, "What changes in leadership practices are associated with the implementation of Lean?" and "When leadership practices change, how do the changed practices contribute to subsequent outcomes?", we used a qualitative, multi-stage approach to work towards developing an initial realist program theory. We describe the implications of realist assumptions for evaluation of this Lean initiative. Formal theories including Normalization Process Theory, Theories of Double Loop and Organization Leaning and the Theory of Cognitive Dissonance help understand this initial rough program theory. Data collection included: key informant consultation; a stakeholder workshop; documentary review; 26 audiotaped and transcribed interviews with health region personnel; and team discussions. A set of seven initial hypotheses regarding the manner in which Lean changes leadership practices were developed from our data. We hypothesized that Lean, as implemented in this particular setting, changes leadership practices in the following ways. Lean: a) aligns the aims and objectives of health regions; b) authorizes attention and resources to quality improvement and change management c) provides an integrated set of tools for particular tasks; d) changes leaders' attitudes or beliefs about appropriate leadership and management styles and behaviors; e) demands increased levels of expertise, accountability and commitment from leaders; f) measures and uses data effectively to identify actual and relevant local problems and the root causes of those problems; and g) creates or supports a 'learning organization' culture. This study has generated initial hypotheses and realist program theory that can form the basis for future evaluation of Lean initiatives. Developing leadership capacity and culture is theorized to be a necessary precursor to other systemic and observable changes arising from Lean initiatives.
A profile of Australian nuclear medicine technologist practice.
Adams, Edwina J; Cox, Jennifer M; Adamson, Barbara J; Schofield, Deborah J
2008-01-01
Nuclear medicine in Australia has encountered significant change over the past 30 years, with a move to privately owned practices, technological advances and the transfer of education of the nuclear medicine technologist (NMT) from technical college apprenticeships to university degrees. Currently, shortages of nuclear medicine technologists are reported in some states of Australia. It is not known whether changes in NMT practice or the type of centre in which an NMT works have an influence on retention of staff. The primary objective of this survey was to establish a profile of NMT practice in Australia, with the aim of producing baseline data that could be used in further research to establish levels of retention and job satisfaction. Chief technologists in three states of Australia were invited to respond to a written questionnaire. The questionnaire included data about staffing levels, imaging modalities, procedures performed, and movement of staff. Findings presented will relate to the profile of practice data only. Forty-eight (54%) chief technologists responded to the questionnaire with 73% working in privately owned practices. The majority of centres employ up to two full-time equivalent nuclear medicine technologists and have two gamma cameras and one full-time equivalent nuclear medicine physician. Most centres perform a limited range of studies with bone scans predominating. More than half the centres make some use of a centralized radiopharmacy service. Further research is required to determine how these changes may impact on workplace satisfaction and in turn, on retention.
Towards a Stronger Covalent Bond: Pedagogical Change for Inclusivity and Equity
ERIC Educational Resources Information Center
Koretsky, Milo; Montfort, Devlin; Nolen, Susan Bobbitt; Bothwell, Michelle; Davis, Susannah; Sweeney, James
2018-01-01
We describe progress on a comprehensive, programmatic change initiative whose goal is to create an inclusive culture that fosters diversity and a shift towards more meaningful, consequential work. While this initiative has several elements that target different aspects of unit practices and culture, we focus here on pedagogical change. Our…
ERIC Educational Resources Information Center
Clarke, Hugh
2013-01-01
In this paper, the author draws upon his interest, as a psychotherapist, in working with change at a psychological and individual level, and on his experience of the radical changes currently taking place in higher education, specifically the University where he manages several services, including a Counselling Service. Through leading and…
Healthcare reforms: implications for the education and training of acute and critical care nurses.
Glen, S
2004-12-01
This paper offers a wide ranging analysis of the drivers that resulted in scrutiny of medical, nursing, and healthcare professional roles. It suggests that what is needed is a coherent vision of the future shape of the health workforce. This requires moving beyond the presumption that reforming working practices primarily involves "delegating doctors" responsibilities to nurses. The paper argues that it is self evident that the implications of changes in healthcare roles and the ability of existing professionals to function effectively in the future will require education, training, and human resource investment supportive of the changes. It suggests a clear definition of competence and a national standard to practice is essential for nurses working in acute and acute critical settings. There should therefore be a correlation between levels of practice, levels of education, and remuneration. Furthermore, education programmes for senior nurses should sit coherently alongside the education programmes required by Modernising Medical Careers. Finally, the realisation of the government's service and modernisation agenda will require a culture change within higher education institutions, postgraduate deaneries, professional organisations, workforce development confederations, and NHS trusts.
Designing Work, Family & Health Organizational Change Initiatives.
Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis
2014-01-01
For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.
Designing Work, Family & Health Organizational Change Initiatives
Hammer, Leslie B.; Kelly, Erin L.; Moen, Phyllis
2014-01-01
Executive Summary For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win–win for productivity and employees’ well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today’s U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor. PMID:24683279
ERIC Educational Resources Information Center
Jepsen, David A.
2008-01-01
This tribute to Tiedeman takes the form of an invitation to read his written work. The author concludes that Tiedeman's body of work is unique and paradoxical, abstract and challenging, and deeply practical. He offered principles intended to change the way counselors think about careers and career development.
Entrance and Exit Requirements of Professional Social Work Education
ERIC Educational Resources Information Center
Duehn, Wayne D.; Mayadas, Nazneen Sada
1977-01-01
A competency-based direct practice curriculum for graduate social work education is described based on: (1) interpersonal behavioral control; (2) judgment and decision making; (3) contracting and goal setting; (4) selection and application of change method; and (5) assessment of outcomes. (Author/LBH)
Career and Family: The Modern Worker's Balancing Act.
ERIC Educational Resources Information Center
Couch, Sue
1989-01-01
Work/family conflict is both an economic problem and a gender-role issue. New federal and state policies and changes in employer policies and practices are needed in such areas as child and dependent care, parental leave, work schedules, and flexible benefit plans. (SK)
Real-Time Culture Change Improves Lean Success: Sequenced Culture Change Gets Failing Grades.
Kusy, Mitchell; Diamond, Marty; Vrchota, Scott
2015-01-01
Success with the Lean management system is rooted in a culture of stakeholder engagement and commitment. Unfortunately, many leaders view Lean as an "add-on" tool instead of one that requires a new way of thinking and approaching culture. This article addresses the "why, how, and what" to promote a Lean culture that works. We present a five-phased approach grounded in evidence-based practices of real-time culture change. We further help healthcare leaders understand the differences between traditional "sequenced" approaches to culture change and "real-time" methods--and why these real-time practices are more sustainable and ultimately more successful than traditional culture change methods.
Cruickshank, Andrew; Collins, Dave; Minten, Sue
2014-02-01
Stimulated by growing interest in the organizational and performance leadership components of Olympic success, sport psychology researchers have identified performance director-led culture change as a process of particular theoretical and applied significance. To build on initial work in this area and develop practically meaningful understanding, a pragmatic research philosophy and grounded theory methodology were engaged to uncover culture change best practice from the perspective of newly appointed performance directors. Delivered in complex and contested settings, results revealed that the optimal change process consisted of an initial evaluation, planning, and impact phase adjoined to the immediate and enduring management of a multidirectional perception- and power-based social system. As the first inquiry of its kind, these findings provide a foundation for the continued theoretical development of culture change in Olympic sport performance teams and a first model on which applied practice can be based.
McKenzie, Thomas L.; Rushall, Brent S.
1974-01-01
Swimmers' attendance at training and work rates were described by their coaches as being poor and irregular. Reinforcement contingencies were developed to remedy these unsatisfactory conditions. Two experiments were conducted. A multiple baseline design verified the effects of publicly marking attendance at practice as a sufficient solution for reducing absenteeism, tardiness, and leaving early. Follow-up analyses showed this contingency to have lasting effects. In the second experiment, a reversal design was used to assess the effects of employing program boards as a means of increasing work output during practice. Work rates in eight selected swimmers were elevated by an average of 27.1% when the boards were instituted. Follow-up evaluations showed that the use of the program boards had lasting effects. Publicly checking the completion of each training unit of work changed the nature of the swimming environment to produce a more productive use of time. The role of the coach was subsequently changed as less time was spent in directing and supervising behaviors. PMID:4436167
McKenzie, T L; Rushall, B S
1974-01-01
Swimmers' attendance at training and work rates were described by their coaches as being poor and irregular. Reinforcement contingencies were developed to remedy these unsatisfactory conditions. Two experiments were conducted. A multiple baseline design verified the effects of publicly marking attendance at practice as a sufficient solution for reducing absenteeism, tardiness, and leaving early. Follow-up analyses showed this contingency to have lasting effects. In the second experiment, a reversal design was used to assess the effects of employing program boards as a means of increasing work output during practice. Work rates in eight selected swimmers were elevated by an average of 27.1% when the boards were instituted. Follow-up evaluations showed that the use of the program boards had lasting effects. Publicly checking the completion of each training unit of work changed the nature of the swimming environment to produce a more productive use of time. The role of the coach was subsequently changed as less time was spent in directing and supervising behaviors.
Effective Classroom-Management & Positive Teaching
ERIC Educational Resources Information Center
Sieberer-Nagler, Katharina
2016-01-01
This article offers practical information for primary teachers to become more knowledgable, skilled and effective in their work. Aspects of positive teaching and learning are explored. Innovative methods for transforming common classroom management struggles into opportunities for positive change and for changing negative behaviors into positive…
Shah, N; Castro-Sánchez, E; Charani, E; Drumright, L N; Holmes, A H
2015-06-01
Improving behaviour in infection prevention and control (IPC) practice remains a challenge, and understanding the determinants of healthcare workers' (HCWs) behaviour is fundamental to develop effective and sustained behaviour change interventions. To identify behaviours of HCWs that facilitated non-compliance with IPC practices, focusing on how appraisals of IPC duties and social and environmental circumstances shaped and influenced non-compliant behaviour. This study aimed to: (1) identify how HCWs rationalized their own behaviour and the behaviour of others; (2) highlight challenging areas of IPC compliance; and (3) describe the context of the working environment that may explain inconsistencies in IPC practices. Clinical staff at a National Health Service hospital group in London, UK were interviewed between December 2010 and July 2011 using qualitative methods. Responses were analysed using a thematic framework. Three ways in which HCWs appraised their behaviour were identified through accounts of IPC policies and practices: (1) attribution of responsibilities, with ambiguity about responsibility for certain IPC practices; (2) prioritization and risk appraisal, which demonstrated a divergence in values attached to some IPC policies and practices; and (3) hierarchy of influence highlighted that traditional clinical roles challenged work relationships. Overall, behaviours are not entirely independent of policy rules, but often an amalgamation of local normative practices, individual preferences and a degree of professional isolation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Moving Away from Social Work and Half Way Back Again: New Research on Skills in Probation
Raynor, Peter; Vanstone, Maurice
2016-01-01
Research on social work in the criminal justice system was well represented in the social work literature until the 1990s. Since then, changes in the organisation, training and research base of probation practice, particularly in England and Wales, have all contributed to a separation between probation research and the mainstream social work research literature. However, recent probation research, by focusing on individual practice skills and on the quality of relationships, is producing findings which resonate with traditional social work concerns. The study presented here, based on analysis of videotaped interviews between probation staff and the people they are supervising, shows what skills are used and the effects of skilled supervision. People supervised by more skilled staff were significantly less likely to be reconvicted over a two-year follow-up, and the most effective supervisors combined good relationship skills with a range of ‘structuring’ or change-promoting skills. In effect, this can be regarded as a test of the impact of social work skills used by probation staff and suggests that a closer relationship between mainstream social work research and probation research could be productive for both. PMID:27559218
ERIC Educational Resources Information Center
Colorado State Univ., Ft. Collins. Human Factors Research Lab.
A project was conducted to determine the relationship between changes in attitudes toward work of seventh grade pupils and specified instructional practices of their social studies or language arts teachers. The study encompassed: (1) developing and administering instruments to students and instructors to asess attitudes toward work, (2)…
The Challenges of Work-Based Learning in the Changing Context of the European Higher Education Area
ERIC Educational Resources Information Center
Schmidt, Reinhard; Gibbs, Paul
2009-01-01
This article discusses the key features of the common European framework for work-based learning (WBL) of the "Developing European Work Based Learning Approaches and Methods" (DEWBLAM) project (2003-2006). It examines the context of recent European initiatives and comments on the potential implications for policy, practice and theory,…
A Commentary on Education and Sustainable Development Goals
ERIC Educational Resources Information Center
Sterling, Stephen
2016-01-01
The Sustainable Development Goals (SDGs) are viewed in the context of Johan Rockström's work on planetary boundaries at the Stockholm Resilience Centre. This work sets a double challenge to educational policy and practice: to embrace and help achieve the Goals, but also to work towards a deeper change in consciousness which can reconcile people…
Engineering as a Social Activity: Preparing Engineers to Thrive in the Changing World of Work
ERIC Educational Resources Information Center
Joyner, Fredricka F.; Mann, Derek T. Y.; Harris, Todd
2012-01-01
Key macro-trends are combining to create a new work context for the practice of engineering. Telecommuting and virtual teams create myriad possibilities and challenges related to managing work and workers. Social network technology tools allow for unprecedented global, 24/7 collaboration. Globalization has created hyper-diverse organizations,…
Exploring Baccalaureate Social Work Students' Self-Efficacy: Did It Change over Time?
ERIC Educational Resources Information Center
Ahn, Bonnie; Boykin, Lolita; Hebert, Corie; Kulkin, Heidi
2012-01-01
This study explored baccalaureate social work students' self-efficacy at a rural southern university. Bandura's concept of self-efficacy is used as a theoretical base for the study. Students (N = 43) in introductory social work courses and in the field practicum course completed the Foundation Practice Self Efficacy Scale. Following The Council on…
Williams-Whitt, Kelly; Bültmann, Ute; Amick, Benjamin; Munir, Fehmidah; Tveito, Torill H; Anema, Johannes R
2016-12-01
Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.
Translating research into practice in nursing homes: can we close the gap?
Rahman, Anna N; Applebaum, Robert A; Schnelle, John F; Simmons, Sandra F
2012-10-01
A gap between research and practice in many nursing home (NH) care areas persists despite efforts by researchers, policy makers, advocacy groups, and NHs themselves to close it. The reasons are many, but two factors that have received scant attention are the dissemination process itself and the work of the disseminators or change agents. This review article examines these two elements through the conceptual lens of Roger's innovation dissemination model. The application of general principles of innovation dissemination suggests that NHs are characteristically slow to innovate and thus may need more time as well as more contact with outside change agents to adopt improved practices. A review of the translation strategies used by NH change agents to promote adoption of evidence-based practice in NHs suggests that their strategies inconsistently reflect lessons learned from the broader dissemination literature. NH-related research, policy, and practice recommendations for improving dissemination strategies are presented. If we can make better use of the resources currently devoted to disseminating best practices to NHs, we may be able to speed NHs' adoption of these practices.
Blending Western Biomedicine with Local Healing Practices.
Chary, Anita; Sargent, Carolyn
2016-07-01
Western allopathic physicians working internationally might encounter allopathic colleagues who endorse local healing practices that are not scientifically supported and, hence, might pose harm to patients. Respect for the autonomy of local physicians and patients thus can conflict with the ethical principles of beneficence and nonmaleficence. In such a situation, it is advisable for Western allopathic physicians to communicate their concerns to local colleagues as equal partners. Making an effort to understand local meanings associated with a traditional therapy demonstrates one's respect for local cultural ideas and practices, even if one disagrees with that therapy, and is crucial to tailoring messages about clinical practice change. A realistic approach to cross-cultural clinical practice change seeks to reduce, rather than eliminate, harm. © 2016 American Medical Association. All Rights Reserved. ISSN 2376-6980.
Gunn, Jane M; Palmer, Victoria J; Dowrick, Christopher F; Herrman, Helen E; Griffiths, Frances E; Kokanovic, Renata; Blashki, Grant A; Hegarty, Kelsey L; Johnson, Caroline L; Potiriadis, Maria; May, Carl R
2010-08-06
Depression and related disorders represent a significant part of general practitioners (GPs) daily work. Implementing the evidence about what works for depression care into routine practice presents a challenge for researchers and service designers. The emerging consensus is that the transfer of efficacious interventions into routine practice is strongly linked to how well the interventions are based upon theory and take into account the contextual factors of the setting into which they are to be transferred. We set out to develop a conceptual framework to guide change and the implementation of best practice depression care in the primary care setting. We used a mixed method, observational approach to gather data about routine depression care in a range of primary care settings via: audit of electronic health records; observation of routine clinical care; and structured, facilitated whole of organisation meetings. Audit data were summarised using simple descriptive statistics. Observational data were collected using field notes. Organisational meetings were audio taped and transcribed. All the data sets were grouped, by organisation, and considered as a whole case. Normalisation Process Theory (NPT) was identified as an analytical theory to guide the conceptual framework development. Five privately owned primary care organisations (general practices) and one community health centre took part over the course of 18 months. We successfully developed a conceptual framework for implementing an effective model of depression care based on the four constructs of NPT: coherence, which proposes that depression work requires the conceptualisation of boundaries of who is depressed and who is not depressed and techniques for dealing with diffuseness; cognitive participation, which proposes that depression work requires engagement with a shared set of techniques that deal with depression as a health problem; collective action, which proposes that agreement is reached about how care is organised; and reflexive monitoring, which proposes that depression work requires agreement about how depression work will be monitored at the patient and practice level. We describe how these constructs can be used to guide the design and implementation of effective depression care in a way that can take account of contextual differences. Ideas about what is required for an effective model and system of depression care in primary care need to be accompanied by theoretically informed frameworks that consider how these can be implemented. The conceptual framework we have presented can be used to guide organisational and system change to develop common language around each construct between policy makers, service users, professionals, and researchers. This shared understanding across groups is fundamental to the effective implementation of change in primary care for depression.
Training for Efficiency: Work, Time and Systems-based Practice in Medical Residency*
Szymczak, Julia E.; Bosk, Charles L.
2013-01-01
Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these changes for the socialization of residents to time management and the development of a professional identity? Based on observations of and interviews with internal medicine residents at 3 training programs, we find that efficiency is both a social norm and strategy that residents employ to manage a workload for which the demand for work exceeds the supply of time available to accomplish it. We found that residents struggle to be efficient in the face of seemingly intractable “systems” problems. Residents work around these problems, and in doing so develop a tolerance for organizational vulnerabilities. PMID:22863601
Midwives in India: a delayed cord clamping intervention using simulation.
Faucher, M A; Riley, C; Prater, L; Reddy, M P
2016-09-01
Iron deficiency is a prevalent health problem in India affecting women and newborns. Delayed umbilical cord clamping at birth is a safe and effective means for increasing serum iron levels in newborns up to 6 months of age. The study aim was to increase the utilization of delayed cord clamping in a group of midwives working in Hyderabad, India. A single group pre- and post-test design was used to evaluate knowledge, beliefs and practice before and after a delayed cord clamping intervention including follow-up at 10 months after the original intervention. The intervention included lectures and simulation. Results show significant increases in knowledge and positive beliefs about the practice of delayed cord clamping. Simulation was effective for eliciting important feedback related to learning. Results represent a small group of midwives working with a non-profit foundation in Southern India. Language discordancy and cultural norms in this group of midwives may have influenced results. Knowledge, beliefs and practice related to delayed cord clamping were all significantly improved after the intervention. The Knowledge to Action framework using simulation is an effective cross-cultural method for implementing education about evidence-based practice. Midwives are invested in learning practices that promote public health. Changing institutional policy may have limitations without first considering normative practice. Using simulation combined with institutional health policy appears to result in significant uptake of practice change. Qualitative studies exploring the interconnections between cultural norms and decision making may be informative about promoting practice change particularly in this setting. Upscaling midwifery has been recommended to improve maternal and child health in India. © 2016 International Council of Nurses.
Hall, Amy L; Smit, Andrea N; Mistlberger, Ralph E; Landry, Glenn J; Koehoorn, Mieke
2017-01-01
Shift work is a common working arrangement with wide-ranging implications for worker health. Organisational determinants of shift work practices are not well characterised; such information could be used to guide evidence-based research and best practices to mitigate shift work's negative effects. This exploratory study aimed to describe and assess organisational-level determinants of shift work practices thought to affect health, across a range of industry sectors. Data on organisational characteristics, shift work scheduling, provision of shift work education materials/training to employees and night-time lighting policies in the workplace were collected during phone interviews with organisations across the Canadian province of British Columbia. Relationships between organisational characteristics and shift work practices were assessed using multivariable logistic regression models. The study sample included 88 participating organisations, representing 30 700 shift workers. Long-duration shifts, provision of shift work education materials/training to employees and night-time lighting policies were reported by approximately one-third of participating organisations. Odds of long-duration shifts increased in larger workplaces and by industry. Odds of providing shift work education materials/training increased in larger workplaces, in organisations reporting concern for shift worker health and in organisations without seasonal changes in shift work. Odds of night-time lighting policies in the workplace increased in organisations reporting previous workplace accidents or incidents that occurred during non-daytime hours, site maintenance needs and client service or care needs. This study points to organisational determinants of shift work practices that could be useful for targeting research and workplace interventions. Results should be interpreted as preliminary in an emerging body of literature on shift work and health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Using practice development methodology to develop children's centre teams: ideas for the future.
Hemingway, Ann; Cowdell, Fiona
2009-09-01
The Children's Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, evaluation and evolution. This paper introduces the Children's Centre Programme and practice development methods and aims to discuss the relevance of using this method to develop teams in children's centres through considering the findings from an evaluation of a two-year project to develop inter-agency public health teams. The evaluation showed that practice development methods can enable successful team development and showed that through effective facilitation, teams can change their practice to focus on areas of local need. The team came up with their own process to develop a strategy for their locality.
A Review of Shared Vision and its Application within an Army Context
2015-07-01
convention and attitudes (p. 134). What is most important to remember is that employees can influence the success of learning organisation practices...require a change in attitude at the leadership level. In changing environments leaders must be people “who are self-aware, adaptive, and agile...Hesselbein and Shinseki, 2004, xviii). Leaders must be willing to work with employees, casting aside their own agendas to work towards shared
Armour, Mark
The business continuity profession has been following a methodology that has barely evolved since its inception. Unfortunately, the stodgy, labour-intensive practices of the past are poorly suited to today's fast-paced and ever-changing work environments. Proposed herein is a new approach to the discipline. Just as agile methodology revolutionised project management, new tactics in preparedness can drastically change how this profession is practised. That is the hope. If there is to be any significant change in business continuity ahead, it may just take a revolution.
Arar, Nedal H.; Noel, Polly H.; Leykum, Luci; Zeber, John E.; Romero, Raquel; Parchman, Michael L.
2012-01-01
Background Implementing improvement programs to enhance quality of care within primary care clinics is complex, with limited practical guidance available to help practices during the process. Understanding how improvement strategies can be implemented in primary care is timely given the recent national movement towards transforming primary care into patient-centered medical homes (PCMH). This study examined practice members’ perceptions of the opportunities and challenges associated with implementing changes in their practice. Methods Semi-structured interviews were conducted with a purposive sample of 56 individuals working in 16 small, community-based primary care practices. The interview consisted of open-ended questions focused on participants’ perceptions of: (1) practice vision, (2) perceived need for practice improvement, and (3) barriers that hinder practice improvement. The interviews were conducted at the participating clinics and were tape-recorded, transcribed, and content analyzed. Results Content analysis identified two main domains for practice improvement related to: (1) the process of care, and (2) patients’ involvement in their disease management. Examples of desired process of care changes included improvement in patient tracking/follow-up system, standardization of processes of care, and overall clinic documentations. Changes related to the patients’ involvement in their care included improving (a) health education, and (b) self care management. Among the internal barriers were: staff readiness for change, poor communication, and relationship difficulties among team members. External barriers were: insurance regulations, finances and patient health literacy. Practice Implications Transforming their practices to more patient-centered models of care will be a priority for primary care providers. Identifying opportunities and challenges associated with implementing change is critical for successful improvement programs. Successful strategy for enhancing the adoption and uptake of PCMH elements should leverage areas of concordance between practice members’ perceived needs and planned improvement efforts. PMID:22186171
Gender and Social Work Education: Directions for the 1990s.
ERIC Educational Resources Information Center
Tice, Karen
1990-01-01
To move beyond the incomplete curricular reform that characterized compliance with Council on Social Work Education curriculum policy standards on women, it is proposed that a gender-inclusive curriculum be developed, including changes in the knowledge base, teaching strategies, and departmental practices. (Author/MSE)
Working toward Employment: Preparing for Tomorrow and Beyond
ERIC Educational Resources Information Center
Erin, Jane N.
2013-01-01
In this Special Issue on Transition and Employment of the "Journal of Visual Impairment & Blindness" ("JVIB"), three practice contributions provide eloquent examples of how young people and older adults have learned to recognize their own changing work abilities and opportunities, thanks in part to support from…
Broughton, J; Cantone, M C; Ginjaume, M; Shah, B
2013-12-01
This report was commissioned by the IRPA President to provide an assessment of the impact on members of IRPA Associate Societies of the introduction of ICRP recommendations for a reduced dose limit for the lens of the eye. The report summarises current practice and considers possible changes that may be required. Recommendations for further collaboration, clarification and changes to working practices are suggested.
An interactive quality of work life model applied to organizational transition.
Knox, S; Irving, J A
1997-01-01
Most healthcare organizations in the United States are in the process of some type of organizational change or transition. Professional nurses and other healthcare providers practicing in U.S. healthcare delivery organizations are very aware of the dramatic effects of restructuring processes. A phenomenal amount of change and concern is occurring with organizational redesign, generating many questions and uncertainties. These transitions challenge the basic assumptions and principles guiding the practice of clinical and management roles in healthcare.
Guidelines for Psychological Practice with Girls and Women
ERIC Educational Resources Information Center
American Psychologist, 2007
2007-01-01
During recent decades, women and girls of diverse ethnicities, social classes, sexual orientations, and life experiences have encountered dramatic and complex changes in education, health, work, reproductive and caregiving roles, and personal relationships. Although many of these changes have resulted in increased equality, opportunity, and…
Casella, Evan; Mills, Jane; Usher, Kim
2014-01-01
Modern communication methods are drastically changing the way people interact with each other. Professions such as nursing need to evolve to remain relevant as social infrastructure changes. In the 1960s, researchers developed a sociotechnical theory that stated workers were more motivated and productive if there was a good balance between the social and technical aspects of their work. Today's technology is blurring the boundaries between the social and the technical thereby transforming human contact and communication into a multi-method process. In Australia, people are adept at utilising social media technology to become more efficient, creative and connected; Australian nurses also need to embrace changing technology to capitalise on the professional opportunities offered by social media. This paper imagines a world where nurses integrate social media into assessing, diagnosing, planning, implementing and evaluating care. Discussion draws on a combination of real-world examples of best-practice and blue-sky thinking to demonstrate that evidence-based care must be combined with the adoption of future-forward technology.
Beyond Work-Life "Integration".
Williams, Joan C; Berdahl, Jennifer L; Vandello, Joseph A
2016-01-01
Research on the work-family interface began in the 1960s and has grown exponentially ever since. This vast amount of research, however, has had relatively little impact on workplace practice, and work-family conflict is at an all-time high. We review the work-family research to date and propose that a shift of attention is required, away from the individual experience of work and family and toward understanding how identity and status are defined at work. Several factors enshrine cherished identities around current workplace norms. The work devotion schema demands that those who are truly committed to their work will make it the central or sole focus of their lives, without family demands to distract them. Importantly, the work devotion schema underwrites valued class and gender identities: Work devotion is a key way of enacting elite class status and functions as the measure of a man--the longer the work hours and higher the demand for his attention, the better. Advocating change in the way work is done and life is lived meets resistance because it places these cherished identities at risk. Resistance to these identity threats keeps current workplace norms in place. This is why even the business case-which shows that current practices are not economically efficient-fails to persuade organizations to enact change. What is needed now is sustained attention to the implicit psychological infrastructure that cements the mismatch between today's workplace and today's workforce.
Sweet, Jerry J; Benson, Laura M; Nelson, Nathaniel W; Moberg, Paul J
2015-01-01
The current survey updated professional practice and income information pertaining to clinical neuropsychology. Doctoral-level members of the American Academy of Clinical Neuropsychology, Division 40 (Clinical Neuropsychology) of the American Psychological Association, and the National Academy of Neuropsychology and other neuropsychologists, as well as postdoctoral trainees in the Association of Postdoctoral Programs in Clinical Neuropsychology and at other training sites were invited to participate in a web-based survey in early 2015. The sample of 1777 respondents, of whom 1579 were doctoral-level practitioners and 198 were postdoctoral trainees, was larger than the prior 2010 income and practice survey. The substantial proportional change in gender has continued, with women now a clear majority in the postdoctoral trainee sample as well as in the practitioner sample. Dissimilar from the median age trajectory of American Psychological Association members, the median age of clinical neuropsychologists remains essentially unchanged since 1989, indicating a substantial annual influx of young neuropsychologists. The question of whether the Houston Conference training model has become an important influence in the specialty can now be considered settled in the affirmative among postdoctoral trainees and practitioners. Testing assistant usage remains commonplace, and continues to be more common in institutions. The vast majority of clinical neuropsychologists work full-time and very few are unemployed and seeking employment. The numbers of neuropsychologists planning to retire in the coming 5-10 years do not suggest a "baby boomer" effect or an unexpected bolus of planned retirements in the next 10 years that would be large enough to be worrisome. Average length of time reported for evaluations appears to be increasing across time. The most common factors affecting evaluation length were identified, with the top three being: (1) goal of evaluation, (2) stamina/health of examinee, and (3) age of examinee. Pediatric specialists remain more likely than others to work part-time, more likely to work in institutions, report lower incomes than respondents with a lifespan professional identity, and are far more likely to be women. Incomes continue to vary considerably by years of clinical practice, work setting, amount of forensic practice, state, and region of country. Neurologists are the number one referral source in institutions and in private practice, as well as for pediatric, adult, and lifespan practitioners. Learning disability is no longer among the top five conditions seen by pediatric neuropsychologists; traumatic brain injury and seizure disorder are common reasons for clinical evaluations at all age ranges. There is a continued increase in forensic practice and a clear consensus on the use of validity testing. There is a substantial interest in subspecialization board certification, with the greatest interest evident among postdoctoral trainees. Income satisfaction, job satisfaction, and work-life balance satisfaction are higher for men. Job satisfaction varies across general work setting and across age range of practice. Work-life balance satisfaction is moderately correlated with income satisfaction and job satisfaction. Again in this five-year interval survey, a substantial majority of respondents reported increased incomes, despite experiencing substantial negative practice effects related to changes in the US health care system. Numerous breakdowns related to income and professional activities are provided. Professional practice survey information continues to provide valuable perspectives regarding consistency and change in the activities, beliefs, and incomes of US clinical neuropsychologists.
Swiger, Pauline A; Patrician, Patricia A; Miltner, Rebecca S Susie; Raju, Dheeraj; Breckenridge-Sproat, Sara; Loan, Lori A
2017-09-01
The Practice Environment Scale of the Nursing Work Index (PES-NWI) is an instrument, which measures the nursing practice environment - defined as factors that enhance or attenuate a nurse's ability to practice nursing skillfully and deliver high quality care. The purpose of this paper is to provide an updated review of the Practice Environment Scale of the Nursing Work Index's use to date and provide recommendations that may be helpful to nursing leaders and researchers who plan to use this instrument. A narrative review of quantitative studies. PubMed, EMBASE, and the Cumulative Index to Nursing & Allied Health Literature were searched to identify relevant literature using the search terms, Practice Environment Scale of the Nursing Work Index and PES-NWI. Studies were included if they were published in English between 2010 and 2016 and focused on the relationship between the Practice Environment Scale of the Nursing Work Index and patient, nurse, or organizational outcomes. Data extraction focused on the reported survey scores and the significance and strength of the reported associations. Forty-six articles, from 28 countries, were included in this review. The majority reported significant findings between the nursing practice environment and outcomes. Although some modifications have been made, the instrument has remained primarily unchanged since its development. Most often, the scores regarding staffing and resource adequacy remained the lowest. The frequency of use of this instrument has remained high. Many researchers advocate for a move beyond the study of the connection between the Practice Environment Scale and nurse, patient, and organizational outcomes. Research should shift toward identifying interventions that improve the environment in which nurses practice and determining if changing the environment results in improved care quality. Published by Elsevier Ltd.
Metrics, Business Plans, and the Vanishing Public Good
ERIC Educational Resources Information Center
Tuchman, Gaye
2011-01-01
For at least 30 years, professional work has been changing. Even such once-elite professionals as doctors, lawyers, and professors have become subject to significant control. Single-practitioner medical practices have given way to group practices subject to the rules of insurance plans; lawyers join mammoth firms where paralegals time the steps…
Practical Recommendations for University Graduates' Readiness Formation to Occupational Mobility
ERIC Educational Resources Information Center
Yakhina, Zulfiya Sh.; Yakovlev, Sergey A.; Kozhevnikova, Natalya V.; Nuretdinova, Yuliya V.; Solovyeva, Natalya A.
2016-01-01
The research urgency is caused by the development of economic integration and demand for professionals able to adapt to constantly changing working conditions. The purpose of the paper is to develop practical recommendations on formation of University graduates' readiness to occupational mobility. A leading approach to the study is the…
The Changing Work of Teacher Educators in Aotearoa New Zealand: A View through Activity Theory
ERIC Educational Resources Information Center
Gunn, Alexandra C.; Hill, Mary F.; Berg, David; Haigh, Mavis
2016-01-01
The study of recruitment practices for teacher educators (TEs) in Aotearoa New Zealand (NZ) universities reveals the academic category of TE constituted along three related trajectories: a professional expert (not required to research), a traditional academic (not required to hold a teaching qualification or teacher's practicing certificate), and…
The Salient Beliefs Review: A New Instrument for Connecting Spirit and Work.
ERIC Educational Resources Information Center
Bloch, Deborah
2000-01-01
The Salient Beliefs Review is an instrument that examines seven dimensions (change, balance, energy, community, calling, harmony, and unity) in relation to behavior and workplace policies and practices. It can be used to measure the degree of congruence between individual beliefs and the perception of company policy and practices. (SK)
Climate Change: Implementing School Discipline Practices That Create a Positive School Climate
ERIC Educational Resources Information Center
Cardichon, Jessica; Roc, Martens
2013-01-01
Middle and high school students subjected to harsh school discipline policies and practices such as suspensions and expulsions are more likely to disengage from the classroom and course work, and increases their chances of dropping out, according to this new report from the Alliance for Excellent Education. The report recommends implementing…
Contemporary Practice in the Elementary Classroom: A Study of Change
ERIC Educational Resources Information Center
Thulson, Anne
2013-01-01
Elementary school is not too early to introduce contemporary art; young students are especially adept at learning by mimicry and embracing contemporary art practices, including site-specific works. Elementary students are poised and capable to comprehend and respond to contemporary art. Tangible products can be made within a conceptual,…
Training for Efficiency: Work, Time, and Systems-Based Practice in Medical Residency
ERIC Educational Resources Information Center
Szymczak, Julia E.; Bosk, Charles L.
2012-01-01
Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these…
How to Transform Teaching with Tablets
ERIC Educational Resources Information Center
Daccord, Tom; Reich, Justin
2015-01-01
Without a change in our technology integration strategies, there's no reason to expect that a new device will magically create new teaching practices. In some iPad classrooms, students are engaged in truly innovative work. On the whole, however, tablets are most often used to reproduce existing practices. To make the most of their investment in…
The Rise of the Embedded Designer in the Creative Industries
ERIC Educational Resources Information Center
Fleischmann, Katja; Daniel, Ryan
2015-01-01
Work practices in the creative industries have changed significantly since the turn of the twenty-first century. The design profession in particular has been influenced by rapidly emerging digital media practices and processes. While the design sector remains a significant source of employment, in recent years, there has been considerable growth…
Learning Styles and Vocational Education Practice. Practice Application Brief.
ERIC Educational Resources Information Center
Brown, Bettina Lankard
Learning styles and the creation of effective learning environments are of emerging significance in education as the changing nature of work requires higher-order thinking skills. Although learning style may be simply defined as the way people come to understand and remember information, the literature is filled with more complex definitions of…
VET Manager Identities: Culture, Philosophy and Professional Practice
ERIC Educational Resources Information Center
Foley, Annette
2011-01-01
Using a post-structural approach this article investigates the working lives of frontline managers in VET and how they negotiate change in their day to day practices and decision making. The article is organised around accounts made by managers from different types of Vocational Education and Training (VET) organisations, namely: Technical and…
From Dissemination to Propagation: A New Paradigm for Education Developers
ERIC Educational Resources Information Center
Froyd, Jeffrey E.; Henderson, Charles; Cole, Renée S.; Friedrichsen, Debra; Khatri, Raina; Stanford, Courtney
2017-01-01
Scholarly studies and national reports document failure of current efforts to achieve broad, sustained adoption of research-based instructional practices, despite compelling bodies of evidence supporting efficacy of many of these practices. The authors of this paper argue that many change agents who are working to promote systemic adoption of…
Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce
2009-03-01
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.
Innovation in ambulatory care: a collaborative approach to redesigning the health care workplace.
Johnson, Paula A; Bookman, Ann; Bailyn, Lotte; Harrington, Mona; Orton, Piper
2011-02-01
To improve the quality of patient care and work satisfaction of the physicians and staff at an ambulatory practice that had recently started an innovative model of clinical care for women. The authors used an inclusive process, collaborative interactive action research, to engage all physicians and staff members in assessing and redesigning their work environment. Based on key barriers to working effectively and integrating work and family identified in that process, a pilot project with new work practices and structures was developed, implemented, and evaluated. The work redesign process established cross-occupational care teams in specific clinical areas. Members of the teams built skills in assessing clinical operations in their practice areas, developed new levels of collaboration, and constructed new models of distributed leadership. The majority of participants reported an improvement in how their area functioned. Integrating work and family/personal life-particularly practices around flexible work arrangements-became an issue for team discussion and solutions, not a matter of individual accommodation by managers. By engaging the workforce, collaborative interactive action research can help achieve lasting change in the health care workplace and increase physicians' and staff members' work satisfaction. This "dual agenda" may be best achieved through a collaborative process where cross-occupational teams are responsible for workflow and outcomes and where the needs of patients and providers are integrated.
Video observation in HIT development: lessons learned on benefits and challenges.
Høstgaard, Anna Marie; Bertelsen, Pernille
2012-08-22
Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings. A multiple case study including nine case studies conducted by DaCHI researchers 2004-2011 using audio-visual, non-participant video observation for data collection within different healthcare settings. In HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices. The video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.
Echevarria, Mercedes
A knowledge translation project involving an academic-practice partnership and guided by action-oriented research was used for exploring barriers that impact management of homebound heart failure patients. The intervention process followed an action research model of interaction, self-reflection, response, and change in direction. External facilitators (academia) and internal facilitators (practice) worked with clinicians to identify a topic for improvement, explore barriers, locate the evidence compare current practice against evidence-based practice recommendations, introduce strategies to "close the gap" between actual practice and the desired practice, develop audit criteria, and reevaluate the impact.
NASA Astrophysics Data System (ADS)
Josephy, Richard
1986-07-01
For some years there has been a growing recognition of the need for changes in assessment patterns in school science. These changes include a move towards criterion-based assessment linking to objectives and an increased emphasis on the assessment of practical and experimental skills. These changes are, to a significant extent, embodied in the new GCSE assessment schemes and will thus affect all students and teachers of physics from September (1986). At least 20% of the total assessment in GCSE physics examinations must be of practical and experimental skills, and at least half of this must be carried out in the laboratory environment. One development which addresses the needs and problems outlined above is the science component of OCEA, the Oxford Certificate of Educational Achievement. Because this covers a much wider field than assessment of practical and experimental skills in physics, a brief description of the whole project is given.
Cunha-Cruz, Joana; Milgrom, Peter; Huebner, Colleen E; Scott, JoAnna; Ludwig, Sharity; Dysert, Jeanne; Mitchell, Melissa; Allen, Gary; Shirtcliff, R Mike
2017-12-20
Dental care delivery systems in the United States are consolidating and large practice organizations are becoming more common. At the same time, greater accountability for addressing disparities in access to care is being demanded when public funds are used to pay for care. As change occurs within these new practice structures, attempts to implement change in the delivery system may be hampered by failure to understand the organizational climate or fail to prepare employees to accommodate new goals or processes. Studies of organizational behavior within oral health care are sparse and have not addressed consolidation of current delivery systems. The objective of this case study was to assess organizational readiness for implementing change in a large dental care organization consisting of staff model clinics and affiliated dental practices and test associations of readiness with workforce characteristics and work environment. A dental care organization implemented a multifaceted quality improvement program, called PREDICT, in which community-based mobile and clinic-based dental services were integrated and the team compensated based in part on meeting performance targets. Dental care providers and supporting staff members (N = 181) were surveyed before program implementation and organizational readiness for implementing change (ORIC) was assessed by two 5-point scales: change commitment and efficacy. Providers and staff demonstrated high organizational readiness for change. Median change commitment was 3.8 (Interquartile range [IQR]: 3.3-4.3) and change efficacy was 3.8 (IQR: 3.0-4.2). In the adjusted regression model, change commitment was associated with organizational climate, support for methods to arrest tooth decay and was inversely related to office chaos. Change efficacy was associated with organizational climate, support for the company's mission and was inversely related to burnout. Each unit increase in the organizational climate scale predicted 0.45 and 0.8-unit increases in change commitment and change efficacy. The survey identified positive readiness for change and highlighted weaknesses that are important cautions for this organization and others initiating change. Future studies will examine how organizational readiness to change, workforce characteristics and work environment influenced successful implementation within this organization.
Adam, Kerry; Gibson, Elizabeth; Lyle, Alexandra; Strong, Jenny
2010-01-01
This paper will explore the development of occupational therapists' and physiotherapists' roles in work related practice from an early focus on rehabilitation of injured workers, to one including prevention and health promotion. A review of international evidence identified the roles, tasks and employment paths for occupational therapists and physiotherapists in work related practice. The relationship between government regulation and therapists' access to the workplace was also examined. Occupational therapists and physiotherapists hold valued positions in work related professional practice. Whilst initially their roles were based on injury management through occupational rehabilitation, both professions have demonstrated a clear vision of the importance of prevention of work related injury and disease. Social and workplace changes in the late 1970s in a number of western countries, commencing with the Robens' reforms in the United Kingdom, led to improved legislation and regulation for managing occupational health and safety. The approach of both disciplines to practice in this field reflects their individual professional education. However, some role overlaps exists in consultancy activities in the industrial environment. Implementation of modern OHS regulatory programs in other western countries, including Australia, has increased and broadened the opportunities for therapists, as governments, employers and insurers support early intervention to minimise the impact of workplace injuries and diseases.
Employment experiences of vocationally trained doctors.
Osler, K
1991-01-01
OBJECTIVES--To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. DESIGN--Survey conducted by confidential postal questionnaire. SETTING--Britain. SUBJECTS--281 doctors, 233 (83%) of whom responded. MAIN OUTCOME MEASURES--Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. RESULTS--77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. CONCLUSIONS--Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children. PMID:1932939
Employment experiences of vocationally trained doctors.
Osler, K
1991-09-28
To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. Survey conducted by confidential postal questionnaire. Britain. 281 doctors, 233 (83%) of whom responded. Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. 77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children.
Ellard, David R; Chimwaza, Wanangwa; Davies, David; O'Hare, Joseph Paul; Kamwendo, Francis; Quenby, Siobhan; Griffiths, Frances
2014-01-01
Objectives The ‘enhancing human resources and the use of appropriate technologies for maternal and perinatal survival in sub-Saharan Africa’ (ETATMBA) project is training emergency obstetric and new-born care (EmONC) non-physician clinicians (NPCs) as advanced clinical leaders. Our objectives were to evaluate the implementation and changes to practice. Design A mixed methods process evaluation with the predominate methodology being qualitative. Setting Rural and urban hospitals in 8 of the 14 districts of northern and central Malawi. Participants 54 EmONC NPCs with 3 years’ plus experience. Intervention Training designed and delivered by clinicians from the UK and Malawi; it is a 2-year plus package of training (classroom, mentorship and assignments). Results We conducted 79 trainee interviews over three time points during the training, as well as a convenience sample of 10 colleagues, 7 district officers and 2 UK obstetricians. Trainees worked in a context of substantial variation in the rates of maternal and neonatal deaths between districts. Training reached trainees working across the target regions. For 46 trainees (8 dropped out of the course), dose delivered in terms of attendance was high and all 46 spent time working alongside an obstetrician. In early interviews trainees recalled course content unprompted indicating training had been received. Colleagues and district officers reported cascading of knowledge and initial changes in practice indicating early implementation. By asking trainees to describe actual cases we found they had implemented new knowledge and skills. These included life-saving interventions for postpartum haemorrhage and eclampsia. Trainees identified the leadership training as enabling them to confidently change their own practice and initiate change in their health facility. Conclusions This process evaluation suggests that trainees have made positive changes in their practice. Clear impacts on maternal and perinatal mortality are yet to be elucidated. PMID:25116455
How Work-Family Research Can Finally Have an Impact in Organizations.
Kossek, Ellen Ernst; Baltes, Boris B; Matthews, Russell A
2011-09-01
Although work-family research has mushroomed over the past several decades, an implementation gap persists in putting work-family research into practice. Because of this, work-family researchers have not made a significant impact in improving the lives of employees relative to the amount of research that has been conducted. The goal of this article is to clarify areas where implementation gaps between work-family research and practice are prevalent, discuss the importance of reducing these gaps, and make the case that both better and different research should be conducted. We recommend several alternative but complementary actions for the work-family researcher: (a) work with organizations to study their policy and practice implementation efforts, (b) focus on the impact of rapid technological advances that are blurring work-family boundaries, (c) conduct research to empower the individual to self-manage the work-family interface, and (d) engage in advocacy and collaborative policy research to change institutional contexts and break down silos. Increased partnerships between industrial-organizational (I-O) psychology practitioners and researchers from many industries and disciplines could break down silos that we see as limiting development of the field.
Dental therapy practice patterns in Minnesota: a baseline study.
Blue, Christine M; Kaylor, Mary Beth
2016-10-01
A chronic shortage of dentists, the importance of oral health, and the lack of access to care led to the introduction of a new oral health practitioner in Minnesota, the dental therapist. Dental therapy graduates from the University of Minnesota have been in practice since 2012. To date, there has been no formal study of how they have been incorporated into dental practice. The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed. Four dental practices were sampled purposefully to obtain various practice types and geographic locations within Minnesota. Secondary data were collected from practice management software databases in each practice between January-March, 2015. Data were used to describe the work undertaken by dental therapists, the types of patients seen and payer mix. Additionally, data from 6 months before and after employment of the dental therapist were collected to determine whether dentists' practice patterns changed after a dental therapist was employed. Dental therapists were employed full-time, seeing an average of 6.8 patients per day. No distinct pattern emerged with regard to ages of patients seen by dental therapists. Dental therapists saw up to 90% of uninsured patients or patients on public assistance. Restorative services across practices comprised an average of 68% of work undertaken by dental therapists. Dentists delegated a full range of procedures within the dental therapy scope of practice indicating trust and acceptance of dental therapists. Dentists in two practices began to take on more complex dental procedures after a dental therapist joined the practice. Dental therapists are treating a high number of uninsured and underinsured patients, suggesting that they are expanding access to dental care in rural and metropolitan areas of Minnesota. Dentists appear to have an adequate workload for dental therapists and are delegating a full range of procedures within their scope of practice. Dentists performed fewer restorative and preventive procedures after a DT was hired. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
ERIC Educational Resources Information Center
Cox, Pamela J.; Lang, Karen S.; Townsend, Stephanie M.; Campbell, Rebecca
2010-01-01
Social work practice has long focused on the connections between an individual and the social environment that affect the individual's social functioning. The Rape Prevention and Education (RPE) Program's theory model, Creating Safer Communities: The Rape Prevention and Education Model of Community Change, provides family social workers with a…
Gender differences in dentists' working practices and job satisfaction.
Ayers, Kathryn M S; Thomson, W Murray; Rich, Alison M; Newton, J Timothy
2008-05-01
To describe the working practices and level of job satisfaction of male and female dentists. A nationwide postal survey of all dentists holding an annual practising certificate in New Zealand (response rate 78.1%). The mean number of hours worked per week was 29.1 for female and 36.0 for male dentists. The main reason for part-time practice given by women was caring for children (cited by 67.2%) and for men was personal choice (cited by 63.6%). A greater proportion of females than males were employed on a salary or as an associate in practice rather than owning their own practice. Male dentists were more active in continuing education than females. The mean career satisfaction score for male respondents was 7.6 and for females 7.1 (P<0.001). Relatively more women than men had taken a career break, usually for child rearing. Two-thirds of women and one-third of men planned to retire from dentistry before 60 years of age. Male and female dentists differ in their working patterns and career satisfaction. There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change.
Enacting Work Space in the Flow: Sensemaking about Mobile Practices and Blurring Boundaries
ERIC Educational Resources Information Center
Davis, Loni
2013-01-01
An increasing portion of the contemporary workforce is using mobile devices to create new kinds of work-space flows characterized by emergence, liquidity, and the blurring of all kinds of boundaries. This changes the traditional notion of the term "workplace." The present study focuses on how people enact and make sense of new work space…
ERIC Educational Resources Information Center
Berzin, Stephanie Cosner; O'Connor, Sarah
2010-01-01
School social work takes place within the dynamic context of the educational landscape, yet research indicates that school social work practice has been slow to adjust to the demands of that landscape. Little research has assessed whether school social workers are being adequately prepared to address the educational shifts that underlie today's…
ERIC Educational Resources Information Center
Dipeolu, Abiola O.; Storlie, Cassandra; Johnson, Carol
2015-01-01
The transition from college to work is a challenging time for students with autism spectrum disorder. College counselors who understand the challenges students face adjusting to the world of work can position themselves to be change agents for this population. This article illuminates the challenges facing these students to help close the…
Language in the World of Work.
ERIC Educational Resources Information Center
Campbell, Jeff H.
In 1980, Midwestern State University (Texas), a typical college in several respects, held a series of panel discussions aimed at making students aware of the practicality and applicability of language study. Originally conceived as a "work fair" that would help recruit English majors, exigencies of a changing academic situation and the English…
Changes in Teachers' Beliefs and Practices in Technology-Rich Classrooms.
ERIC Educational Resources Information Center
Dwyer, David C.; And Others
1991-01-01
The Apple Classrooms of Tomorrow (ACOT) project is a flexible consortium of researchers, educators, students, and parents who have worked collaboratively to create and study innovative learning environments since 1985. ACOT classrooms are true multimedia environments where students move from competitive work patterns toward collaborative ones. (10…
A Work Revolution in U.S. Industry.
ERIC Educational Resources Information Center
Business Week, 1983
1983-01-01
Changes in work rules are moving the workplace away from rigid labor practices created by labor/management. A more flexible structure is evolving that can adapt to new technology and provide new products at competitive cost. Discusses the movement and the impact of international competition/deregulation on the trend. (JN)
Bluth, Edward I; Muroff, Lawrence R; Cernigliaro, Joseph G; Moore, Arl V; Smith, Geoffrey G; Flug, Jonathan; DeStigter, Kristen K; Allen, Bibb; Thorwarth, William T; Roberts, Anne C
2015-05-01
The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function. In contrast, the majority of academic medical school practices expect little or no impact. Residents and fellows should not expect work time off or protected time to study for the certifying examination or for their maintenance of certification examinations in the future. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Collaboration Best Practices Today and in the Future
NASA Technical Reports Server (NTRS)
Soderstrom, Thomas J.
2006-01-01
This viewgraph presentation reviews the idea of collaboration in the work place and changes that are occurring and the direction that these changes will take collaboration.. The new style of collaboration is driven by the new generation and the expected retirement of the baby boom generation.
Epele, Maria E
2010-03-01
Closely linked to the increase in psychotropic pill consumption, forgetting and remembering emerged from devastated social scenarios as a new local idiom among poor youth in the late 1990s and the new millennium. Drawing on ethnographic fieldwork carried out during the years of the deepest economic crisis in Argentina (2001-03), I argue that psychotropic pill consumption is associated with not only deteriorating economic conditions but also changes in the quality and price of cocaine, and in the scarcity and subsequent change of status of medications during the economic breakdown. Taking into account developments in the field of memory studies, I examine the relationship among political economy, social memory work, and changing drug-use practices. Regarding memory as a social practice, I argue that the growth of psychotropic pill consumption in the late 1990s can be understood through the interplay of Paul Ricoeur's notions regarding different kinds and levels of forgetting. By analyzing changing survival strategies, social network dismantlement, changing mortality patterns, and abusive police repression, I discuss how social fragmentation engendered by structural reforms has modified social memory work.
Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison
2015-08-01
Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n = 9), followed by telephone interviews with their line managers ( n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.
Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison
2015-01-01
Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions. Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased. PMID:26321786
The development of professional practice standards for Australian general practice nurses.
Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine
2017-08-01
The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.
Topics to ponder: Part-time practice and pay parity.
Tracy, Erin E; Wiler, Jennifer L; Holschen, Jolie C; Patel, Soha Sumanchandra; Ligda, Kristin Ondecko
2010-08-01
The medical profession has undergone a significant demographic change, with a dramatic increase in the number of women applying to medical school and practicing medicine. In recognition of the changing demographics in the medical profession, the American Medical Association's Women Physicians Congress (AMA-WPC) conducted a members' survey to identify the issues affecting women physicians and to ascertain certain practice characteristics. In 2008, an e-mail survey link was sent to a randomly selected nationwide sample of 4992 WPC members, and a second, identical survey was sent to 596 female AMA members, utilizing the Epocrates database (Epocrates, Inc., San Mateo, California). Two e-mail reminders were sent for the first survey, which had a 15% response rate. A quota of 148 physicians was received within 4 days and was utilized to interpret results from the second survey. Achieving work-life balance was a significant concern for 91% of the respondents (n = 884). Half of the respondents believed that pay is gender neutral, and 28% indicated that they were "somewhat or very concerned about sexual harassment". When queried regarding practice patterns, 29% of respondents indicated that they had worked part-time at some point during their careers. In this survey, women physicians indicated that gender pay disparity and sexual harassment remain important issues in the medical profession. Less than a third of respondents had ever worked part-time, which should be a consideration for physician workforce studies. Barriers to part-time practice may exist. Copyright © 2010 Excerpta Medica Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Niepold, F., III; Crim, H.; Fiorile, G.; Eldadah, S.
2017-12-01
Since 2012, the Climate and Energy Literacy community have realized that as cities, nations and the international community seek solutions to global climate change over the coming decades, a more comprehensive, interdisciplinary approach to climate literacy—one that includes economic and social considerations—will play a vital role in knowledgeable planning, decision-making, and governance. City, county and state leaders are now leading the American response to a changing climate by incubating social innovation to prevail in the face of unprecedented change. Cities are beginning to realize the importance of critical investments to support the policies and strategies that will foster the climate literacy necessary for citizens to understand the urgency of climate actions and to succeed in a resilient post-carbon economy and develop the related workforce. Over decade of federal and non-profit Climate Change Education effective methods have been developed that can support municipality's significant educational capabilities for the purpose of strengthening and scaling city, state, business, and education actions designed to sustain and effectively address this significant social change. Looking to foster the effective and innovative strategies that will enable their communities several networks have collaborated to identify recommendations for effective education and communication practices when working with different types of audiences. U.S. National Science Foundation funded Climate Change Education Partnership (CCEP) Alliance, the National Wildlife Federation, NOAA Climate Program Office, Tri-Agency Climate Change Education Collaborative and the Climate Literacy and Energy Awareness Network (CLEAN) are working to develop a new web portal that will highlight "effective" practices that includes the acquisition and use of climate change knowledge to inform decision-making. The purpose of the web portal is to transfer effective practice to support communities to be empowered to address the challenges of a new climate reality and ensure that all people are capable of taking an active role in shaping a sustainable future.
Cox, S S; Langhout, K J; Scheid, R C
1993-01-01
This article utilizes findings from the Ohio Dental Hygiene Survey and Ohio Dentist Survey to uncover what specific dental hygiene attitudes exist relative to employment and what factors have led to job termination and to re-entry. Ohio dental hygiene employees are most satisfied with patient relationships, co-worker relationships, and flexible working hours. The dental hygienists are least satisfied with fringe benefits, financial growth, and career creativity. Salary, benefits, nor career longevity were significant factors in determining satisfaction. Dental hygienists who were not working when surveyed, said they would consider returning to practice if a better salary were available, if they could find part-time work, if there were a good wage scale with benefits, or if their own financial need changed. Thirty-six percent of the non-practitioners said they would not ever consider returning to practice due to working conditions, establishment of a new career, or inadequate compensation. Dentist employers stated that they were satisfied or very satisfied with their dental hygienists' patient care and contribution to the practice.
A method for assessing work productivity and flexibility in livestock farms.
Hostiou, N; Dedieu, B
2012-05-01
Changes affecting livestock farming systems have made farm work a central concern for both the sector and for farmers themselves. Increased pressure on farms to be competitive and productive together with farmers' demand for greater autonomy, holidays or time to spend on private activities and the family converge to underline the two key dimensions of work - productivity and flexibility - required for the assessment of work organization. This paper proposes a method called the QuaeWork (QUAlification and Evaluation of Work in livestock farms) to assess work productivity and flexibility on a farm, and its use to identify how livestock management can contribute to work organization on dairy farms. The QuaeWork method was set up through an iterative process combining surveys conducted with farmers in two regions of France, discussions with different experts and literature review. The QuaeWork was applied on a sample of seven dairy farms in the southern Massif Central in France to identify patterns of how livestock management contributes to work organization. The QuaeWork was used to analyse work organization over the year through a systemic approach to the farm, integrating interactions between herd and land management, workforce composition, equipment facilities and combinations of activities through a characterization of 'who does what, when and for how long'. The criteria for assessing work productivity were work duration (routine work, seasonal work) and work efficiency (per livestock unit or hectare of utilized agricultural area). The criteria for assessing work flexibility were room for manoeuvre and adjustments to internal and external events. The three main patterns of livestock management practices to work organization were identified. In pattern-1, farmers used indoor stable feeding practices with delegated work, with moderate room for manoeuvre and efficiency. In pattern-3, farmers used simplified milking, reproduction and breeding practices to seasonalize work and make it efficient with consistent room for manoeuvre. The method suggests social sustainability criteria to assess work productivity and flexibility, which are important for making reasoned decisions on livestock farm changes, especially innovations. Researchers could usefully exploit the QuaeWork to integrate work objectives (productivity, flexibility) into technical and economic goals.
Courses offered by the Minas Health Channel: perception of primary care workers.
Pereira, Lizziane D' Ávila; Sena, Roseni Rosângela de
2016-06-01
To analyse how primary healthcare workers perceive the impact of the Health Channel Mines courses in their work process. This is a descriptive exploratory qualitative study conducted with 38 professionals working in primary health care units of three municipalities in the state of Minas Gerais, Brazil. Data were collected in 2014 by means of semi-structured interviews and subjected to thematic content analysis. Data analysis revealed the following three categories: interest in training and its contribution to professional practice; factors that alter professional practices; and proposals for improvement. The study data demonstrated that the Mines Health Channel courses cannot single-handedly change professional practices. Continued and refresher education resources that enable the exchange and articulation of knowledge between the various specialities are needed to transform professional practices.
ERIC Educational Resources Information Center
Mutsune, Myra Kanaidza
Until 1982, achievement in A-level biology in Kenya was measured by an examination which consisted of four papers, three measuring theory work and one measuring practical skills. In 1982, a three paper examination was developed, the first two papers measuring theory and the third paper measuring practical skills. Based on the change in the test…
Aiken, Alice
2012-01-01
This article provides an overview of work done in Canada involving the use of physiotherapists in models of collaborative care to enhance orthopedic care and practice. Valuable lessons learned and an important model of collaborative care are summarized. The research around these models of care has also contributed to important scope of practice changes for the profession of physiotherapy.
Dilley, Julia A; Reuer, Jennifer R; Colman, Victor; Norman, Robbi Kay
2009-04-01
Steps to a Healthier Washington, in collaboration with other programs in the Washington State Department of Health and external partners, has implemented training to improve public health practice and create greater organizational and staff capacity for promoting effective policy and systems changes, including reducing disparities. The training is grounded in behavior change and adult learning theories. A comprehensive post training evaluation found long-term improvements in self-efficacy, reported changes in work, and attribution of those changes to the training. Organizations working to refocus public health work on policy and systems change should consider providing skills-based policy training to their staff. This study suggests that an integrated training, using adult learning theory, has led to long-term improvements in capacity among public health staff and partners.
Perry, Lin; Bellchambers, Helen; Howie, Andrew; Moxey, Annette; Parkinson, Lynne; Capra, Sandra; Byles, Julie
2011-10-01
This study examined the relevance and fit of the PARiHS framework (Promoting Action on Research Implementation in Health Services) as an explanatory model for practice change in residential aged care. Translation of research knowledge into routine practice is a complex matter in health and social care environments. Examination of the environment may identify factors likely to support and hinder practice change, inform strategy development, predict and explain successful uptake of new ways of working. Frameworks to enable this have been described but none has been tested in residential aged care. This paper reports preliminary qualitative analyses from the Encouraging Best Practice in Residential Aged Care Nutrition and Hydration project conducted in New South Wales in 2007-2009. We examined congruence with the PARiHS framework of factors staff described as influential for practice change during 29 digitally recorded and transcribed staff interviews and meetings at three facilities. Unique features of the setting were flagged, with facilities simultaneously filling the roles of residents' home, staff's workplace and businesses. Participants discussed many of the same characteristics identified by the PARiHS framework, but in addition temporal dimensions of practice change were flagged. Overall factors described by staff as important for practice change in aged care settings showed good fit with those of the PARiHS framework. This framework can be recommended for use in this setting. Widespread adoption will enable cross-project and international synthesis of findings, a major step towards building a cumulative science of knowledge translation and practice change. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina
2009-01-01
The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.
ACOG committee opinion number 398, February 2008: fatigue and patient safety.
2008-02-01
It has long been recognized that fatigue can affect human cognitive and physical function. Although there are limited published data on the effects of fatigue on health care providers, including full-time practicing physicians, there is increasing awareness within the patient safety movement that fatigue, even partial sleep deprivation, impairs performance. Most of the current literature reviews resident function after recent work reform changes. However, the information available from many studies in health care and other occupations can be applied to the work habits of practicing obstetrician-gynecologists.
Schroeder, Krista; Kulage, Kristine M; Lucero, Robert
2015-10-01
We apply Critical Theory to examine menu labeling with the aim of uncovering important implications for nursing practice, research, and policy. Our critical analysis uncovers barriers to menu labeling's effectiveness, particularly for vulnerable populations. Nurses must work to minimize the impact of these barriers and optimize the effectiveness of menu labeling, in order to strengthen the fight against obesity. We suggest changes, guided by this critical analysis, which can be implemented by nurses working in clinical practice, research, and policy. © 2015, Wiley Periodicals, Inc.
Artificial intelligence in medicine: the challenges ahead.
Coiera, E W
1996-01-01
The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change.
Adaptive trials for tuberculosis: early reflections on theory and practice.
Montgomery, C M
2016-08-01
Adaptive designs (ADs) have been proposed for anti-tuberculosis treatment trials. This call for innovation occurs against the backdrop of fundamental changes in the acceptable evidence base in anti-tuberculosis treatment. To contextualise ADs for tuberculosis (TB) and explore early responses from those working in the field. In this qualitative study investigating processes of theoretical and practical change in randomised controlled trials, 24 interviews were conducted with professionals involved in AD trials, half of whom worked in the TB field. Clinical trialists working on AD trials in TB are positive about the efficiency these designs offer, but remain cautious about their suitability. In addition to technical concerns, informants discussed the challenges of implementing AD in developing countries, including limited regulatory capacity to evaluate proposals, investments needed in infrastructure and site capacity, and challenges regarding informed consent. Respondents identified funding, interdisciplinary communication and regulatory and policy responses as additional concerns potentially affecting the success of AD for TB. Empirical research is needed into patient experiences of AD, including informed consent. Further consideration of the contexts of innovation in trial design is needed. These are fundamental to the successful translation of theory into practice.
Health Educators' Perceptions of a Sexual Health Intervention for Homeless Adolescents
Rew, Lynn; Rochlen, Aaron B.; Murphey, Christina
2008-01-01
Objective The purpose of this qualitative descriptive study was to explore the perceptions and experiences of health educators in providing a brief, street-based intervention to homeless adolescents. Method Qualitative data were collected via e-mail from a purposive sample of 13 male and female health educators who provided the intervention and analyzed using manifest and latent content analysis techniques. Results Five categories with two or more subcategories were identified in the data and included how the educators' views changed, how they felt homeless youth were similar to and different from other adolescents, positive aspects and challenges of providing the intervention, and suggestions for future interventionists working with this population. Conclusions The health educators' practice was strengthened over the course of providing the intervention through their positive experiences, changes in their perceptions, some of which were biased, and ability to confront the challenges that accompany working with this vulnerable population. Practice Implications Health educators who work with this population should learn about the culture of homeless youth and characteristics of homeless youth that may influence their participation in a sexual health intervention. Moreover, they need to be non-judgmental, practice the intervention, be aware of their biases, and remain flexible. PMID:18343623
Changing behavior towards sustainable practices using Information Technology.
Iveroth, Einar; Bengtsson, Fredrik
2014-06-15
This article addresses the question of how to change individuals' behavior towards more sustainable practices using Information Technology (IT). By following a multidisciplinary and socio-technical perspective, this inquiry is answered by applying a new framework-The Commonality Framework for IT-enabled Change-on a case study of sustainable behavioral change. The framework is grounded in practice theory and is used to analyze the implementation of an IT-system aimed at changing citizens' behavior towards more sustainable transport logistics and procurement in Uppsala, Sweden. The article applies case study research design and the empirical data consists of surveys, in-depth and semi-structured interviews, observations and archival documents. The results show how the change towards sustainable practices is an entanglement of both social and technical-structural elements across time. In this process, structures such as IT are the enablers, and the actors and their social activities are the tipping-point factors that ultimately determine the success of changing individuals' behavior towards a more sustainable direction. This article provides a more balanced view of how both actor and structure related properties interact during the on-going work with change towards greater sustainability practices than earlier research has offered. More specifically, the article offers both a lower-level theory and a method from which we can analyze change processes where technology is seen in its context, and where both technology and the human actor is brought forth to center stage. Copyright © 2014 Elsevier Ltd. All rights reserved.
Coleman, Mary Thoesen; Nasraty, Soraya; Ostapchuk, Michael; Wheeler, Stephen; Looney, Stephen; Rhodes, Sandra
2003-05-01
The Accreditation Council for Graduate Medical Education (ACGME) recommends integrating improvement activities into residency training. A curricular change was designed at the Department of Family and Community Medicine, University of Louisville, to address selected ACGME competencies by incorporating practice-based improvement activities into the routine clinical work of family medicine residents. Teams of residents, faculty, and office staff completed clinical improvement projects at three ambulatory care training sites. Residents were given academic credit for participation in team meetings. After 6 months, residents presented results to faculty, medical students, other residents, and staff from all three training sites. Residents, staff, and faculty were recognized for their participation. Resident teams demonstrated ACGME competencies in practice-based improvement: Chart audits indicated improvement in clinical projects; quality improvement tools demonstrated analysis of root causes and understanding of the process; plan-do-study-act cycle worksheets demonstrated the change process. Improvement activities that affect patient care and demonstrate selected ACGME competencies can be successfully incorporated into the daily work of family medicine residents.
Creating Possibilities: Studying the Student Experience
ERIC Educational Resources Information Center
Ryerson, Rachel
2017-01-01
Background: How can educators and students partner in the work of making transformational changes in schools and school systems? This paper will address how teacher researchers, funded by the Ontario Ministry of Education in Canada, have studied the student experience to generate evidence. It will outline changes in practice and benefits for…
International Handbook of Research on Conceptual Change
ERIC Educational Resources Information Center
Vosniadou, Stella
2008-01-01
The study of conceptual change traces its heritage to the notions of paradigm (networks of shared beliefs, concepts, practices) and paradigm shift made famous by Thomas Kuhn in his book, "The Structure of Scientific Revolutions". Kuhn's work was quickly linked to developmental psychology (how knowledge develops) and to science education (teaching…
Contextualized Support for Urban Teachers Implementing Writer's Workshop
ERIC Educational Resources Information Center
Kaiser, Eileen
2013-01-01
Gladwell (2000) describes context as "the tipping point" for leveraging change. This paper explores how differentiated learning opportunities situated in the school context supported changes in practice for urban elementary teachers during the implementation of Writer's Work-shop (Calkins, 2003 & 2006). The teachers in this…
Conflict in Staff Development Implementation: A Case Study
ERIC Educational Resources Information Center
Ponticell, Judith A.; Thomas, Julie A.; Cooper, Sandra B.
2006-01-01
Staff development is aimed at changing practice. Change creates conflict. Little work has been done to gain insight into the conflict that teachers experience in the implementation of staff development. This study examines conflict in a staff development project aimed at increasing teachers' knowledge and implementation of problem-based integrated…
TQM--Will It Work in Your Library?
ERIC Educational Resources Information Center
Butcher, Karyle
Scarce resources, changing customer expectation, and the changing role of top management are all factors that have contributed to the implementation of total quality management (TQM) in libraries. Instructional articles, conferences, and videos can alleviate some concerns of cost and time commitment. Many libraries already practice some of the…
Examining Increased Flexibility in Assessment Formats
ERIC Educational Resources Information Center
Irwin, Brian; Hepplestone, Stuart
2012-01-01
There have been calls in the literature for changes to assessment practices in higher education, to increase flexibility and give learners more control over the assessment process. This article explores the possibilities of allowing student choice in the format used to present their work, as a starting point for changing assessment, based on…
UCLA Working Group on Public Catalogs. Final Report.
ERIC Educational Resources Information Center
Aroeste, Jean; And Others
Though recent technological developments have promised solutions to the costly problems of expanding card catalogs and changing cataloging practices, at the University of California libraries the problems have been compounded by a desire to stay compatible with the changing conventions of the Library of Congress and by an increasingly stringent…
Curriculum Model for Optometry: Outcomes of the Process.
ERIC Educational Resources Information Center
Berman, Morris S.
1994-01-01
A national conference of colleges of optometry focused on planning for optometric curricular reform and faculty development. Issues addressed included changes needed to meet entry-level professional needs, available resources, changes in optometry practice, and optometry's role in health care reform. Task forces worked together to develop a…
Mobile work: Ergonomics in a rapidly changing work environment.
Honan, Meg
2015-01-01
Places of work have been completely transformed by innovations in mobile work tools and ever-present access to internet data. This article characterizes use patterns and provides preliminary considerations for productive and comfortable use of common mobile devices. Two surveys described trends in mobile work. In the first, ergonomics professionals who oversee programs reported common mobile devices, their users and what data is accessed. The second, an end user survey, explored common activities performed on mobile devices, duration of use and locations where mobile work is common. The survey results provide a baseline data point for the status of mobile work in early 2014. Research indicates that additional risks have been introduced to the neck, thumbs and hands when using mobile devices. Possible trends regarding device use and work locations emerge. Intervention studies provide some direction for the practitioner. Practical strategies are outlined to reduce exposure intensity and duration. Contemporary mobile work presents tremendous change and opportunity for ergonomists and researchers to keep pace with fitting the changing models of work to the person. Continued research is needed on current mobile device use patterns to better understand ergonomic risk exposure in this rapidly changing realm.
A Bold Experiment: Teachers Team with Scientists to Learn Next Generation Science Standards
ERIC Educational Resources Information Center
Gilman, Sharon L.; Fout, Martha C.
2017-01-01
The "Next Generation Science Standards" place an emphasis on the practices of science and engineering, where ensuring that students understand and experience how science works is as important as, or maybe more important than, memorizing facts. The idea is that, while some facts may change, the practices will always be applicable, and it…
Working with the Divides: Two Critical Axes in Development for Transformative Professional Practices
ERIC Educational Resources Information Center
Avery, Helen; Nordén, Birgitta
2017-01-01
Purpose: The paper aims to provide a conceptual map of how to mediate between sustainability theory and practice in higher education and how disciplinary divides can be bridged. It further looks at issues linked to knowledge views and drivers for institutional change that affect opportunities for whole institution development promoting action…
Theory to Practice through Teacher Inquiry Courses in a Graduate Program: Two Teachers' Perspectives
ERIC Educational Resources Information Center
Keat, Jane Blakely
2005-01-01
Our graduate degree program includes a component of six one-credit courses, in which teachers find ways to bring into their own classroom practices theory learned in related three-credit courses. Prior research indicates that taking course work alone may not bring about changes in teachers' decision-making. Prior research also encourages higher…
ERIC Educational Resources Information Center
Ottmar, Erin R.; Rimm-Kaufman, Sara E.; Larsen, Ross A.; Berry, Robert Q.
2015-01-01
This study investigates the effectiveness of the Responsive Classroom (RC) approach, a social and emotional learning intervention, on changing the relations between mathematics teacher and classroom inputs (mathematical knowledge for teaching [MKT] and standards-based mathematics teaching practices) and student mathematics achievement. Work was…
ERIC Educational Resources Information Center
Mårtensson, Katarina; Roxå, Torgny; Stensaker, Bjørn
2014-01-01
One of the main beliefs in quality assurance is that this activity--indirectly--will stimulate change in the work practices associated with teaching and learning in higher education. However, few studies have provided empirical evidence of the existence of such a link. Instead, quality assurance has created an unfortunate divide between formal…
Euro-NOTES Status Paper: from the concept to clinical practice.
Fuchs, K H; Meining, A; von Renteln, D; Fernandez-Esparrach, G; Breithaupt, W; Zornig, C; Lacy, A
2013-05-01
The concept of natural orifice transluminal endoscopic surgery (NOTES) consists of the reduction of access trauma by using a natural orifice access to the intra-abdominal cavity. This could possibly lead to less postoperative pain, quicker recovery from surgery, fewer postoperative complications, fewer wound infections, and fewer long-term problems such as hernias. The Euro-NOTES Foundation has organized yearly meetings to work on this concept to bring it safely into clinical practice. The aim of this Euro-NOTES status update is to assess the yearly scientific working group reports and provide an overview on the current clinical practice of NOTES procedures. After the Euro-NOTES meeting 2011 in Frankfurt, Germany, an analysis was started regarding the most important topics of the European working groups. All prospectively documented information was gathered from Euro-NOTES and D-NOTES working groups from 2007 to 2011. The top five topics were analyzed. The statements of the working group activities demonstrate the growing information and changing insights. The most important selected topics were infection issue, peritoneal access, education and training, platforms and new technology, closure, suture, and anastomosis. The focus on research topics changed over time. The principle of hybrid access has overcome the technical and safety limitations of pure NOTES. Currently the following NOTES access routes are established for several indications: transvaginal access for cholecystectomy, appendectomy and colon resections; transesophageal access for myotomy; transgastric access for full-thickness small-tumor resections; and transanal/transcolonic access for rectal and colon resections. NOTES and hybrid NOTES techniques have emerged for all natural orifices and were introduced into clinical practice with a good safety record. There are different indications for different natural orifices. Each technique has been optimized for the purpose of finding a safe and realistic solution to perform the procedure according to the specific indication.
Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue.
Shaw, William S; Main, Chris J; Pransky, Glenn; Nicholas, Michael K; Anema, Johannes R; Linton, Steven J
2016-12-01
Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.
In retrospect--a reflection on a 50-year research journey.
Howie, John G R
2014-02-01
This essay is a personal review of a research journey extending over 50 years during which time the understanding of medical practice has changed out of all recognition and the quality and standing of the discipline of general practice has improved substantially. Three main bodies of work are reviewed and set against the reasons why they were undertaken. The first, on the pathology of the appendix and the management of possible appendicitis, was carried out almost entirely in the hospital setting. The second, about the prescribing of antibiotics for respiratory illnesses, and the third, about the determinants of good consulting practice, were carried out in general practice. The essay concludes with a reflection on the relevance of the work to some contemporary academic and health service issues. Although the work was carried out in the UK in the context of its National Health Service (NHS), the conclusions are widely generalizable and have contributed to health service and academic developments in many other countries.
Stacey, G; Baldwin, V; Thompson, B; Aubeeluck, A
2018-05-21
Negative attitudes exist in practice towards those with a diagnosis of personality disorder. Preregistration training offers the opportunity to address this by developing understanding of the diagnosis, confidence in working with people with the diagnosis and empowering new nurses to challenge prevailing attitudes. Attempts to integrate and evaluate specific educational interventions of this nature into pre-registration nurse education have not been explored elsewhere. To explore preregistration nurses' experience of a programme of training focused on personality disorder and their perception of its influence on attitudes, understanding of clients and their experience of practice. A qualitative study using thematic analysis of two focus groups of pre-registration mental health nursing students. Evidence of positive attitudes and confidence to supportively challenge negative attitudes in practice were found. Students showed a shift away from a focus on changing the perceived 'difficult' behaviour of a client towards an understanding of their own emotional responses to the behaviours. The Knowledge and Understanding Framework training shows potential for students to change attitudes and develop progressive practice working with people with personality disorder. The integration of the Knowledge and Understanding Framework should be considered as part of preregistration training. Further research into the sustained influence of the training post registration is required. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
ERIC Educational Resources Information Center
Parkes, Sarah; Young, Julie Blackwell; Cleaver, Elizabeth; Archibald, Kenny
2014-01-01
This research project explored how academic and professional personnel work together in new ways to deliver the best possible student experience. The project analysed why certain models of good working practice seemed to work well. The research investigated: how the change management process was perceived and managed by key stakeholders; the role…
Lunau, Thorsten; Dragano, Nico; Siegrist, Johannes; Wahrendorf, Morten
2017-10-01
In times of demographic change, maintaining health and employability of older employees is important. In this context, studies show that stressful working conditions differ by countries. Yet, it is unclear if specific national management practices to deal with these conditions contribute towards explaining country differences. This study combines two different data sources. The first one provides detailed information on psychosocial working conditions in 17 European countries, based on 12,284 employees from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA). We link this information to the second data source that provides information on health and safety management practices in each of the countries under study (collected among 17,477 managers at the level of companies in the Enterprise survey on new and emerging risks (ESENER)). We distinguish six different types of risk management procedures in the analysis. Results show that levels of psychosocial risks are generally lower in countries with more developed management practices, in particular if national management practices are marked by (1) procedures to deal with work stress, (2) information about whom to address in case of work-related psychosocial problems, and (3) health and safety services provided by psychologists. The findings underline the importance of a comprehensive psychosocial risk management approach in reducing work-related stress, as lower levels of psychosocial risks are linked to specific psychosocial risk management practices within companies, in particular those pointing to clear responsibilities and coordinated procedures in dealing with psychosocial risks.
Navigating change: how outreach facilitators can help clinicians improve patient outcomes.
Laferriere, Dianne; Liddy, Clare; Nash, Kate; Hogg, William
2012-01-01
The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care. We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program. Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care. Outreach facilitation can be an effective method of assisting and supporting practices to make the changes necessary to improve processes and delivery of care. Multiple jurisdictions use outreach facilitation for system redesign, improved efficiencies, and advanced access. The development and implementation of quality improvement programs using practice facilitation can be challenging. Our research team has learned valuable lessons in developing tools, finding resources, and assisting practices to reach their quality improvement goals. These lessons can lead to improved experiences for the practices and overall improved outcomes for the patients they serve.
Changing Trends and Practices in Cytopathology.
Gonzalez, Maria F; Akhtar, Israh; Manucha, Varsha
2017-01-01
To explore the current and anticipated changes in the practice of cytopathology. The present review is based on a review of recent literature and an evaluation of the authors' personal experiences. In recent years the practice of cytopathology, nationwide and in our institute, has witnessed a major change affecting gynecologic and nongynecologic cytology. There has been a decline in the number of Papanicolaou tests which has affected the utilization of cytotechnologists and provoked a reorganization of their work flow. The "need to do more with less" in the era of targeted therapy/personalized medicine has resulted in an increasing preference for needle core biopsy when performing a rapid on-site evaluation. We feel that this change is unavoidable. It is pertinent that cytopathologists as a group recognize this change and prepare themselves and the trainees not only to become adapt but also to use this as an opportunity to discover the yet unexplored world of cytology. © 2017 S. Karger AG, Basel.
Reskilled and "Running Ahead": Teachers in an International School Talk about Their Work
ERIC Educational Resources Information Center
Bailey, Lucy
2015-01-01
This article reports on a study of the professional identity of expatriate teachers working in an international school in Malaysia. It examines the practical, cultural and professional challenges they experienced as they transitioned to an international school setting. Their experiences of curricular, organisational and cultural change are…
Preparing for the Personal Side of Work.
ERIC Educational Resources Information Center
Burge, Penny L.
1989-01-01
Conflict between work and family roles can be stressful and damaging to the job performance of both sexes. Instruction in combining these roles will improve the quality of life, increase worker productivity, and enable workers to exert a constructive influence on business, industry, and government in stimulating changes in policy and practice. (SK)
ERIC Educational Resources Information Center
Asunka, Stephen
2011-01-01
In the present knowledge economy, individuals, particularly working adults, need to continuously acquire purposeful knowledge and skills so they can better contribute towards addressing society's ever-changing developmental challenges. In the developing world however, few opportunities exist for working adults to acquire such new learning…
Evaluation of the Recognizing and Responding to Suicide Risk Training
ERIC Educational Resources Information Center
Jacobson, Jodi Michelle; Osteen, Philip; Jones, Andrea; Berman, Alan
2012-01-01
Changes in attitudes, confidence, and practice behaviors were assessed among 452 clinicians who completed the training, Recognizing and Responding to Suicide Risk, and who work with clients at risk for suicide. Data were collected at three time points. Scores on measures of attitudes toward suicide prevention and confidence to work with clients at…
Professional Development for Family Learning Programmes: A Rationale and Outline Curriculum
ERIC Educational Resources Information Center
Heydon, Liz; Reilly, Jill
2007-01-01
Practice in working with parents is changing and communicating with parents is increasingly a part of teachers' responsibilities. Besides focusing on supporting their children's learning, many schools now involve parents in education for themselves. Yet despite the expectation that they will work to engage parents in their children's learning, in…
Reconsidering Interests: The Next Big Idea in Career Counseling Theory Research and Practice
ERIC Educational Resources Information Center
Chope, Robert C.
2011-01-01
A population of people that are living longer and working longer invite a reconsideration of interests and interest measurement as individuals make substantial changes in their vocational and avocational pursuits later in life. The relationship of interests to vocational hope and childhood exposure to work is also discussed.
The Learning Institute: Promoting Social Justice Advocacy within a Continuing Education Program
ERIC Educational Resources Information Center
Rice, Karen; Girvin, Heather; Frank, Jennifer; Foels, Leonora
2016-01-01
The pursuit of social justice is an overarching framework that defines the social work profession. The goals of macro social work practice are centered on issues of social justice with strategies that include changing community conditions and creating a sense of solidarity, with particular emphasis on broadening the opportunities for marginalized…
Use of Self in the Context of Youth Work
ERIC Educational Resources Information Center
Fusco, Dana
2012-01-01
Used in the education of counselors, nurses, occupational therapists and social workers, "use of self" is a way of understanding how practitioners bring about human change. In this article, the author discusses how use of self can be applied to youth work and is related to "developmentally responsive practice" thereby providing a deep theoretical…
Hart's Hardware and Supply: An Independent Consulting Dilemma
ERIC Educational Resources Information Center
Williams, Sandra L.
2017-01-01
The practice of Human Resource Development (HRD) work often occurs in consulting opportunities at ongoing businesses, agencies and non-profit organizations. These are the spaces where human resources development (HRD) consultants hone their skills and affect change in work settings. Consultants in HRD utilize skills not only across the HRD field…
Organizational factors associated with readiness for change in residential aged care settings.
von Treuer, Kathryn; Karantzas, Gery; McCabe, Marita; Mellor, David; Konis, Anastasia; Davison, Tanya E; O'Connor, Daniel
2018-02-01
Organizational change is inevitable in any workplace. Previous research has shown that leadership and a number of organizational climate and contextual variables can affect the adoption of change initiatives. The effect of these workplace variables is particularly important in stressful work sectors such as aged care where employees work with challenging older clients who frequently exhibit dementia and depression. This study sought to examine the effect of organizational climate and leadership variables on organizational readiness for change across 21 residential aged care facilities. Staff from each facility (N = 255) completed a self-report measure assessing organizational factors including organizational climate, leadership and readiness for change. A hierarchical regression model revealed that the organizational climate variables of work pressure, innovation, and transformational leadership were predictive of employee perceptions of organizational readiness for change. These findings suggest that within aged care facilities an organization's capacity to change their organizational climate and leadership practices may enhance an organization's readiness for change.
Towards multidisciplinary assessment of older people: exploring the change process.
Ross, Fiona; O'Tuathail, Claire; Stubberfield, Debbie
2005-04-01
This paper discusses the process of change that took place in an intervention study of standardized multidisciplinary assessment guidelines implemented in a female ward for older people in a District General Hospital in South London. This study was one of nine implementation projects in the South Thames Evidence-Based Practice Project. The relationship between the worlds of research and healthcare practice is uneasy and contested and, as such, is a breeding ground for challenging questions about how evidence can be used to foment change in clinical practice. Recent literature on change highlights the importance of understanding complexity, which informed our approach and analysis. A multifaceted approach to change that comprised evidence-based guidelines, leadership (project leader) and change management was evaluated before and after the implementation by telephone interviews with patients, a postal survey of community staff and interviews with ward staff. A diagnostic analysis of current assessment practice informed the change process. The project leader collected data on adherence. This paper draws on descriptive and qualitative data and addresses the links between contextual issues and the processes and pathways of change, informed by theoretical ideas from the change literature. Key themes emerged: working through others and across boundaries, managing uncertainty and unanticipated challenges. Adherence of ward staff to using the multidisciplinary assessment guidelines was high, with evidence of some dissemination to community staff at follow-up. Three years after the project finished the multidisciplinary assessment is still part of routine clinical practice. The analysis contributes to understanding about the nursing leadership of change within an interprofessional arena of practice. It highlights the importance of understanding the context in relation to the impact and sustainability of change and thus the utility of conducting a diagnostic analysis in the early stages of implementation. This has implications for developing approaches to change in nursing and interprofessional practice in other settings. Using research to change practice needs clinical leaders who are supported by the organization and have the skills to implement research evidence, manage uncertainty and build trust with a range of other professionals.
From theory to practice: integrating instructional technology into veterinary medical education.
Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; Herman, Cheryl; Miesner, Matt; Renter, David; Gehring, Ronette
2013-01-01
Technology has changed the landscape of teaching and learning. The integration of instructional technology into teaching for meaningful learning is an issue for all educators to consider. In this article, we introduce educational theories including constructivism, information-processing theory, and dual-coding theory, along with the seven principles of good practice in undergraduate education. We also discuss five practical instructional strategies and the relationship of these strategies to the educational theories. From theory to practice, the purpose of the article is to share our application of educational theory and practice to work toward more innovative teaching in veterinary medical education.
Gaskell, Lynne; Beaton, Susan
2010-09-01
This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008). (c) 2009 Elsevier Ltd. All rights reserved.
Nature and Scope of Certified Nurse-Midwifery Practice in One Large State in the United States.
Hastings-Tolsma, Marie; Wilcox Foster, Sarah; Brucker, Mary C; Nodine, Priscilla; Burpo, Rebecca; Camune, Barbara; Griggs, Jackie; Callahan, Tiffany J
2018-04-21
To describe the nature and scope of nurse-midwifery practice in Texas and to determine legislative priorities and practice barriers. Across the globe, midwives are the largest group of maternity care providers despite little known about midwifery practice. With a looming shortage of midwives, there is a pressing need to understand midwives' work environment and scope of practice. Mixed methods research utilizing prospective descriptive survey and interview. An online survey was administered to nurse-midwives practicing in the state of Texas (N=449) with a subset (n=10) telephone interviewed. Descriptive and inferential statistics and content analysis was performed. The survey was completed by 141 midwives with 8 interviewed. Most were older, Caucasian, and held a master's degree. A majority worked full-time, were in clinical practice in larger urban areas, and were employed by a hospital or physician-group. Care was most commonly provided for Hispanic and white women; approximately a quarter could care for greater numbers of patients. Most did not clinically teach midwifery students. Physician practice agreements were believed unnecessary and prescriptive authority requirements restrictive. Legislative issues were typically followed through the professional organization or social media sites; most felt a lack of competence to influence health policy decisions. While most were satisfied with current clinical practice, a majority planned a change in the next 3 to 5 years. An aging midwifery workforce, not representative of the race/ethnicity of the populations served, is underutilized with practice requirements that limit provision of services. Health policy changes are needed to ensure unrestricted practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
NASA Astrophysics Data System (ADS)
McDaris, J. R.; Manduca, C. A.; Orr, C. H.
2016-12-01
As geoscience and STEM programs address common challenges like increasing the diversity of graduates or implementing active learning pedagogies, it is important to learn from the experiences of others in the community. Individual faculty members embody a wealth of experience on these topics but distilling that experience into practical guidance that has value for a broad audience is not as simple as knowing exactly what one person did. Context is important, not only because activities used in similar contexts are easier to adapt, but also because activities that work across multiple contexts are more robust. The development of any best practices guidance benefits from the engagement of a community. Synthesizing across multiple viewpoints leads to a consensus that builds on the diversity of individual experiences. The Science Education Resource Center (SERC) at Carleton College has had success generating such resources in geoscience and STEM education. Working with different groups of educators, we have helped develop content around making change happen at the program or institutional levels, increasing the diversity of students graduating in geoscience and STEM, fostering interdisciplinary learning, translating the results of education research into practice, and several others. These resources draw out common practices, situate them in the education research base, and highlight examples of their use in the real world but also communicate the different ways individuals or institutions have adapted these practices for their particular situation. These resources were developed through a group synthesis process involving the contribution of individual or group expertise, a face-to-face meeting of teams working on themes drawn from the contributed work, and asynchronous group revision and review following the meeting. The materials developed via this process provide reliable and adaptable guidance firmly rooted in the community's experience. This presentation will showcase these materials and describe the development process in detail. The materials that have been developed are being added to SERC's For Higher Ed portal (serc.carleton.edu/highered/index.html).
Changing Workplaces to Reduce Work-Family Conflict: Schedule Control in a White-Collar Organization
Kelly, Erin L.; Moen, Phyllis; Tranby, Eric
2011-01-01
Work-family conflicts are common and consequential for employees, their families, and work organizations. Can workplaces be changed to reduce work-family conflict? Previous research has not been able to assess whether workplace policies or initiatives succeed in reducing work-family conflict or increasing work-family fit. Using longitudinal data collected from 608 employees of a white-collar organization before and after a workplace initiative was implemented, we investigate whether the initiative affects work-family conflict and fit, whether schedule control mediates these effects, and whether work demands, including long hours, moderate the initiative’s effects on work-family outcomes. Analyses clearly demonstrate that the workplace initiative positively affects the work-family interface, primarily by increasing employees’ schedule control. This study points to the importance of schedule control for our understanding of job quality and for management policies and practices. PMID:21580799
Changing Workplaces to Reduce Work-Family Conflict: Schedule Control in a White-Collar Organization.
Kelly, Erin L; Moen, Phyllis; Tranby, Eric
2011-04-01
Work-family conflicts are common and consequential for employees, their families, and work organizations. Can workplaces be changed to reduce work-family conflict? Previous research has not been able to assess whether workplace policies or initiatives succeed in reducing work-family conflict or increasing work-family fit. Using longitudinal data collected from 608 employees of a white-collar organization before and after a workplace initiative was implemented, we investigate whether the initiative affects work-family conflict and fit, whether schedule control mediates these effects, and whether work demands, including long hours, moderate the initiative's effects on work-family outcomes. Analyses clearly demonstrate that the workplace initiative positively affects the work-family interface, primarily by increasing employees' schedule control. This study points to the importance of schedule control for our understanding of job quality and for management policies and practices.
Self-determination, control, and reactions to changes in workload: a work simulation.
Parker, Stacey L; Jimmieson, Nerina L; Amiot, Catherine E
2013-04-01
The objective of this experimental study is to capture the dynamic temporal processes that occur in changing work settings and to test how work control and individuals' motivational predispositions interact to predict reactions to these changes. To this aim, we examine the moderating effects of global self-determined and non-self-determined motivation, at different levels of work control, on participants' adaptation and stress reactivity to changes in workload during four trials of an inbox activity. Workload was increased or decreased at Trial 3, and adaptation to this change was examined via fluctuations in anxiety, coping, motivation, and performance. In support of the hypotheses, results revealed that, for non-self-determined individuals, low work control was stress-buffering and high work control was stress-exacerbating when predicting anxiety and intrinsic motivation. In contrast, for self-determined individuals, high work control facilitated the adaptive use of planning coping in response to a change in workload. Overall, this pattern of results demonstrates that, while high work control was anxiety-provoking and demotivating for non-self-determined individuals, self-determined individuals used high work control to implement an adaptive antecedent-focused emotion regulation strategy (i.e., planning coping) to meet situational demands. Other interactive effects of global motivation emerged on anxiety, active coping, and task performance. These results and their practical implications are discussed.
Promoting evidence-based practice: managing change in the assessment of pressure damage risk.
Gerrish, K; Clayton, J; Nolan, M; Parker, K; Morgan, L
1999-11-01
This study set out to facilitate the development of evidence-based practice in the assessment of pressure damage risk to patients within a large acute hospital. The importance of nursing practice being based on the best available evidence is emphasized in recent health policy. Meeting this objective is not easy as both individual and organizational factors create barriers to the implementation of research findings and the achievement of change. The study was based on an action research model. It comprised three stages: a review of the research evidence; a survey of qualified nurses' knowledge of risk assessment of pressure damage and an audit of record keeping, and a multifaceted approach to achieving change in which researchers, managers, practitioners and clinical nurse specialists worked together collaboratively. The findings from the survey and audit indicated a shortfall in nurses' knowledge of risk assessment of pressure damage and in their record keeping. The researchers, with the help of the clinical nurse specialist, built upon these findings by assisting practitioners and managers to take ownership of the need to base practice on the appropriate evidence. Achieving evidence-based practice is a complex undertaking that requires the development of an evaluative culture and a commitment by practitioners and managers to change practice. Researchers can play a valuable role in facilitating this process.
The organizational transformative power of nurse residency programs.
Kramer, Marlene; Maguire, Pat; Halfer, Diana; Budin, Wendy C; Hall, Debra S; Goodloe, Lauren; Klaristenfeld, Jessica; Teasley, Susan; Forsey, Lynn; Lemke, Johanna
2012-01-01
Residency programs for newly licensed registered nurses (NLRNs) have been strongly advocated by the Institute of Medicine, American Organization of Nurse Executives, and other professional organizations. Their cost-effectiveness as well as their impact on NLRN retention, job and practice satisfaction, improved performance, and reduction in environmental reality shock has been demonstrated. This qualitative study sought answers to the question: what people, components, processes and activities of Nurse Residency Programs (NRPs), and the work environment are instrumental in the transition and integration of NLRNs into the professional practice role and into professional communities? In the course of interviewing 907 nurses-NLRNs, experienced nurses, managers, and educators-practicing on clinical units with confirmed "very healthy work environments" in 20 Magnet hospitals, it became evident that not only did NRPs positively impact the professional socialization of NLRNs, they led to transformative changes in the organization and in the practice of other health care professionals. The organizational transformative changes described by the interviewees are presented for each of the 7 major challenges identified by NLRNs-delegation, prioritization, managing patient care delivery, autonomous decision-making, collaboration with other disciplines, constructive conflict resolution, and utilizing feedback to restore self-confidence. If it can be demonstrated that these transformative changes stimulated by NRPs also lead to improved patient outcomes, NRPs may be the most significant organization transformation instituted by nurse leaders in recent years.
Integrated Theory of Health Behavior Change
RYAN, POLLY
2009-01-01
An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care. PMID:19395894
Current economic trends in equine practice.
Clark, Andrew R
2009-12-01
Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.
An overview of the general practice nurse workforce in Australia, 2012?15.
Heywood, Troy; Laurence, Caroline
2018-05-08
Several surveys of the general practice nurse (GPN) workforce have been undertaken in Australia over the last decade, but they have limitations, which mean that the workforce is not well-understood. The aim of this study is to describe the profile of the GPN workforce using the dataset available through the Australia Health Practitioner Registration Agency and to explore how it differs from the non-GPN nursing workforce, and if this workforce is changing over time. Data from labour force surveys conducted from 2012 to 2015 were used. Variables examined were age group, gender, remoteness area, hours worked, nurse type (enrolled (EN) or registered (RN)), years in the workforce and also intended years of work before exiting the workforce. When compared with the broader nursing workforce, a greater proportion of GPNs in 2015 were older (60 v. 51%), worked part-time (65 v. 48%) and worked in regional areas (35 v. 26%). Additionally, the characteristics of GPNs has changed between 2012 and 2015, with an increased proportion of younger nurses, more registered nurses and fewer working in remote areas. To ensure a sustainable workforce, particularly in rural and remote areas, strategies to recruit and retain this workforce will be needed.
Multidisciplinary workshops: learning to work together.
Fatchett, Anita; Taylor, Dawn
2013-03-01
Health and social care professional practice needs to move with the times and to respond to the ever-changing combination of health needs, economic realities and health-policy imperatives. A clear understanding of the variety of forces at play and the ability to marshal these to good effect by working in partnership with multidisciplinary colleagues and children/families is a must, not least in this time of economic austerity and ever-rising health inequalities, when vulnerable children's lives and complex family relationships and behaviours so easily become increasingly strained and challenged. This sad reality calls out for relevant joined-up solutions by all participants--an agenda so often called into question by court judgement after court judgement. The multidisciplinary workshops to be discussed have developed and changed over the past decade and provide a safe but realistic learning environment for students from health and social care backgrounds to experience the difficulties and barriers to good multidisciplinary working, to better understand others' perspectives and activities and consider and develop new and better practical strategies for working with multidisciplinary professional colleagues, children and families. All of the workshops are underpinned by specific discipline-focused theoretical work.
North, Nicola; Leung, William; Lee, Rochelle
2014-12-01
To describe temporary and permanent separation patterns and changes in nursing practice over 5 years, for the 2006 cohort of nurses aged ≥50 years in New Zealand. As ageing populations increase demand on nursing services, workforce projections need better information on work and retirement decision-making of large 'baby-boomer' cohorts. Retrospective cohort analysis using the Nursing Council of New Zealand administrative dataset. A cohort of all nurses aged ≥50 years on the register and practising in 2006 (n = 12,606) was tracked until 2011. After 5 years, a quarter (n = 3161) of the cohort (equivalent to 8·4% of all 2006 practising nurses) was no longer practising. There were no significant differences in permanent separation rates between the ages of 50-58; between 18-54% of annual separations re-entered the workforce. On re-entry, 56% returned to the same clinical area. Annual separations from the workforce declined sharply during the global financial crisis and more of those leaving re-entered the workforce. In 2006, half the cohort worked in hospitals. After 5 years, the number of cohort nurses working in hospitals fell by 45%, while those in community settings increased by 12%. Over 5 years, weekly nursing practice hours declined significantly for every age-band. To retain the experience of older nurses for longer, workforce strategies need to take account of patterns of leaving and re-entering the workforce, preferences for work hours and the differences between the sub-groups across employment settings and practice areas. © 2014 John Wiley & Sons Ltd.
Kia, Hannah; MacKinnon, Kinnon Ross; Legge, Melissa Marie
2016-01-01
Despite the emergence of research on microaggressions targeting lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) communities in recent years, there remains an insufficiency of theoretical literature in this area. In this article, we draw on the works of Michel Foucault to conceptualize the effects of microaggressive practices on LGBTQ people accessing health and other social services, and generate insight into strategies these groups use to resist these effects. We emphasize the need for social workers, particularly those in health care settings, to support these communities' ongoing attempts at challenging the effects of microaggression, and to this end, outline several implications of our analysis for social work practice.
Rural long-term care work, gender, and restructuring.
Leach, Belinda; Joseph, Gillian
2011-06-01
Restructuring--the introduction of changes that alter the way health care is delivered for maximum efficiency and least cost--layered with rurality and with rural gender ideologies and practices, results in rural long-term care settings that have particular consequences for the women working in them, and for the residents and communities that they serve. This research investigated how rurality affects the implementation of patient classification in Ontario long-term care homes. Methods involved interviews and focus groups with front-line long-term care workers, administrators, and key participants. The findings revealed that rural long-term care delivery takes place when a restructured work environment intersects with gender ideologies and practices that take on particular characteristics when developed and sustained in a rural context. These factors shape the labor market and working conditions for rural women. We argue that this produces a uniquely rural experience for long-term care workers and conclude that those implementing classification systems must consider contextual factors as well as practical and financial exigencies.
Li, Wen-Dong; Fay, Doris; Frese, Michael; Harms, Peter D; Gao, Xiang Yu
2014-09-01
Previous proactivity research has predominantly assumed that proactive personality generates positive environmental changes in the workplace. Grounded in recent research on personality development from a broad interactionist theoretical approach, the present article investigates whether work characteristics, including job demands, job control, social support from supervisors and coworkers, and organizational constraints, change proactive personality over time and, more important, reciprocal relationships between proactive personality and work characteristics. Latent change score analyses based on longitudinal data collected in 3 waves across 3 years show that job demands and job control have positive lagged effects on increases in proactive personality. In addition, proactive personality exerts beneficial lagged effects on increases in job demands, job control, and supervisory support, and on decreases in organizational constraints. Dynamic reciprocal relationships are observed between proactive personality with job demands and job control. The revealed corresponsive change relationships between proactive personality and work characteristics contribute to the proactive personality literature by illuminating more nuanced interplays between the agentic person and work characteristics, and also have important practical implications for organizations and employees. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Cunningham, Nicola; Pham, Tony; Kennedy, Briohny; Gillard, Alexander; Ibrahim, Joseph
2017-05-29
To explore whether subscribers reported clinical practice changes as a result of reading the Clinical Communiqué (CC). Secondarily, to compare the characteristics of subscribers who self-reported changes to clinical practice with those who did not, and to explore subscribers' perceptions of the educational value of the CC. Online cross-sectional survey between 21 July 2015 and 18 August 2015 by subscribers of the CC (response rate=29.9%, 1008/3373), conducted by a team from Monash University, Australia. Change in clinical practice as a result of reading the CC. 53.0% of respondents reported that their practice had changed after reading the CC. Respondents also found that the CC raised awareness (96.5%) and provided ideas about improving patient safety and care (94.1%) leading them to discuss cases with their colleagues (79.6%) and review their practice (75.7%). Multivariate analysis indicated that working in a residential aged care facility (p<0.05) and having taken part in an inquest (p<0.05) were significantly associated with practice change. The design and content of the CC has generated a positive impact on the healthcare community. It is presented in a format that appears to be accessible and acceptable to readers and achieves its goals of promoting safer clinical care through greater awareness of the medico-legal context of practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Community psychology practice: expanding the impact of psychology's work.
Wolff, Tom
2014-11-01
This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Kardakis, Therese; Jerdén, Lars; Nyström, Monica E; Weinehall, Lars; Johansson, Helene
2018-04-02
Implementation of interventions concerning prevention and health promotion in health care has faced particular challenges resulting in a low frequency and quality of these services. In November 2011, the Swedish National Board of Health and Welfare released national clinical practice guidelines to counteract patients' unhealthy lifestyle habits. Drawing on the results of a previous study as a point of departure, the aim of this two-year follow up was to assess the progress of work with lifestyle interventions in primary healthcare as well as the uptake and usage of the new guidelines on lifestyle interventions in clinical practice. Longitudinal study among health professionals with survey at baseline and 2 years later. Development over time and differences between professional groups were calculated with Pearson chi-square test. Eighteen percent of the physicians reported to use the clinical practice guidelines, compared to 58% of the nurses. Nurses were also more likely to consider them as a support in their work than physicians did. Over time, health professionals usage of methods to change patients' tobacco habits and hazardous use of alcohol had increased, and the nurses worked to a higher extent than before with all four lifestyles. Knowledge on methods for lifestyle change was generally high; however, there was room for improvement concerning methods on alcohol, unhealthy eating and counselling. Forty-one percent reported to possess thorough knowledge of counselling skills. Even if the uptake and usage of the CPGs on lifestyle interventions so far is low, the participants reported more frequent counselling on patients' lifestyle changes concerning use of tobacco and hazardous use of alcohol. However, these findings should be evaluated acknowledging the possibility of selection bias in favour of health promotion and lifestyle guidance, and the loss of one study site in the follow up. Furthermore, this study indicates important differences in physicians and nurses' attitudes to and use of the guidelines, where the nurses reported working to a higher extent with all four lifestyles compared to the first study. These findings suggest further investigations on the implementation process in clinical practice, and the physicians' uptake and use of the CPGs.
Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R
2018-05-01
To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.
Lee, Chun-Hsien; Wang, Mei-Ling; Liu, Min-Shi
2017-01-01
This research explores the linking mechanisms and conditional processes underlying the relationship between psychological voice climate and individual change readiness. In accordance with the social identity theory, we argued that normative commitment would mediate the relationship between psychological voice climate and individual change readiness; furthermore, work engagement would moderate the proposed indirect effect. Two-wave survey data were collected from 187 full-time employees in a government-owned institute of research and development and were adopted for moderated mediation analysis. The results showed that normative commitment mediates the relationship between psychological voice climate and individual change readiness. Furthermore, work engagement strengthens the effect of psychological voice climate on individual change readiness in an indirect manner via normative commitment. Based on the findings, the theoretical implications and practical suggestions were discussed. PMID:29062294
Lee, Chun-Hsien; Wang, Mei-Ling; Liu, Min-Shi
2017-01-01
This research explores the linking mechanisms and conditional processes underlying the relationship between psychological voice climate and individual change readiness. In accordance with the social identity theory, we argued that normative commitment would mediate the relationship between psychological voice climate and individual change readiness; furthermore, work engagement would moderate the proposed indirect effect. Two-wave survey data were collected from 187 full-time employees in a government-owned institute of research and development and were adopted for moderated mediation analysis. The results showed that normative commitment mediates the relationship between psychological voice climate and individual change readiness. Furthermore, work engagement strengthens the effect of psychological voice climate on individual change readiness in an indirect manner via normative commitment. Based on the findings, the theoretical implications and practical suggestions were discussed.
One Way--Frustrating, but Rewarding!
ERIC Educational Resources Information Center
Yencer, Dick
1979-01-01
Describes the experiences of a vocational agriculture teacher who worked for four years with rice farmers in Indonesia. Suggests reasons why changes in farming practices are hard to bring about in developing nations. (LRA)
Multiple Intelligences: From the Ivory Tower to the Dusty Classroom - But Why?
ERIC Educational Resources Information Center
Kornhaber, Mindy L.
2004-01-01
This article draws on research conducted over a 10-year period in an attempt to answer three central questions about the widespread adoption of Gardner's theory of multiple intelligences (MI): Why do educators adopt MI? Once MI is adopted, does anything really change in practice? When educators claim MI is working, what is happening in practice?
ERIC Educational Resources Information Center
Long, Michael; Fischer, John
Leading-edge firms (LEFs)--at the forefront of their industry in terms of growth or market share--may influence skill development through diffusion of technology, products, or practices and use of market power to set standards or change customer businesses. Study of LEFs can identify the type and mix of skills needed in the industry. LEFs are…
Towards a Disruptive Pedagogy: Changing Classroom Practice with Technologies and Digital Content
ERIC Educational Resources Information Center
Hedberg, John G.
2011-01-01
Over the past 40 years, the goal of using technologies within learning and teaching processes has always been the incorporation of more effective practices and strategies to redefine the task of learning. Some authors claim that the exercise is not working; other authors beseech us to rethink learning processes to the extent that we are dealing…
Digital Writing Practices: A Close Look at One Grade Three Author
ERIC Educational Resources Information Center
Kervin, Lisa; Mantei, Jessica
2016-01-01
This paper reports on the digital writing practices of a Grade Three primary school student as he used an iPad to plan, produce and share digital texts. The case study acknowledges that writing is undergoing a period of great change in many classrooms and works to show how a student author has interpreted and produced digital texts with new…
Bolívar Murcia, María Paula; Cruz González, Joan Paola; Rodríguez Bello, Luz Angélica
2018-02-01
Evaluate the change over time of psychosocial risk management for the nursing personnel of an intermediate complexity clinic of Bogota (Colombia). Descriptive and correlational research performed under the approach of risk management (identification, analysis, assessment and treatment). The psychosocial risk of the nursing personnel was studied through 10-year system dynamics models (with and without the implementation of the policy of good practices on the risk treatment) in two scenarios: when the nursing personnel works shifts of 6 hours (morning or afternoon) and when they work over 12 hours (double shift or night shift). When implementing a policy of good practices on the risk treatment, the double shift scenario shows an improvement among 25% to 88% in the variables of: health, labor motivation, burnout, service level and productivity; as well as in the variables of the organization associated to number of patients, nursing personnel and profit. Likewise, the single shift scenario with good practices improves in all the above-mentioned variables and generates stability on the variables of absenteeism and resignations. The best scenario is the single shift scenario with the application of good practices of risk treatment in comparison with the double shift scenario with good practices, which allows concluding that the good practices have a positive effect on the variables of nursing personnel and on those associated to the organization. Copyright© by the Universidad de Antioquia.
Pierre Bourdieu: Expanding the scope of nursing research and practice.
Nairn, Stuart; Pinnock, David
2017-10-01
Bourdieu is an important thinker within the sociological tradition and has a philosophically sophisticated approach to theoretical knowledge and research practice. In this paper, we examine the implication of his work for nursing and the health sciences more broadly. We argue that his work is best described as a reflexive realist who provides a space for a nonpositivist approach to knowledge that does not fall into the trap of idealism or relativism. We emphasize that Bourdieu was not an abstract theorist, but only utilized theories to understand and explain the social world in all its empirical complexity. Theory is emphasized over method without denying the importance of method. We then provide a brief overview of some of his key concepts: habitus, field and capital. His work is a scientifically astute practice that has an emancipatory purpose, with particular resonance to the problems of nursing as a social practice. Some have criticized Bourdieu for undermining agency and we briefly address this issue, but argue that his conceptual framework helps us to understand what endures in social practice and why change is often problematic. In short, this paper argues that Bourdieu's work is a fruitful resource for critiquing existing nursing approaches that are preoccupied with agency over structure. © 2017 John Wiley & Sons Ltd.
Katz, Aviva; Mallory, Baird; Gilbert, James C; Bethel, Colin; Hayes-Jordan, Andrea A; Saito, Jacqueline M; Tomita, Sandra S; Walsh, Danielle S; Shin, Cathy E; Wesley, John R; Farmer, Diana
2010-10-01
There has been increasing interest and concern raised in the surgical literature regarding changes in the culture of surgical training and practice, and the impact these changes may have on surgeon stress and the appeal of a career in surgery. We surveyed pediatric surgeons and their partners to collect information on career satisfaction and work-family balance. The American Pediatric Surgical Association Task Force on Family Issues developed separate survey instruments for both pediatric surgeons and their partners that requested demographic data and information regarding the impact of surgical training and practice on the surgeon's opportunity to be involved with his/her family. We found that 96% of pediatric surgeons were satisfied with their career choice. Of concern was the lack of balance, with little time available for family, noted by both pediatric surgeons and their partners. The issues of work-family balance and its impact on surgeon stress and burnout should be addressed in both pediatric surgery training and practice. The American Pediatric Surgical Association is positioned to play a leading role in this effort. Copyright © 2010 Elsevier Inc. All rights reserved.
Aging, practice effects, and genetic risk in the Wisconsin Registry for Alzheimer’s Prevention
Jonaitis, Erin M.; Koscik, Rebecca L.; La Rue, Asenath; Johnson, Sterling C.; Hermann, Bruce; Sager, Mark A.
2015-01-01
BACKGROUND In the last five years, a consensus has developed that Alzheimer’s disease (AD) may begin years before overt cognitive impairment (Sperling et al., 2011). Accordingly, the focus has shifted to identifying preclinical disease in order to match treatments to those most likely to benefit. Subtle cognitive changes, including reduced benefit from practice, may be one such preclinical sign. In this paper, we explore cognitive aging trajectories within a large cohort of clinically intact late-middle-aged adults. METHOD Longitudinal cognitive data were analyzed from 594 participants in the Wisconsin Registry for Alzheimer’s Prevention. Mixed models were used to examine trajectories, adjusting for prior exposure, and the moderation thereof by markers of dementia risk, APOE-ε4 status, and family history of AD. RESULTS Practice effects were observed for Verbal Learning & Memory, Working Memory, Speed & Flexibility, and Visual Learning. However, for Working Memory and Speed & Flexibility, these effects were attenuated for FH+ subjects. CONCLUSION Reduced practice effects have previously been observed in clinical groups (Cooper et al., 2001; Machulda et al., 2013). These results in middle-aged adults suggest that they may also indicate preclinical changes on the path to AD. PMID:26012360
Observation intervention: time for an overview.
Kettles, A M; Addo, M A
2009-11-01
This paper aims to illustrate the nature and extent of research and development work related to observation practice over the last 28 years. It aims to show both local Scottish work and the National picture, how there is still a lack of research evidence despite all the work that has taken place and what needs to be performed to explore observation practice for the future. It is not intended to be a literature review in the traditional sense. Observation has not been studied enough to know the continuing ever-changing picture of what goes on in the reality of practice. There are now studies examining observation but none of these are 'gold standard' randomized controlled trials; some are quantitative and some are qualitative audit or guidelines all based at a lower level in research evidence terms. The time has come to take the evidence base to the next level through evaluative research.
Changing Organizational Culture to Achieve Excellence in Research
ERIC Educational Resources Information Center
Shera, Wes
2008-01-01
This article describes the research capacity building efforts of the Factor-Inwentash Faculty of Social Work at the University of Toronto over the past 12 years. It identifies the role of strategic planning, the process of change, and the key practices, in terms of personnel, resources, research center development, and strategic community…
Stirring the Head, Heart, and Soul: Redefining Curriculum and Instruction. Second Edition.
ERIC Educational Resources Information Center
Erickson, H. Lynn
This work reviews curricular designs, providing educators a practical structure for making curricular decisions. Chapter 1, "Making Change in a Changing World," argues that an appreciation of the role of pressure groups and partnerships is essential to a quality education plan. Chapter 2, "Concept-Based Curriculum," explores the history of the…
Predicting Employee Retention through Preemployment Assessment
ERIC Educational Resources Information Center
Hendrick, Ruth Z.; Raspiller, Edward E.
2011-01-01
Twenty-first century is seeing changes in the nature of work, the workforce, and employment practices. These changes, along with increased employer need to select employees who will have the best fit with particular jobs in order to increase return on investment, are leading employers toward greater use of preemployment assessments. The purpose of…
Systemic Change for RTI: Key Shifts for Practice
ERIC Educational Resources Information Center
Kozleski, Elizabeth B.; Huber, Jennifer J.
2010-01-01
RTI has the potential to meet the challenges of increasing diversity in student populations and the need for increasingly complex systems of instructional design. Three fundamental shifts in understanding systems and systems change must ground RTI policy and implementation work. First, RTI must be seen as an activity system nested within a larger…
Dental work force strategies during a period of change and uncertainty.
Brown, L J
2001-12-01
Both supply and demand influence the ability of the dental work force to adequately and efficiently provide dental care to a U.S. population growing in size and diversity. Major changes are occurring on both sides of the dental care market. Among factors shaping the demand for dental care are changing disease patterns, shifting population demographics, the extent and features of third-party payment, and growth of the economy and the population. The capacity of the dental work force to provide care is influenced by enhancements of productivity and numbers of dental health personnel, as well as their demographic and practice characteristics. The full impact of these changes is difficult to predict. The dentist-to-population ratio does not reflect all the factors that must be considered to develop an effective dental work force policy. Nationally, the dental work force is likely to be adequate for the next several years, but regional work force imbalances appear to exist and may get worse. Against this backdrop of change and uncertainty, future dental work force strategies should strive for short-term responsiveness while avoiding long-term inflexibility. Trends in the work force must be continually monitored. Thorough analysis is required, and action should be taken when necessary.
2013-01-01
Background There is growing acceptance that optimal service provision for individuals with severe and recurrent mental illness requires a complementary focus on medical recovery (i.e., symptom management and general functioning) and personal recovery (i.e., having a ‘life worth living’). Despite significant research attention and policy-level support, the translation of this vision of healthcare into changed workplace practice continues to elude. Over the past decade, evidence-based training interventions that seek to enhance the knowledge, attitudes, and skills of staff working in the mental health field have been implemented as a primary redress strategy. However, a large body of multi-disciplinary research indicates disappointing rates of training transfer. There is an absence of empirical research that investigates the importance of worker-motivation in the uptake of desired workplace change initiatives. ‘Autonomy’ is acknowledged as important to human effectiveness and as a correlate of workplace variables like productivity, and wellbeing. To our knowledge, there have been no studies that investigate purposeful and structured use of values-based interventions to facilitate increased autonomy as a means of promoting enhanced implementation of workplace change. Methods This study involves 200 mental health workers across 22 worksites within five community-managed organisations in three Australian states. It involves cluster-randomisation of participants within organisation, by work site, to the experimental (values) condition, or the control (implementation). Both conditions receive two days of training focusing on an evidence-based framework of mental health service delivery. The experimental group receives a third day of values-focused intervention and 12 months of values-focused coaching. Well-validated self-report measures are used to explore variables related to values concordance, autonomy, and self-reported implementation success. Audits of work files and staff work samples are reviewed for each condition to determine the impact of implementation. Self-determination theory and theories of organisational change are used to interpret the data. Discussion The research adds to the current knowledge base related to worker motivation and uptake of workplace practice. It describes a structured protocol that aims to enhance worker autonomy for imposed workplace practices. The research will inform how best to measure and conceptualise transfer. These findings will apply particularly to contexts where individuals are not ‘volunteers’ in requisite change processes. Trial registration ACTRN: ACTRN12613000353796. PMID:23819816
Maiorova, Tanja; Stevens, Fred; van der Velden, Lud; Scherpbier, Albert; van der Zee, Jouke
2007-01-01
Background An increasing number of newly trained Dutch GPs prefer to work in a group practice and as a non-principal rather than in a single-handed practice. In view of the greater number of female doctors, changing practice preferences, and discussions on future workforce problems, the question is whether male and female GPs were able to realise their initial preferences in the past and will be able to do so in the future. Methods We have conducted longitudinal cohort study of all GPs in the Netherlands seeking a practice between 1980 and 2004. The Netherlands Institute of Health Services Research (NIVEL) in Utrecht collected the data used in this study by means of a postal questionnaire. The overall mean response rate was 94%. Results Over the past 20 years, an increasing proportion of GPs, both male and female, were able to achieve their preference for working in a group practice and/or in a non-principal position. Relatively more women than men have settled in group practices, and more men than women in single-handed practices; however, the practice preference of men and women is beginning to converge. Dropout was highest among the GPs without any specific practice preference. Conclusion The overwhelming preference of male and female GPs for working in group practices is apparently being met by the number of positions (principal or non-principal) available in group practices. The preference of male and female GPs regarding the type of practice and job conditions is expected to converge further in the near future. PMID:17629907
Adapting total quality management for general practice: evaluation of a programme.
Lawrence, M; Packwood, T
1996-01-01
OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529
Relationship among practice change, motivation, and self-efficacy.
Williams, Betsy W; Kessler, Harold A; Williams, Michael V
2014-01-01
The relationship between an individual's sense of self-efficacy, motivation to change, and the implementation of improvement programs has been reported. This research reports the relationship among self-efficacy, motivation to change, and intent to implement continuing medical education (CME) activity learnings. The measure of individual sense of self-efficacy was a 4-item scale. The measure of motivation was a 4-item scale following on the work of Johnson, et al. The self-efficacy scale has been confirmed for structure, and together the 2 scales provide indicators of 3 underlying variables-2 self-efficacy constructs and a motivation variable. In addition, a global intent to implement measure was collected. Preliminary analysis demonstrates a significant relationship between a self-efficacy construct, the motivation to change construct, and global intent to change. Specifically, the sense of efficacy in effecting change in the practice environment is predictive of a high level of motivation to change, which, in turn, is predictive of formation of an intent to change practice patterns. Further inspection of the motivation to change construct suggests that it mediates the self-efficacy constructs' effect on intent. This is consistent with an earlier report on the relationship among self-efficacy, barriers to change, and stated intent. This new finding suggests that the proximal construct motivation completely masks an important underlying causal relationship that appears to contribute to practice change following CME: self-efficacy. A focus on the participants' sense of self-agency may provide a path to practice change. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.
Appleton, K; House, A; Dowell, A
1998-01-01
BACKGROUND: The past seven years have seen rapid changes in general practice in the United Kingdom (UK), commencing with the 1990 contract. During the same period, concern about the health and morale of general practitioners (GPs) has increased and a recruitment crisis has developed. AIM: To determine levels of psychological symptoms, job satisfaction, and subjective ill health in GPs and their relationship to practice characteristics, and to compare levels of job satisfaction since the introduction of the 1990 GP contract with those found before 1990. METHOD: Postal questionnaire survey of all GP principals on the Leeds Health Authority list. The main outcome measures included quantitative measures of practice characteristics, job satisfaction, mental health (General Health Questionnaire), and general physical health. Qualitative statements about work conditions, job satisfaction, and mental health were collected. RESULTS: A total of 285/406 GPs (70%) returned the questionnaires. One hundred and forty-eight (52%) scored 3 or more on the General Health Questionnaire (GHQ-12), which indicates a high level of psychological symptoms. One hundred and sixty GPs (56%) felt that work had affected their recent physical health. Significant associations were found between GHQ-12 scores, total job satisfaction scores, and GPs' perceptions that work had affected their physical health. Problems with physical and mental health were associated with several aspects of workload, including list size, number of sessions worked per week, amount of time spent on call, and use of deputizing services. In the qualitative part of the survey, GPs reported overwork and excessive hours, paperwork and administration, recent National Health Service (NHS) changes, and the 1990 GP contract as the most stressful aspects of their work. CONCLUSIONS: Fifty-two per cent of GPs in Leeds who responded showed high levels of psychological symptoms. Job satisfaction was lower than in a national survey conducted in 1987, and GPs expressed the least satisfaction with their hours, recognition for their work, and rates of pay. Nearly 60% felt that their physical health had been affected by their work. These results point to a need to improve working conditions in primary care and for further research to determine the effect of any such changes. PMID:9624747
Health and Employment after Fifty (HEAF): a new prospective cohort study.
Palmer, Keith T; Walker-Bone, Karen; Harris, E Clare; Linaker, Cathy; D'Angelo, Stefania; Sayer, Avan Aihie; Gale, Catharine R; Evandrou, Maria; van Staa, Tjeerd; Cooper, Cyrus; Coggon, David
2015-10-19
Demographic trends in developed countries have prompted governmental policies aimed at extending working lives. However, working beyond the traditional retirement age may not be feasible for those with major health problems of ageing, and depending on occupational and personal circumstances, might be either good or bad for health. To address these uncertainties, we have initiated a new longitudinal study. We recruited some 8000 adults aged 50-64 years from 24 British general practices contributing to the Clinical Practice Research Datalink (CPRD). Participants have completed questionnaires about their work and home circumstances at baseline, and will do so regularly over follow-up, initially for a 5-year period. With their permission, we will access their primary care health records via the CPRD. The inter-relation of changes in employment (with reasons) and changes in health (e.g., major new illnesses, new treatments, mortality) will be examined. CPRD linkage allows cost-effective frequent capture of detailed objective health data with which to examine the impact of health on work at older ages and of work on health. Findings will inform government policy and also the design of work for older people and the measures needed to support employment in later life, especially for those with health limitations.
Yellowlees, Peter; Richard Chan, Steven; Burke Parish, Michelle
2015-01-01
The doctor-patient relationship is evolving and changing through the impact of many technological, social and environmental factors. These factors will be examined, especially the impact of changing attitudes among younger generations of physicians and patients who live in an information-driven networked world. Telepsychiatry is already over 50 years old and has a strong evidence base which suggests that it is a better form of practice compared with the traditional in-person consultation for certain patient groups. In particular, telepsychiatry encourages intimacy in relationships through the use of the 'virtual space' in the consultation, better collaboration between psychiatrists and primary care physicians, and improved patient satisfaction. The practice of psychiatry will change through the use of mobile devices, asynchronous consultations, and the opportunities that automated interpretation and translation bring to work across cultures. The future will likely bring many psychiatrists working increasingly in a hybrid model, both in-person, and online, using the strengths of both approaches to improve patient care.
Lander, Bryn; Wilcox, Elizabeth; McAlpine, Jessica N; Finlayson, Sarah J; Huntsman, David G; Miller, Dianne; Hanley, Gillian E
2018-05-11
The aim of the study was to explore the factors that contributed to the adoption of opportunistic salpingectomies (removal of fallopian at the time of hysterectomy or in lieu of tubal ligation) by gynecologic surgeons in British Columbia (where a knowledge translation initiative took place) and in Ontario (a comparator where no knowledge translation initiative took place). We aimed to understand why the knowledge translation initiative undertaken by OVCARE in British Columbia resulted in such a dramatic uptake in opportunistic salpingectomy. We undertook a qualitative evaluation of clinicians' decisions about whether or not they should adopt the practice of opportunistic salpingectomy based on interviews with gynecologic surgeons in British Columbia and Ontario (n = 28). The analysis draws from the Consolidated Framework for Implementation Research. Regional cohesion combined with practice change information exposure and thought leader support were important in explaining differences in adoption levels between participants. The British Columbian knowledge translation campaign was successful because provincial thought leaders exposed gynecologic surgeons to recommendations through multiple sources within a highly socially cohesive environment wherein clinicians felt pressure to adopt the recommendations. In both provinces, high adopters often believed that the workload and surgical risk associated with the adoption was low and the potential benefit-because of limited ovarian cancer detection and treatment options-was high. This research points to the important role that local professional networks can play in encouraging clinicians to change their practice by creating a cohesive regional environment where clinicians are repeatedly exposed to important information and supported in their practice change by local thought leaders.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Abad-Corpa, Eva; Delgado-Hito, Pilar; Cabrero-García, Julio; Meseguer-Liza, Cristobal; Zárate-Riscal, Carmen Lourdes; Carrillo-Alcaraz, Andrés; Martínez-Corbalán, José Tomás; Caravaca-Hernández, Amor
2013-03-01
To implement evidence in a nursing unit and to gain a better understanding of the experience of change within a participatory action research. Study design of a participatory action research type was use from the constructivist paradigm. The analytical-methodological decisions were inspired by Checkland Flexible Systems for evidence implementation in the nursing unit. The study was carried out between March and November 2007 in the isolation unit section for onco-haematological patients in a tertiary level general university hospital in Spain. Accidental sampling was carried out with the participation of six nurses. Data were collected using five group meetings and individual reflections in participants' dairies. The participant observation technique was also carried out by researchers. Data analysis was carried out by content analysis. The rigorous criteria were used: credibility, confirmability, dependence, transferability and reflexivity. A lack of use of evidence in clinical practice is the main problem. The factors involved were identified (training, values, beliefs, resources and professional autonomy). Their daily practice (complexity in taking decisions, variability, lack of professional autonomy and safety) was compared with an ideal situation (using evidence it will be possible to normalise practice and to work more effectively in teams by increasing safety and professional recognition). It was decided to create five working areas about several clinical topics (mucositis, pain, anxiety, satisfaction, nutritional assessment, nauseas and vomiting, pressure ulcers and catheter-related problems) and seven changes in clinical practice were agreed upon together with 11 implementation strategies. Some reflections were made about the features of the study: the changes produced; the strategies used and how to improve them; the nursing 'subculture'; attitudes towards innovation; and the commitment as participants in the study and as healthcare professionals. The findings throw light on the process of change in the healthcare sector. The results are useful to modify nursing practice based on evidence. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.
Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice
Hassanein, Mohamed; Belhadj, Mohamed; Abdallah, Khalifa; Bhattacharya, Arpan D.; Singh, Awadhesh K.; Tayeb, Khaled; Al-Arouj, Monira; Elghweiry, Awad; Iraqi, Hinde; Nazeer, Mohamed; Jamoussi, Henda; Mnif, Mouna; Al-Madani, Abdulrazzaq; Al-Ali, Hossam; Ligthelm, Robert
2014-01-01
The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2–3 months pre-Ramadan. Although, American diabetes association (ADA) recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin. PMID:25364673
Artificial intelligence in medicine: the challenges ahead.
Coiera, E W
1996-01-01
The modern study of artificial intelligence in medicine (AIM) is 25 years old. Throughout this period, the field has attracted many of the best computer scientists, and their work represents a remarkable achievement. However, AIM has not been successful-if success is judged as making an impact on the practice of medicine. Much recent work in AIM has been focused inward, addressing problems that are at the crossroads of the parent disciplines of medicine and artificial intelligence. Now, AIM must move forward with the insights that it has gained and focus on finding solutions for problems at the heart of medical practice. The growing emphasis within medicine on evidence-based practice should provide the right environment for that change. PMID:8930853
The Oral Health Care Delivery System in 2040: Executive Summary.
Bailit, Howard L
2017-09-01
This executive summary for Section 4 of the "Advancing Dental Education in the 21 st Century" project examines the projected oral health care delivery system in 2040 and the likely impact of system changes on dental education. Dental care is at an early stage of major changes with the decline in solo practice and increase in large group practices. These groups are not consolidated at the state level, but further consolidation is expected as they try to increase their negotiating leverage with dental insurers. At this time, there is limited integration of medical and dental care in terms of financing, regulation, education, and delivery. This pattern may change as health maintenance organizations and integrated medical systems begin to offer dental care to their members. By 2040, it is expected that many dentists will be employed in large group practices and working with allied dental staff with expanded duties and other health professionals, and more dental graduates will seek formal postdoctoral training to obtain better positions in group practices.
Quantum change and psychotherapy.
Bien, Thomas H
2004-05-01
Deep change in psychotherapy more typically comes slowly rather than suddenly, but this difference between therapeutic change and quantum change may be one of perspective rather than substance. Psychotherapy may be understood as a kind of mindfulness practice similar to working with koans in that the client presents a life dilemma incapable of rational solution. While quantum change cannot be engineered, the psychotherapist can create an environment conducive to such transformation by producing true presence and modeling calm, concerned, sustained attention to the dilemma that precipitated treatment. Psychotherapists who also maintain a sense of their work as a high art and a way of being, and who in consequence cultivate their own emotional and spiritual development, may be more likely to create such an environment. Copyright 2004 Wiley Periodicals, Inc.
Learning as discourse change: A sociocultural mechanism
NASA Astrophysics Data System (ADS)
Wickman, Per-Olof; Östman, Leif
2002-09-01
This paper deals with a theoretical mechanism for learning and a methodological approach for analyzing meaning making in classroom talk and action. It examines the potential of the approach for illuminating learning on a discursive level, i.e., how discourses change and how individuals become participants of new practices. Our approach involves a high-resolution analysis of how meaningful relations are built in encounters between individuals and between individuals and the world. The approach is based mainly on the work of the later Wittgenstein, but also on pragmatism and sociocultural research. To demonstrate how our approach can be used, we analyze what university students learn during a practical on insects. We specifically demonstrate how the encounters with physical pinned insects contribute to the meaning students make and how these encounters interact with other experiences during laboratory work.
For society, state and self: juggling the logics of professionalism in general practice appraisal.
Entwistle, Tom; Matthews, Elaine
2015-11-01
Sociologists repeatedly appeal to notions of altruism, bureaucratisation and self interest in their efforts to explain the changing place of the professions in contemporary society. We treat these three readings as institutional logics that are key to understanding the way in which doctors respond to the appraisal system at the heart of the UK's approach to revalidation. Our analysis of a survey of 998 general practitioners (GPs) working in Wales finds an altruistic commitment to learning and improvement, bureaucratic demands for reporting information and self-regarding resentment of changes in the occupational package provided by general practice. But the data also demonstrate that the maintenance of the appraisal regime is dependent on the preparedness and capacity of individual GPs to do micro-level institutional work on all fronts. © 2015 Foundation for the Sociology of Health & Illness.
Commercial sexual practices before and after legalization in Australia.
Seib, Charrlotte; Dunne, Michael P; Fischer, Jane; Najman, Jackob M
2010-08-01
The nature of sex work changes over time for many reasons. In recent decades around the world, there has been movement toward legalization and control of sex economies. Studies of the possible impact of legalization mainly have focused on sexually transmitted infections and violence, with little attention to change in the diversity of sexual services provided. This study examined the practices of sex workers before and after legalization of prostitution. Cross-sectional surveys of comparable samples of female sex workers were conducted in 1991 (N = 200, aged 16-46 years) and 2003 (N = 247, aged 18-57 years) in Queensland, Australia, spanning a period of major change in regulation of the local industry. In 2003, male clients at brothels and private sole operators (N = 161; aged 19-72 years) were also interviewed. Over time, there was a clear increase in the provision of "exotic" sexual services, including bondage and discipline, submission, fantasy, use of sex toys, golden showers, fisting, and lesbian double acts, while "traditional" services mostly remained at similar levels (with substantial decrease in oral sex without a condom). Based on comparisons of self-reports of clients and workers, the demand for anal intercourse, anal play, and urination during sex apparently exceeded supply, especially in licensed brothels. Within this population, legalization of sex work coincided with a substantial increase in diversity of services, but it appears that in the regulated working environments, clients who prefer high risk practices might not dictate what is available to them.
Attanapola, Chamila T
2004-06-01
Since the economic liberalization in 1977, a large number of Sri Lankan women have entered the labour market and engaged in income-generating activities. Some women choose to travel abroad as domestic workers, while others choose to work in export-processing industries. This process has a profound impact on gender and gender roles in Sri Lanka. Young rural women have changed their traditional women's roles to become independent daughters, efficient factory workers and partially modernized women. Even though changing gender roles are identified as a positive impact of industrial work, the new social, cultural, and legal environments of industrial work have negative impacts on these women's lives. This paper explores health impacts of changing gender roles and practices of young rural women, focusing on the experiences of female workers in export-processing industries. Further, it contributes to the literature on gender and health, and on qualitative approaches within health geographic studies. A model is formulated to suggest a conceptual framework for studying women's health. The model describes the determinant factors of individual health status based on the question of who (personal attributes) does what (type of work) where (place), when and how (behaviours). These are also determinant factors of gender and gender roles of a society. The three types of health problems (reproductive, productive and mental health) of a woman, in this case a female industrial worker, are determined by her gender roles and practices associated with these roles.
Winder, Charlotte B; LeBlanc, Stephen J; Haley, Derek B; Lissemore, Kerry D; Godkin, M Ann; Duffield, Todd F
2016-12-01
Disbudding and dehorning dairy calves is very common, despite the introduction of polled genetics to most dairy breeds. Appropriate pain-control practices for these procedures affect both calf welfare and public perception of the dairy industry. Previously published work has shown that North American dairy producers have not widely adopted use of these medications for disbudding or dehorning. However, since the last published work examining these practices in Canada, changes regarding awareness, availability, and future requirements for pain control have occurred in the industry. With this in mind, online and telephone surveys of both veterinarians (n=238) and dairy producers (n=603) in Ontario, Canada, were conducted in the fall of 2014 with a goal of describing current disbudding and dehorning practices and examining factors associated with the adoption of pain control use. Approximately three-quarters of dairy producers reported performing disbudding or dehorning themselves, whereas the remainder used a veterinarian or technician. Almost all (97%) of the veterinarians surveyed reported using local anesthetic, 62% used sedation, and 48% used a nonsteroidal anti-inflammatory drug. Producer use of local anesthetic was 62%, 38% used sedation and 24% used a nonsteroidal anti-inflammatory drug. Seventy-eight percent of veterinarian disbudding or dehorning was done before 8wk of age, whereas 64% of dairy producers performed this procedure before 8wk of age. Seventy-two percent of veterinarians and 63% of producers reported changing their disbudding or dehorning practices over the past 10 yr; of producers that changed their practices, 73% cited their herd veterinarian as influential. The use of pain control described in these surveys is higher than previously reported in Ontario. Identification of factors associated with best practices, or the lack of adoption of these practices, may help veterinarians target appropriate educational opportunities for their dairy clients. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Private sector approaches to workforce enhancement.
Wendling, Wayne R
2010-06-01
This paper addresses the private practice model of dental care delivery in the US. The great majority of dental care services are delivered through this model and thus changes in the model represent a means to substantially change the supply and availability of dental services. The two main forces that change how private practices function are broad economic factors, which alter the demand for dental care and innovations in practice structure and function which alter the supply and cost of services. Economics has long recognized that although there are private market solutions for many issues, not all problems can be addressed through this model. The private practice of dentistry is a private market solution that works for a substantial share of the market. However, the private market may not work to resolve all issues associated with access and utilization. Solutions for some problems call for creative private - public arrangements - another form of innovation; and market-based solutions may not be feasible for each and every problem. This paper discusses these economic factors and innovation as they relate to the private practice of dentistry, with special emphasis on those elements that have increased the capacity of the dental practice to offer services to those with limited means to access fee-based care. Innovations are frequently described as new care delivery models or new workforce models. However, innovation can occur on an ongoing and regular basis as dental practices examine new ways to combine capital and human resources and to leverage the education and skill of the dentists to a greater number of patients. Innovation occurs within a market context as the current and projected economic returns reward the innovation. Innovation can also occur through private-public arrangements. There are indications of available capacity within the existing delivery system to expand service delivery. The Michigan Medicaid Healthy Kids Dental program is discussed as one example of how dental services to Medicaid insured children were effectively expanded using the private practice model.
Restaurant supervisor safety training: evaluating a small business training intervention.
Bush, Diane; Paleo, Lyn; Baker, Robin; Dewey, Robin; Toktogonova, Nurgul; Cornelio, Deogracia
2009-01-01
We developed and assessed a program designed to help small business owners/managers conduct short training sessions with their employees, involve employees in identifying and addressing workplace hazards, and make workplace changes (including physical and work practice changes) to improve workplace safety. During 2006, in partnership with a major workers' compensation insurance carrier and a restaurant trade association, university-based trainers conducted workshops for more than 200 restaurant and food service owners/managers. Workshop participants completed posttests to assess their knowledge, attitudes, and intentions to implement health and safety changes. On-site follow-up interviews with 10 participants were conducted three to six months after the training to assess the extent to which program components were used and worksite changes were made. Post-training assessments demonstrated that attendees increased their understanding and commitment to health and safety, and felt prepared to provide health and safety training to their employees. Follow-up interviews indicated that participants incorporated core program concepts into their training and supervision practices. Participants conducted training, discussed workplace hazards and solutions with employees, and made changes in the workplace and work practices to improve workers' health and safety. This program demonstrated that owners of small businesses can adopt a philosophy of employee involvement in their health and safety programs if provided with simple, easy-to-use materials and a training demonstration. Attending a workshop where they can interact with other owners/ managers of small restaurants was also a key to the program's success.
International migration and dietary change in Mexican women from a social practice framework.
Bojorquez, Ietza; Rosales, Cecilia; Angulo, Alexandra; de Zapien, Jill; Denman, Catalina; Madanat, Hala
2018-06-01
Migration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts. Copyright © 2018 Elsevier Ltd. All rights reserved.
Baxter, Gordon D; Monk, Andrew F; Tan, Kenneth; Dear, Peter R F; Newell, Simon J
2005-11-01
New medical systems may be rejected by staff because they do not integrate with local practice. An expert system, FLORENCE, is being developed to help staff in a neonatal intensive care unit (NICU) make decisions about ventilator settings when treating babies with respiratory distress syndrome. For FLORENCE to succeed it must be clinically useful and acceptable to staff in the context of local work practices. The aim of this work was to identify those contextual factors that would affect FLORENCE's success. A cognitive task analysis (CTA) of the NICU was performed. First, work context analysis was used to identify how work is performed in the NICU. Second, the critical decision method (CDM) was used to analyse how staff make decisions about changing the ventilator settings. Third, naturalistic observation of staff's use of the ventilator was performed. A. The work context analysis identified the NICU's hierarchical communication structure and the importance of numerous types of record in communication. B. It also identified important ergonomic and practical requirements for designing the displays and positioning the computer. C. The CDM interviews suggested instances where problems can arise if the data used by FLORENCE, which is automatically read, is not manually verified. D. Observation showed that most alarms cleared automatically. When FLORENCE raises an alarm, staff will normally be required to intervene and make a clinical judgement, even if the ventilator settings are not subsequently changed. FLORENCE must not undermine the NICU's hierarchical communication channels (A). The re-design of working practices to incorporate FLORENCE, reinforced through its user interface, must ensure that expert help is called on when appropriate (A). The procedures adopted with FLORENCE should ensure that the data the advice is based upon is valid (C). For example, FLORENCE could prompt staff to manually verify the data before implementing any suggested changes. FLORENCE's audible alarm should be clearly distinguishable from other NICU alarms (D); new procedures should be established to ensure that FLORENCE alarms receive attention (D), and false alarms from FLORENCE should be minimised (B, D). FLORENCE should always provide the data and reasoning underpinning its advice (A, C, D). The methods used in the CTA identified several contextual issues that could affect FLORENCE's acceptance. These issues, which extend beyond FLORENCE's capability to suggest changes to the ventilator settings, are being addressed in the design of the user interface and plans for FLORENCE's subsequent deployment.
Corporate working in health visiting: a concept analysis.
Houston, A M; Clifton, J
2001-05-01
The aim of this paper is to examine individualized health visiting care and compare it to corporate working within a consensual management style. Corporate working has been discussed and used in many different ways since the idea first came to light at the end of the 1980s. Resource management makes it an appealing model, however, analysing how corporate working functions in the practice setting reveals the complexity of this method of service provision. This paper is based on a method of practice developed by health visitors in Haywards Heath, West Sussex, who implemented the process. The article examines individualized health visiting care and compares it to corporate working within a consensual management style. Important in this analysis are the elements of reflexivity, active listening, reflection and the application of 'praxis' within the corporate caseload approach. Rogers' evolutionary concept model was used to illuminate and explain the different ways of delivering the health visiting service. There are benefits in working corporately: shared workload, increased professional support and improved accountability. Alongside the integrated supervision of this model is the opportunity offered to practitioners to innovate. This offsets any initial difficulty experienced in setting up this method and makes it a worthwhile change of style in health visiting practice. Improved service delivery, enhanced professional growth and increased opportunity for public health work can be demonstrated as outcomes of this model. For professionals this method may prevent 'burn-out', enhance practice and increase innovation in health visiting practice. Using this method as a blueprint, practitioners can develop their own style of corporate working that offers a service that is equitable, proactive, efficient and accessible to clients.
Using Students' Ways of Thinking to Re-Cast the Tasks of Teaching about Functions
ERIC Educational Resources Information Center
Doerr, Helen M.
2003-01-01
Recent research suggests that the examination of students' work may lead to changes in teaching practice that are more effective in terms of students' mathematical learning. However, the link between the examination of students' work and the teachers' actions in the classroom is largely unexamined, particularly at the secondary level. In this…
ERIC Educational Resources Information Center
Tate, Alice
2016-01-01
In Aotearoa New Zealand, many early childhood teachers gain their teaching qualification via distance study while working in an early childhood centre. Early childhood teachers work in a team environment, and it is important to understand more about how distance students negotiate changes in their workplace practice as their professional knowledge…
Promising School Social Work Practices of the 1920s: Reflections for Today
ERIC Educational Resources Information Center
Shaffer, Gary L.
2006-01-01
As we celebrate the centennial of school social work, the field faces many of the same professional and social situations first encountered at the turn of the past century. Immigrant populations are growing rapidly, social worker-student ratios continue to be high, and schools remain bureaucratic, inflexible, and slow to change. The "Roaring…
ERIC Educational Resources Information Center
Blevins, Brooke; Moore, Brandon; Dexter Torti, Cameron
2017-01-01
This study was designed to use critical reflective journaling practices to explore the experiences of preservice teachers working in a juvenile justice education program called the Reach Academy. Using a qualitative case study design, the researchers explored how 48 preservice teachers utilized critical reflective journaling to examine their own…
ERIC Educational Resources Information Center
Santamaría, Andrés P.; Webber, Melinda; Santamaría, Lorri J.; Dam, Lincoln I.
2015-01-01
In early 2014, a team of researchers was invited into partnership with the Maori Success Initiative (MSI), a national, indigenous led network of Maori and non-Maori principals committed to working collaboratively to raise Maori student achievement. Working with over sixty principals across six regional clusters throughout Aotearoa New Zealand,…
Managing Further Education: Learning Enterprise. Educational Management: Research and Practice.
ERIC Educational Resources Information Center
Lumby, Jacky
Based on a national survey of college managers, this book discusses how incorporation of colleges in England has changed working lives of middle and senior managers. Chapter 1 describes the context in which colleges have worked since 1993 and the research rationale and methodology. Chapter 2 analyzes how far senior and middle managers' leadership…
Disturbing the Pedagogical Status Quo: LLN and Vocational Teachers Working Together
ERIC Educational Resources Information Center
Black, Stephen; Yasukawa, Keiko
2013-01-01
When language, literacy and numeracy (LLN) teachers work together with vocational teachers as a team, not only do students improve their course outcomes in terms of completions and employment, but the pedagogical practices of both teachers can change and improve. In this article, we begin to explore some of the issues and provide examples of…
McCaugherty, D
1991-09-01
Kurt Lewin, the originator of action research, proposed that it was valuable not only for innovating change, but also the process of change could lead to new insights into the nature of the problem that was being tackled. This action research project developed and evaluated a teaching model that aimed to help RGN (registered general nurse) students to bridge the theory-practice gap. During the course of this work, the possible reasons for a theory-practice gap started to become clear. This paper provides a discussion of these factors. The viewpoint for this discussion is that of the student nurse. The student is assumed to 'own' the problem and it is from her perspective that the theory-practice gap is analysed. The paper includes a critical examination of books, lectures, the school curriculum and ward nursing practice. Finally, possible solutions to the theory-practice problem are discussed and it is hoped that these will provide a rational basis for tackling the problem.
Lloyd, Helen M; Pearson, Mark; Sheaff, Rod; Asthana, Sheena; Wheat, Hannah; Sugavanam, Thava Priya; Britten, Nicky; Valderas, Jose; Bainbridge, Michael; Witts, Louise; Westlake, Debra; Horrell, Jane; Byng, Richard
2017-11-22
Fragmented care results in poor outcomes for individuals with complexity of need. Person-centred coordinated care (P3C) is perceived to be a potential solution, but an absence of accessible evidence and the lack of a scalable 'blue print' mean that services are 'experimenting' with new models of care with little guidance and support. This paper presents an approach to the implementation of P3C using collaborative action, providing examples of early developments across this programme of work, the core aim of which is to accelerate the spread and adoption of P3C in United Kingdom primary care settings. Two centrally funded United Kingdom organisations (South West Collaboration for Leadership in Applied Health Research and Care and South West Academic Health Science Network) are leading this initiative to narrow the gap between research and practice in this urgent area of improvement through a programme of service change, evaluation and research. Multi-stakeholder engagement and co-design are core to the approach. A whole system measurement framework combines outcomes of importance to patients, practitioners and health organisations. Iterative and multi-level feedback helps to shape service change while collecting practice-based data to generate implementation knowledge for the delivery of P3C. The role of the research team is proving vital to support informed change and challenge organisational practice. The bidirectional flow of knowledge and evidence relies on the transitional positioning of researchers and research organisations. Extensive engagement and embedded researchers have led to strong collaborations across the region. Practice is beginning to show signs of change and data flow and exchange is taking place. However, working in this way is not without its challenges; progress has been slow in the development of a linked data set to allow us to assess impact innovations from a cost perspective. Trust is vital, takes time to establish and is dependent on the exchange of services and interactions. If collaborative action can foster P3C it will require sustained commitment from both research and practice. This approach is a radical departure from how policy, research and practice traditionally work, but one that we argue is now necessary to deal with the most complex health and social problems.
Foley, Barbara Jo; Kee, Carolyn C; Minick, Ptlene; Harvey, Susan S; Jennings, Bonnie M
2002-05-01
The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals. Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities. A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables. Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment. This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.
Pitcher, Jane
2015-01-01
This article draws on research with adult sex workers in indoor settings in Great Britain to explore diverse forms of self-employment, employment relationships and small business development, set within the context of changes to the wider economy. It considers how external constraints such as the legal context, social stigma and dominant policy discourses can impact on sex workers' autonomy and actively work against their safety and wellbeing. The article argues that broad policy and legal approaches which fail to recognise the complexity of sex work constrain sex workers' opportunities for business development and improvement of their working circumstances. It suggests the need for recognition of sex work as legitimate labour, as a prerequisite for policy changes to support sex workers and pave the way for improved working conditions, not only in managed settings but also facilitating collective arrangements and independent lone working.
Improving the health care work environment: implications for research, practice, and policy.
Harrison, Michael I; Henriksen, Kerm; Hughes, Ronda G
2007-11-01
Despite the gains to date, we need better understanding of practices for implementing and sustaining improvements in health care work environments and further study of organizational conditions affecting implementation of improvements. Limiting work hours, improving schedules, and providing sleep hygiene training will help combat clinician fatigue. Hospital crowding can be reduced through systemwide improvement of patient flow and capacity management, coupled with management support, measurement, and reporting on crowding. Long-term solutions to nurse staffing shortfalls include process redesign to enhance efficiency. Improvement of organizational climate, human resource management, and interoccupational relations will also contribute to staff retention. Evidence-based enhancements to patient rooms and other physical features in hospitals contribute directly to safety and quality and also affect staff performance. POLICY: Landrigan and his colleagues call for external restrictions on residents' work shifts. Clarke examines prospects for mandated nursing-staff ratios. Public reporting on staffing, crowding, and other risks may incent change. Reporting and pay for performance require standardized measures of targeted conditions. Organizations promoting care quality can help spread safe work practices; they can also support collaborative learning and other strategies that may enhance implementation of improvements in work environments.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yu, Ann T.W., E-mail: bsannyu@polyu.edu.hk; Poon, C.S.; Wong, Agnes
Highlights: Black-Right-Pointing-Pointer A significant reduction of construction waste was achieved at the first 3 years of CWDCS implementation. Black-Right-Pointing-Pointer However, the reduction cannot be sustained. Black-Right-Pointing-Pointer Implementation of the CWDCS has generated positive effects in waste reduction by all main trades. - Abstract: Waste management in the building industry in Hong Kong has become an important environmental issue. Particularly, an increasing amount of construction and demolition (C and D) waste is being disposed at landfill sites. In order to reduce waste generation and encourage reuse and recycling, the Hong Kong Government has implemented the Construction Waste Disposal Charging Scheme (CWDCS)more » to levy charges on C and D waste disposal to landfills. In order to provide information on the changes in reducing waste generation practice among construction participants in various work trades, a study was conducted after 3 years of implementation of the CWDCS via a structured questionnaire survey in the building industry in Hong Kong. The study result has revealed changes with work flows of the major trades as well as differentiating the levels of waste reduced. Three building projects in the public and private sectors were selected as case studies to demonstrate the changes in work flows and the reduction of waste achieved. The research findings reveal that a significant reduction of construction waste was achieved at the first 3 years (2006-2008) of CWDCS implementation. However, the reduction cannot be sustained. The major trades have been influenced to a certain extent by the implementation of the CWDCS. Slight improvement in waste management practices was observed, but reduction of construction waste in the wet-finishing and dry-finishing trades has undergone little improvement. Implementation of the CWDCS has not yet motivated subcontractors to change their methods of construction so as to reduce C and D waste.« less
Ellard, David R; Chimwaza, Wanangwa; Davies, David; O'Hare, Joseph Paul; Kamwendo, Francis; Quenby, Siobhan; Griffiths, Frances
2014-08-12
The 'enhancing human resources and the use of appropriate technologies for maternal and perinatal survival in sub-Saharan Africa' (ETATMBA) project is training emergency obstetric and new-born care (EmONC) non-physician clinicians (NPCs) as advanced clinical leaders. Our objectives were to evaluate the implementation and changes to practice. A mixed methods process evaluation with the predominate methodology being qualitative. Rural and urban hospitals in 8 of the 14 districts of northern and central Malawi. 54 EmONC NPCs with 3 years' plus experience. Training designed and delivered by clinicians from the UK and Malawi; it is a 2-year plus package of training (classroom, mentorship and assignments). We conducted 79 trainee interviews over three time points during the training, as well as a convenience sample of 10 colleagues, 7 district officers and 2 UK obstetricians. Trainees worked in a context of substantial variation in the rates of maternal and neonatal deaths between districts. Training reached trainees working across the target regions. For 46 trainees (8 dropped out of the course), dose delivered in terms of attendance was high and all 46 spent time working alongside an obstetrician. In early interviews trainees recalled course content unprompted indicating training had been received. Colleagues and district officers reported cascading of knowledge and initial changes in practice indicating early implementation. By asking trainees to describe actual cases we found they had implemented new knowledge and skills. These included life-saving interventions for postpartum haemorrhage and eclampsia. Trainees identified the leadership training as enabling them to confidently change their own practice and initiate change in their health facility. This process evaluation suggests that trainees have made positive changes in their practice. Clear impacts on maternal and perinatal mortality are yet to be elucidated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
O'Connell, Jane; Gardner, Glenn; Coyer, Fiona
2014-12-01
This paper presents a discussion on the application of a capability framework for advanced practice nursing standards/competencies. There is acceptance that competencies are useful and necessary for definition and education of practice-based professions. Competencies have been described as appropriate for practice in stable environments with familiar problems. Increasingly competencies are being designed for use in the health sector for advanced practice such as the nurse practitioner role. Nurse practitioners work in environments and roles that are dynamic and unpredictable necessitating attributes and skills to practice at advanced and extended levels in both familiar and unfamiliar clinical situations. Capability has been described as the combination of skills, knowledge, values and self-esteem which enables individuals to manage change, be flexible and move beyond competency. A discussion paper exploring 'capability' as a framework for advanced nursing practice standards. Data were sourced from electronic databases as described in the background section. As advanced practice nursing becomes more established and formalized, novel ways of teaching and assessing the practice of experienced clinicians beyond competency are imperative for the changing context of health services. Leading researchers into capability in health care state that traditional education and training in health disciplines concentrates mainly on developing competence. To ensure that healthcare delivery keeps pace with increasing demand and a continuously changing context there is a need to embrace capability as a framework for advanced practice and education. © 2014 John Wiley & Sons Ltd.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1991-01-24
The testimony contains the comments of NIOSH regarding the proposed rule on occupational exposure to asbestos (1332214), tremolite (14567738), anthophyllite (17068789) and actinolite (77536664) exposures. NIOSH supports OSHA in proposing changes to the existing asbestos standard to minimize the risk of asbestos related diseases in workers. The current standard is insufficient to protect the health of workers exposed to asbestos, and the proposed changes represent a prudent and necessary approach to accomplish this goal. Specific topics addressed in the testimony include exposure limits for asbestos; methods for sampling and analysis of airborne fibers; use of time weighted averages to measuremore » exposure; use of engineering controls, good work practices and personal protective equipment; use of engineering controls and work practices for brake and clutch repair and service; required use of specific work practices during maintenance of vinyl asbestos floor tile; housekeeping; definitions of small scale and short duration operations; exemption of roofing operations from the requirement for negative pressure enclosures; communication among employers and owners; regulated areas for asbestos removal, maintenance, demolition, and renovation operations; use of glove bags; definition of competent person; and notification to OSHA and method of notification.« less
Work-based learning: supporting advanced perioperative practice.
Quick, Julie
2010-07-01
The arrival of work-based learning awards in professional education offers an alternative route for healthcare professionals looking to undertake post-registration education. The unique way that work-based learning integrates individual learning needs with that of role requirements makes the award an ideal choice for the advanced perioperative practitioner (APP) who wishes to combine academic study with professional development. As an experienced and professionally qualified practitioner (Thatcher 2003) the APP will have an accumulation of knowledge, skills and experience that may go unrecognised in alternative awards. The term APP refers to a nurse, ODP or allied healthcare professional who undertakes a role that challenges the traditional boundaries of care within the perioperative environment (Radford 2004), such as that of a surgical care practitioner (SCP). Here Julie Quick, a SCP, examines the changes within post-registration education and in particular describes why work-based learning awards may be an appropriate choice for practitioners working at a higher level of practice.
Shannon, Kay; McKenzie-Green, Barbara
2016-01-01
Challenges facing healthcare assistants in aged residential care are a focus of global debate. These challenges involve remuneration, education, skill mix, work conditions and organisational structures. We enter the discussion by acknowledging current work, education and remuneration for healthcare assistants. We then consider the supervisory relationships between registered nurses (RNs), enrolled nurses (ENs) and healthcare assistants, educational levels for RNs, ENs and healthcare assistants, and the interplay between organisation and practice in aged residential care. We suggest that improving work for the healthcare assistant has the potential to lead change in all role levels. Discussion paper. We argue that adjustments to work structures, education and skill advancement of RNs, ENs and healthcare assistants could improve staff working conditions and clarify practice boundaries. The ultimate result is likely to be an improvement to quality of care and the life of residents in aged residential care.
Lynch, Elizabeth A; Luker, Julie A; Cadilhac, Dominique A; Fryer, Caroline E; Hillier, Susan L
2017-07-01
To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke. Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework. Eight acute stroke units in two states of Australia. Health professionals working in acute stroke units. Health professionals at all sites had participated in interventions to improve rehabilitation assessment and referral practices, which included provision of copies of an evidence-based decision-making rehabilitation Assessment Tool and pathway. Eight focus groups were conducted (32 total participants). Reported rehabilitation assessment and referral practices varied markedly between units. Continence and mood were not routinely assessed (4 units), and people with stroke symptoms were not consistently referred to rehabilitation (4 units). Key factors influencing practice were identified and included whether health professionals perceived that use of the Assessment Tool would improve rehabilitation assessment practices (theoretical domain 'social and professional role'); beliefs about outcomes from changing practice such as increased equity for patients or conversely that changing rehabilitation referral patterns would not affect access to rehabilitation ('belief about consequences'); the influence of the unit's relationships with other groups including rehabilitation teams ('social influences' domain) and understanding within the acute stroke unit team of the purpose of changing assessment practices ('knowledge' domain). This study has identified that health professionals' perceived roles, beliefs about consequences from changing practice and relationships with rehabilitation service providers were perceived to influence rehabilitation assessment and referral practices on Australian acute stroke units.
Turnaround distressed physician practices. 20 tips for success.
Wolper, L F
1999-01-01
Physician practices are restructuring through merger and acquisition, and sale to practice management companies and to hospital systems. Many also are expanding internally by recruiting new physicians and opening additional offices. For many these strategies are working, but many others are experiencing operational and financial distress and failure that arise from rapid organizational growth without concomitant infrastructural change. Further, in the last several months, many national and regional practice management companies have decided to withdraw from the business, and others have declared bankruptcy. The number of physician practices that are in financial and operational distress is unprecedented. These groups require a solution, as proposed in this article.
The birth of a house call practice.
De Leon, Fidias E
2009-01-01
Increasingly, physicians of all specialties are frustrated with the complex, unrewarding system of third-party billing in the United States. It has led many physicians to wonder how best to change their practice to ameliorate these challenges or leave their practice altogether. It is possible that family physicians suffer most because they are trained to provide comprehensive care to all comers, regardless of reimbursement status. What they may not know is that leaving the practice might be the best thing for everyone, and it doesn't necessarily mean leaving medicine! As I realized during my experiences working in South Florida, transitioning to a house call practice can be emotionally and financially rewarding.
Zhu, Jing; Wanberg, Connie R; Harrison, David A; Diehn, Erica W
2016-04-01
We examine changes in work adjustment among 179 expatriates from 3 multinational organizations from predeparture through the first 9 months of a new international assignment. Our 10-wave results challenge classic U-shaped theories of expatriate adjustment (e.g., Torbiorn, 1982). Consistent with uncertainty reduction theory, our results instead suggest that expatriates typically experience a gradual increase in work adjustment over time. Two resources that expatriates bring to their assignments (previous culture-specific work experience and core self-evaluations) moderate the trajectory of work adjustment. Trajectory of adjustment predicts Month 9 career instrumentality and turnover intention, as well as career advancement (job promotion) 1.5 years further. Implications for theory, as well as for changes in expatriate management practices, are discussed. (c) 2016 APA, all rights reserved).
Kato-Wallace, Jane; Barker, Gary; Eads, Marci; Levtov, Ruti
2014-01-01
Promoting men's participation in unpaid care work is part of the Programme of Action for the International Conference on Population and Development. However, men's involvement in care work does not mirror the advances women have made in paid work outside the home. This mixed method study explores which men are more involved in caregiving, and what childhood and adulthood factors influence their level of involvement. Quantitative research presents findings from 1169 men across six countries with children aged 0-4, and a qualitative study presents findings from in-depth interviews with 83 men engaged in atypical caregiving practices. Survey research finds that being taught to care for children, witnessing one's father take care of one's siblings, respondents' present attitudes about gender equality and having outside help (or none, in some cases) were all also associated with men's higher level of involvement. Qualitative research reveals that men's experiences of violence, the normalisation of domestic work as children and life circumstances rather than greater-than-average beliefs in gender equality all propelled them into care work. Findings suggest that engaging more men into care work implies changes to policies and structural realities in the workplace coupled with changing gender attitudes. These insights inform policy and practice aimed at promoting greater involvement in care work by men.
Out-of-hospital emergency care providers' work and challenges in a changing care environment.
Mikkola, Riitta; Paavilainen, Eija; Salminen-Tuomaala, Mari; Leikkola, Päivi
2018-03-01
Acutely ill patients are often treated on site instead of being transported to hospital, so wide-ranging professional competence is required from staff. The aim of this study was to describe and produce new information about out-of-hospital emergency care providers' competence, skills and willingness to engage in self-development activities, and to uncover challenges experienced by care providers in the midst of changing work practices. A quantitative questionnaire was sent to out-of-hospital emergency care providers (N = 142, response rate 53%) of one Finnish hospital district. Data were analysed using spss for Windows 22 software. Almost all respondents found their work interesting and their ability to work independently sufficient. The majority found the work meaningful. Almost 20% felt that work was dominated by constant rush, and 40%, more than half of 25-year-olds but <10% of over 45-years-olds, found the work physically straining. The majority indicated that they had a sufficient theoretical-practical basis to perform their regular duties, and more than one-third felt that they had sufficient skills to deal with multiple patient or disaster situations. Over 20% stated that they were unsure about performing new or infrequent procedures. A number of factors experienced as challenging were revealed. The results provide a basis for improving care providers' initial and further training. © 2017 Nordic College of Caring Science.
Sturge-Apple, Melissa L.; Davies, Patrick T.; Cicchetti, Dante; Cummings, E. Mark
2010-01-01
Guided by the affective spillover hypothesis, the present study examined the mediational role of parental adrenocortical reactivity to interparental conflict in explaining associations between interparental conflict and subsequent changes in mothers’ and fathers’ parenting practices over a 2 year period in a sample of 202 parents and their six year old children. Results of autoregressive, path models indicated that marital withdrawal was associated with increases in adrenocortical reactivity to conflict for mothers but not fathers. Furthermore, elevated adrenocortical reactivity in turn predicted greater psychologically controlling parenting practices and inconsistent discipline over time for mothers, but was not associated with changes in maternal warmth. Implications for clinicians and therapists working with maritally distressed parents and families are discussed. PMID:19364215
Managing health care organizations in an age of rapid change.
Benjamin, S; al-Alaiwat, S
1998-03-01
Health care managers find their work increasingly difficult, due in part to rapid environmental change that plagues organizational life. Management practices and attitudes that may have been appropriate in previous eras are ineffective today. A study was conducted among managers in the Ministry of Health, State of Bahrain, seeking information about current trends in the macro or external environment that affect the Ministry of Health, as well as internal environmental pressures that may be similar or different. This article provides a clear picture of the context in which managers perform their work and offers recommendations for coping with change in dynamic, complex organizations.
Application of high technology in highway transportation.
DOT National Transportation Integrated Search
1985-01-01
Highway and traffic engineering practice is rapidly changing as communications technology and computer systems are being adopted to facilitate the work of the practitioners and expand their capabilities. This field has been an evolutionary one since ...
Acolet, Dominique; Jelphs, Kim; Davidson, Deborah; Peck, Edward; Clemens, Felicity; Houston, Rosie; Weindling, Michael; Lavis, John; Elbourne, Diana
2007-10-08
Gaps between research knowledge and practice have been consistently reported. Traditional ways of communicating information have limited impact on practice changes. Strategies to disseminate information need to be more interactive and based on techniques reported in systematic reviews of implementation of changes. There is a need for clarification as to which dissemination strategies work best to translate evidence into practice in neonatal units across England. The objective of this trial is to assess whether an innovative active strategy for the dissemination of neonatal research findings, recommendations, and national neonatal guidelines is more likely to lead to changes in policy and practice than the traditional (more passive) forms of dissemination in England. Cluster randomised controlled trial of all neonatal units in England (randomised by hospital, n = 182 and stratified by neonatal regional networks and neonatal units level of care) to assess the relative effectiveness of active dissemination strategies on changes in local policies and practices. Participants will be mainly consultant lead clinicians in each unit. The intervention will be multifaceted using: audit and feedback; educational meetings for local staff (evidence-based lectures on selected topics, interactive workshop to examine current practice and draw up plans for change); and quality improvement and organisational changes methods. Policies and practice outcomes for the babies involved will be collected before and after the intervention. Outcomes will assess all premature babies born in England during a three month period for timing of surfactant administration at birth, temperature control at birth, and resuscitation team (qualification and numbers) present at birth.
ERIC Educational Resources Information Center
Månsson, Jonas; Lundin, Christofer
2017-01-01
In this paper we investigate the effect of difference in outcome definitions on the result of impact evaluations. The Swedish workplace practice programme is evaluated, using matching methods. The key findings are that changing how the outcome is defined has a considerable influence on the results of the impact assessment. From the results of this…
ERIC Educational Resources Information Center
Magne, Marie-Angelina; Ingrand, Stephane
2004-01-01
French farms have to adapt quickly in an economic and social context that is in profound change. For this, advice procedures must themselves be reconsidered. The aim of this work was to characterize the advice practices in beef-cattle systems in Creuse and define farmers' and advisers' requirements according to future methods of providing advice.…
ERIC Educational Resources Information Center
Schostak, John
2010-01-01
Over the years, Bridget Somekh has made a substantial contribution to the development of action research. Her concern has been to make real change in the quality of everyday practices in education and to influence policy. In particular, this article explores the significance of her work for methodology, professional practice and for what may be…
Empowering occupational therapists to become evidence-based work rehabilitation practitioners.
Vachon, Brigitte; Durand, Marie-José; LeBlanc, Jeannette
2010-01-01
Occupational therapists (OTs) engage in continuing education to integrate best available knowledge and skills into their practice. However, many barriers influence the degree to which they are currently able to integrate research evidence into their clinical decision making process. The specific objectives were to explore the clinical decision-making processes they used, and to describe the empowerment process they developed to become evidence-based practitioners. Eight OTs, who had attended a four-day workshop on evidence-based work rehabilitation, were recruited to participate to a reflective practice group. A collaborative research methodology was used. The group was convened for 12 meetings and held during a 15-month period. The data collected was analyzed using the grounded theory method. The results revealed the different decision-making modes used by OTs: defensive, repressed, cautious, autonomous intuitive and autonomous thoughtful. These modes influenced utilization of evidence and determined the stances taken toward practice change. Reflective learning facilitated their utilization of an evidence-based practice model through a three-level empowerment process: deliberateness, client-centeredness and system mindedness. During the course of this study, participants learned to become evidence-based practitioners. This process had an impact on how they viewed their clients, their practice and the work rehabilitation system.
Gould, Natalie J; Lorencatto, Fabiana; Stanworth, Simon J; Michie, Susan; Prior, Maria E; Glidewell, Liz; Grimshaw, Jeremy M; Francis, Jill J
2014-07-29
Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice. The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability. Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability. This intervention development work reflects the UK Medical Research Council's guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.
"The Record is Our Work Tool!"-Physicians' Framing of a Patient Portal in Sweden.
Grünloh, Christiane; Cajander, Åsa; Myreteg, Gunilla
2016-06-27
Uppsala County in Sweden launched an eHealth patient portal in 2012, which allows patients to access their medical records over the Internet. However, the launch of the portal was critically debated in the media. The professionals were strongly skeptical, and one reason was possible negative effects on their work environment. This study hence investigates the assumptions and perspectives of physicians to understand their framing of the patient portal in relation to their work environment. The study uses the concept of technological frames to examine how physicians in different specialties make sense of the patient portal in relation to their work environment. A total of 12 semistructured interviews were conducted with physicians from different specialties. Interviews were transcribed and translated. A theoretically informed thematic analysis was performed. The thematic analysis revealed 4 main themes: work tool, process, workload, and control. Physicians perceive medical records as their work tool, written for communication within health care only. Considering effects on work environment, the physicians held a negative attitude and expected changes, which would affect their work processes in a negative way. Especially the fact that patients might read their test results before the physician was seen as possibly harmful for patients and as an interference with their established work practices. They expected the occurrence of misunderstandings and needs for additional explanations, which would consequently increase their workload. Other perceptions were that the portal would increase controlling and monitoring of physicians and increase or create a feeling of mistrust from patients. Regarding benefits for the patients, most of the physicians believe there is only little value in the patient portal and that patients would mostly be worried and misunderstand the information provided. Supported by the study, we conclude: (1) The transfer of a paper-based health care process where patients read on paper into a digital process challenges current work practices and has consequences for the work environment. Mostly, this is explained by the changing positions between the physicians and the patient: the latter can drive the process, which reduces the physicians' ability to guide the patient. (2) The physicians' experiences were expressed as worries: patients would not understand the content of the record and become unnecessarily anxious from misunderstandings. The concerns are to some extent based on a generalized view of patients, which might disregard those, who already actively participate in health care. This study hence reveals a need to provide physicians with information about the values for patients from using patient portals. (3) A change of work practices may be beneficial to increase patient participation, but such changes should preferably be designed and discussed with physicians. However, the strong resistance from the physicians made this challenging when launching the patient portal.
Registered nurse job satisfaction and satisfaction with the professional practice model.
McGlynn, Karen; Griffin, Mary Quinn; Donahue, Moreen; Fitzpatrick, Joyce J
2012-03-01
This paper describes the initial assessment of job satisfaction and satisfaction with the professional practice environment of registered nurses working on units where a professional practice model was implemented and the relationship between these two variables. The nursing shortage has been linked to overall job satisfaction and specifically to nurses' satisfaction with the professional practice environment. Initiatives to increase retention and recruitment and decrease turnover have been linked to work satisfaction among nurses. A descriptive, cross-sectional design was used with participants (N = 101) from four patient care units; this represented a 55% response rate. The nurses were moderately satisfied with the professional practice environment but had overall low job satisfaction. There was a significant negative relationship between overall work satisfaction and satisfaction with the professional practice environment (P < 0.0001). The introduction of the professional practice model may have raised awareness of the components of job satisfaction that were not being met. Thus, the nurses may have become more knowledgeable about the potential needs in these areas. Nurse managers and leaders must recognize that job satisfaction consists of many dimensions, and each of these dimensions is important to nurse retention. Implementation of a professional practice model may heighten awareness of the missing components within a practice environment and lead to decreased overall satisfaction. A broader understanding of characteristics associated with increased satisfaction may aid in development of organizational change necessary to retain and attract nurses. © 2012 Blackwell Publishing Ltd.
Dombo, Eileen A; Bass, Ami P
2014-01-01
In practice with adult women who survived childhood sexual abuse, the field of social work currently lacks an evidence-based intervention. The current interventions, from the 1990s, come primarily from psychologists. The hypothesis that the Feminist-Cognitive-Relational Social Work Model and Intervention will be more effective in decreasing cognitive distortions, and increasing intimacy and relational health when compared to the standard agency intervention was tested in a quasi-experimental study. The challenges in carrying out the study in small, non-profit organizations are explored to highlight the difficulties in developing evidence-based interventions. Changes to implementation that resulted from the research findings are discussed.
The research subject as wage earner.
Anderson, James A; Weijer, Charles
2002-01-01
The practice of paying research subjects for participating in clinical trials has yet to receive an adequate moral analysis. Dickert and Grady argue for a wage payment model in which research subjects are paid an hourly wage based on that of unskilled laborers. If we accept this approach, what follows? Norms for just working conditions emerge from workplace legislation and political theory. All workers, including paid research subjects under Dickert and Grady's analysis, have a right to at least minimum wage, a standard work week, extra pay for overtime hours, a safe workplace, no fault compensation for work-related injury, and union organization. If we accept that paid research subjects are wage earners like any other, then the implications for changes to current practice are substantial.
Creating Meaningful Change in Education: A Cascading Logic Model. Scaling-Up Brief. Number 6
ERIC Educational Resources Information Center
Blase, Karen; Fixsen, Dean; Jackson, Kathleen Ryan
2015-01-01
Creating meaningful change in a state's education system from the capitol to the classroom is complex and challenging work. Over the past several decades, considerable research, policy, and funding have focused on the use of evidence-based programs (EBP) in schools. However, these practices only are effective when fully and effectively implemented…
ERIC Educational Resources Information Center
Junge, Melissa; Krvaric, Sheara
2016-01-01
Much has been written on the subject of school turnaround, but relatively little about how to "pay for" turnaround-related work. Turning around low-performing schools not only requires changing instructional and related practices, but changing spending patterns as well. Too often education dollars are spent on the same costs from…
Learning and Developing as a University Teacher: Narratives of Early Career Academics in Estonia
ERIC Educational Resources Information Center
Remmik, Marvi; Karm, Mari; Lepp, Liina
2013-01-01
In recent years the higher education context in Estonia, as in most European countries, has changed a lot. All changes have an impact on university teachers' practice and their work organisation, and are presenting new challenges. The current research aims at developing an understanding of Estonian early career academics' professional identity by…
Measuring the mechanical behavior of paperboard in a changing humidity environment
Dennis E. Gunderson; John M. Considine
1986-01-01
âBoth the strength and stability of compressively loaded paperboard are known to be adversely affected by cyclic changes in relative humidity. Current research at the Forest Products Laboratory (FPL) seeks to observe and explain this phenomenon and to develop a simple, practical test to determine allowable "working loads" in cyclicmoisture environments. A new...
ERIC Educational Resources Information Center
Shea, Nicole A.; Mouza, Chrystalla; Drewes, Andrea
2016-01-01
In this work, we present the design, implementation, and initial outcomes of the Climate Academy, a hybrid professional development program delivered through a combination of face-to-face and online interactions, intended to prepare formal and informal science teachers (grades 5-16) in teaching about climate change. The Climate Academy was…
Dialogue as a Catalyst for Teacher Change: A Conceptual Analysis
ERIC Educational Resources Information Center
Penlington, Clare
2008-01-01
Teacher-teacher dialogue is a central activity within many professional learning programs. Understanding how and why dialogue works as an effective tool for teacher change is a question, however, that needs more careful probing in the extant literature. In this paper, I draw upon the philosophical theory of practical reason in order to show why…
Helping Policy Makers See through the Eyes of the Infant
ERIC Educational Resources Information Center
Hill, Sheri
2009-01-01
Policies and policymakers have an enormous impact on how we as individuals and communities are able to meet the needs of infants and toddlers. All systems must work together to change how communities are able to support families with very young children. The author shares practical lessons about creating system change by focusing on collaboration…
Small Steps, Big Changes: Eight Essential Practices for Transforming Schools through Mathematics
ERIC Educational Resources Information Center
Confer, Chris; Ramirez, Marco
2012-01-01
During the past two decades, Chris Confer and Marco Ramirez have worked to deepen and improve mathematics instruction at schools around the country. Wherever they go, they find the raw ingredients for success already present: "The potential for positive change lies within each school. Abundance is present in the form of capable children,…
Supporting the Development of Assessment Literacy of Staff through Institutional Process Change
ERIC Educational Resources Information Center
Forsyth, Rachel; Cullen, Rod; Ringan, Neil; Stubbs, Mark
2015-01-01
This paper reflects on the work done at a large UK university to redesign assessment procedures in a way that was intended to contribute to an improvement in assessment literacy for staff. Existing practice was reviewed and showed that changes in assessment processes were needed to make the organization of assessment more consistent and more…
Effecting Media Change: The Role of Cooperative Consultation on Alcohol Topics.
ERIC Educational Resources Information Center
Breed, Warren; De Foe, James R.
1982-01-01
Reports on a concerted effort by consultant-scholars to influence the portrayal of drinking on television by working cooperatively with media writers, directors, and producers, while avoiding the pitfalls of traditional pressure group practices. Content analyses of prime-time programs were used as the basis of the appeal to change media messages.…
ERIC Educational Resources Information Center
McCaughtry, Nate; Martin, Jeffrey; Kulinna, Pamela Hodges; Cothran, Donetta
2006-01-01
The purpose of this study was to understand factors that make teacher professional development successful and what success might mean in terms of teachers' instructional practices and feelings about change. Specifically, this study focused on the impact of instructional resources on the large-scale curricular reform of 30 urban physical education…