Practice teaching in the Republic of the Maldives : issues and challenges

Practicum is an important but challenging part of primary teacher education especially in developing countries like the Republic of the Maldives where the effectiveness of practicum can be impeded by geographical distance, isolation, levels of teacher expertise, and by a highly structured system of primary schooling and teacher education. The current paper reports on a study of beginning teachers in their first year of full-time teaching practice and their perceptions of the effectiveness of their practicum experiences during their teacher training both generally and in terms of developing desirable teaching competencies. Teachers reported that their relationship with school and academic staff was one of the most effective and positive features of practice teaching but reported less positively on the processes used to assess and evaluate students during their teaching practice.

Assessment of variation in the alberta context tool : the contribution of unit level contextual factors and practice specialty in Canadian pediatric acute care settings

Background: There are few validated measures of organizational context and none that we located are parsimonious and address modifiable characteristics of context. The Alberta Context Tool (ACT) was developed to meet this need. The instrument assesses 8 dimensions of context, which comprise 10 concepts. The purpose of this paper is to report evidence to further the validity argument for ACT. The specific objectives of this paper are to: (1) examine the extent to which the 10 ACT concepts discriminate between patient care units and (2) identify variables that significantly contribute to between-unit variation for each of the 10 concepts.

Methods: 859 professional nurses (844 valid responses) working in medical, surgical and critical care units of 8 Canadian pediatric hospitals completed the ACT. A random intercept, fixed effects hierarchical linear modeling (HLM) strategy was used to quantify and explain variance in the 10 ACT concepts to establish the ACT’s ability to discriminate between units. We ran 40 models (a series of 4 models for each of the 10 concepts) in which we systematically assessed the unique contribution (i.e., error variance reduction) of different variables to between-unit variation. First, we constructed a null model in which we quantified the variance overall, in each of the concepts. Then we controlled for the contribution of individual level variables (Model 1). In Model 2, we assessed the contribution of practice specialty (medical, surgical, critical care) to variation since it was central to construction of the sampling frame for the study. Finally, we assessed the contribution of additional unit level variables (Model 3).

Results: The null model (unadjusted baseline HLM model) established that there was significant variation between units in each of the 10 ACT concepts (i.e., discrimination between units). When we controlled for individual characteristics, significant variation in the 10 concepts remained. Assessment of the contribution of specialty to between-unit variation enabled us to explain more variance (1.19% to 16.73%) in 6 of the 10 ACT concepts. Finally, when we assessed the unique contribution of the unit level variables available to us, we were able to explain additional variance (15.91% to 73.25%) in 7 of the 10 ACT concepts.

Conclusion: The findings reported here represent the third published argument for validity of the ACT and adds to the evidence supporting its use to discriminate patient care units by all 10 contextual factors. We found evidence of relationships between a variety of individual and unit-level variables that explained much of this between-unit variation for each of the 10 ACT concepts. Future research will include examination of the relationships between the ACT’s contextual factors and research utilization by nurses and ultimately the relationships between context, research utilization, and outcomes for patients.

Excess gestational weight gain : an exploration of midwives' views and practice.

Background
Excess gestational weight gain (GWG) can affect the immediate and long term health outcomes of mother and infant. Understanding health providers' views, attitudes and practices around GWG is crucial to assist in the development of practical, time efficient and cost effective ways of supporting health providers to promote healthy GWGs. This study aimed to explore midwives' views, attitudes and approaches to the assessment, management and promotion of healthy GWG and to investigate their views on optimal interventions.
Methods
Midwives working in antenatal care were recruited from one rural and one urban Australian maternity hospital employing purposive sampling strategies to assess a range of practice areas. Face-to-face interviews were conducted with 15 experienced midwives using an interview guide and all interviews were digitally recorded, transcribed verbatim and analysed thematically.
Results
Midwives interviewed exhibited a range of views, attitudes and practices related to GWG. Three dominant themes emerged. Overall GWG was given low priority for midwives working in the antenatal care service in both hospitals. In addition, the midwives were deeply concerned for the physical and psychological health of pregnant women and worried about perceived negative impacts of discussion about weight and related interventions with women. Finally, the midwives saw themselves as central in providing lifestyle behaviour education to pregnant women and identified opportunities for support to promote healthy GWG.
Conclusions
The findings indicate that planning and implementation of healthy GWG interventions are likely to be challenging because the factors impacting on midwives' engagement in the GWG arena are varied and complex. This study provides insights for guideline and intervention development for the promotion of healthy GWG.

Extending the paramedic role in rural Australia : a story of flexibility and innovation

Introduction: This article identifies trends in the evolving practice of rural paramedics and describes key characteristics, roles and expected outcomes for a Rural Expanded Scope of Practice (RESP) model.

Methods: A multiple case study methodology was employed to examine the evolution of rural paramedic practice. Paramedics, volunteer ambulance officers and other health professionals were interviewed in four rural regions of south-eastern Australia where innovative models of rural paramedic practice were claimed to exist. The research team collected and thematically analysed the data using the filter of a sociological framework throughout 2005 and 2006.

Results: The study found that paramedics are increasingly becoming first line primary healthcare providers in small rural communities and developing additional professional responsibilities throughout the cycle of care.

Conclusions: Adoption of the RESP model would mean that paramedics undertake four broad activities as core components of their new role: (1) rural community engagement; (2) emergency response; (3) situated practice; and (4) primary health care. The model’s key feature is a capacity to integrate existing paramedic models with other health agencies and health professionals to ensure that paramedic care is part of a seamless system that provides patients with well-organized and high quality care. This expansion of paramedics’ scope of practice offers the potential to improve patient care and the general health of rural communities.

Working at the nexus between public health policy, practice and research : dynamics of knowledge sharing in the Netherlands

Background
Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.
This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing.
Method
An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories.
Results
Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives.
Conclusion
We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks.

Through the looking glass : teaching and learning in blended immersive multiuser virtual and real world environments

This paper reports on the participation of higher education students and educators in blended immersive multi user virtual (MUVE) environments and real life teaching and learning experiences. Selected next generation technologies engage students and educators within the virtual socially networked elearning landscape of Deakin Arts Education Centre , and support the interaction of communities of learners in multiple modes, ranging from text and images accessed within the Deakin Studies Online learning management system to the "through the looking glass" virtual world in which the user’s creative imagination transports them to the “other side“ of their computer screens.

These constructed environments enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools, and represent themselves through avatars, to communicate with other participants and participate in collaborative art learning.

Factors to drive clinical practice improvement in a Malaysian intensive care unit : assessment of organisational readiness using a mixed method approach

This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identified as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.

“People’s law” and restorative justice: the success of circle sentencing in New South Wales

Informal sentencing procedures in remote Indigenous communities of Australia have been occurring for some time, but it was in the late 1990s that formalization of the practice began in urban areas with the advent of Indigenous sentencing and circle courts. These circle courts emerged primarily to address the over-representation and incarceration of Indigenous people in the criminal justice system. The first Indigenous urban court was assembled in Port Adelaide, South Australia in June 1999 and was named the Nunga Court. Courts emerging since in other states are based on the Nunga Court model, although they have been adapted to suit local conditions. The practice of circle sentencing was introduced in New South Wales (NSW) in Nowra in February 2002.

Analysis of psycholinguistic processes and topics in online autism communities

Current growth of individuals on the autism spectrum disorder (ASD) requires continuous support and care. With the popularity of social media, online communities of people affected by ASD emerge. This paper presents an analysis of these online communities through understanding aspects that differentiate such communities. In this paper, the aspects given are not expressed in terms of friendship, exchange of information, social support or recreation, but rather with regard to the topics and linguistic styles that people express in their on-line writing. Using data collected unobtrusively from LiveJournal, we analyze posts made by ten autism communities in conjunction with those made by a control group of standard communities. Significant differences have been found between autism and control communities when characterized by latent topics of discussion and psycholinguistic features. Latent topics are found to have greater predictive power than linguistic features when classifying blog posts as either autism or control community. This study suggests that data mining of online blogs has the potential to detect clinically meaningful data. It opens the door to possibilities including sentinel risk surveillance and harnessing the power in diverse large datasets.

Network dynamics of mobile social networks

With the rapid development of smartphones and mobile Internet technology, we witness an overwhelming growth of mobile social networks (MSN), which is a type of social network, forming virtual communities among people with similar interests or commonalities. In MSNs, users play a crucial role for their development, deployment and success. Understanding the MSN user behavior therefore attracts interests of different entities - ISPs, service providers, and researchers. However, it is hard to gather a comprehensive real data set, little is known and even less has been published about MSN user activities. In this paper, we focus on analyzing MSN user behavior from the perspective of ISP network, which is seldom reported in literature. Based on the real data set collected from the mobile network gateway of a major mobile carrier who has more than five million subscribers, we present an in-depth user behavior analysis of four popular social networks. We study the MSN user behavior from six aspects: user requests, active online time, sessions, inter-session, the number of requests in a session, and inter-request. We found that power law and lognormal are two popular features of the studied objects, and exposed some interesting findings as well. We hope our work could be helpful for ISPs, MSN content providers, and researchers. © 2014 IEEE.

Learning to reason: a journey of professional socialisation

One of the key attributes that health professional students and new graduates develop during professional socialisation is clinical reasoning ability. Clinical reasoning is a complex skill that is essential for professional practice. There is limited research specifically addressing how physiotherapists learn to reason in the workplace. The research reported in this paper addressed this gap by investigating how experienced physiotherapists learned to reason in daily practice. This learning journey was examined in the context of professional socialisation. A hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated, semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants' learning journeys were diverse, although certain episodes of learning were common or similar. Role models, mentors and colleagues were found to be influential in the development of reasoning. An important implication for the professional socialisation of physiotherapists and other health professionals and for those involved in practice development is the need to recognise and enhance the role of practice communities in the explicit learning of clinical reasoning skills.

Edge of centre: Australian cities and the public architecture of recent immigrant communities

In the late 1990s, the author undertook a survey of the public architecture of non-western immigrant communities in Melbourne (Beynon 2002). The survey was undertaken within a social context of rapid recent growth in non-Western immigration to Australian cities, coupled with a political context where at state and local level Australian governments were engaged in managing cultural diversity through multiculturalist policies. By the late 1990s, the number of overseas-born, or with overseas-born parentage, had become almost 40% of Australia's total population (Australian Bureau of Statistics 1998-89). Substantial numbers of such immigrants originated from outside the 'West'. Compared to other Australian cities, Melbourne had at the time of the survey the largest communities of certain birthplace groups: notably Sri Lankans, Malaysians, Turks and Somalis. The purpose of this survey was to see to what extent Melbourne's diversifying demography had changed its architectural landscape, and more broadly, what such changes in the built environment indicated about Melbourne's (and by extension Australia's) cultural identity.

Comparison of medication policies to guide nursing practice across seven Victorian health services

Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria. Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice. Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals' responsibilities among medication management policies were identified. What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors. What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications. What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.

The temptations and failings of teacher effectiveness research: provocations of a ‘practice perspective’

This chapter provides a critical appraisal of teacher effectiveness research (TER). Like others before us, we argue that TER employs a reductive view of teaching—narrowly focused on the agency of individual teachers’ classroom-based pedagogic behaviours; overemphasising the role these behaviours have on student achievement; representing these behaviours as assayable in unproblematic ways; and, potentially having negative impacts on teachers and teaching. We suggest that the theoretical sensibilities of practice theory support more productive engagements with the complexities of teaching, and we argue that this alternative theoretical framing is more likely to engage teachers in transformational agendas than those offered by current manifestations of TER. We do this by drawing on the practice writings of Reckwitz (2002), Thrift (1996, 2007) and Schatzki (2012), who provide analyses of commonalities to be found amongst diverse practice theories. We argue that a ‘practice perspective’ provides an affirmative engagement with the complexities of teaching practice and is more likely to embolden new interpretations of what teaching is and can be.