Patience, Persistence and Pragmatism: Experiences and Lessons Learnt from the Implementation of Clinically Integrated Teaching and Learning of Evidence-Based Health Care - A Qualitative Study

Background

Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC) knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes.

Methods and Findings

We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling.

Conclusions

Implementing clinically integrated EBHC curricula requires institutional support, a critical mass of the right teachers and role models in the clinical setting combined with patience, persistence and pragmatism on the part of teachers.

Qualidade, sustentabilidade e FCS: o caso de uma IES privada no Brasil

Este trabalho de investigação foi realizado com o objetivo geral de se descobrir quais são os Fatores Críticos de Sucesso e os aspectos chaves de qualidade e sustentabilidade, a serem considerados no ensino de Engenharia de Produção em um IES privada no Brasil. No presente estudo de caso executou-se uma revisão teórica sistemática nas áreas temáticas da pesquisa, que propiciou a criação de um framework que define os 7 Fatores Críticos de Sucesso ao ensino de Engenharia de Produção, apontando sua divisão nas áreas de qualidade e sustentabilidade, e, por fim, a subdivisão em 6 subáreas de ações operacionais a serem consideradas pela gestão de IES para alcançar melhorias de desempenho em suas atividades. Posteriormente ao levantamento teórico, foi realizado o estudo de caso propriamente dito, que dividiu-se em duas etapas, uma qualitativa e uma quantitativa. Na primeira elaborou-se um roteiro de entrevista em profundidade aplicada a um terço do corpo docente do curso em estudo, captando a impressão destes sobre as temáticas em estudo voltadas à execução de suas atividades. Os dados obtidos foram organizados com o auxílio do software WebQDA, gerando ideias do que deve ser trabalhado para melhorar as condições e resultados do referido curso. A etapa quantitativa foi iniciada com a elaboração de um questionário on-line, desenvolvido a partir do enquadramento teórico e da informação obtida na parte qualitativa do estudo, que envolveu respostas de cerca de dois terços dos discentes de Engenharia de Produção. A informação foi recolhida através de um formulário disponibilizado pelo googledocs, e os resultados foram analisados com o auxílio do software SPSS, permitindo conhecer as expectativas e percepções dos alunos e, consequentemente, os gaps provenientes a serem trabalhados. Finalmente, o estudo revelou que para aspectos de qualidade, os pontos de tangibilidade, como infraestrutura geral, laboratórios técnicos específicos, cantina e biblioteca, precisam ser melhorados, e, para aspectos de sustentabilidade, surge a necessidade de melhorar as formas de divulgação do curso, captação de alunos e propostas para a retenção dos mesmos para outros cursos e projetos da IES. Deste modo, o trabalho desenvolvido atingiu seu objetivo e se mostrou válido para aplicações na IES e em outros cursos da mesma (com as devidas adaptações). Fica como recomendação final aplicar o estudo periodicamente para se captar as mudanças situacionais que ocorrerem, manter um controle eficiente dos aspectos estudados e gerar melhorias contínuas no curso estudado e na própria IES.

International cooperation for development in tourism destinations

The main goal of this thesis is to propose a conceptual theoretical model of critical success factors of International Development Cooperation programmes that are based in knowledge transfer approaches in the context of tourism development. The research was structured around three main theoretical pillars: international development cooperation (IDC), tourism as a tool for development, and knowledge transfer (KT). By exploring these pillars´ main interrelations, it was possible to gather the necessary background to develop the theoretical model and apply it to a real context. It was adopted a qualitative research approach using as a case study an IDC programme in tourism - the UNWTO.Volunteers programme. The key contribution of this thesis in the theoretical realm is the bridging of fields of study that are insufficiently covered in the scientific literature. The resulting model proposal applied to a real context of an IDC programme implementation permitted to test it partially providing useful insights for future research. It is postulated that IDC programmes in these contexts constitute a process rather than an end in itself. Therefore, they should be seen as a way of changing the state of the art of the tourism system in a sustainable manner so that it potentially generates positive development changes. This study suggested that it is not possible to achieve positive results if, instead of encouraging a KT and learning environment, it is simply disseminated knowledge in a linear, static, north-south approach. The characteristics of these interventions should be reviewed in that it was found that it is very difficult to guarantee the maintenance of the development changes induced by them if it is not safeguarded the necessary conditions and accountability to implement the recommended actions. While it was perceived a great potential for development changes to be induced by some IDC programmes in tourism destinations, it was concluded that these processes are too much dependent on the local political systems and existing power relations, as well as on the level of tourism development of the destination. However, more research is needed to examine the ability to generalise the findings to other IDC programmes and different destinations of developing countries.

The role of urban consolidation centres in sustainable freight transport

The chapter considers the role that urban consolidation centres (UCCs) can play in helping to reduce goods vehicle traffic and its environmental impacts in urban areas. A UCC is a logistics facility that is situated in relatively close proximity to the area that it serves. Goods destined for this area are dropped off at the UCC, and are sorted and consolidated onto goods vehicles for delivery to their final destinations, often using environmentally friendly vehicles such as electric and gas-powered goods vehicles, and electrically-assisted cycles. The development of UCCs since their first appearance in the 1970s is reviewed and the various types of UCC categorised. The freight transport and logistics advantages offered by UCCs are discussed. Case studies of four recent UCC trials are included. The objectives, operational and financial aspects and impacts of these UCCs are compared and their critical success factors identified.

A review of urban consolidation centres in the supply chain based on a case study approach

The paper considers how urban consolidation centres (UCCs) can be used in the supply chain to reduce goods vehicle traffic and its associated environmental impacts, while also helping to make supply chains more responsive and efficient and thereby generate commercial benefits. The role of UCCs is presented and the various types discussed. The potential supply chain impacts of UCCs are considered. Case studies of six UCC schemes and trials are included, with their objectives, operational characteristics and impacts compared. The critical success factors associated with UCCs are identified.

Standardization of project management processes

Software development is a discipline that is almost as old as the history of computers. With the advent of the Internet and all of its related technologies, software development has been on high demand. But, and especially in SME (small and medium enterprise), this was not accompanied with a comparable effort to develop a set of sustainable and standardized activities of project management, which lead to increasing inefficiencies and costs. Given the actual economic situation, it makes sense to engage in an effort to reduce said inefficiencies and rising costs. For that end, this work will analyze the current state of software development’s project management processes on a Portuguese SME, along with its problems and inefficiencies in an effort to create a standardized model to manage software development, with special attention given to critical success factors in an agile software development environment, while using the best practices in process modeling. This work also aims to create guidelines to correctly integrate these changes in the existing IS structure of a company.

Internationalization strategy of reliance to Brazil

This Work Project was focused, firstly, in an internal analysis to assess the possible competitive advantage sources of the firm and to identify the key weakness that the firm should improve before advancing with the internationalization strategy. Completed the analysis was possible to verify that the source of sustainable competitive advantage of Relance is the use of specific raw materials and that its biggest weaknesses are the lack of capacity and the excessive dependence on key employees. Overall, it was possible to conclude that the firm is in position of competing in the international markets. Secondly, due to its crucial importance, the country selection was made with a deep objective analysis, resulting with the selection of Brazil as the country with the highest market potential. Regarding the strategy to actually enter in Brazil’s market, after the study of 12 modes of entry it was possible to conclude that there is no ideal mode. However, the study performed allowed to undertake the conclusion that in order to obtain long-term optimization on the process, the adaptation, to the firm´s situation, of the Uppsala model progressive stages is the ideal. At the course of this Work Project it was inferred that the critical success factors are the choice of the distributor and the promotion of Relance as a premium brand.

The role of information systems in business process redesign : a case of Turkish electricity market

This study is specifically concerned with the effect of the Enterprise Resource Planning (ERP) on the Business Process Redesign (BPR). Researcher’s experience and the investigation on previous researches imply that BPR and ERP are deeply related to each other and a study to found the mentioned relation further is necessary. In order to elaborate the hypothesis, a case study, in particular Turkish electricity distribution market and the phase of privatization are investigated. Eight companies that have taken part in privatization process and executed BPR serve as cases in this study. During the research, the cases are evaluated through critical success factors on both BPR and ERP. It was seen that combining the ERP Solution features with business processes lead the companies to be successful in ERP and BPR implementation. When the companies’ success and efficiency were compared before and after the ERP implementation, a considerable change was observed in organizational structure. It was spotted that the team composition is important in the success of ERP projects. Additionally, when the ERP is in driver or enabler role, the companies can be considered successful. On the contrary, when the ERP has a neutral role of business processes, the project fails. In conclusion, it can be said that the companies, which have implemented the ERP successfully, have accomplished the goals of the BPR.

Commercialization of Biopharmaceuticals

Biotekniikkaa pidetään yhtenä lupaavimmista nykyään tunnetuista teknologioista. Biotekniikan alalta erityisesti uusien lääkeaineiden kehittely on saavuttanut huomiota julkisuudessa. Biotekniikkaa lääkeaineiden kehittämiseen soveltavien yritysten määrä on kasvanut nopeasti viimeisen vuosikymmenen aikana, mutta tämänhetkiset tulokset osoittavat, että yritykset voisivat hyötyä riskien hallintaan ja kaupallistamiseen liittyvien prosessien kehittämisestä. Tutkielma keskittyy biolääkkeiden kaupallistamiseen, erityisesti suomalaisten uusien biolääkeyritysten kannalta. Tutkielma jakaantuu kahteen osaan: ensimmäinen osa tutkii kaupallistamista käsitteenä ja biolääkeliiketoiminnan erityispiirteitä. Toinen osa keskittyy kaupallistamisen empiiriseen tutkimukseen, joka kattaa viisi suomalaista uutta biolääkeyritystä. Empiirisen osan tavoitteena oli tunnistaa ne keinot, jotka auttavat menestyksekkään kaupallistamisprosessin luomisessa tuotekehitysvaiheen läpäisseelle lääkeaineelle. Saavutetut tulokset voidaan tiivistää neljän kriittisen menestystekijän ympärille, jotka ovat 1) tuote, 2) viestintä, 3) uskottavuus ja 4) yhteistyökumppanin valinta. Ensimmäinen menestystekijä on ainutlaatuinen biolääke, joka parantaa kansantaloudellisesti merkittäviä tauteja. Toisen menestystekijän avulla yritys viestittää uudesta ainutlaatuisesta tuotteestaan mahdollisille yhteistyökumppaneilleen. Kolmas menestystekijä kohdistuu yrityksen uskottavuuteen uutena korkean teknologian biolääkeaineiden kehittäjänä. Uskottavuustekijä on erityisen tärkeä suhteiden luomisessa kansainvälisiin lääkeyrityksiin. Neljäs tekijä keskittyy yhteistyökumppanin valintaan, joka alan erityisluonteesta johtuen on tärkeä uudelle biolääkeyritykselle. Viimeiseksi havaittiin, että uusi biolääkeyritys virtuaalisen rakenteensa vuoksi tarvitsee hyvät johdon suhdemarkkinointikyvyt.

Konzeption eines generischen Vorgehensmodells zur strategieorientierten und partizipativen Einführung komplexer Softwaresysteme unter Berücksichtigung organisatorischer Gestaltungsprozesse

Die Dissertation befasst sich mit der Einführung komplexer Softwaresysteme, die, bestehend aus einer Kombination aus parametrisierter Standardsoftware gepaart mit Wettbewerbsvorteil sichernden Individualsoftwarekomponenten, keine Software-Engineering-Projekte im klassischen Sinn mehr darstellen, sondern einer strategieorientierten Gestaltung von Geschäftsprozessen und deren Implementierung in Softwaresystemen bedürfen. Die Problemstellung einer adäquaten Abwägung zwischen TCO-optimierender Einführung und einer gleichzeitigen vollständigen Unterstützung der kritischen Erfolgsfaktoren des Unternehmens ist hierbei von besonderer Bedeutung. Der Einsatz integrierter betriebswirtschaftlicher Standardsoftware, mit den Möglichkeiten einer TCO-Senkung, jedoch ebenfalls der Gefahr eines Verlustes von Alleinstellungsmerkmalen am Markt durch Vereinheitlichungstendenzen, stellt ein in Einführungsprojekten wesentliches zu lösendes Problem dar, um Suboptima zu vermeiden. Die Verwendung von Vorgehensmodellen, die sich oftmals an klassischen Softwareentwicklungsprojekten orientieren oder vereinfachte Phasenmodelle für das Projektmanagement darstellen, bedingt eine fehlende Situationsadäquanz in den Detailsituationen der Teilprojekte eines komplexen Einführungsprojektes. Das in dieser Arbeit entwickelte generische Vorgehensmodell zur strategieorientierten und partizipativen Einführung komplexer Softwaresysteme im betriebswirtschaftlichen Anwendungsbereich macht - aufgrund der besonders herausgearbeiteten Ansätze zu einer strategieorientierten Einführung, respektive Entwicklung derartiger Systeme sowie aufgrund der situationsadäquaten Vorgehensstrategien im Rahmen der Teilprojektorganisation � ein Softwareeinführungsprojekt zu einem Wettbewerbsfaktor stärkenden, strategischen Element im Unternehmen. Die in der Dissertation diskutierten Überlegungen lassen eine Vorgehensweise präferieren, die eine enge Verschmelzung des Projektes zur Organisationsoptimierung mit dem Softwareimplementierungsprozess impliziert. Eine Priorisierung der Geschäftsprozesse mit dem Ziel, zum einen bei Prozessen mit hoher wettbewerbsseitiger Priorität ein organisatorisches Suboptimum zu vermeiden und zum anderen trotzdem den organisatorischen Gestaltungs- und den Systemimplementierungsprozess schnell und ressourcenschonend durchzuführen, ist ein wesentliches Ergebnis der Ausarbeitungen. Zusätzlich führt die Ausgrenzung weiterer Prozesse vom Einführungsvorgang zunächst zu einem Produktivsystem, welches das Unternehmen in den wesentlichen Punkten abdeckt, das aber ebenso in späteren Projektschritten zu einem System erweitert werden kann, welches eine umfassende Funktionalität besitzt. Hieraus ergeben sich Möglichkeiten, strategischen Anforderungen an ein modernes Informationssystem, das die kritischen Erfolgsfaktoren eines Unternehmens konsequent unterstützen muss, gerecht zu werden und gleichzeitig ein so weit als möglich ressourcenschonendes, weil die Kostenreduktionsaspekte einer Standardlösung nutzend, Projekt durchzuführen. Ein weiterer wesentlicher Aspekt ist die situationsadäquate Modellinstanziierung, also die projektspezifische Anpassung des Vorgehensmodells sowie die situationsadäquate Wahl der Vorgehensweisen in Teilprojekten und dadurch Nutzung der Vorteile der verschiedenen Vorgehensstrategien beim konkreten Projektmanagement. Der Notwendigkeit der Entwicklung einer Projektorganisation für prototypingorientiertes Vorgehen wird in diesem Zusammenhang ebenfalls Rechnung getragen. Die Notwendigkeit der Unternehmen, sich einerseits mit starken Differenzierungspotenzialen am Markt hervorzuheben und andererseits bei ständig sinkenden Margen einer Kostenoptimierung nachzukommen, lässt auch in Zukunft das entwickelte Modell als erfolgreich erscheinen. Hinzu kommt die Tendenz zu Best-Of-Breed-Ansätzen und komponentenbasierten Systemen im Rahmen der Softwareauswahl, die eine ausgesprochen differenzierte Vorgehensweise in Projekten verstärkt notwendig machen wird. Durch die in das entwickelte Modell integrierten Prototyping-Ansätze wird der auch in Zukunft an Bedeutung gewinnenden Notwendigkeit der Anwenderintegration Rechnung getragen.

Los beneficios de implementar un sistema ERP en las empresas colombianas – estudio de caso

El objeto de este trabajo es establecer, mediante el método de estudio de caso, los beneficios tangibles que para las empresas colombianas puede generar la implantación de un sistema ERP. Se inicia con la revisión del concepto de información, tecnología de información y sistemas de información. En esta parte se efectúa un recorrido teórico de la importancia de los sistemas de información y el diferente tratamiento que se ha dado a este concepto. En la segunda parte, se exploran los sistemas ERP, sus principales características, beneficios, factores críticos de éxito y costos de implantación. Finalmente, en la tercera parte, se presentan los resultados del estudio de caso sobre cinco empresas colombianas, que implementaron sistemas ERP, observando su desempeño individual y frente a las empresas de su subsector económico mediante el uso de 36 indicadores clasificados para medir liquidez, endeudamiento, rentabilidad, actividad y crecimiento.

Kids Club, Un modelo de negocio exitoso del Sector del Calzado en Colombia

“Los modelos de negocio describen las bases sobre las cuales una empresa, crea, proporciona y capta valor”. Osterwalder, Alexander. (2010). Kids Club es una empresa manufacturera de calzado para niños catalogada por PROEXPORT como una de las mejores empresas Colombianas dentro del sector; y una de las pocas empresas que en menos de 10 años logro exportar sus productos a mercados internacionales a partir de técnicas administrativas empíricas. A través del siguiente estudio de caso, se pretende describir el modelo de negocio de la empresa; identificando sus segmentos de mercado, estructura de cadena de valor y mecanismos de generación de ventas con el objetivo de identificar sus factores críticos de éxito y proponer nuevas alternativas para que se mantenga como líder del sector, en el entorno empresarial actual.

Análisis de procesos de renovación urbana en áreas centrales. Influencia de la estrategia de renovación urbana en la dinámica de consolidación del sector de San Victorino en Bogotá (1996 – 2010)

San Victorino es un centro popular que cuenta con un gran dinamismo y funcionalidad comercial en el centro de Bogotá. El interés de este estudio de caso es revisar el tema de renovación urbana en las áreas centrales, específicamente, caracterizar las intervenciones urbanas sobre el sector de San Victorino, para identificar los factores críticos y factores de éxito de aquellas intervenciones en el proceso de consolidación física, que lo han mantenido como un territorio en construcción. Se analizan intervenciones urbanas que producen cambios físicos, funcionales y que han incidido en un proceso de consolidación como área comercial de carácter nacional. El resultado permite identificar algunos aspectos ligados la dinámica de subdivisión y cambios morfológicos asociados al mayor aprovechamiento del suelo y que pueden incidir en nuevas dinámicas de transformación territorial.

Utilidad de las relaciones estratégicas comunitarias y el marketing en la administración de negocios con clientes corporativos

Este trabajo de grado propone identificar la utilidad de las relaciones estratégicas comunitarias y el marketing en la administración de negocios con clientes corporativos, también se toman en cuenta conceptos como el marketing organizacional y relacional, estos conceptos ayudan en la investigación a determinar relaciones estratégicas entre las empresas, y el beneficio que estas le generan a las corporaciones; para así fomentar la implementación de estas estrategias en a las empresas a nivel nacional e internacional, así mismo, identificar el concepto de comunidad que tienen los clientes corporativos y como este concepto se puede adaptar al entorno que los rodea. Con el fin de entender las funciones y características de un cliente corporativo, así como su comportamiento, los objetivos específicos de la investigación son describir las estrategias de marketing en la administración de negocios con clientes corporativos, determinar si existe el concepto de comunidad en la administración de negocios con clientes corporativos y determinar si se utilizan relaciones estratégicas comunitarias en la administración de negocios con clientes corporativos. La metodología que se planteó usar fue teórica-conceptual, teniendo en cuenta el marketing y las relaciones estratégicas comunitarias de los clientes corporativos. Llevando la investigación al ámbito de la gerencia y dirección, los resultados que se obtuvieron gracias a la investigación, ayudaran a potenciar la dirección de las empresas, donde se evalué la verdadera utilidad de las estrategias basadas en las relaciones comunitarias y marketing en los negocios con clientes corporativos. Las estrategias comunitarias y el marketing influencian de manera directa las relaciones de las compañias con sus clientes corporativos, debido a que marketing nos permite extender la relación y generar una utilidad a futuro entre ambas partes. De la investigación se concluye que las empresas que logran crear estrategias comunitarias y relaciones estrechas entre ellas, tienden a tener mejores utilidades en el largo plazo y ser empresas más sostenibles.

Sustainable urban development to 2050: complex transitions in the built environment of cities

The majority of the world’s population now live in cities. This poses great challenges, but also great opportunities in terms of tackling climate change, resource depletion and environmental degradation. Policy agendas have increasingly focused on how to develop and maintain ‘integrated sustainable urban development’, and a number of theoretical conceptualisations of urban transition have been formulated to help our thinking and understanding in both developed and developing countries. Drawing on examples around the world the paper aims to examine the key ‘critical success factors’ that need to be in place for cities to traverse a pathway to a more sustainable future in urban development terms by 2050. The paper explores how important the issues of ‘scale’ is in the context of complexity and fragmentation in the city’s built environment, identifies the lessons that can be learned for future sustainable urban development, and the further research which is needed to address future urban transitions to 2050.