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.

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.

NSP work project investment styles

This paper analyzes the Nova Student Portfolio (NSP) with the objective to understand performances of the fund. Each investment style has been analyzed (growth, value and momentum) in order to highlight what style allocation contributed positively and which had a negative impact. The results show that the team mainly invested in value stocks, which contributed positively but that its growth investments had a negative impact on the stock picking performance. The stock selection shows a major influence of the value investment style. A statistical approach shows that the market factor was the one explaining the most the NSP returns.

Underemployment and depressive affect : the moderating influence of coping styles /

This study tested a model which predicted the relationship between underemployment and depressive affect as moderated by coping styles. A randomly selected community sample of 574 young adults completed a self-report employment status measure, the Underemployment Scale, the Center for Epidemiological Study Depression Scale, and the Coping^Stralegy Indicator. The interaction model was supported for men only. Results indicated that significant interactions between Perceived Job Requirements Underemployment by avoidance copings and Subjective Underemployment by avoidance coping predicted depressive affect for men. Further, the same results were found even after controlling for prior depressive affect. UsingJhe^ selfreport employment status measure revealed significant group differences between unemployed and underemployed men. Underemployed men who utilized more support seeking coping strategies reported higher depressive affect than unemployed men. The interaction model was not supported for women even though women have consistently reported higher depressive affect rates. These results have implications for underemployment and depressive affect research and practical implications for assisting men who feel subjectively underemployed and need to find an appropriate strategy to cope with the situation.

A model of personality and health : coping styles as a moderator in the perfectionism-health connection

The purpose of this study was to examine a model of personality and health. Specifically, this thesis examined perfectionism as a predictor of health status and health behaviours, as moderated by coping styles. A community sample of 813 young adults completed the Multidimensional Perfectionism Scale, the Coping Strategy Indicator, and measures of health symptoms, health care utilization, and various health behaviours. Multiple regression analyses revealed a number of significant findings. First, perfectionism and coping styles contributed significant main effects in predicting health status and health behaviours, although coping styles were not shown to moderate the perfectionism-health relationship. The data showed that perfectionism did constitute a health risk, both in terms of health status and health behaviours. Finally, an unexpected finding was that perfectionism also included adaptive features related to health. Specifically, some dimensions of perfectionism were also associated with reports of better health status and involvement in some positive health behaviours.

Relating leadership, thinking styles, self-concept, motivation and stress management in education

Seventy-five principals and vice-.wincipals from public elementary and secondary schools in Hamilton, Ontario, Canada participated in this study. Participants provided ,information concerning their thinking styles, motivations, and the physical effects of stress. This information was examined to find out how satisfaction-oriented, and how security-oriented the thinking styles of the participants were. Second, the data were analysed to see how the thinking style orientations related to life style habits and the effects of stress. The satisfaction-oriented thinking styles scored higher than all of the security-oriented thinking styles by a wide margin with a small preference for the satisfaction-people-oriented styles labelled humanistic-helpful, and affiliative as opposed to the satisfaction-task-oriented styles labeled achievement, and self-actualizing. Although all eight of the security-oriented thinking styles scored well below all of the satisfaction-oriented thinking styles on the Life Styles Inventory, the perfectionistic style scored higher than all of the security-oriented styles by an impressive margin. The next highest scores were recorded by a cluster of three passive-defensive people-oriented thinking styles labeled approval, conventional, and dependent. The competitive style scored lower, and the styles labeled avoidance, oppositional, and power scored the lowest of all the defensive-security-oriented styles. These findings suggest that principals and vice-principals see themselves as relaxed, flexible, and satisfied with their ability to adapt to the stress levels they experience in their lives; however, there was some support for medical research findings that suggest that specific security-oriented thinking styles are associated with emotional stresses that contribute to the development of specific lifestyle habits, physical symptoms, and illnesses. Although the number of females in this study provides very limited generalizability, the findings of this study suggest that high achieving females tend to develop satisfaction-growth styles to a higher level than males, and they tend to use security-oriented styles to a lesser degree than males.

Continuing education learning preferences and styles of legal clinic lawyers /

The purpose of this qualitative research was to study the learning preferences and styles of management lawyers who work in Ontario's legal aid clinics. Data were gathered from two sources and analyzed using the constant comparison method. A preand postconference survey provided the principal data on clinic lawyers' learning preferences. Follow-up interviews were then conducted with 3 purposefully selected survey participants to explore their personal learning styles. Kolb's experiential learning theory provided the theoretical framework for discussing personal learning styles. The findings showed a general consistency among the lawyers to learn by listening to lectures and experts. This preference may suggest a lingering influence from law school training. The lawyers' more informal learning associated with daily practice, however, appeared to be guided by various learning styles. The learning style discussions provided some support for Kolb's model but also confirmed some shortcomings noted by other authors. Educators who design continuing education programs for lawyers may benefit from some insights gained from this exploratory research. This study adds to a limited but growing body of work on the learning preferences and styles of lawyers and suggests new questions for future research.

Learning styles and achievement in postsecondary classrooms

The purpose of this study was to investigate the relationship between learning styles and academic achievement in postsecondary education. It was the intent of the study to establish if there was a relationship between student learning style, teacher style, learner/teacher matching and/or mismatching, student gender and age, to the academic grades of students. This study was basically a replication of a study completed by Mary J. Thompson and Terrance P. O'Brien in 1991 on two campuses of a southeast community college in the United States. In the present study, 243 students and 18 teachers from two different campuses of a community college in the Province of Ontario participated in the research. All participants were administered the Gregorc Style Delineator and students identified by program, age and gender. Data were tested by two analysis of variance (ANOVA) models. In the first ANOVA model considered in this study, significant main effects were manifested in regard to the teaching style, age group and gender. With the exception of gender, these findings were very similiar to those of the original study. Duncan's multiple range test revealed that Concrete Sequential (CS) teachers assigned significantly lower grades than did teachers dominant in any of the other three learning styles. Post hoc testing revealed that students 25 years of age and older received significantly higher grades than did younger students. Female students also received significantly higher grades than did male students. In the second ANOVA model student/teacher learning style match/mismatch did emerge as a significant main effect. However, Duncan's multiple range test and Chi square analysis did not substantiate the relationship. Forty-eight references are cited.

How Learning Styles, Chemistry Attitudes and Experiences, Confidence, and Demographics Correlate with Academic Success in First and Second Year Chemistry Courses

At Brock University, the Faculty of Mathematics and Science currently has one of the highest percentages of students on academic probation, with many students reporting the most difficulty with Introductory Chemistry in first year and Organic Chemistry in second year. To identify strategies to improve students' performance and reduce the number of students on academic probation, a multi-year research project was undertaken involving several chemistry courses. Students were asked to complete three questionnaires, and provide consent to obtain their final Chemistry grade from the Registrar's Office. Research began at the end of the 2007-08 academic year with CHEM IPOO, and in the 2008-09 academic year, students in the larger CHEM IF92 Introductory Chemistry course were invited to participate in this research near the beginning of the academic year. Students who went on to take second year Organic and Analytical Chemistry were asked to complete these questionnaires in each second year course. The three questionnaires included the Kolb Learning Styles Inventory (Kolb, 1984) modified to include specific reference to Chemistry in each question, Dalgety, ColI, and Jones' (2002) Chemistry Attitudes and Experiences Questionnaire (CAEQ), and lastly, a demographic survey. Correlations were found between learning style and academic success; concrete learners were not as successful as abstract learners. Differences were noted between females and males with respect to learning styles, academic success, and confidence. Several differences were also noted between those who are the First in the Family to attend university and those who are not First in the Family to attend university.