Deregulation, competition policy and intra-professional contests in medical education

This paper investigates how government policy directions embracing deregulation and market liberalism, together with significant pre-existing tensions within the Australian medical profession, produced ground breaking change in the funding and delivery of medical education for general practitioners. From an initial view between and within the medical profession, and government, about the goal of improving the standards of general practice education and training, segments of the general practice community, particularly those located in rural and remote settings, displayed increasingly vocal concerns about the approach and solutions proffered by the predominantly urban-influenced Royal Australian College of General Practitioners (RACGP). The extent of dissatisfaction culminated in the establishment of the Australian College of Rural and Remote Medicine (ACRRM) in 1997 and the development of an alternative curriculum for general practice. This paper focuses on two decades of changes in general practice training and how competition policy acted as a justificatory mechanism for putting general practice education out to competitive tender against a background of significant intra-professional conflict. The government's interest in increasing efficiency and deregulating the 'closed shop' practices of professions, as expressed through national competition policy, ultimately exposed the existing antagonisms within the profession to public view and allowed the government some influence on the sacred cow of professional training. Government policy has acted as a mechanism of resolution for long standing grievances of the rural GPs and propelled professional training towards an open competition model. The findings have implications for future research looking at the unanticipated outcomes of competition and internal markets.

Noise, regularizers, and unrealizable scenarios in online learning from restricted training sets

We study the dynamics of on-line learning in multilayer neural networks where training examples are sampled with repetition and where the number of examples scales with the number of network weights. The analysis is carried out using the dynamical replica method aimed at obtaining a closed set of coupled equations for a set of macroscopic variables from which both training and generalization errors can be calculated. We focus on scenarios whereby training examples are corrupted by additive Gaussian output noise and regularizers are introduced to improve the network performance. The dependence of the dynamics on the noise level, with and without regularizers, is examined, as well as that of the asymptotic values obtained for both training and generalization errors. We also demonstrate the ability of the method to approximate the learning dynamics in structurally unrealizable scenarios. The theoretical results show good agreement with those obtained by computer simulations.

Human resource management in the Indian public and private sectors:an empirical comparison

This study compares human resource management (HRM) practices in Indian public- and private-sector organizations. The investigation is based on a questionnaire survey of 137 large manufacturing firms (public sector = 81: private sector = 56). The key areas of analysis include the structure of human resource (HR) department, the role of HR function in corporate change, recruitment and selection, pay and benefits, training and development, employee relations and emphasis on key HRM strategies. Internal labour markets (ILMs) are used to make the comparative analysis. The statistical results show a number of similarities and differences in the HRM systems of Indian public-and private-sector organizations. Against the established notion, the results of this study reveal that the gap between Indian private- and public-sector HRM practices is not very significant. Moreover, in a few HR functional areas (for example, compensation and training and development), Indian private-sector firms have adopted a more rational approach than their public-sector counterparts. © 2004 Taylor and Francis Ltd.

Diabetes service provision:a qualitative study of newly diagnosed Type 2 diabetes patients' experiences and views

Aims: To explore newly diagnosed Type 2 diabetes patients' views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings. Methods: Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results: Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they dis-liked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals. Conclusions: Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run 'one-stop' diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK. © 2005 Diabetes UK.

A comparison of the vocational training system of Britain and West Germany as experienced by minimum-age school leavers.

The sectoral and occupational structure of Britain and West Germany has increasingly changed over the last fifty years from a manual manufacturing based to a non-manual service sector based one. There has been a trend towards more managerial and less menial type occupations. Britain employs a higher proportion of its population in the service sector than in manufacturing compared to West Germany, except in retailing, where West Germany employs twice as many people as Britain. This is a stable sector of the economy in terms of employment, but the requirements of the workforce have changed in line with changes in the industry in both countries. School leavers in the two countries, faced with the same options (FE, training schemes or employment) have opted for the various options in different proportions: young Germans are staying longer in education before embarking on training and young Britons are now less likely to go straight into employment than ten years ago. Training is becoming more accepted as the normal route into employment with government policy leading the way, but public opinion still slow to respond. This study investigates how vocational training has adapted to the changing requirements of industry, often determined by technological advancements. In some areas e.g. manufacturing industry the changes have been radical, in others such as retailing they have not, but skill requirements, not necessarily influenced by technology have changed. Social-communicative skills, frequently not even considered skills and therefore not included in training are coming to the forefront. Vocational training has adapted differently in the two countries: in West Germany on the basis of an established over-defined system and in Britain on the basis of an out-dated ill-defined and almost non-existent system. In retailing German school leavers opt for two or three year apprenticeships whereas British school leavers are offered employment with or without formalised training. The publicly held view of the occupation of sales assistant is one of low-level skill, low intellectual demands and a job anyone can do. The traditional skills - product knowledge, selling and social-communicative skills have steadily been eroded. In the last five years retailers have recognised that a return to customer service, utilising the traditional skills was going to be needed of their staff to remain competitive. This requires training. The German retail training system responded by adapting its training regulations in a long consultative process, whereas the British experimented with YTS, a formalised training scheme nationwide being a new departure. The thesis evaluates the changes in these regulations. The case studies in four retail outlets demonstrate that it is indeed product knowledge and selling and social-communicative skills which are fundamental to being a successful and content sales assistant in either country. When the skills are recognised and taught well and systematically the foundations for career development in retailing are laid in a labour market which is continually looking for better qualified workers. Training, when planned and conducted professionally is appreciated by staff and customers and of benefit to the company. In retailing not enough systematic training, to recognisable standards is carried out in Britain, whereas in West Germany the training system is nevertheless better prepared to show innovative potential as a structure and is in place on which to build. In Britain the reputation of the individual company has a greater role to play, not ensuring a national provision of good training in retailing.

An evaluation of pharmacy education and pre-registration training

This thesis covers two major aspects of pharmacy education; undergraduate education and pre-registration training. A cohort of pharmacy graduates were surveyed over a period of four years, on issues related to undergraduate education, pre-registration training and continuing education. These graduates were the first-ever to sit the pre-registration examination. In addition, the opinions of pre-registration tutors were obtained on pre-registration training, during the year that competence-based assessment was introduced. It was concluded that although the undergraduate course provided a broad base of knowledge suitable for graduates in all branches of pharmacy, several issues were identified which would require attention in future developments of the course. These were: 1. the strong support for the expansion of clinical, social and practice-based teaching. 2. the strong support to retain the scientific content to the same extent as in the three-year course. 3. a greater use of problem-based learning methods. The graduates supported the provision of a pre-registration continuing education course to help prepare for the examination and in areas inadequately covered in the undergraduate course. There was also support for the introduction of some form of split branch training. There was no strong evidence to suggest that the training had been an application of undergraduate education. In general, competence-based training was well regarded by tutors as an appropriate and effective method of skill assessment. However, community tutors felt it was difficult to carry out effectively due to day-to-day time constraints. The assistant tutors in hospital pharmacy were found to have a very important role in provision of training, and should be adequately trained and supported. The study recommends the introduction of uniform training and a quality assurance mechanism for all tutors and assistants undertaking this role.

The dynamics of global sourcing : perspectives and practices:6th global sourcing workshop 2012, Courchevel, France, March 12-15, 2012, revised selected papers

This edited book is intended for use by students, academics and practitioners who take interest in the outsourcing and offshoring of information technology and business services and processes. The book offers a review of the key topics in outsourcing and offshoring, populated with practical frameworks that serve as a tool kit for practitioners, academics and students. The range of topics covered in this book is wide and diverse, and represents both client and supplier perspectives on sourcing of global services. Various aspects related to the decision making process (e.g., asset transfer), learning mechanisms and organizational practices for managing outsourcing relationships are discussed in great depth. Contemporary sourcing models, including cloud services, are examined. Client dependency on the outsourcing provider, and social aspects, such as identity, are discussed in detail. Furthermore, resistance in outsourcing and failures are investigated to derive lessons as to how to avoid them and improve efficiency in outsourcing. Topics discussed in this book combine theoretical and practical insights regarding challenges that both clients and vendors face. Case studies from client and vendor organizations are used extensively throughout the book. Last but not least, the book examines current and future trends in outsourcing and offshoring, placing particular attention on the centrality of innovation in sourcing arrangements, and how innovation can be realized in outsourcing. The book is based on a vast empirical base brought together through years of extensive research by leading researchers in information systems, strategic management and operations.

Theorizing accounting and other [calculative] practices in private equity:Experimenting with Schatzki’s ‘site’ ontology

This thesis contributes to social studies of finance and accounting (Vollmer, Mennicken, & Preda, 2009) and the practice theory literatures (Feldman & Orlikowski, 2011) by experimenting (Baxter & Chua, 2008) with concepts developed by Theodore Schatzki and demonstrating their relevance and usefulness in theorizing and explaining accounting and other organizational phenomena. Influenced by Schatzki, I have undertaken a sociological investigation of the practices, arrangements, and nexuses forming (part of) the social ‘site’ of private equity (PE). I have examined and explained the organization of practices within the PE industry. More specifically, I have sought to throw light on the practice organizations animating various PE practices. I have problematized a particular aspect of Schatzki’s practice organization framework: ‘general understanding’, which has so far been poorly understood and taken for granted in the accounting literature. I have tried to further explore the concept to clarify important definitional issues surrounding its empirical application. In investigating the forms of accounting and control practices in PE firms and how they link with other practices forming part of the ‘site’, I have sought to explain how the ‘situated functionality’ of accounting is ‘prefigured’ by its ‘dispersed’ nature. In doing so, this thesis addresses the recent calls for research on accounting and control practices within financial services firms. This thesis contributes to the social studies of finance and accounting literature also by opening the blackbox of investment [e]valuation practices prevalent in the PE industry. I theorize the due diligence of PE funds as a complex of linked calculative practices and bring to fore the important aspects of ‘practical intelligibility’ of the investment professionals undertaking investment evaluation. I also identify and differentiate the ‘causal’ and ‘prefigurational’ relations between investment evaluation practices and the material entities ‘constituting’ those practices. Moreover, I demonstrate the role of practice memory in those practices. Finally, the thesis also contributes to the practice theory literature by identifying and attempting to clarify and/or improve the poorly defined and/or underdeveloped concepts of Schatzki’s ‘site’ ontology framework.

Emberi erőforrás menedzsment és gyakorlatai a lean termelésben – a tevékenységmenedzsment irodalmának tükrében = Human resource management and practices in lean manufacturing – review of Operations Management’s literature

A lean bevezetése nem korlátozódik a termelés újraértelmezésére, hanem jellemzően a vállalati belső működés (számvitel, emberi erőforrás, beszerzés) és külső kapcsolatok (beszállítók, ellátási lánc) újszervezését is megköveteli. Ezek a kapcsolódási pontok számos, tudományterületek határán fekvő kutatási irányt nyitnak meg. Ebben a tanulmányban a lean termelés és a belső működéshez sorolt emberi erőforrás menedzsment kapcsolatára fókuszálok. Célom, hogy a tevékenységmenedzsment vonatkozó irodalmának áttekintésével bemutassam a lean termelés logikájához illeszkedő emberi erőforrás menedzsmentet, annak jellemző gyakorlatait. = Lean goes beyond manufacturing, implementing its principles usually requires companies to reorganize their companywide internal operations (accounting, human resource, purchasing) and also external relations (supplier, supply chain). This linkages offer several multidisciplinary research directions, this study focuses on the relationship between human resource management and lean production. The main aim of this working paper is to review Operations Management’s literatures on this issue and present the human resource policy and its practices that fit and support lean production.

An evaluation of child welfare inservice training: The relative effectiveness of substance abuse content in improving worker knowledge and attitudes

Given the seriousness of substance abuse as a child welfare problem, the purpose of this study was to examine the relative effectiveness of an inservice training curriculum for child welfare workers. The training was designed to improve worker knowledge and attitudes in working with substance abusing families. Seventy (70) child welfare workers from public and private agencies in two south Florida counties participated in a pretest/posttest control group design that also trained and retested the control group. The literature review supports that the general preparedness of child welfare workers for the issues presented by substance abusing families is in question. Confounding this problem is a lack of understanding of substance abuse dynamics, worker biases, and predispositions. The two research hypotheses focused on whether inservice training could increase worker knowledge and improve worker attitudes in working with this population. Training delivery was in the form of a five-day inservice focusing on an array of substance abuse knowledge and attitudinal topics. Separate knowledge and attitude instruments were developed for the research and were administered, before and after training, to a purposive sample of participants that were randomly assigned to the experimental and control groups. The data analysis supported the research hypotheses but raised a question. Specifically, the experimental group demonstrated significant improvement in posttest scores on both instruments after receiving the training; whereas the control group, with training withheld, also demonstrated a significant improvement at posttest, but only on the knowledge instrument. Although the question was unanswered, when examined at a more critical significance level, only the experimental group remained significant. The hypotheses were reconfirmed when, after training and retesting, the control group also displayed significant improvement on both instruments. The findings support the conclusion that this substance abuse inservice was effective in improving worker knowledge and attitudes regarding working with substance abusing families. As an implication for social work practice, it suggests that similar inservice training can be a viable training resource when formal substance abuse training is unavailable. Additional research is suggested regarding to what degree increased substance abuse knowledge and improved worker attitudes correlate with improved practice.

Cultural influence and learning to teach: Beginning teachers' perceptions of teacher preparation programs and school support systems

Beginning teachers in the field of English Language Arts and Reading are responsible for providing literacy instruction to students. Teachers need a broad background in teaching reading, writing, listening, speaking, and viewing, as well as critical thinking. In secondary schools in particular, beginning English Language Arts and Reading teachers are also faced with the challenge of preparing students to be proficient enough readers and writers to meet required State standards. Beginning teachers must navigate compelling challenges that exist during the first years of teaching. The school support systems available to new teachers are an integral part of their educational development. ^ This qualitative study was conceptualized as an in-depth examination of the experiences and perceptions of eight beginning teachers. They represented different racial/ethnic groups, attended different teacher preparation programs, and taught in different school cultures. The data were collected through formal and informal interviews and classroom observations. A qualitative system of data analysis was used to examine the patterns relating to the interrelationship between teacher preparation programs and school support systems. ^ The experiences of the beginning teachers in this study indicated that teacher education programs should provide preservice teachers with a critical knowledge base for teaching literature, language, and composition. A liberal arts background in English, followed by an extensive program focusing on pedagogy, seems to provide a thorough level of curriculum and instructional practices needed for teaching in 21st century classrooms. The data further suggested that a school support system should pair beginning teachers with mentor teachers and provide a caring, professional environment that seeks to nurture the teacher as she/he develops during the first years of teaching. ^

Best practices in exemplary service delivery: A multiple case study of service quality

The purpose of this study was to explain how exemplary service providers in luxury hotels provide consistently excellent service. Using a case study framework, the study investigated the service provider's strategies and concepts of service delivery, the importance and implementation of organizational and individual controls, and the role of training and learning. The study identified barriers to service provision and characteristics of the exemplary individuals that affect their ability to deliver luxury service. This study sought to better understand how exemplary service providers learn, think about, and do their work. The sample population of three Five-Diamond-Award winning resorts was selected for their potential for learning about the phenomenon of interest. The results demonstrate that exemplary service providers possess individual characteristics that are enhanced by the organizations for which they work. Exemplary service providers are often exemplary communicators who are emotionally generous and genuinely enjoy helping and serving others. Exemplary service organizations treat their employees as they treat their customers, as suggested by the Service-Profit Chain (Heskett, Sasser & Schlesinger, 1997). Further, they have systems and standards to guarantee satisfactory service experiences for every guest. They also encourage their service providers to personalize their service delivery and to seek opportunities to delight their guests, using a combination of controls, traditions and cultural values. Several customer service theories are discussed in relationship to whether they were or were not supported by the data. The study concluded that the delivery of exemplary service is a complex phenomenon that requires successful interactions between guests, service providers and the organization. A Model of Exemplary Service Delivery is presented and discussed that demonstrates the components of service quality as shown in the data. The model can be used by practitioners seeking to create, enhance, or evaluate their service quality, and by researchers seeking insights into the complex concepts in service quality research. Implications for future research are discussed.

An investigation of the relationships between selected characteristics and leadership outcomes of Athletic Training Education Program directors

There is currently no evidence describing what characteristics make an Athletic Training Program Director (PD) an effective leader. An influx of accredited programs resulted in a rapid increase in the demand for PDs, yet training and preparation for these positions has failed to evolve. Although Certified Athletic Trainers (ATs) are trained in specific content areas, they may not always be prepared for the administrative and leadership responsibilities associated with the role of PD (Leone, 2008). This dissertation examined the relationships between selected characteristics and leadership outcomes of Athletic Training Program Directors. Each PD participants (n=27) completed a demographic questionnaire to obtain the leader's academic preparation, accreditation experience and leadership training history. Each participant also completed the Multifactor Leadership Questionnaire (MLQ) to obtain leadership styles, behaviors, and outcomes. Overall, the PDs reported utilizing transformational leadership most often and passive avoidant leadership least often. There was no significant difference between PDs with master's and doctorate degrees on overall leadership outcome. However, participants with a doctorate degree scored significantly different on the effectiveness component of the leadership outcome compared with participants with a master's degree. Those participants who have completed academic coursework on leadership scored significantly different on the leadership outcome compared to those who have not completed academic coursework on leadership. Findings from this study indicate that changes to the current requirements for the role of PD may be warranted. Consideration should be given to increasing the minimum degree requirement and requiring academic coursework on leadership. Future research may be useful in determining specific degree guidelines and types and amounts of leadership training that would be beneficial to Athletic Training PDs.

The impact of cross -training on team processes and performance

Recently, researchers have begun to investigate the benefits of cross-training teams. It has been hypothesized that cross-training should help improve team processes and team performance (Cannon-Bowers, Salas, Blickensderfer, & Bowers, 1998; Travillian, Volpe, Cannon-Bowers, & Salas, 1993). The current study extends previous research by examining different methods of cross-training (positional clarification and positional modeling) and the impact they have on team process and performance in both more complex and less complex environments. One hundred and thirty-five psychology undergraduates were placed in 45 three-person teams. Participants were randomly assigned to roles within teams. Teams were asked to “fly” a series of missions on a PC-based helicopter flight simulation. ^ Results suggest that cross-training improves team mental model accuracy and similarity. Accuracy of team mental models was found to be a predictor of coordination quality, but similarity of team mental models was not. Neither similarity nor accuracy of team mental models was found to be a predictor of backup behavior (quality and quantity). As expected, both team coordination (quality) and backup behaviors (quantity and quality) were significant predictors of overall team performance. Contrary to expectations, there was no interaction between cross-training and environmental complexity. Results from this study further cross-training research by establishing positional clarification and positional modeling as training strategies for improving team performance. ^

The impact of pre -training interventions on cognitive, skill, and affective learning outcomes: A meta -analytic examination of four decades of research

Technological advancements and the ever-evolving demands of a global marketplace may have changed the way in which training is designed, implemented, and even managed, but the ultimate goal of organizational training programs remains the same: to facilitate learning of a knowledge, skill, or other outcome that will yield improvement in employee performance on the job and within the organization (Colquitt, LePine, & Noe, 2000; Tannenbaum & Yukl, 1992). Studies of organizational training have suggested medium to large effect sizes for the impact of training on employee learning (e.g., Arthur, Bennett, Edens, & Bell, 2003; Burke & Day, 1986). However, learning may be differentially affected by such factors as the (1) level and type of preparation provided prior to training, (2) targeted learning outcome, (3) training methods employed, and (4) content and goals of training (e.g., Baldwin & Ford, 1988). A variety of pre-training interventions have been identified as having the potential to enhance learning from training and practice (Cannon-Bowers, Rhodenizer, Salas, & Bowers, 1998). Numerous individual studies have been conducted examining the impact of one or more of these pre-training interventions on learning. ^ I conducted a meta-analytic examination of the effect of these pre-training interventions on cognitive, skill, and affective learning. Results compiled from 359 independent studies (total N = 37,038) reveal consistent positive effects for the role of pre-training interventions in enhancing learning. In most cases, the provision of a pre-training intervention explained approximately 5–10% of the variance in learning, and in some cases, explained up to 40–50% of variance in learning. Overall attentional advice and meta-cognitive strategies (as compared with advance organizers, goal orientation, and preparatory information) seem to result in the most consistent learning gains. Discussion focuses on the most beneficial match between an intervention and the learning outcome of interest, the most effective format of these interventions, and the most appropriate circumstances under which these interventions should be utilized. Also highlighted are the implications of these results for practice, as well as propositions for important avenues for future research. ^