How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol

Background: Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues—such as IPV management—get integrated into health systems, and that focuses on healthcare teams’ learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. Methods: This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Discussion: Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.

Developing a programme theory to explain how primary health care teams learn to respond to intimate partner violence: a realist case-study

Background: Despite the progress made on policies and programmes to strengthen primary health care teams’ response to Intimate Partner Violence, the literature shows that encounters between women exposed to IPV and health-care providers are not always satisfactory, and a number of barriers that prevent individual health-care providers from responding to IPV have been identified. We carried out a realist case study, for which we developed and tested a programme theory that seeks to explain how, why and under which circumstances a primary health care team in Spain learned to respond to IPV. Methods: A realist case study design was chosen to allow for an in-depth exploration of the linkages between context, intervention, mechanisms and outcomes as they happen in their natural setting. The first author collected data at the primary health care center La Virgen (pseudonym) through the review of documents, observation and interviews with health systems’ managers, team members, women patients, and members of external services. The quality of the IPV case management was assessed with the PREMIS tool. Results: This study found that the health care team at La Virgen has managed 1) to engage a number of staff members in actively responding to IPV, 2) to establish good coordination, mutual support and continuous learning processes related to IPV, 3) to establish adequate internal referrals within La Virgen, and 4) to establish good coordination and referral systems with other services. Team and individual level factors have triggered the capacity and interest in creating spaces for team leaning, team work and therapeutic responses to IPV in La Virgen, although individual motivation strongly affected this mechanism. Regional interventions did not trigger individual and/ or team responses but legitimated the workings of motivated professionals. Conclusions: The primary health care team of La Virgen is involved in a continuous learning process, even as participation in the process varies between professionals. This process has been supported, but not caused, by a favourable policy for integration of a health care response to IPV. Specific contextual factors of La Virgen facilitated the uptake of the policy. To some extent, the performance of La Virgen has the potential to shape the IPV learning processes of other primary health care teams in Murcia.

Teaching-learning process of historical heritage: a Journey as a beginning, path and end

The implantation of new university degrees within the European Higher Education Area implies the need of innovative methodologies in teaching and learning to improve the skills and competencies of students and to answer the growing needs that society continuously demands to heritage management experts. The present work shows an application of the teaching methodology proposed during the international workshop entitled “I International Planning Preservation Workshop. Learning from Al Andalus”, which included the participation of the University of Alicante and Granada, Università Politecnico di Milano and Hunter College City University of New York; where we tried to dissolve traditional boundaries derived of interuniversity cooperation programs. The main objective of the workshop was to discuss and debate the role of urban Historical Centers within the Global Heritage by the integrated work through multidisciplinary teams and the creation of a permanent international working group between these universities to both teach and research. The methodology of this workshop was very participatory and considered the idea of a new learning process generated by "a journey experience." A trip from global to local (from the big city to the small village) but also a trip from the local (historical) part of a big city to the global dimension of contemporary historical villages identified by the students through a system of exhibition panels in affinity groups, specific projects proposed by lecturers and teachers or the generation of publications in various areas (texts, photographs, videos, etc.). So, the participation of the students in this multidisciplinary meeting has enhanced their capacity for self-criticism in several disciplines and has promoted their ability to perform learning and research strategies in an autonomous way. As a result, it has been established a permanent international work structure for the development of projects of the Historical City. This relationship has generated the publication of several books whose contents have reflected the conclusions developed in the workshop and several teaching proposals shared between those institutions. All these aspects have generated a new way of understanding the teaching process through a journey, in order to study the representative role of university in the historical heritage and to make students (from planning, heritage management, architecture, geography, sociology, history or engineering areas) be compromised on searching strategies for sustainable development in the Contemporary City.

Is video-case an efficient tool to complement the practical learning in real contexts? Effects on satisfaction and performance in Social Work Degree students

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