Évaluation d’un programme de développement professionnel en santé publique : le laboratoire de promotion de la santé

Il y a quelques décennies, l’émergence du discours de la promotion de la santé infléchissait un nouveau tournant à la santé publique, orientant sa pratique vers l’action communautaire, participative et intersectorielle. Parallèlement, au Québec, la réforme du système de santé de 2004 réorganisait le niveau de gouverne locale à travers la création des centres de santé et de services sociaux (CSSS). Ceux-ci doivent articuler les secteurs des soins et de la santé publique à travers un continuum de services qui va de la promotion de la santé aux soins palliatifs. Ces changements ont des implications majeures pour les acteurs de la santé et de la santé publique, qui doivent composer avec de nouveaux rôles professionnels et de nouvelles stratégies d’action. Le développement professionnel est considéré comme un levier potentiel pour soutenir ces changements. En 2009, une équipe de la Direction de la santé publique de l’Agence de santé et des services sociaux de Montréal concevait un programme de développement professionnel appelé le Laboratoire de promotion de la santé. Ce programme mise sur une approche d’apprentissage de groupe pour permettre aux professionnels des CSSS de développer de nouvelles compétences, une pratique réflexive ainsi que de nouvelles pratiques de promotion de la santé. Basée sur une méthodologie générale qualitative et une approche d’évaluation collaborative, cette thèse utilise plusieurs stratégies d’investigation afin d’évaluer le Laboratoire de promotion de la santé sous trois angles, qui renvoient à sa conceptualisation, à son implantation et à ses effets. Plus spécifiquement, elle vise à : (1) examiner la plausibilité de la théorie d’intervention du programme; (2) décrire et comprendre les processus d’apprentissage d’équipe ainsi que les facteurs qui les influencent; et (3) explorer, du point de vue des participants, les effets réflexifs du Laboratoire. Afin de répondre à ces objectifs, la thèse mobilise diverses perspectives théoriques liées à l’apprentissage individuel, d’équipe et organisationnel. Les résultats des analyses démontrent que : (1) malgré quelques améliorations possibles, le modèle du programme est généralement bien conçu pour parvenir aux résultats visés; (2) l’implantation de ce modèle dans deux sites a donné lieu à des processus d’apprentissage d’équipe différents, bien que conditionnés par des facteurs communs liés aux participants, à l’équipe, au contexte organisationnel et à l’implantation du programme; (3) tel que visé, les participants des deux sites ont développé de la réflexivité vis-à-vis leur pratique et leur rôle professionnel – cette réflexivité adoptant une fonction formative ou critique en regard de l’expérience professionnelle. Ces résultats soulignent le potentiel que représente l’évaluation de la théorie d’intervention pour améliorer la conceptualisation d’un programme de développement professionnel, ainsi que l’intérêt et la pertinence d’évaluer les processus d’apprentissage au niveau de l’équipe dans le cadre d’une approche collective de développement professionnel. De plus, ils appuient l’importance de l’apprentissage réflexif pour l’amélioration des pratiques et l’engagement social des professionnels. En ce sens, ils proposent différentes avenues qui ont le potentiel de consolider les capacités de la main-d’œuvre de santé publique et d’influer conséquemment sur son efficacité à améliorer la santé des collectivités dans le prochain siècle.

Estilos de aprendizagem e interfaces online: aporte ao ensino presencial em saúde, na disciplina Interação Universidade-Serviço-Comunidade I da Faculdade de Medicina de Botucatu-UNESP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estilos de aprendizagem e interfaces online: aporte ao ensino presencial em saúde, na disciplina Interação Universidade-Serviço-Comunidade I da Faculdade de Medicina de Botucatu-UNESP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Models for intensive care training. A European perspective.

The diversity of European culture is reflected in its healthcare training programs. In intensive care medicine (ICM), the differences in national training programs were so marked that it was unlikely that they could produce specialists of equivalent skills. The Competency-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) program was established in 2003 as a Europe-based worldwide collaboration of national training organizations to create core competencies for ICM using consensus methodologies to establish common ground. The group's professional and research ethos created a social identity that facilitated change. The program was easily adaptable to different training structures and incorporated the voice of patients and relatives. The CoBaTrICE program has now been adopted by 15 European countries, with another 12 countries planning to adopt the training program, and is currently available in nine languages, including English. ICM is now recognized as a primary specialty in Spain, Switzerland, and the UK. There are still wide variations in structures and processes of training in ICM across Europe, although there has been agreement on a set of common program standards. The combination of a common "product specification" for an intensivist, combined with persisting variation in the educational context in which competencies are delivered, provides a rich source of research inquiry. Pedagogic research in ICM could usefully focus on the interplay between educational interventions, healthcare systems and delivery, and patient outcomes, such as including whether competency-based program are associated with lower error rates, whether communication skills training is associated with greater patient and family satisfaction, how multisource feedback might best be used to improve reflective learning and teamworking, or whether increasing the proportion of specialists trained in acute care in the hospital at weekends results in better patient outcomes.

Encouraging student to reflect on their employment experience

The purpose behind this case study is to share with a wider audience of placement officers, tutors and those who are involved in the management of placement students or employment of graduates, the approach taken to encourage reflective learning in undergraduate placement students at Aston Business School. Reflective learning forms an important foundation of the placement year at Aston Business School, where a professional placement is a mandatory element of the four year degree, for all Home/EU students (optional for International students) who are taking a Single Honours degree (i.e. a fully business programme). The placement year is not compulsory for those students taking a Combined Honours degree (i.e. a degree where two unrelated subjects are studied), although approximately 50% of those students taking an Aston Business School subject opt to take a placement year. Students spend their year out undertaking a ‘proper’ job within a company or public sector organisation. They are normally paid a reasonable salary for their work (in 2004/5 the average advertised salary was £13,700 per annum). The placement year is assessed, carrying credits which amount to a contribution of 10% towards the students’ final degree. The assessment methods used require the students to submit an academic essay relating theory to practice, a factual report about the company which can be of use to future students, and a log book, the latter being the reflective piece of work. Encouragement to reflect on the placement year has always been an important feature of Aston Business School’s approach to learning. More recently, however, feedback from employers indicated that, although our students have excellent employability skills, “they do not think about them” (Aston Business School Advisory Panel, 2001). We, therefore, began some activities which would encourage students to go beyond the mere acquisition of skills and knowledge. This work became the basis of a programme of introductions to reflective learning, mentoring and awareness of different learning styles written up in Higson and Jones (2002). The idea was to get students used to the idea of reflection on their experiences well before they entered the placement year.

Specialist business skills of international students

This paper follows on from that presented at the last BEST conference in Edinburgh (Higson & Hamilton-Jones(2004)). At that stage, the authors outlined their initial research work with students studying on the yearlong International Foundation programmes. at three local FE Colleges allied to Aston University. The research (funded by the University's Teaching Quality Enhancement Funds (TQEF) involved questionnaires and interviews with staff and students (the latter all from overseas). it aimed to identify ways to improve the learning experience of students on the International Foundation programmes, to aid their smooth transition to full degree programmes in Business and Management and to improve the progression rates of such students while studying at Aston. The initial research findings were used to design a module for those students' progress to degree programmes in Aston Business School. This paper discusses how the module was designed, its content and the assessment methods used to help determine whether students are achieving the learning outcomes. The basic principle was to identify areas of study where the International Foundation Programme students needed help in order to improve their learning styles to assist them with the requirements of other modules that they would be studying during their time at Aston. Particular emphasis was put on the need to develop active learners who were not disadvantaged by their lack of awareness of UK culture and society and who were as comfortable performing written work under examination conditions or presenting orally as their UK counterparts. An additional aim was to prepare these students for the placement year which was a compulsory part of their degree. The module, therefore, comprises a range of inputs for a number of staff, a company visit, weekly reflective learning leading to Personal Development Plan (PDP) work, formal examinations, presentations, group work •and individual case studies. This paper also reports on the initial reaction of the students and tutors to the new learning experience with currently 30 participants undertaking the module. Provisional findings suggest that the International Foundation programme has prepared the students well for degree-level work and that as a group of international students they are much more analytical and, after studying the module interactive than their counterparts who have come directly onto Aston degrees. It has shown them still to be quite passive learners, comfortable with facts and lecture-style learning environments, but less comfortable when asked to use their own initiatives. Continuing progress needs to be made in terms of encouraging them to develop a reflective approach to learning with the students taking some time to feel comfortable with an analytical approach to learning. In addition, im account of the students' reactions to having to work through a formal (PDP) and the results of their first assessments will be provided. At Aston, this work is being used as a pilot to recognise good practice with regards to work with further groups of international students. it is hoped that this would have widespread application across the sector.

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.

Inquiring how a lecturer keeps learning about their teaching:a personal case history on reflective imagination

In order to reverse the use of lecture-based teaching, it is argued that personal reflection can be used as part of the quality assurance process. This paper proposes one response to personal reflection - reflective imagination, which is summarised as an action plan with six activities. It combines two conceptual issues raised in the US, the need to think creatively about learning and the reflective mindset, and one issue raised in the UK, cultivating the entrepreneurial imagination. Reflective imagination is linked to wider social science research, the place of self and reflexivity in scholarship. Finally, a personal history case study is presented which records a visit to Harvard Business School. The visit implements the six activities associated with reflective imagination. This is a method paper exploring reflective imagination.

Transdisciplinarity and reflective practice in sustainable development learning

Using various extracts from the reflective commentaries of MSc students, this article explores how transdisciplinarity and reflective practice operate in the programme. It shows how learners managed the uncertainties of sustainable development through regular critical and evaluative reflections. Students were able to apprehend the several worlds making up the sustainable development project and their own personal learning journey through the various competing, complementary and occasionally contradictory perspectives, modes of learning, sources of knowledge and information. One conceptual device facilitating this process was offering an understanding of sustainable development as constituting a ‘dialogue of values’, an approach that effectively invites students to square the metaphorical circle - i.e. broadly reconciling (ecological) sustainability with (economic) development.

Prospective Teachers Serving as Physics Learning Assistants’ Perspectives on Reflective Practice

A physics Learning Assistant (LA) program was established at Florida International University (FIU) for recruiting and preparing pre-service physics teachers. One goal of this program is to help prospective teachers to develop reflective practice. The purpose of this study is to understand these prospective teachers’ perspectives on reflective practice.

Learning to manage in knowledge based organizations: the role of portfolios

Paper presented at the 8th European Conference on Knowledge Management, Barcelona, 6-7 Sep. 2008 URL: http://www.academic-conferences.org/eckm/eckm2007/eckm07-home.htm

Lifelong learning: case study of adult students in portuguese technological schools and higher education institutions

Paper to be presented in ESREA 2007 ADC Network Seminar - Changing Relationships between the State, Civil Society and the Citizen: Implications for adult education and adult learning, 14 -16 June 2007 - University of Minho - Campus de Gualtar, Braga (Portugal).