Clinical teaching: Maintaining an educational role for doctors in the new health care environment

Context and objectives: Good clinical teaching is central to medical education but there is concern about maintaining this in contemporary, pressured health care environments. This paper aims to demonstrate that good clinical practice is at the heart of good clinical teaching. Methods: Seven roles are used as a framework for analysing good clinical teaching. The roles are medical expert, communicator, collaborator, manager, advocate, scholar and professional. Results: The analysis of clinical teaching and clinical practice demonstrates that they are closely linked. As experts, clinical teachers are involved in research, information retrieval and sharing of knowledge or teaching. Good communication with trainees, patients and colleagues defines teaching excellence. Clinicians can 'teach' collaboration by acting as role models and by encouraging learners to understand the responsibilities of other health professionals. As managers, clinicians can apply their skills to the effective management of learning resources. Similarly skills as advocates at the individual, community and population level can be passed on in educational encounters. The clinicians' responsibilities as scholars are most readily applied to teaching activities. Clinicians have clear roles in taking scholarly approaches to their practice and demonstrating them to others. Conclusion: Good clinical teaching is concerned with providing role models for good practice, making good practice visible and explaining it to trainees. This is the very basis of clinicians as professionals, the seventh role, and should be the foundation for the further development of clinicians as excellent clinical teachers.

In-training assessment - Its potential in enhancing clinical teaching

Context In-training assessment (ITA) has established its place alongside formative and summative assessment at both the undergraduate and postgraduate level. In this paper the authors aimed to identify those characteristics of ITA that could enhance clinical teaching. Methods A literature review and discussions by an expert working group at the Ninth Cambridge Conference identified the aspects of ITA that could enhance clinical teaching. Results The features of ITA identified included defining the specific benefits to the learner, teacher and institution, and highlighting the patient as the context for ITA and clinical teaching. The ‘mapping’ of a learner’s progress towards the clinical teaching objectives by using multiple assessments over time, by multiple observers in both a systematic and opportunistic way correlates with the incremental nature of reaching clinical competence. Conclusions The importance of ITA based on both direct and indirect evidence of what the learner actually does in the real clinical setting is emphasized. Particular attention is given to addressing concerns in the more controversial areas of assessor training, ratings and documentation for ITA. Areas for future research are also identified.

Diverse bodies-space politics: Towards a critique of social (in)justice of built environment

Writing has long played an important role in the progression of architecture and the built environment. Histories of architecture are written, manifestoes that form the basis for a designer’s work are written and most importantly, the built environment advances itself through the act of critical writing. Not unlike the visual arts, literature and poetry, the tradition of written criticism has been crucial to the progression of architecture and its allied professions (Franz 2003). This article contributes to architecture and the built environment through the act of a written essay that critiques the problem of bodily diversity to architecture. In particular, the article explores the implications of body-space politics and abstracted body thinking on diverse bodies and their spatial justice. Using Soja’s Spatial Justice theory (2008), we seek to point out the underlying conceptions and power differentials assigned to different bodies spatially and how this leads to spatial injustices and contested spaces. The article also critically analyses the historical emergence of ‘the standardised body’ in architecture and its application in design theory and practice , and looks at how bodies often found on the outside of architecture highlight how such thinking creates in justices. Different theories are drawn on to help point to how design through the use of the upright, forward facing, male bod willingly and unwillingly denies access to resources and spatialities of everyday life. We also suggest ways to re-conceptualise the body in design practice and teaching.

Saving Indigenous nurses and midwives from historical oblivion

Learning about the Indigenous women who had worked between 1950-2005 was a surprise to me. This area of under researched Australian history became a passion which I've continued to explore and, in recent years. have extended. It's a challenging field. with issues familiar to many historians. There may be many documentary records about Indigenous nurses, hidden in publicly accessible archives and collections, but individuals may not easily be identified as Indigenous. Another enormous challenge is to question widely-held assumptions. Historically, Aboriginal people have been positioned within a deficit model and cast as recipients of health care. So it's assumed that Indigenous people did not deliver care in any way. were not part of formal training schemes, or were not in paid employment. More evidence is emerging that counters those assumptions. Aboriginal women have worked as nurses and midwives within Australia as far back as the 1890s and, who knows, perhaps earlier. Their contribution is a hidden but significant element in Indigenous and Australian history

Supistamista, rationalisointia vai kehittämistä? : Valtiovarainministeriön järjestelyosaston järjestämän henkilöstökoulutus- ja tutkimustoiminnan rakentuminen osaksi valtionhallintoa vuosina 1943-1971

The study examines the personnel training and research activities carried out by the Organization and Methods Division of the Ministry of Finance and their becoming a part and parcel of the state administration in 1943-1971. The study is a combination of institutional and ideological historical research in recent history on adult education, using a constructionist approach. Material salient to the study comes from the files of the Organization and Methods Division in the National Archives, parliamentary documents, committee reports, and the magazines. The concentrated training and research activities arranged by the Organization and Methods Division, became a part and parcel of the state administration in the midst of controversial challenges and opportunities. They served to solve social problems which beset the state administration as well as contextual challenges besetting rationalization measures, and organizational challenges. The activities were also affected by a dependence on decision-makers, administrative units, and civil servants organizations, by different views on rationalization and the holistic nature of reforms, as well as by the formal theories that served as resources. It chose long-term projects which extended to the political decision-makers and administrative units turf, and which were intended to reform the structures of the state administration and to rationalize the practices of the administrative units. The crucial questions emerged in opposite pairs (a constitutional state vs. the ideology of an administratively governed state, a system of national boards vs. a system of government through ministries, efficiency of work vs. pleasantness of work, centralized vs. decentralized rationalization activities) which were not solvable problems but impossible questions with no ultimate answers. The aim and intent of the rationalization of the state administration (the reform of the central, provincial, and local governments) was to facilitate integrated management and to render a greater amount of work by approaching management procedures scientifically and by clarifying administrative instances and their respon-sibilities in regards to each other. The means resorted to were organizational studies and committee work. In the rationalization of office work and finance control, the idea was to effect savings in administrative costs and to pare down those costs as well as to rationalize and heighten those functions by developing the institution of work study practitioners in order to coordinate employer and employee relationships and benefits (the training of work study practitioners, work study, and a two-tier work study practitioner organization). A major part of the training meant teaching and implementing leadership skills in practice, which, in turn, meant that the learning environment was the genuine work community and efforts to change it. In office rationalization, the solution to regulate the relations between the employer and the employees was the co-existence of the technical and biological rationalization and the human resource administration and the accounting and planning systems at the turn of the 1960s and 1970s. The former were based on the school of scientific management and human relations, the latter on system thinking, which was a combination of the former two. In the rationalization of the state administration, efforts were made to find solutions to stabilize management ideologies and to arrange the relationships of administrative systems in administrative science - among other things, in the Hoover Committee and the Simon decision making theory, and, in the 1960s, in system thinking. Despite the development-related vocabulary, the practical work was advanced rationalization. It was said that the practical activities of both the state administration and the administrative units depended on professional managers who saw to production results and human relations. The pedagogic experts hired to develop training came up with a training system, based on the training-technological model where the training was made a function of its own. The State Training Center was established and the training office of the Organization and Methods Division became the leader and coordinator of personnel training.

Topeliaaninen usko : Kirjailija Sakari Topelius uskontokasvattajana

ABSTRACT The author Zacharias Topelius as a religious educator The present study concerns the author Zacharias Topelius (1818-98) as a religious educator. The study´s main questions are as follows: What is the theological and pedagogical content of Topelius books and how is his religious instruction linked with the history of his time. The primary sources are his educational books Naturens bok (The Book of the Nature, 1856), Boken om vårt land (The Book of our Land, 1875) and Evangelium för Barnen (Gospel for Children, 1893), as well as his storybooks Läsning för barn I-VIII (Reading for Children I-VIII, 1865-96). The dissertation concerns the his-tory of religious education. Its primary method is background-based systematic analy-sis. In Topelius children s books the view of God is characterised both as an omnipresent spirit and as Providence, who guides world history according to his plan. In addition to Lutheranism this view is also influenced by Nationalism and Romanticism. The theological content of the books emphasises instruction in Christian life that is natural to normative children s books. Topelius strongly expresses the importance of a personal relationship to God, an idealistic Christian view of one s fellow man and of one s own nation as well as the value of nature conservation. The books of Topelius were some of the first educational works on nature preservation in Finland. The didactic quality of Topelius children s books was high for 19th century Finland. Their main emphasis in terms of educational goals is on civilisation (Bildung), self-awareness, national solidarity and living idealism. The pedagogical argumentation is mostly based on theological, historical, social and rational reasoning. The primary principles in Topelius teaching are Christian nationalism, idealistic harmony and the agrarian bourgeois. Christian nationalism is the main element of Topelius religious education. He considers the fatherland as a God-given project and the taking care of it as a part of holy service. Idealistic harmony is seen as the comprehensive development of one s character in the sense of romantic idealism. The agrarian bourgeois principle combines the Finnish peasant tradition with the values of 19th century modern bourgeois culture. I have named Topelius vision of religious education the Christian national project of civilisation (Bildung). Its main theses are home, religion and fatherland. The author himself strongly believed in this vision and never questioned it despite its national chauvinism and theological inconsistency. The religious ideology represented in Topelius educational works and storybooks was popular among pedagogues during the whole era of the Finnish folk school. It fit per-fectly with the Christian national discourse stemming from 19th century ideological ten-dencies. Due to their appropriate content combined with their practical language and pedagogical methods, the books were popular both at school and in the home for a long period of time. Therefore the books of Topelius aptly symbolise the religious education of their time and manifest their author s pedagogical talent as a national religious educator and as a populariser of Christian nationalism. Topelius books have had a lasting influence on Finnish religiosity. Key words: Topelius, theology, religion, education, nationalism and national project

A course for teaching design research methodology

Design research informs and supports practice by developing knowledge to improve the chances of producing successful products.Training in design research has been poorly supported. Design research uses human and natural/technical sciences, embracing all facets of design; its methods and tools are adapted from both these traditions. However, design researchers are rarely trained in methods from both the traditions. Research in traditional sciences focuses primarily on understanding phenomena related to human, natural, or technical systems. Design research focuses on supporting improvement of such systems, using understanding as a necessary but not sufficient step, and it must embrace methods for both understanding reality and developing support for its improvement. A one-semester, postgraduate-level, credited course that has been offered since 2002, entitled Methodology for Design Research, is described that teaches a methodology for carrying out research into design. Its steps are to clarify research success; to understand relevant phenomena of design and how these influence success; to use this to envision design improvement and develop proposals for supporting improvement; to evaluate support for its influence on success; and, if unacceptable, to modify, support, or improve the understanding of success and its links to the phenomena of design. This paper highlights some major issues about the status of design research and describes how design research methodology addresses these. The teaching material, model of delivery, and evaluation of the course on methodology for design research are discussed.

Subject Teacher Training and Teaching in English

The purpose of this Master s thesis is on one hand to find out how CLIL (Content and Language Integrated Learning) teachers and English teachers perceive English and its use in teaching, and on the other hand, what they consider important in subject teacher education in English that is being planned and piloted in STEP Project at the University of Helsinki Department of Teacher Education. One research question is also what kind of language requirements teachers think CLIL teachers should have. The research results are viewed in light of previous research and literature on CLIL education. Six teachers participate in this study. Two of them are English teachers in the comprehensive school, two are class teachers in bilingual elementary education, and two are subject teachers in bilingual education, one of whom teaches in a lower secondary school and the other in an upper secondary school. One English teacher and one bilingual class teacher have graduated from a pilot class teacher program in English that started at the University of Helsinki in the middle of the 1990 s. The bilingual subject teachers are not trained in English but they have learned English elsewhere, which is a particular focus of interest in this study because it is expected that a great number of CLIL teachers in Finland do not have actual studies in English philology. The research method is interview and this is a qualitative case study. The interviews are recorded and transcribed for the ease of analysis. The English teachers do not always use English in their lessons and they would not feel confident in teaching another subject completely in English. All of the CLIL teachers trust their English skills in teaching, but the bilingual class teachers also use Finnish during lessons either because some teaching material is in Finnish, or they feel that rules and instructions are understood better in mother tongue or students English skills are not strong enough. One of the bilingual subject teachers is the only one who consciously uses only English in teaching and in discussions with students. Although teachers good English skills are generally considered important, only the teachers who have graduated from the class teacher education in English consider it important that CLIL teachers would have studies in English philology. Regarding the subject teacher education program in English, the respondents hope that its teachers will have strong enough English skills and that it will deliver what it promises. Having student teachers of different subjects studying together is considered beneficial. The results of the study show that acquiring teaching material in English continues to be the teachers own responsibility and a huge burden for the teachers, and there has, in fact, not been much progress in the matter since the beginning of CLIL education. The bilingual subject teachers think, however, that using one s own material can give new inspiration to teaching and enable the use of various pedagogical methods. Although it is questionable if the language competence requirements set for CLIL teachers by the Finnish Ministry of Education are not adhered to, it becomes apparent in the study that studies in English philology do not necessarily guarantee strong enough language skills for CLIL teaching, but teachers own personality and self-confidence have significance. Keywords: CLIL, bilingual education, English, subject teacher training, subject teacher education in English, STEP

Kotitalouden opetustilat osana kehittyvää oppimisympäristöä : asumistoiminnot ja opetussuunnitelma muutoksen määrittäjinä

Home Economics Classrooms as Part of Developing the Environment Housing Activities and Curriculums Defining Change --- The aim of the research project was to develop home economics classrooms to be flexible and versatile learning environments where household activities might be practiced according to the curriculum in different social networking situations. The research is based on the socio-cultural approach, where the functionality of the learning environment is studied specifically from an interactive learning viewpoint. The social framework is a natural starting point in home economics teaching because of the group work in classrooms. The social nature of learning thus becomes a significant part of the learning process. The study considers learning as experience based, holistic and context bound. The learning environment, i.e. home economics classrooms and the material tools there, plays a significant role in developing students skills to manage everyday life. --- The first research task was to analyze the historical development of household activities. The second research task was to develop and test criteria for functional home economics classrooms in planning both the learning environment and the students activities during lessons. The third research task was to evaluate how different professionals (commissioners, planners and teachers) use the criteria as a tool. The research consists of three parts. The first contains a historical analysis of how social changes have created tension between traditional household classrooms and new activities in homes. The historical analysis is based on housing research, regulations and instructions. For this purpose a new theoretical concept, the tension arch, was introduced. This helped in recognizing and solving problems in students activities and in developing innovations. The functionality criteria for home economics classrooms were developed based on this concept. These include technical (health, safety and technical factors), functional (ergonomic, ecological, aesthetic and economic factors) and behavioural (cooperation and interaction skills and communication technologies) criteria. --- The second part discusses how the criteria were used in renovating school buildings. Empirical data was collected from two separate schools where the activities during lessons were recorded both before and after classrooms were renovated. An analysis of both environments based on video recordings was conducted. The previously created criteria were made use of, and problematic points in functionality looked for particularly from a social interactive viewpoint. The results show that the criteria were used as a planning tool. The criteria facilitated layout and equipment solutions that support both curriculum and learning in home economics classrooms taking into consideration cooperation and interaction in the classroom. With the help of the criteria the home economics classrooms changed from closed and complicated space into integrated and open spaces where the flexibility and versatility of the learning environment was emphasized. The teacher became a facilitator and counselor instead a classroom controller. --- The third part analyses the discussions in planning meetings. These were recorded and an analysis was conducted of how the criteria and research results were used in the planning process of new home economics classrooms. The planning process was multivoiced, i.e. actors from different interest groups took part. All the previously created criteria (technical, functional and behavioural) emerged in the discussions and some of them were used as planning tools. Planning meetings turned into planning studios where boundaries between organizations were ignored and the physical learning environments were developed together with experts. The planning studios resulted in multivoiced planning which showed characteristics of collaborative and participating planning as well as producing common knowledge and shared expertise. --- KEY WORDS: physical learning environment, socio-cultural approach, tension arch, boundary crossing, collaborative planning.

Historical considerations and evolution of the forest policies for small woodlot owners of Quebec.

XVIII IUFRO World Congress, Ljubljana 1986.

Human Ecology in India Some Historical Perspectives

Before the spread of extensive settled cultivation, the Indian subcontinent would have been inhabited by territorial hunter–gatherers and shifting cultivators with cultural traditions of prudent resource use. The disruption of closed material cycles by export of agricultural produce to centres of non-agricultural population would have weakened these traditions. Indeed, the fire-based sacrificial ritual and extensive agricultural settlements might have catalysed the destruction of forests and wildlife and the suppression of tribal peoples during the agricultural colonization of the Gangetic plains. Buddhism, Jainism and later the Hindu sects may have been responses to the need for a reassertion of ecological prudence once the more fertile lands were brought under cultivation. British rule radically changed the focus of the country's resource use pattern from production of a variety of biological resources for local consumption to the production of a few commodities largely for export. The resulting ecological squeeze was accompanied by disastrous famines and epidemics between the 1860s and the 1920s. The counterflows to tracts of intensive agriculture have reduced such disasters since independence. However, these are quite inadequate to balance the state-subsidized outflows of resources from rural hinterlands. These imbalances have triggered serious environmental degradation and tremendous overcrowding of the niche of agricultural labour and marginal cultivator all over the country.