An examination of learning resulting from a transition from a directed to a self-directed work environment

~ This study focuses on the process of self-directed learning that individuals go through as they adapt to new work situations. This is a study of how one critical incident, specifically the transition from a traditional office structure to a home office structure, affected employees and what their learning process was as they adapted to the new environment. This study has 3 educational foundations: adult learning, self-directed learning, and the social context from which the learning will occur. Six women and 2 men were interviewed approximately 1 year following the transition. Analysis of the data revealed 5 themes of: impacts of the self-directed environment on participants' personal lives, their roles, skill set, productivity, and the physical environment; support offered by the organization, family, and office administration; personal development, specific learning needs, and personal skills; boundaries as they relate to family and work; and skill set and orientation requirements of new home office employees. The findings revealed the learning processes of the 8 participants. The learning processes of these participants were discussed within a theoretical framework of the learners, their immediate surroundings, and the larger social environment. The results indicated that the transition from a directed work environment to a self directed work environment is a complex, interrelated process. An element found throughout the theoretical framework is that of control. A second critical element is the need for participants to have a clearly defined work role and an opportunity to engage in discussion with peers and the community. Further findings reinforced the importance of climate and found that the physical environment is a key factor in a successful selfdirected work environment. The findings of this study revealed that no one factor makes an individual function successfully in a self-directed work environment, but that it is a complex interplay among the leamer, their immediate surroundings, and the social environment that will have the greatest impact on success. Recommendations are made which can be used to guide organizational leaders in facilitating employees' transition from a directed to a self-directed work environment. Additionally, recommendations are made for further research in the area of self-directed work environments.

The Social Enterprise as an Alternative Work Option for Persons with Developmental Disabilities: A Case Study of Staff Perspectives at Common Ground Co-operative

Traditional employment options for persons with developmental disabilities are lacking. Employment options available for persons with developmental disabilities are reflective of the medical and social model perspectives of disability; with segregated and supported employment reinforcing the idea that persons with developmental disabilities are incapable and competitive employment missing the necessary accommodations for persons to be successful. This study examined social enterprises as an alternative employment option that can balance both medical and social model perspectives by accommodating for weaknesses or limitations and recognizing the strengths and capabilities of persons with developmental disabilities in the workplace. Moreover, this study is part of a broader case study which is examining the nature and impacts of a social enterprise, known as Common Ground Co-operative (CGC), which supports five social purpose businesses that are owned and operated by persons with developmental disabilities. This study is part of the Social Business and Marginalized Social Groups Community-University Research Alliance. To date, a case study has been written describing the nature and impacts of CGC and its related businesses from the perspectives of the Partners, board members, funders and staff (Owen, Readhead, Bishop, Hope & Campbell, in press & Readhead, 2012). The current study used a descriptive case study approach to provide a detailed account of the perceptions and opinions of CGC staff members who support each of the Partners in the five related businesses. Staff members were chosen for the focus of this study because of the integral role that they play in the successful outcomes of the persons they support. This study was conducted in two phases. In the first phase five staff members were interviewed. During this stage of interviews, several themes were presented which needed to be examined in further detail, specifically staff stress and burnout and duty of care for business Partners versus the promotion of their autonomy. A second phase of interviews was then conducted with one individual participant and a focus group of seven. During both interview phases, Staff participants described an employment model that creates a non-judgemental environment for the business Partners that promotes their strengths, accommodates for their limitations, provides educational opportunities and places the responsibility for the businesses on the persons with developmental disabilities cultivating equality and promoting independence. Staff described the nature of their role including risk factors for stress, the protective factors that buffer stress, and the challenges associated with balancing many role demands. Issues related to the replication of this social enterprise model are described.

Interprofessional Collaboration: The Experience of Nursing and Medical Students’ Interprofessional Education

In this hermeneutic phenomenological study, we examined the experience of interprofessional collaboration from the perspective of nursing and medical students. Seventeen medical and nursing students from two different universities participated in the study. We used guiding questions in face-to-face, conversational interviews to explore students’ experience and expectations of interprofessional collaboration within learning situations. Three themes emerged from the data: the great divide, learning means content, and breaking the ice. The findings suggest that the experience of interprofessional collaboration within learning events is influenced by the natural clustering of shared interests among students. Furthermore, the carry-forward of impressions about physician–nurse relationships prior to the educational programs and during clinical placements dominate the formation of new relationships and acquisition of new knowledge about roles, which might have implications for future practice.

In Search of Advice for Physicians in Entry-Level Medical Markets

We consider entry-level medical markets for physicians in the United Kingdom. These markets experienced failures which led to the adoption of centralized market mechanisms in the 1960's. However, different regions introduced different centralized mechanisms. We advise physicians who do not have detailed information about the rank-order lists submitted by the other participants. We demonstrate that in each of these markets in a low information environment it is not beneficial to reverse the true ranking of any two acceptable hospital positions. We further show that (i) in the Edinburgh 1967 market, ranking unacceptable matches as acceptable is not profitable for any participant and (ii) in any other British entry-level medical market, it is possible that only strategies which rank unacceptable positions as acceptable are optimal for a physician.

Who has responsibility for access to essential medical drugs in the developing world?

L’accès aux traitements de base est un enjeu crucial pour la santé, la pauvreté et le développement. La responsabilité en matière d’accès est alors une question essentielle. Le huitième Objectif du Millénaire pour le Développement postule qu’en coopération avec les firmes pharmaceutiques, l’accès aux traitements essentiels doit être assuré. Les principales parties prenantes qui doivent engager leur responsabilité pour l’accès aux médicaments sont (1) l’industrie pharmaceutique, (2) les gouvernements, (3) la société au sens large, et (4) les individus (qu’ils soient ou non malades). Quatre approches permettent d’appréhender la responsabilité: (a) l’approche déontologique; (b) l’utilitarisme; (c) l’égalitarisme; (b) l’approche basée sur les droits de l’homme. Ces quatre arguments peuvent être utilisés pour assigner une responsabilité aux gouvernements dans l’accès aux médicaments. Le papier conclut qu’il est parfois difficile de distinguer entre ces quatre approches et qu’un « glissement-d’échelle » de la responsabilité est une voie utile pour appréhender les rôles des quatre principales parties prenantes dans l’accès aux médicaments, dépendant du pays ou de la région et de son environnement interne.

La pratique d’infirmières ayant participé à une mission humanitaire en Haïti suite au séisme de 2010 au sein d’une organisation non-gouvernementale

Les vies de millions de personnes sont dévastées par des désastres naturels à travers le monde. Les écrits scientifiques relatifs aux efforts humanitaires dans ces contextes ciblent les travailleurs humanitaires sans toutefois les différencier quant à leur appartenance disciplinaire ou à l’organisation qui les emploie. Les connaissances liées à la pratique des infirmières dans le contexte d’urgence humanitaire sont limitées, malgré qu’elles jouent un rôle vital auprès des populations touchées. Cette ethnographie focalisée, guidée par la théorie du caring bureaucratique de Ray (1989) répond à la question de recherche: Comment des infirmières ayant participé à une mission humanitaire d’urgence suite au séisme à Haïti en janvier 2010 au sein de l’organisation Médecins Sans Frontières décrivent-elles leur pratique dans les contextes légal, politique, économique, éducationnel, socioculturel, physique et technologique de cette expérience? Des entrevues semi-structurées en profondeur de 90 minutes ont été menées auprès de quatre participantes qui ont également échangé à propos de photographies prises durant leurs missions. Les participantes ont discuté de leur préparation, de leurs objectifs, des rôles qu’elles assumaient, ainsi que des défis rencontrés au retour de leurs missions. Des facteurs inhérents à l’infirmière et à l’organisation ont émergé comme importants pour l’articulation et la délimitation de leur pratique. Cette étude révèle également que des facteurs contextuels importants, soit l’équipe, le temps, l’environnement physique, la médiatisation, la sécurité, ainsi que les conditions de travail et les contextes sociopolitique et culturel avaient une influence sur la pratique. Les participantes, selon leur évaluation de ces contextes et des besoins immédiats, devaient constamment ajuster leur pratique. Cette recherche permet une meilleure compréhension de la pratique d’infirmières dans un contexte d’urgence humanitaire de laquelle découlent des implications pour la pratique, la formation et la recherche.

Impact of Information Communication Technology (ICT) on Professional Development and Educational Needs of Library Professionals in the Universities of Kerala

The shift from print to digital information has a high impact on all components of the academic library system in India especially the users, services and the staff. Though information is considered as an important resource, the use of ICT tools to collect and disseminate information has been in a slow pace in majority of the University libraries This may be due to various factors like insufficient funds, inadequate staff trained in handling computers and software packages, administrative concerns etc. In Kerala, automation has been initiated in almost all University libraries using library automation software and is under different stages of completion. There are not much studies conducted about the effects of information communication technologies on the professional activities of library professionals in the universities in Kerala. It is important to evaluate whether progress in ICT has had any impact on the library profession in these highest educational institutions. The aim of the study is to assess whether the developments in information communication technologies have any influence on the library professionals’ professional development, and the need for further education and training in the profession and evaluate their skills in handling developments in ICT. The total population of the study is 252 including the permanently employed professional library staff in central libraries and departmental libraries in the main campuses of the universities under study. This is almost a census study of the defined population of users. The questionnaire method was adopted for collection of data for this study, supplemented by interviews of Librarians to gather additional information. Library Professionals have a positive approach towards ICT applications and services in Libraries, but majority do not have the opportunities to develop their skills and competencies in their work environment. To develop competitive personnel in a technologically advanced world, high priority must be given to develop competence in ICT applications, library management and soft skills in library professionals, by the University administrators and Library associations. Library science schools and teaching departments across the country have to take significant steps to revise library science curriculum, and incorporate significant changes to achieve the demands and challenges of library science profession.

Management of Higher Educational Institutions in Kerala

Economists consider education as an investment in man. Education develops human resources necessary for the economic and political growth of any nation. Adam Smith stressed the importance of education and included the acquired and useful activities of all the inhabitants or members of society in his concept of fixed capital.‘ Karl Marx shared with Smith's view when he laid down that the function of education in a socialist society will be to overcome the alienation of the worker from the means of production; while developing the technical skill it will make him a complete man as well as a producer.2 Education is also considered as a powerful instrument for social change. By inculcating moral and spiritual values, it brings changes both in the individual and in the society. It aims at creating a social order founded on the values of freedom, social justice and equal opportunity.3 The objective of this exploratory study is to enquire into the existing system of managing higher educational institutions in Kerala, compare it with the accepted principles of management believed to be applicable to all organisations, and develop a model capable of introducing more effective management practices

Influence of the buffer environment on the Relative Biological Effectiveness of carbon ion radiation, investigated by Scanning Force Microscopy and gel electrophoresis

This work focuses on the analysis of the influence of environment on the relative biological effectiveness (RBE) of carbon ions on molecular level. Due to the high relevance of RBE for medical applications, such as tumor therapy, and radiation protection in space, DNA damages have been investigated in order to understand the biological efficiency of heavy ion radiation. The contribution of this study to the radiobiology research consists in the analysis of plasmid DNA damages induced by carbon ion radiation in biochemical buffer environments, as well as in the calculation of the RBE of carbon ions on DNA level by mean of scanning force microscopy (SFM). In order to study the DNA damages, besides the common electrophoresis method, a new approach has been developed by using SFM. The latter method allows direct visualisation and measurement of individual DNA fragments with an accuracy of several nanometres. In addition, comparison of the results obtained by SFM and agarose gel electrophoresis methods has been performed in the present study. Sparsely ionising radiation, such as X-rays, and densely ionising radiation, such as carbon ions, have been used to irradiate plasmid DNA in trishydroxymethylaminomethane (Tris buffer) and 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES buffer) environments. These buffer environments exhibit different scavenging capacities for hydroxyl radical (HO0), which is produced by ionisation of water and plays the major role in the indirect DNA damage processes. Fragment distributions have been measured by SFM over a large length range, and as expected, a significantly higher degree of DNA damages was observed for increasing dose. Also a higher amount of double-strand breaks (DSBs) was observed after irradiation with carbon ions compared to X-ray irradiation. The results obtained from SFM measurements show that both types of radiation induce multiple fragmentation of the plasmid DNA in the dose range from D = 250 Gy to D = 1500 Gy. Using Tris environments at two different concentrations, a decrease of the relative biological effectiveness with the rise of Tris concentration was observed. This demonstrates the radioprotective behavior of the Tris buffer solution. In contrast, a lower scavenging capacity for all other free radicals and ions, produced by the ionisation of water, was registered in the case of HEPES buffer compared to Tris solution. This is reflected in the higher RBE values deduced from SFM and gel electrophoresis measurements after irradiation of the plasmid DNA in 20 mM HEPES environment compared to 92 mM Tris solution. These results show that HEPES and Tris environments play a major role on preventing the indirect DNA damages induced by ionising radiation and on the relative biological effectiveness of heavy ion radiation. In general, the RBE calculated from the SFM measurements presents higher values compared to gel electrophoresis data, for plasmids irradiated in all environments. Using a large set of data, obtained from the SFM measurements, it was possible to calculate the survive rate over a larger range, from 88% to 98%, while for gel electrophoresis measurements the survive rates have been calculated only for values between 96% and 99%. While the gel electrophoresis measurements provide information only about the percentage of plasmids DNA that suffered a single DSB, SFM can count the small plasmid fragments produced by multiple DSBs induced in a single plasmid. Consequently, SFM generates more detailed information regarding the amount of the induced DSBs compared to gel electrophoresis, and therefore, RBE can be calculated with more accuracy. Thus, SFM has been proven to be a more precise method to characterize on molecular level the DNA damage induced by ionizing radiations.

How to improve the formal analytic reasoning and scientific motivation in the intellectual training of medical students

A review article of the The New England Journal of Medicine refers that almost a century ago, Abraham Flexner, a research scholar at the Carnegie Foundation for the Advancement of Teaching, undertook an assessment of medical education in 155 medical schools in operation in the United States and Canada. Flexner’s report emphasized the nonscientific approach of American medical schools to preparation for the profession, which contrasted with the university-based system of medical education in Germany. At the core of Flexner’s view was the notion that formal analytic reasoning, the kind of thinking integral to the natural sciences, should hold pride of place in the intellectual training of physicians. This idea was pioneered at Harvard University, the University of Michigan, and the University of Pennsylvania in the 1880s, but was most fully expressed in the educational program at Johns Hopkins University, which Flexner regarded as the ideal for medical education. (...)

Adaption of Courses and Learning Environment to the User Context in dotLRN

The explosive growth of Internet during the last years has been reflected in the ever-increasing amount of the diversity and heterogeneity of user preferences, types and features of devices and access networks. Usually the heterogeneity in the context of the users which request Web contents is not taken into account by the servers that deliver them implying that these contents will not always suit their needs. In the particular case of e-learning platforms this issue is especially critical due to the fact that it puts at stake the knowledge acquired by their users. In the following paper we present a system that aims to provide the dotLRN e-learning platform with the capability to adapt to its users context. By integrating dotLRN with a multi-agent hypermedia system, online courses being undertaken by students as well as their learning environment are adapted in real time

Medical Student’s Use of Time During Clinical Clerkships and the Credits Based System

Introduction: Comprehensive undergraduate education in clinical sciences is grounded on activities developed during clerkships. To implement the credits system we must know how these experiences take place. Objectives: to describe how students spend time in clerkships, how they assess the educative value of activities and the enjoyment it provides. Method: We distributed a form to a random clustered sample of a 100 students coursing clinical sciences, designed to record the time spent, and to assess the educative value and the grade of enjoyment of the activities in clerkship during a week. Data were registered and analyzed on Excel® 98 and SPSS. Results: mean time spent by students in clerkship activities on a day were 10.8 hours. Of those, 7.3 hours (69%) were spent in formal education activities. Patient care activities with teachers occupied the major proportion of time (15.4%). Of the teaching and learning activities in a week, 28 hours (56%) were spent in patient care activities and 22.4 hours (44.5%) were used in independent academic work. The time spent in teaching and learning activities correspond to 19 credits of a semester of 18 weeks. The activities assessed as having the major educational value were homework activities (4.6) and formal education activities (4.5). The graded as most enjoyable were extracurricular activities, formal educational activities and independent academic work. Conclusion: our students spend more time in activities with patients than the reported in literature. The attending workload of our students is greater than the one reported in similar studies.

Métodos de análisis de las comunidades de clientes mediante la relación estratégica comunitaria y el marketing.

En este proyecto analizaremos como las organizaciones se relacionan con el medio y marketing. La idea es determinar cuáles son los métodos de análisis de las comunidades de clientes mediante la relación estratégica comunitaria y el marketing. Por medio del mercadeo se puede conocer el entorno y determinar qué métodos de análisis utilizar para conocer a la comunidad de clientes. Las personas de mercadeo se ocupan de todo lo que ocurre en el entorno, de estar al tanto para saber cuándo hay oportunidades que puedan ser provechosas para la organización o por otro lado cuando hay amenazas de las que debe tener cuidado. Dependiendo del entorno, la organización diseña sus actividades de mercadeo enfocadas en satisfacer las necesidades del consumidor. Las actividades del consumidor se conceptualizan en producto, precio, promoción y plaza que se definen y diseñan basados en la comunidad en la que este inmersa la organización. Es importante buscar información confiable sobre el grupo objetivo al cual se le va ofrecer el producto o servicio, ya que toca analizarlos y comprender a estas personas para diseñar una buena oferta que satisfaga sus necesidades y deseos. Esta persona que recibe el producto o servicio por parte de la organización es el cliente. Los clientes son las personas que llegan a una organización en búsqueda de satisfacer necesidades a través de los bienes y servicios que las empresas ofrecen. Es esencial determinar que los clientes viven en comunidad, es decir comparten ideas por la comunicación tan estrecha que tienen y viven en conjunto bajo las mismas costumbres. Debido a estos es que hoy en día, los consumidores se conglomeran en comunidades de clientes, y para saberles llegar a estos clientes, toca analizarlos por medio de diversos métodos. El uso de las estrategias comunitarias es necesario ya que por medio del marketing se analiza el entorno y se buscan los métodos para analizar a la comunidad de clientes, que comparten características y se analizan en conjunto no por individuo. Es necesario identificar los métodos para relacionarse con la comunidad de clientes, para poder acercarnos a estos y conocerlos bien, saber sus necesidades y deseos y ofrecerles productos y servicios de acuerdo a éstos. En la actualidad estos métodos no son muy comunes ni conocidos, es por esto que nuestro propósito es indagar e identificar estos métodos para saber analizar a las comunidades. En este proyecto se utilizara una metodología de estudio tipo teórico-conceptual buscando las fuentes de información necesarias para llevar a cabo nuestra investigación. Se considera trabajar con El Grupo de Investigación en Perdurabilidad Empresarial y se escogió la línea de gerencia ya que permite entrar en la sociedad del conocimiento, siendo capaces de identificar oportunidades gerenciales en el entorno. Es interesante investigar sobre estos métodos, ya que los clientes esperan un servicio excelente, atento y que se preocupe por ellos y sus necesidades.

Herramienta para la gestión de convenios de docencia-servicio en Instituciones Prestadoras de Servicios de Salud

Los procesos de formación de profesionales de salud idóneos en el mundo, complementan su conocimiento entre dos componentes fundamentales, un componente teórico y el otro componente práctico. La formación que recibe en las aulas y la realización de las prácticas académicas a las cuales pueda acceder, le permite al estudiante trasformar el conocimiento académico adquirido en conocimiento cercano a la realidad y con fundamento profesional, razón por la cual las Instituciones Educativas tienen la responsabilidad de formar profesionales que sean capaces de desempeñarse en componentes sociales, administrativos y prácticos. Dentro de las ventajas que aporta la realización de las prácticas en la formación de los profesionales en salud se reconocen: la posibilidad de tener una visión de la responsabilidad del trabajo a la cual se van a ver enfrentados, desarrollar habilidades de interrelaciones sociales, incrementar su nivel de madurez, desarrollar e implementar estrategias de supervisión y así lograr el reconocimiento personal del nivel de confianza en su desempeño. Sin embargo también se puede convertir en un aspecto negativo si la práctica no se desarrolla de manera adecuada y si no logra tener una integración exitosa con el conocimiento teórico. Para el caso de la formación de talento humano en salud, el espacio utilizado para la realización de estas prácticas son las Instituciones Prestadoras de Servicios de Salud, deben ser lugares que les faciliten a los estudiantes encontrar una relación integral entre la formación teórica y su aplicación a la práctica profesional, de esta manera el estudiante podrá incrementar su preparación específica. Las prácticas académicas tienen interés en la formación de profesionales y representan un período donde el estudiante se convierte en sujeto entre la Institución Educativa y la Institución Prestadora. Es un espacio de inducción que le permite al estudiante realizar una evaluación de sí mismo y a la vez puede evaluar el entorno donde se va a desarrollar en su colectivo profesional. El objetivo de esta investigación es desarrollar una herramienta técnica que le permita a la Dirección facilitar la supervisión, el monitoreo y la evaluación de convenios de Docencia-Servicio en las Instituciones Prestadoras de Servicios de Salud, garantizando el respeto a los derechos de los usuarios, la calidad de los servicios prestados, la seguridad del paciente y la humanización de la atención, aspectos que no pueden ser afectados negativamente por el desarrollo de las prácticas académicas. Todas las actividades asistenciales que sean desarrolladas por estudiantes en la realización de su práctica profesional, deben ser realizadas bajo una estricta supervisión de docentes y de personal especializado responsable de la prestación del servicio, dando cumplimiento con el Sistema de Garantía de la Calidad del Sistema de Seguridad en Salud en Colombia.

Riesgo de accidentes biológicos en estudiantes de la salud: revisión de la literatura en los últimos 14 años.

Introducción: Todos los trabajadores del área de la salud están en riesgo de padecer un accidente biológico. No obstante los estudiantes de estas aéreas, pueden presentar más riesgo porque apenas están en formación y no tienen la práctica o experiencia suficiente. Existen varios artículos que han estudiado la incidencia y prevalencia de accidentes biológicos en los trabajadores del área de la salud, Sin embargo, sobre esta problemática de la población estudiantil del área de la salud, se encuentra menos literatura. Por lo tanto con esta revisión sistemática se busca analizar y actualizar este tema. Métodos: Se realizó una revisión de la literatura científica de artículos publicados en los últimos 14 años, en relación con la prevalencia de accidentes biológicos en estudiantes de medicina, odontología, enfermería y residentes del área de la salud a nivel mundial. Se llevó a cabo la búsqueda en la base de datos de Pubmed, encontrando un total de 100 artículos, escritos en inglés, francés, español o portugués. Resultados: Las prevalencias encontradas sobre accidentes biológicos en estudiantes fueron las siguientes: en países europeos a nivel de enfermería los valores oscilan entre 10.2 % a 32%, en medicina fueron del 16%-58.8%, y en odontología del 21 %. En países asiáticos, se encontró que en enfermería el porcentaje varía de 49%-96 %, en medicina van del 35% -68%, y en odontología varia de 68.a 75.4%. En Norte América, en medicina las cifras fluctúan alrededor del 11-72.7 % y en odontología giran alrededor del 19.1%. Finalmente respecto a Suramérica la prevalencia fue de 31.2 a 46.7% en medicina, y del 40% en enfermería. Conclusiones: Por lo anterior se pudo concluir que, la prevalencia de accidentes biológicos en los estudiantes del área de la salud es elevada y varía según el continente en el que se encuentren.