Attending Physician Variability: A Model of Four Supervisory Styles

Purpose: There is wide variability in how attending physician roles on teaching teams, including patient care and trainee learning, are enacted. This study sought to better understand variability by considering how different attendings configured and rationalized direct patient care, trainee oversight, and teaching activities. 

Method: Constructivist grounded theory guided iterative data collection and analyses. Data were interviews with 24 attending physicians from two academic centers in Ontario, Canada, in 2012. During interviews, participants heard a hypothetical presentation and reflected on it as though it were presented to their team during a typical admission case review. 

Results: Four supervisory styles were identified: direct care, empowerment, mixed practice, and minimalist. Driven by concerns for patient safety, direct care involves delegating minimal patient care responsibility to trainees. Focused on supporting trainees’ progressive independence, empowerment uses teaching and oversight strategies to ensure quality of care. In mixed practice, patient care is privileged over teaching and is adjusted on the basis of trainee competence and contextual features such as patient volume. Minimalist style involves a high degree of trust in senior residents, delegating most patient care, and teaching to them. Attendings rarely discussed their styles with the team. 

Conclusions: The model adds to the literature on variability in supervisory practice, showing that the four styles reflect different ways of responding to tensions in the role and context. This model could be refined through observational research exploring the impact of context on style development and enactment. Making supervisory styles explicit could support improvement of team competence.

Writing the History of the British Stage, 1660-1900

A monograph on British theatre historiography from its emergence in the Restoration to its foundation as an academic discipline in the early 20th century.

Unsettling modernity: Shifting values and changing housing styles in the Kathmandu Valley

Abstract

Culture has always been important for the character of the cities, as have the civic and public institutions that sustain a lifestyle and provide an identity. Substantial evidence of the unique historical, urban civilisation remains within the traditional settlements in the Kathmandu Valley in Nepal; manifested in houses, palaces, temples, rest houses, open spaces, festivals, rituals, customs and cultural institutions. Indigenous knowledge and practices prescribed the arrangement of houses, roads and urban spaces giving the city a distinctive physical form, character and a unique oriental nativeness. In technical sense, these societies did not have written rules for guiding development. In recent decades, the urban culture of the city has been changing with the forces of urbanisation and globalisation and the demand for new buildings and spaces. New residential design is increasingly dominated by distinctive patterns of Western suburban ideal comprising detached or semi-detached homes and high rise tower blocks. This architectural iconoclasm can be construed as a rather crude response to the indigenous culture and built form. The paper attempts to dismantle the current tension between traditional and contemporary ‘culture’ (and hence society) and housing (or built form) in the Kathmandu Valley by engaging in a discussion that cuts across space, time and meaning of architecture as we know it.

Women of Letters: Gender, Writing and the Life of the Mind in Early Modern England

Women of letters writes a new history of English women's intellectual worlds using their private letters as evidence of hidden networks of creative exchange. The book argues that many women of this period engaged with a life of the mind and demonstrates the dynamic role letter-writing played in the development of ideas. Until now, it has been assumed that women's intellectual opportunities were curtailed by their confinement in the home. This book illuminates the household as a vibrant site of intellectual thought and expression. Amidst the catalogue of day-to-day news in women's letters are sections dedicated to the discussion of books, plays and ideas. Through these personal epistles, Women of letters offers a fresh interpretation of intellectual life in the late seventeenth and early eighteenth centuries, one that champions the ephemeral and the fleeting in order to rediscover women's lives and minds.

Feminist Genealogies in the Writing of the Self

Maria Tamboukou links Foucauldian ideas to feminism and education. Its central argument is that the Foucauldian notion of 'technologies of the self' needs to be gendered and contextualized. This argument is pursued through a genealogical analysis of auto/biographical narratives of women educators at the turn of the nineteenth century. This is a new theoretical approach, since Foucault's work has proved to be of great interest to feminist scholars, but as yet, his theroies have only intermittently been used in educational feminist work. The genealogical analysis of situated female sujectivities has highlighted the importance of space in the 'technologies of the female self' and has reconsidered the private/public couplet. It has acted as a continuous source of uncertainty, experimenting with Foucauldian questions of what we are, of how we have become what we are, but also and perhaps most importantly of how we can become other than what we are already.

Robot

Klimowski’s graphic novel, Robot, was commissioned by the Adam Mickiewicz Institute in Warsaw to mark Poland’s Presidency of the European Union’s Cultural Programme in 2011. Self Made Hero and Timof Comiks published the book simultaneously in the UK and Poland. Klimowski adapted and translated Stanisław Lem’s short fiction ‘The sanatorium of Dr Vliperdius’ (1977), aiming to develop a new position for illustration and the graphic novel aside from mainstream graphic novels and literature, and a new approach to visual bookmaking. The project proved to be an artistic challenge: Lem often proclaimed his disapproval of adaptations of his work, dismissing even Andrei Tarkovsky’s film adaptation (1972) of his novel Solaris (1961). Produced in collaboration with Danusia Schejbal, Robot features a diptych form, counter-pointing (both formally and conceptually) two contrasting stories. The first is a colourful parable describing a totalitarian and autocratic regime that must be vanquished, the second a monochromatic dialectic on philosophy, humanism and mechanisation. Klimowski and Schejbal’s publication is intended to challenge stereotypes and established styles and formulas associated with the production of graphic novels. Much emphasis was laid upon the depiction of space and location, artificiality and realism. Silence and the suspension of linear time were also strong features of the artists’ investigations. These qualities were recognised and discussed by the media, in particular by a panel of critics on Polish Television’s Cultural Channel, in the most respected comics blog, Zeszyty Komiksowe (http://zeszytykomiksowe.org/recenzja_robot, 2012), and by Monika Malkowskain in the national newspaper Rzeczpospolita (2011). The artists gave a special talk at the Science Museum, London, during the Robot Festival ‘Robotville’ (December 2011). Lem, one of the world’s leading writers of science fiction, was featured throughout the year in the UK on stage, cinema and in literary events (Barbican Centre London, British Library, Science Museum London).

‘Not like rose-tinted glasses… like taking a pair of dirty glasses off’: A pilot intervention using positive emotions in expressive writing

Studies conducted in various contexts and with varied populations have found expressive writing enhances physical and psychological wellbeing. This pilot intervention study countered the predominantly quantitative evidence by adopting a qualitative methodology, exploring the experience of using positive emotions in expressive writing. Participants (n = 10), who all had previous experience in expressive writing, were asked to select one of ten positive emotion cards (PECs) each day for three days. Participants were then asked to write expressively through the ‘lens’ of their chosen emotion. Semi-structured interviews were conducted and experiences were evaluated using Thematic Analysis. The results identified two main themes that compared the experience of expressive writing both with and without the PECs. The first theme, Processing (without the PECs) contained three sub-themes: sense of relief, habitual perspective and reactive to experience. The second main theme, Progressing (with the PECs) contained three different sub-themes: sense of direction, changed perspective and interactive with experience. This study found that, for expressive writers, positive emotions may function in three ways: to relate to others or self-expand, to move past challenges cognitively or change unconstructive perspectives, and finally as a way to interactively link or ‘bridge’ from the written subject matter to constructive action, thus breaking cycles of reactive writing and rumination. Implications of the study on the practice of expressive writing and its potential as a positive psychology intervention (PPI) are discussed.

What is poetic attention

Tese de doutoramento, Estudos de Literatura e de Cultura (Teoria da Literatura), Universidade de Lisboa, Faculdade de Letras, 2014

Implementing self-regulated strategy development for teaching argumentative writing : a multidimensional approach

Tese de doutoramento, Psicologia (Psicologia da Educação), Universidade de Lisboa, Faculdade de Psicologia, Universidade de Coimbra, Faculdade de Psicologia e de Ciências da Educação, 2015

Estilos parentais, dificuldades de leitura e psicopatologia infantil

Tese de doutoramento, Psicologia (Psicologia Clínica), Universidade de Lisboa, Faculdade de Psicologia, 2015