Learning through Listening: Conversations for Strategic Change in a Healtcare Provider

The aim of this paper is investigate the role of conversation in strategic change so as to enhance both theory and practice in this respect. As an investigation on how conversations shape change processes in practice, we reflect on an interpretive case study in a health care organization. Through an OD project complemented by semi-structured interviews with participants, we gained a set of data and experiences that allows us to inquire into the relationship between conversations and change in more depth.

Building the capacity for learning and change through reflective conversation

Conversation is central to the process of organizational learning and change. Drawing on the notion of reflective conversation, we describe an action research project, "learning through listening" in Omega, a residential healthcare organization. In this project, service users, staff, members of management committees, trustees, managers, and central office staff participated in listening to each other and in working together towards building capacity for creating their own vision of how the organization could move into the future, according to its values and ethos. In doing so they developed ways of engaging in reflective conversation that enabled progress towards a strategic direction.

Team training to establish a safety culture in dialysis access surgery.

Operating room (OR) team safety training and learning in the field of dialysis access is well suited for the use of simulators, simulated case learning and root cause analysis of adverse outcomes. The objectives of OR team training are to improve communication and leadership skills, to use checklists and to prevent errors. Other objectives are to promote a change in the attitudes towards vascular access from learning through mistakes in a nonpunitive environment, to positively impact the employee performance and to increase staff retention by making the workplace safer, more efficient and user friendly.

Safe Reflection Through Polymorphism

Code executed in a fully reflective system switches back and forth between application and interpreter code. These two states can be seen as contexts in which an expression is evaluated. Current language implementations obtain reflective capabilities by exposing objects to the interpreter. However, in doing so these systems break the encapsulation of the application objects. In this paper we propose safe reflection through polymorphism, \ie by unifying the interface and ensuring the encapsulation of objects from both the interpreter and application context. We demonstrate a \emphhomogeneous system that defines the execution semantics in terms of itself, thus enforcing that encapsulation is not broken.

Dynamic Synchronization: A Synchronization Model through Behavioral Reflection

In conventional software applications, synchronization code is typically interspersed with functional code, thereby impacting understandability and maintainability of the code base. At the same time, the synchronization defined statically in the code is not capable of adapting to different runtime situations. We propose a new approach to concurrency control which strictly separates the functional code from the synchronization requirements to be used and which adapts objects to be synchronized dynamically to their environment. First-class synchronization specifications express safety requirements, and a dynamic synchronization system dynamically adapts objects to different runtime situations. We present an overview of a prototype of our approach together with several classical concurrency problems, and we discuss open issues for further research.

Testing the 'Learning for Sustainabiliy' Approach in a Training for Trainers: Contribution to new learning theory and approaches

Mainstreaming the LforS approach is a challenge due to dive rging institutional priorities, customs, and expectations of classically traine d staff. A workshop to test LforS theory and practice, and explore how to mainstream it, took place in a concrete context in a rural district of Mozambique, focusing on agricultural, forest and water resources. The evaluation showed that the principles of interaction applied pe rmitted to link rational know ledge with practical experience through mutual learning and iterative self-reflection. The combination of learning techniques was considered usef ul; participants called for further opportunities to apply the LforS methodology, proposing next steps.

Endogenous Development as a Social Learning Process

The author perceives endogenous development as a social learning process, which is constructed by all actors involved. To enhance social learning, a methodology called Autodidactic Learning for sustainability is used, in which the perception of both local actors and external actors are highlighted. Reflecting on differences, conflicts and common interests leads to highly motivated debate and shared reflection, which is almost identical with social learning, and flattens the usual hierarchy between local and external actors. The article shows that the energies generated through collective learning can trigger important technical, social and political changes, which take into account the multiple dimensions of local reality.

Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial

BACKGROUND E-learning and blended learning approaches gain more and more popularity in emergency medicine curricula. So far, little data is available on the impact of such approaches on procedural learning and skill acquisition and their comparison with traditional approaches. OBJECTIVE This study investigated the impact of a blended learning approach, including Web-based virtual patients (VPs) and standard pediatric basic life support (PBLS) training, on procedural knowledge, objective performance, and self-assessment. METHODS A total of 57 medical students were randomly assigned to an intervention group (n=30) and a control group (n=27). Both groups received paper handouts in preparation of simulation-based PBLS training. The intervention group additionally completed two Web-based VPs with embedded video clips. Measurements were taken at randomization (t0), after the preparation period (t1), and after hands-on training (t2). Clinical decision-making skills and procedural knowledge were assessed at t0 and t1. PBLS performance was scored regarding adherence to the correct algorithm, conformance to temporal demands, and the quality of procedural steps at t1 and t2. Participants' self-assessments were recorded in all three measurements. RESULTS Procedural knowledge of the intervention group was significantly superior to that of the control group at t1. At t2, the intervention group showed significantly better adherence to the algorithm and temporal demands, and better procedural quality of PBLS in objective measures than did the control group. These aspects differed between the groups even at t1 (after VPs, prior to practical training). Self-assessments differed significantly only at t1 in favor of the intervention group. CONCLUSIONS Training with VPs combined with hands-on training improves PBLS performance as judged by objective measures.

Decision Support Models for Composing and Navigating through e-Learning Objects

Libraries of learning objects may serve as basis for deriving course offerings that are customized to the needs of different learning communities or even individuals. Several ways of organizing this course composition process are discussed. Course composition needs a clear understanding of the dependencies between the learning objects. Therefore we discuss the metadata for object relationships proposed in different standardization projects and especially those suggested in the Dublin Core Metadata Initiative. Based on these metadata we construct adjacency matrices and graphs. We show how Gozinto-type computations can be used to determine direct and indirect prerequisites for certain learning objects. The metadata may also be used to define integer programming models which can be applied to support the instructor in formulating his specifications for selecting objects or which allow a computer agent to automatically select learning objects. Such decision models could also be helpful for a learner navigating through a library of learning objects. We also sketch a graph-based procedure for manual or automatic sequencing of the learning objects.