Conceptualising health literacy from the patient perspective

Objective : A person's health literacy, i.e., their ability to seek, understand and use health information, is a critical determinant of whether they are able to actively participate in their healthcare. The objective of this study was to conceptualise health literacy from the patient perspective.

Methods : Using comprehensive qualitative methods 48 individuals were interviewed across three distinct groups in Australia: those with a chronic condition, the general community and individuals who had recently presented to a metropolitan public hospital emergency department. Purposeful sampling was employed to ensure a range of experiences was captured.

Results : Seven key abilities were identified: knowing when to seek health information; knowing where to seek health information; verbal communication skills; assertiveness; literacy skills; capacity to process and retain information; application skills.

Conclusion : This study identifies key abilities patients identified as critical to seek, understand and utilise information in the healthcare setting. These abilities are not reflected in existing measures for health literacy. Future measures of health literacy could consider incorporating abilities identified in this study and may provide guidance in developing health interventions to assist patients to participate effectively in their health.

Practice implications : More comprehensive measures to assess patient's health literacy are needed.

A systematic review of reliable and valid tools for the measurement of patient participation in healthcare

INTRODUCTION: Patient participation in healthcare is recognised internationally as essential for consumer-centric, high-quality healthcare delivery. Its measurement as part of continuous quality improvement requires development of agreed standards and measurable indicators. AIM: This systematic review sought to identify strategies to measure patient participation in healthcare and to report their reliability and validity. In the context of this review, patient participation was constructed as shared decision-making, acknowledging the patient as having critical knowledge regarding their own health and care needs and promoting self-care/autonomy. METHODS: Following a comprehensive search, studies reporting reliability or validity of an instrument used in a healthcare setting to measure patient participation, published in English between January 2004 and March 2014 were eligible for inclusion. RESULTS: From an initial search, which identified 1582 studies, 156 studies were retrieved and screened against inclusion criteria. Thirty-three studies reporting 24 patient participation measurement tools met inclusion criteria, and were critically appraised. The majority of studies were descriptive psychometric studies using prospective, cross-sectional designs. Almost all the tools completed by patients, family caregivers, observers or more than one stakeholder focused on aspects of patient-professional communication. Few tools designed for completion by patients or family caregivers provided valid and reliable measures of patient participation. There was low correlation between many of the tools and other measures of patient satisfaction. CONCLUSION: Few reliable and valid tools for measurement of patient participation in healthcare have been recently developed. Of those reported in this review, the dyadic Observing Patient Involvement in Decision Making (dyadic-OPTION) tool presents the most promise for measuring core components of patient participation. There remains a need for further study into valid, reliable and feasible strategies for measuring patient participation as part of continuous quality improvement.

Professional development for school administrators : computer applications in data communication

This action research project set out to develop the competence of senior personnal from a private vocational college in Thailand in the use of administrative computer systems. The findings demonstrate the critical significance of progressive incremental learning that is tailored to the professional personal needs of learners. Learner competence was found to be dependent upon the creation of an environment promoting learner confidence.

Information communication technologies (ICTs) an knowledge sharing : the case of professional accountants in Malaysia

Based on the knowledge sharing model by Nonaka (1994), this study examines the relative efficacy of various Information Communication Technologies (ICTs) applications in facilitating sharing of explicit and tacit knowledge among professional accountants in Malaysia. The results of this study indicate that ICTs, generally, facilitate all modes of knowledge sharing. Best-Practice Repositories are effective for sharing of both explicit and tacit knowledge, while internet/e-mail facilities are effective for tacit knowledge sharing. Data warehousing /mining, on the other hand, is effective in facilitating self learning through tacit-to-tacit mode and explicit-to-explicit mode. ICT facilities used mainly for office administration are ineffective for knowledge sharing purpose. The implications of the findings are
discussed.

Teaching HRD personnel : experiences of computer-mediated communication in differently structured environments

This paper will provide an overview of the CMC structure in two different units of study in the Masters of Professional Education and Training at Deakin University. Each of these structures makes a set of demands on participants, and provides differing collaborative learning opportunities. The paper examines the experiences we have had in each of these structures, focusing on student participation, style of contribution to CMC, and the relationship between socialisation processes and knowledge construction.

Educating for professional capability in the field of information technology: integrating industry-based learning with the academic curriculum

In response to the forces of globalisation, societies and organisations have had to adapt and even proactively transform themselves. Universities, as knowledge-based organisations, have recognised that there are now many other important sites of knowledge construction and use. The apparent monopoly over valued forms of knowledge making and knowledge certification is disappearing. Universities have had to recognise the value of practical working knowledge developed in workplace settings beyond university domains, and promote the value of academic forms of knowledge making to the practical concerns of everyday learning. It is within this broader systems view that professional curriculum development undertaken by universities needs to be examined.

University educational planning responds to these external forces in ways that are drawing together formal academic capability/competence and practice-based capability/competence. Both forms of academic and practice-based knowledge and knowing are being equally valued and related one to the other. University planning in turn gives impetus to the development of new forms of professional education curricula. This paper presents a contemporary case of a designed professional curriculum in the field of information technology that situates workplace learning as a central element in the education of Information Technology (IT)/Information Systems (IS) professionals.

The key dimensions of the learning environment of Deakin University’s BIT (Hons) program are considered with a view to identifying areas of strong integration between the worlds of academic and workplace learning from the perspectives of major stakeholders. The dynamic interplay between forms of theorising and practising is seen as critical in educating students for professional capability in their chosen field. From this analysis, an applied research agenda, relating to desired forms of professional learning in higher education, is outlined, with specific reference to the information and communication technology professions.

Change happens: acceptance of 'impermanence' and 'flow' in teachers' professional reflections on technology and change

For several years the authors of this paper have monitored the use of information and communication technologies (ICT) in primary and secondary schools. In this paper they report on their work in progress, focusing particularly on data collected via teacher interviews in 2003. It is a 'good news' story that celebrates a shift in the way school teachers approach ICT, and that shows that teachers are a lot more comfortable with ICT than the authors have previously observed. The authors argue that a significant transition has occurred in the hardware, software and 'warmware', the people and how they can work with the hardware and software as part of their pedagogy. Existing research tends to construct change as something that has to be planned, prepared for and managed (eg. Fullan, 1997), and as something that teachers often resist (eg. Cuban, 1993; Grunberg & Summers, 1992; Hodas, 1998). This paper is distinctive in drawing on Eastern approaches to understanding change. Through an examination of the concepts of "impermanence" and "flow," and how they apply to ICT, schools and teachers' work, we seek to demystify change: Change happens, has happened and will continue to happen. We conclude that teachers' increased familiarity with, and increasingly relaxed approach to, ICT has led to a shift in their attentions, such that they are less concerned with obtaining and mastering particular software and hardware, and more concerned with pedagogy and student learning.

Working and learning in vocational education and training in the knowledge era : final report of the professional development for the future project

This Report summarises the outcomes of the phases of the Professional
Development for the Future Project and presents the implications of this research for professional development of staff in Vocational Education and Training (VET), as they become knowledge workers.

These shifts are occurring within the knowledge era. Distinguishing features of this era are summarised into four broad areas:
- the importance and value placed on knowledge in organisations
- the time span of discretion
- the complexity of relationships, and
- the ubiquitous nature of information and communication technology.

It is within this context that work is currently performed, and understanding this context provides the foundation for considering new capabilities required in the knowledge era.
Key capabilities required of knowledge workers to work effectively in the
knowledge era were drawn together from an analysis of the theoretical literature and the results of interviews with knowledge workers. The core capabilities identified include:
- adaptive problem solving – becoming designers as well as problem -
solvers
- rapid knowledge gathering and sharing with others
- discriminating between relevant and irrelevant information, and
- understanding and working effectively with the organisation’s culture.

Knowledge era characteristics and knowledge worker capabilities have been mapped to each other illustrating conceptual linkages between these two areas.

Professional development themes drawn from interviews with knowledge
workers are presented. While global trends in knowledge work have been well documented, the impact of these trends on the capabilities of workers, and the ways in which knowledge workers develop these capabilities is less well understood. Their learning methods challenge our current thinking in relation to the ways in which workers acquire skills and knowledge. Some of the professional development methods include seeking exposure to new ideas from a wide variety of sources, embracing intense learning opportunities, and using relationships to increase knowledge.

‘Thought pieces’ (see p17 ff) commissioned for this Project, as well as
subsequent interviews with the authors, provided further insights into the
professional development of knowledge workers. The implications of these insights are an extension of earlier themes and emphasise:
- the emergent nature of knowledge work
- the importance of relationships that facilitate knowledge sharing
- coherent conversations and dialogue
- collaborative work and generosity.

A key insight is the shift from thinking about knowledge work in terms of
borrowed knowledge to an emphasis on generated knowledge within a context.

Data from focus groups of the Project provide further insights for knowledge worker professional development. These augment the perspectives of the earlier data analysis but also add greater emphasis to:
- the clear and direct relationship between professional development and
work and career aspirations of knowledge workers,
- the relationship of professional development to the organisational
mission, and
- the issues of managing and leading knowledge workers and their
development.

As part of this analysis the defining features of organisational life in VET were reviewed in relation to effective professional development of knowledge workers.

The final section of the Report revisits the core dimensions of the Project.
Concise commentaries on working and learning in the knowledge era,
professional development in the knowledge era, and leadership and
management in the knowledge era are presented.

The Report concludes with a discussion of the enablers of professional
development for knowledge workers in VET. This discussion is introduced by a re-statement of the VET sector’s positioning in the knowledge era and the consequences of this for VET managers an d staff in terms of complexity, uncertainty and diminished prospects for accurate predictiveness. The enablers comprised:
- integration of information technology into socio -technical systems
- greater understanding of the organisation from within
- connecting staff to the organisation’s fundamental identity
- connecting to the work and career trajectories of workers
- establishing work structures which integrate the use of professional
development resources with knowledge work
- providing workers with the autonomy to design their own professional
development activities
- building professional development into the iterative nature of knowledge
work, and
- creating organisational contexts that value intuitive thinking and working.

Professional development needs to be thou ght of in a much broader context in the knowledge era. What each VET staff member knows and shares will become increasingly central to their work, and in that sense all VET workers require capabilities for knowledge work. This report accurately describes t he VET context, the capabilities required, and the organisational enablers that will promote ‘knowing’ and thus embed a new style of professional development within VET.

QTP in Victoria: listening to teachers leads to quality professional development

How do you get information and communication technology working for authentic learning across the curriculum? It depends on quality professional development. The author draws on her research and evaluation work on a Quality Teacher Program pilot project by the Victorian Department of Education and Training to explain why listening to teachers is leading to just that.

Technology advances : transforming university teaching through professional development

Increasing use of information and communication technologies (ICTs) in universities is a global trend. However, many teaching academics are unfamiliar with the possibilities of ICTs and have limited understanding of how to integrate them into their teaching in pedagogically appropriate ways. Th is highlights a need for universities to provide professional development opportunities to assist staff to better understand their teaching practices, and the theoretical perspectives underpinning them, in order to exploit current educational technologies for the benefi t of student learning. This paper introduces the broad trends infl uencing the advancement of technology in higher education before considering the opportunities that the new context off ers for pushing the boundaries of theory and practice relating to learning and teaching in higher education. It then describes an online professional development initiative which responds to these opportunities. Th is is an exemplars website entitled Designing Electronic Learning and Teaching Approaches (DELTA) which has been introduced at Monash University to support pedagogically appropriate teaching with technology.

Professional carers' knowledge and response to depression among their aged-care clients : the care recipients' perspective

Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

Investigating the factors of professional development programs that effect change in the classroom

This paper reports on the implementation of two professional development programs designed to support ICT based pedagogies in Victorian (Australia) schools. In both programs the teachers participated in an intensive program of professional development designed to assist them in embedding ICT into their classroom practice. There was a large diversity of circumstances experienced by the schools, not only in terms of ICT availability and use, and teacher experience, but also in issues of cultures of curriculum planning and integration, size, communication, and pedagogical presumptions. Both projects were successful in implementing change; however there were teachers in both projects who failed to take advantage of the PD. Some of the limitations with both studies include the high expectations of time comittment by the teachers – who are already fully committed with full teaching loads, and the high expectations of the change that will occur in the teaching and
learning as a result of the PD, wthout consideration of the time needed to learn and adopt new pedagogical practice. In some cases, teachers and the school did not appreciate the necessary commitment to take full advantage of the opportunity being provided. This was compounded by the lack of support and recognition by school management.