Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

Modeling, stability analysis and control of microgrid

With the increase in the level of global warming, renewable energy based distributed generators (DGs) will increasingly play a dominant role in electricity production. Distributed generation based on solar energy (photovoltaic and solar thermal), wind, biomass, mini-hydro along with use of fuel cells and micro turbines will gain considerable momentum in the near future. A microgrid consists of clusters of load and distributed generators that operate as a single controllable system. The interconnection of the DG to the utility/grid through power electronic converters has raised concern about safe operation and protection of the equipments. Many innovative control techniques have been used for enhancing the stability of microgrid as for proper load sharing. The most common method is the use of droop characteristics for decentralized load sharing. Parallel converters have been controlled to deliver desired real power (and reactive power) to the system. Local signals are used as feedback to control converters, since in a real system, the distance between the converters may make the inter-communication impractical. The real and reactive power sharing can be achieved by controlling two independent quantities, frequency and fundamental voltage magnitude. In this thesis, an angle droop controller is proposed to share power amongst converter interfaced DGs in a microgrid. As the angle of the output voltage can be changed instantaneously in a voltage source converter (VSC), controlling the angle to control the real power is always beneficial for quick attainment of steady state. Thus in converter based DGs, load sharing can be performed by drooping the converter output voltage magnitude and its angle instead of frequency. The angle control results in much lesser frequency variation compared to that with frequency droop. An enhanced frequency droop controller is proposed for better dynamic response and smooth transition between grid connected and islanded modes of operation. A modular controller structure with modified control loop is proposed for better load sharing between the parallel connected converters in a distributed generation system. Moreover, a method for smooth transition between grid connected and islanded modes is proposed. Power quality enhanced operation of a microgrid in presence of unbalanced and non-linear loads is also addressed in which the DGs act as compensators. The compensator can perform load balancing, harmonic compensation and reactive power control while supplying real power to the grid A frequency and voltage isolation technique between microgrid and utility is proposed by using a back-to-back converter. As utility and microgrid are totally isolated, the voltage or frequency fluctuations in the utility side do not affect the microgrid loads and vice versa. Another advantage of this scheme is that a bidirectional regulated power flow can be achieved by the back-to-back converter structure. For accurate load sharing, the droop gains have to be high, which has the potential of making the system unstable. Therefore the choice of droop gains is often a tradeoff between power sharing and stability. To improve this situation, a supplementary droop controller is proposed. A small signal model of the system is developed, based on which the parameters of the supplementary controller are designed. Two methods are proposed for load sharing in an autonomous microgrid in rural network with high R/X ratio lines. The first method proposes power sharing without any communication between the DGs. The feedback quantities and the gain matrixes are transformed with a transformation matrix based on the line R/X ratio. The second method involves minimal communication among the DGs. The converter output voltage angle reference is modified based on the active and reactive power flow in the line connected at point of common coupling (PCC). It is shown that a more economical and proper power sharing solution is possible with the web based communication of the power flow quantities. All the proposed methods are verified through PSCAD simulations. The converters are modeled with IGBT switches and anti parallel diodes with associated snubber circuits. All the rotating machines are modeled in detail including their dynamics.

Service learning in teacher education

If the student wellbeing pedagogy characterised by the troika metaphor is to become more widely adopted, beginning teachers need to be inducted into service learning. In this chapter, we discuss the implementation and outcomes of a service learning program in a Bachelor of Education course in Australia. The program provides pre-service teachers with insights into service learning practice. Pre-service teachers are given supported opportunities to examine and challenge traditional beliefs and values about student diversity and the role of schools in developing a more inclusive society. They are supported in developing ethics of care and concern for inclusive and equitable practices – characteristics necessary for quality teaching. Thus, the Queensland University of Technology (QUT) service learning program is an ideal example of the troika effect in practice, in that the pedagogy fuses values education, quality teaching and service learning to develop within each student an inclusive ethical framework that will inform their classroom practice as beginning quality teachers.

Embedding 'philosophy in the classroom' in pre-service teacher education

The holistic conception of the troika, as described in the first chapter, centres on the relationship between the implicit and explicit teaching of values the nurturing of the specific dimensions of quality teaching and the opportunity to ‘walk the talk’ of the values education program through aspects such as practical citizenship (Lovat, Toomey, Clement, Crotty & Nielsen, 2009). It is proposed in this chapter that the conception can be realized through the embedding of Philosophy in the Classroom within pre-service teaching programs. The troika, a Russian sleigh with three horses, only function well when there is complete synergy and balance between all Classroom is a scaffold for ensuring that all three elements of the troika, namely, quality teaching, values education and service learning in the form of education for citizenship, exist within the classroom to achieve an optimal learning, growth and wellbeing for all students. For this to be more widely accomplished Philosophy in the Classroom and discusses how it constitutes a successful synergy and balance of the troika for effective teaching. It then proposes how it might be embedded into pre-service teacher education.

Service bid comparisons by fuzzy ranking in open railway market timetabling

In an open railway access market, the Infrastructure Provider (IP), upon the receipts of service bids from the Train Service Providers (TSPs), assigns track access rights according to its own business objectives and the merits of the bids; and produces the train service timetable through negotiations. In practice, IP chooses to negotiate with the TSPs one by one in such a sequence that IP optimizes its objectives. The TSP bids are usually very complicated, containing a large number of parameters in different natures. It is a difficult task even for an expert to give a priority sequence for negotiations from the contents of the bids. This study proposes the application of fuzzy ranking method to compare and prioritize the TSP bids in order to produce a negotiation sequence. The results of this study allow investigations on the behaviors of the stakeholders in bid preparation and negotiation, as well as evaluation of service quality in the open railway market.

Complaining in cyberspace : the motives and forms of hotel guests’ complaints online

Traditionally, consumers who have been dissatisfied with service have typically complained to the frontline personnel or to a manager in either a direct (face-to-face, over the phone) manner, indirect by writing, or done nothing but told friends and family of the incident. More recently, the Internet has provided various “new” ways to air a grievance, especially when little might have been done at the point of service failure. With the opportunity to now spread word-of-mouth globally, consumers have the potential to impact the standing of a brand or a firm's reputation. The hotel industry is particularly vulnerable, as an increasing number of bookings are undertaken via the Internet and the decision process is likely to be influenced by what other previous guests might post on many booking-linked sites. We conducted a qualitative study of a key travel site to ascertain the forms and motives of complaints made online about hotels and resorts. 200 web-based consumer complaints were analyzed using NVivo 8 software. Findings revealed that consumers report a wide range of service failures on the Internet. They tell a highly descriptive, persuasive, and credible story, often motivated by altruism or, at the other end of the continuum, by revenge. These stories have the power to influence potential guests to book or not book accommodation at the affected properties. Implications for managers of hotels and resorts are discussed.

Scheduling coordination through negotiation between train service providers in an open railway access market

A schedule coordination problem involving two train services provided by different operators is modeled as an optimization of revenue intake. The coordination is achieved through the adjustment of commencement times of the train services by negotiation. The problem is subject to constraints regarding to passenger demands and idle costs of rolling-stocks from both operators. This paper models the operators as software agents having the flexibility to incorporate one of the two (and potentially more) proposed negotiation strategies. Empirical results show that agents employing different combination of strategies have significant impact on the quality of solution and negotiation time.

Fostering cultural awareness in pre-service teacher education : an experiment in Asia literacy capacity building in an Australian university

This paper presents the findings of a small pilot study conducted with a group of final year pre-service teachers studying a secondary social science curriculum method unit in an Australian university. One of the study’s research objectives aimed at identifying how students responded to efforts to embed intercultural understanding through Studies of Asia in their final curriculum method unit. The unit was designed and taught by the researcher on the assumption that beginning social science teachers need to be empowered with pedagogical skills and new dispositions to deal with value laden emerging regional and global concerns in their Australian secondary school classrooms. This pilot study’s research methodology was located within the qualitative framework of a participatory action research model whereby the lecturer who designed, coordinated and taught the unit was also the researcher. Its scope was limited to one semester with volunteer students. The pilot study sought to investigate responses to several issues, and this paper reports on pre-service teacher reflections on the content, pedagogy and learning they experienced in their weekly sessions with specific reference to cultural understanding, Studies of Asia and the development of Asia literacy. It also reports on pre-service teacher reflections about their own evolving capacity as beginning teachers. The findings indicate that pre-service teachers valued the opportunity to engage with learning experiences which enhanced their conceptual understandings about culture whilst also extending their pedagogical and content knowledge.

Embedding values through global education in social sciences pre-service teacher education : linking the head and heart

This chapter aims to situate values education as a core component of social science pre-service teacher education. In particular, it reflects on an experiment in embedding a values laden Global Education perspective in a fourth year social science curriculum method unit. This unit was designed and taught by the researcher on the assumption that beginning social science teachers need to be empowered with pedagogical skills and new dispositions to deal with value laden emerging global and regional concerns in their secondary school classrooms. Moreover, it was assumed that when pre-service teachers engage in dynamic and interactive learning experiences in their curriculum unit, they commence the process of ‘capacity building’ those skills which prepare them for their own lifelong professional learning. This approach to values education also aimed at providing pre-service teachers with opportunities to ‘create deep understandings of teaching and learning’ (Barnes, 1989, p. 17) by reflecting on the ways in which ‘pedagogy can be transformative’ (Lovat and Toomey, 2011 add page no from Chapter One). It was assumed that this tertiary experience would foster the sine qua non of teaching – a commitment to students and their learning. Central to fostering new ‘dispositions’ through this approach, was the belief in the power of pedagogy to make the difference in enhancing student participation and learning. In this sense, this experiment in values education in secondary social science pre-service teacher education aligns with the Troika metaphor for a paradigm change, articulated by Lovat and Toomey (2009) in Chapter One.

Regulation of train service by coasting control in metro railway system

To maximise the capacity of the rail lineand provide a reliable service for pas-sengers throughout the day, regulation of train service to maintain steady service headway is es-sential. In most current metro systems, train usually starts coasting at a fixed distance from the departed station to achieve service regulation. However, this approach is only effective with re-spect to a nominal operational condition of train schedule but not necessarily the current service demand. Moreover, it is not simply to identify the necessary starting point for coasting under the run time constraints of current service conditions since train movement is attributed by a large number of factors, most of which are non-linear and inter-dependent. This paper presents an ap-plication of classical measures to search for the appropriate coasting point to meet a specified inter-station run time and they can be integrated in the on-board Automatic Train Operation (ATO) system and have the potential for on-line implementation in making a set of coasting command decisions.

Weighted fairness with MCR guarantee and a general-purpose explicit rate allocation algorithm for ATM ABR service

In this paper, weighted fair rate allocation for ATM available bit rate (ABR) service is discussed with the concern of the minimum cell rate (MCR). Weighted fairness with MCR guarantee has been discussed recently in the literature. In those studies, each ABR virtual connection (VC) is first allocated its MCR, then the remaining available bandwidth is further shared among ABR VCs according to their weights. For the weighted fairness defined in this paper, the bandwidth is first allocated according to each VC's weight; if a VC's weighted share is less than its MCR, it should be allocated its MCR instead of the weighted share. This weighted fairness with MCR guarantee is referred to as extended weighted (EXW) fairness. Certain theoretical issues related to EXW, such as its global solution and bottleneck structure, are first discussed in the paper. A distributed explicit rate allocation algorithm is then proposed to achieve EXW fairness in ATM networks. The algorithm is a general-purpose explicit rate algorithm in the sense that it can realise almost all the fairness principles proposed for ABR so far whilst only minor modifications may be needed.

Fair flow control of ABR service by per-VC virtual queuing

In this paper, a rate-based flow control scheme based upon per-VC virtual queuing is proposed for the Available Bit Rate (ABR) service in ATM. In this scheme, each VC in a shared buffer is assigned a virtual queue, which is a counter. To achieve a specific kind of fairness, an appropriate scheduler is applied to the virtual queues. Each VC's bottleneck rate (fair share) is derived from its virtual cell departure rate. This approach of deriving a VC's fair share is simple and accurate. By controlling each VC with respect to its virtual queue and queue build-up in the shared buffer, network congestion is avoided. The principle of the control scheme is first illustrated by max–min flow control, which is realised by scheduling the virtual queues in round-robin. Further application of the control scheme is demonstrated with the achievement of weighted fairness through weighted round robin scheduling. Simulation results show that with a simple computation, the proposed scheme achieves the desired fairness exactly and controls network congestion effectively.

Embracing Philosophy and Raising the Standard of Pre-service Teacher Education Programs

In this chapter, a rationale is developed for incorporating philosophy into teacher training programs as a means of both preparing quality teachers for the 21st century and meeting the expectations detailed in the professional standards established by the statutory authority that regulates the profession in Queensland, the Queensland College of Teaching is presented. Furthermore, in-service teachers from Buranda State School, a Brisbane primary school that has been successfully teaching philosophy to its students for over 10 years, shares their experiences of teaching philosophy and how it has enhanced student learning and the quality of teaching and professionalism of the teachers. Finally, the implications of embedding philosophy into teacher training programs are explored in terms of developing the personal integrity of beginning teachers.

The Patches program : supporting the development of Malaysian pre-service teachers' academic literacy

The Patches program involves Malaysian pre-service teachers working closely with Australian pre-service teachers on a series of academic and intercultural communication tasks. A recurring problem for international students is the challenge to develop social relationships with Australian students. Similarly, it is often difficult for Australian students to step outside their accustomed social worlds to establish relationships with international students. The Patches Program supported rich cross-cultural social and academic exchanges among the students facilitating the development of students' academic literacy skills, their knowledge of self and knowledge of learning, and their skills in cross-cultural communication.