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.

Business education in operations management

This paper examines trends in the practice of Operations Management and in teaching the field in major Business Schools. Operations Management has been defined as the design and management of transformation processes that create value for society. The operations function is the one function directly involved in that transformation, and hence is directly responsible for the activities that justify the existence of the firm, both economically and as a value-creating organization in society. The top rated schools in Operations Management are the top-rated research-intensive Business Schools in the world. Operations Management is an area that has been undergoing rapid change in response to changes in business practices worldwide. It is at the heart of changes of which the AACSB report Management Education at Risk, August 2002 (p 20), comments of Business Schools in general: ‘With regard to global relevance (of Business Schools), the complex opportunities and challenges that emanate from the world scope of operations, outsourcing, supply chains, partnerships, and financial and consumer markets – all linked in real time through the Internet – are not reflected adequately in curricula and learning approaches.’ Products, and even services, depend increasingly on advanced technology. This is true globally and especially so for countries in South East and East Asia, from which Australian Universities draw a significant number of students. Services operations management has become much more important, while there are both educational and industrial needs in management science or operations research.

Can we get General Practitioners to Promote Physical Activity? Results of the 10,000 Steps Rockhampton Community-Based Physical Activity Promotion Project

Evidence supporting the efficacy of physical activity promotion in primary care settings has evaluated patient-level changes in physical activity, with little focus on the issue of general practitioner (GP) uptake. The 'GP Strategy' of 10,000 Steps Rockhampton provided an opportunity to explore this issue in the context of a multi-strategy, community-based physical activity intervention project. The 'GP Strategy' was developed in partnership with the Capricornia Division of General Practice. It aimed to: 1) increase GP awareness of the 10,000 Steps project, 2) upskill GPs in brief physical activity counselling techniques, and 3) provide GPs with evidencebased physical activity counselling materials and pedometers. The evaluation, which was guided by the RE-AIM evaluation framework, used a pre-post design, including a GP mailed survey, and collection of process data. Survey response rates were 67% (n=44/66; baseline) and 70% (n=37/53; 14-month follow-up). GP awareness of 10,000 Steps Rockhampton increased from 46% to 97%. 21/23 practices were visited by 10,000 Steps staff and accepted 10,000 Steps posters, brochures, and pedometers. At follow-up, 78% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients. Despite the very high rate of uptake and use of 10,000 Steps materials, there was no change in the percentage of patients counselled, and relatively few pedometers had been loaned to patients. The results of this trial indicate that it will take more effort to change GP physical activity counselling behaviour, and provide only modest support for use of pedometers in the busy general practice setting. Acknowledgement:This project is supported by a grant from Health Promotion Queensland.

DOS CABIDES DE EMPREGO AOS CABIDES DO CONHECIMENTO: UM CASO DE PARCERIA ENTRE O INSTITUTO GENERAL MOTORS E A ESCOLAMUNICIPAL DE ENSINO PROFª. ALCINA DANTAS FEIJÃO NO DESENVOLVIMENTO DA RESPONSABILIDADE SOCIAL EMPRESARIAL

O Brasil, até poucos anos atrás, não via em sua agenda de prioridades a educação como foco principal para o crescimento econômico, talvez por não acreditar que com a estabilidade da moeda, abertura da economia e outros fatores necessitassem de pessoal qualificado para poder manter a capacidade produtiva. Assim, o país tenta corrigir esta situação investindo em educação, incorporando novas tecnologias no processo produtivo, necessitando de uma força de trabalho hábil para aprender e desenvolver as novas técnicas. Atualmente o Brasil mantém um dos menores índices de desemprego, no entanto, muitas empresas sofrem com o apagão da qualificação, necessitando realizar treinamentos e por consequência aumento em seus custos. As empresas tentam driblar a falta de pessoal qualificado investindo nos programas de estágio e trainee, realizando contratações de profissionais estrangeiros, criando universidades corporativas, e em alguns casos, as empresas estreitam seus laços junto às redes de ensino, a fim de preparar jovens para o domínio de novas tecnologias, associado ao aprimoramento em sua área de atuação, evitando assim o desequilíbrio entre teoria e prática . As organizações empresariais conscientes de seu papel começam a compreender que a prosperidade tão almejada não se traduz por faturamentos vultosos ou simplesmente pela quantidade de produtos vendidos. Estas despertam para a criação e adaptação de empresas-cidadãs que por meio de suas ações sociais, buscam desenvolver atividades solidárias. Neste contexto, o presente trabalho tem como objetivo geral analisar a Responsabilidade Social Empresarial sob a ótica de parcerias com escolas (parceria entre a General Motors do Brasil, por meio de seu braço social - o Instituto General Motors e a Escola Municipal de Ensino Profª. Alcina Dantas Feijão da Cidade de São Caetano do Sul). A parceria se concretiza, por meio do Programa Jovens Empreendedores ou Fábrica de Cabides . O intuito do Programa é despertar o espírito empreendedor nos estudantes e incentivar a formação de futuros empresários. Com os objetivos específicos determinou-se: a) estudar parcerias entre empresas e escolas no desenvolvimento da RSE; b) entender os motivos que levaram a empresa e a escola a concretizar a parceria e suas expectativas; c) identificar possíveis alterações ocorridas na escola, atribuídas ao processo de parceria. A partir destes objetivos, o procedimento metodológico foi orientado pelo método de estudo de caso, objetivando uma pesquisa mais voltada para abordagem qualitativa, levantando-se referenciais teóricos, bem como, procedimentos de análise de dados por meio de questionário, observação direta e artefatos físicos. A análise compreensiva dos dados foi realizada a partir de dois núcleos temáticos: importância da parceria e mercado de trabalho. Os resultados evidenciam que iniciativas de parcerias podem se reverter em melhoria da qualidade de ensino que permita o desenvolvimento de habilidades e competências necessárias à inserção responsável no mercado de trabalho com uma dimensão cidadã.

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.

Time and professional work in public sector organisations: an examination of four occupational groups in education and medicine

The aim of this thesis is to examine the experience of time of four professional occupational groups working in public sector organisations and the factors affecting this experience. The literature on time and work is examined to delineate the key parameters of research in this area. A broad organisation behaviour approach to the experience of time and work is developed in which individual, occupational, organisational and socio-political factors are inter-related. The experience of secondary school teachers, further education lecturers, general medical practitioners and hosoital consultants is then examined. Multiple methods of data collection are used: open-ended interviews, a questionnaire survey and the analysis of key documents relating to the institutional settings in which the four groups work. The research aims to develop our knowledge of working time by considering the dimensions of the experience of time at work, the contexts in wlhich this experience is generated and the constraints these contexts give rIse to. By developing our understanding of time as a key feature of work experience we also extend our knowledge of organisation behaviour in general. In conclusion a model of the factors relating the experience of time to the negotiation of time at work is presented.

Education and self-management for people newly diagnosed with type 2 diabetes: a qualitative study of patients' views.

OObjectives: We explored the perceptions, views and experiences of diabetes education in people with type 2 diabetes who were participating in a UK randomized controlled trial of methods of education. The intervention arm of the trial was based on DESMOND, a structured programme of group education sessions aimed at enabling self-management of diabetes, while the standard arm was usual care from general practices. Methods: Individual semi-structured interviews were conducted with 36 adult patients, of whom 19 had attended DESMOND education sessions and 17 had been randomized to receive usual care. Data analysis was based on the constant comparative method. Results: Four principal orientations towards diabetes and its management were identified: `resisters', `identity resisters, consequence accepters', `identity accepters, consequence resisters' and `accepters'. Participants offered varying accounts of the degree of personal responsibility that needed to be assumed in response to the diagnosis. Preferences for different styles of education were also expressed, with many reporting that they enjoyed and benefited from group education, although some reported ambivalence or disappointment with their experiences of education. It was difficult to identify striking thematic differences between accounts of people on different arms of the trial, although there was some very tentative evidence that those who attended DESMOND were more accepting of a changed identity and its implications for their management of diabetes. Discussion: No one single approach to education is likely to suit all people newly diagnosed with diabetes, although structured group education may suit many. This paper identifies varying orientations and preferences of people with diabetes towards forms of both education and self-management, which should be taken into account when planning approaches to education.

Drug information in general practice pharmacy

The drug information sources currently available to general practice pharmacists have been identified. The use of and attitudes to these sources were assessed as well as the perceived information needs of practising pharmacists. The special requirements of women pharmacists and pharmacists working part-time were studied. The relationship of the medical representative as an information source for pharmacists was evaluated. Participation in continuing education programmes as a vital means of ensuring current information awareness and knowledge for the practising profession has been considered. Investigations were mainly pursued by questionnaire survey, while computer facilities were used for the processing and the analyses of data. The desirability of collated and evaluated information from one or more independent authoritative sources has been discussed. The increasing advisory role of the general practice pharmacist and the needs of the patient and potential customer have been discussed, with projections for the pharmacist's future health care contribution.