Évaluation de la simulation à haute fidélité pour améliorer la communication interprofessionnelle aux soins intensifs : étude expérimentale à double insu

Objectifs: Les patients hospitalisés aux soins intensifs (SI) sont souvent victimes d’erreurs médicales. La nature interprofessionnelle des équipes de SI les rend vulnérables aux erreurs de communication. L’objectif primaire du projet est d’améliorer la communication dans une équipe interprofessionnelle de soins intensifs par une formation en simulation à haute fidélité. Méthodologie Une étude prospective randomisée contrôlée à double insu a été réalisée. Dix équipes de six professionnels de SI ont complété trois scénarios de simulations de réanimation. Le groupe intervention était débreffé sur des aspects de communication alors que le groupe contrôle était débreffé sur des aspects techniques de réanimation. Trois mois plus tard, les équipes réalisaient une quatrième simulation sans débreffage. Les simulations étaient toutes évaluées pour la qualité, l’efficacité de la communication et le partage des informations critiques par quatre évaluateurs. Résultats Pour l’issue primaire, il n’y a pas eu d’amélioration plus grande de la communication dans le groupe intervention en comparaison avec le groupe contrôle. Une amélioration de 16% de l’efficacité des communications a été notée dans les équipes de soins intensifs indépendamment du groupe étudié. Les infirmiers et les inhalothérapeutes ont amélioré significativement l’efficacité de la communication après trois sessions. L’effet observé ne s’est pas maintenu à trois mois. Conclusion Une formation sur simulateur à haute fidélité couplée à un débreffage peut améliorer à court terme l’efficacité des communications dans une équipe interprofessionnelle de SI.

Human Resources Development in Higher Education in Kerala

The study is entitled “HUMAN RESOURCES DEVELOPMENT IN HIGHER EDUCATION IN KERALA”. The concept “Human Resource Development” is of high value in business and industry and has been used and applied since years. In industry and business the 'human' element is considred as a resource and hence its development and protection is very essential and inevitable. Of all the factors of production, human resource is the only factor having rational faculty and therefore, it must be handled with utmost care. Right recruitment, right training and right induction followed by faultless monitoring and welfare measures are but decisive factors in business and industry. Altogether there is a constant attention up on human factor there. But this is not a practice at all in education. So far there has not been any such measure of care and close watch and performance analysis of human resource on education front. This may be the main reason for lack of accountability in the sphere of education. The present study reveals the importance of introducing HRD practices in higher educational institutions in Kerala. In order to promise human capital formation through education, it is basic requirement. The higher educational institutions must follow the method of industry and commerce because education can be treated as an industry in service sector. There also we can follow the methods of right recruitment, right training and promotion, delegation, performance analysis and accountability checking of human resource. HRD is a powerful idea of transformation of human being into highly productive and contributing factor The HRD of students is the sum total of HRD of teachers. Reminding the primordial usage 'Yatha Raja Thadha Praja’ the quality of faculty resembles in students. The quality of administrative staff in colleges also affects the quality of higher education. Hence, it is high time to introduce the managerial method of HRD with all its paraphernalia in higher educational institutions so as to assure proper human capital formation in higher education in India.

Human Resources Development in Higher Education in Kerala

The study is entitled “HUMAN RESOURCES DEVELOPMENT IN HIGHER EDUCATION IN KERALA”. The concept “Human Resource Development” is of high value in business and industry and has been used and applied since years. In industry and business the ‘human’ element is considred as a resource and hence its development and protection is very essential and inevitable. Of all the factors of production, human resource is the only factor having rational faculty and therefore, it must be handled with utmost care. Right recruitment, right training and right induction followed by faultless monitoring and welfare measures are but decisive factors in business and industiy. Altogether there is a constant attention up on human factor there. But this is not a practice at all in education. So far there has not been any such measure of care and close watch and performance analysis of human resource on education front. This may be the main reason for lack of accountability in the sphere of education. The present study reveals the importance of introducing HRD practices in higher educational institutions in Kerala. In order to promise human capital formation through education, it is basic requirement. The higher educational institutions must follow the method of industry and commerce because education can be treated as an industry in service sector. There also we can follow the methods of right recruitment, right training and promotion, delegation, performance analysis and accountability checking of human resource. HRD is a powerful idea of transformation of human being into highly productive and contributing factor The HRD of students is the sum total of HRD of teachers. Reminding the primordial usage ‘Yatha Raja Thadha Praja’ the quality of faculty resembles in students. The quality of administrative staff in colleges also affects the quality of higher education. Hence, it is high time to introduce the managerial method of HRD with all its paraphernalia in higher educational institutions so as to assure proper human capital formation in higher education in India.

Higher Education Sector in India: Issues and Imperatives

The 21st century is marked by a paradigm shift in education that has resulted both in threats and opportunities. It has brought new challenges and an opportunity for higher education. Higher education in India is undergoing rapid changes. The challenges ahead are multifaceted and multidimensional. Though the data show a massive growth in the number of students' enrollment in colleges/universities, holistic view reveals that still only a meager of the total population has access to higher education. Globalization and privatization are imposing new challenges but the nations are still entangled in solving the basic problems of accessibility to higher education for all. In the wake of the transition from elitist to mass education, universities worldwide are under pressure to enhance access and equity, on the one hand, and to maintain high standards of quality and excellence, on the other. Today the notion of equity not only implies greater access to higher education, but also opportunities for progress. In recent debates on higher education, the notions of equity and access go beyond minority to diversity. Affirmative action, too, has become raceexclusive and gender-neutral.1

Political Education in Plural Societies: Using the Anti-Bias Approach to Challenge Oppression in Bombay and Berlin

This study addresses the effectivity of the Anti-Bias approach and training methodology as a pedagogical political strategy to challenge oppression among student groups in the cities of Bombay and Berlin. The Anti-Bias trainings conducted within the framework of this study also become the medium through which the perpetuation of oppressive structures by students within and outside the school is investigated. Empirical data from predominantly qualitative investigations in four secondary schools, two each in Bombay and Berlin, is studied and analysed on the basis of theoretical understandings of prejudice, discrimination and identity. This study builds on insights offered by previous research on prejudices and evaluations of anti-bias and diversity interventions, where the lack of sufficient research and thorough evaluations testing impact has been identified (Levy Paluck, 2006). The theoretical framework suggests that prejudices and discriminatory practices are learnt and performed by individuals over the years by way of pre-existing discourses, and that behaviour and practices can be unlearnt through a multi-step process. It proposes that the discursive practices of students contribute to the constitution of their viable selves and in the constitution of ‘others’. Drawing on this framework, the study demonstrates how student-subjects in Bombay and Berlin perpetuate oppressive discourses by performing their identities and performing identities onto ‘others’. Such performative constitution opens up the agency of the individual, disclosing the shifting and dynamic nature of identities. The Anti-Bias approach is posited as an alternative to oppressive discourses and a vehicle that encourages and assists the agency of individuals. The theoretical framework, which brings together a psychological approach to prejudice, a structural approach to discrimination and a poststructural approach to identity, facilitates the analysis of the perpetuation of dominant discourses by the students, as well as how they negotiate their way through familiar norms and discourses. Group discussions and interviews a year after the respective trainings serve to evaluate the agency of the students and the extent to which the training impacted on their perceptions, attitudes and behavioural practices. The study reveals the recurrence of the themes race, religion, gender and sexuality in the representational practices of the students groups in Berlin and Bombay. It demonstrates how students in this study not only perform, but also negotiate and resist oppressive structures. Of particular importance is the role of the school: When schools offer no spaces for discussion, debate and action on contemporary social issues, learning can neither be put into practice nor take on a positive, transformative form. In such cases, agency and resistance is limited and interventionist actions yield little. This study reports the potential of the Anti-Bias approach and training as a tool of political education and action in education. It demonstrates that a single training can initiate change but sustaining change requires long-term strategies and on-going actions. Taking a poststructural perspective, it makes concrete suggestions to adapt and alter the Anti-Bias approach and the implementation of Anti-Bias trainings.

Beyond the mincer equation: the internal rate of return to higher education in Colombia

In order to present an estimation of the Internal Rate of Return (IRR) to higher education in Colombia we take advantage of the methodological approach provided by Heckman, Lochner and Todd (2005). Trying to overcome the criticism that surrounds interpretations of the education coefficient of Mincer equations as being the rate of return to investments in education we develop a more structured approach of estimation, which controls for selection bias, includes more accurate measures of labor income and the role of education costs and income taxes. Our results implied a lower rate of return than the ones found in the Colombian literature and show that the Internal Rate of Return for higher education in Colombia lies somewhere between 0.074 and 0.128. The results vary according to the year analyzed and individual’s gender. This last result reinforces considerations regarding gender discrimination in the Colombian labor market.

Language, education and ethnicity: whose rights will prevail in an age of globalisation?

Education and ethnicity cannot be discussed without taking language into account. This paper will argue that any discussion of ethnic minorities cannot ignore the question of language, nor can any discussion of human rights ignore the question of language rights. Unfortunately, in today's globalised world, governments and minorities are faced with conflicting pressures: on the one hand, for the development and use of education in a global/international language; on the other for the use and development of mother tongue, local or indigenous languages in education. Language complexity and ethnic plurality were largely brought about as a result of the creation of nation-states, which were spread around the world as a result of European colonialism. European languages and formal education systems were used as a means of political and economic control. The legacy that was left by the colonial powers has complicated ethnic relations and has frequently led to conflict. While there is now greater recognition of the importance of language both for economic and educational development, as well as for human rights, the forces of globalisation are leading towards uniformity in the languages used, in culture and even in education. They are working against the development of language rights for smaller groups. We are witnessing a sharp decline in the number of languages spoken. Only those languages which are numerically, economically and politically strong are likely to survive. As a result many linguistic and ethnic groups are in danger of being further marginalised. This paper will illustrate this thesis both historically and from several contemporary societies, showing how certain policies have exacerbated ethnic conflict while others are seeking to promote harmony and reconciliation. Why this should be so will be explored. (c) 2006 Elsevier Ltd. All rights reserved.

Issues in language and development in multilingual settings: a case-study of knowledge exchange and teacher education in South Africa

The quality of a country’s human-resource base can be said to determine its level of success in social and economic development. This study focuses on some␣of the major human-resource development issues that surround the implementation of South Africa’s policy of multilingualism in education. It begins by discussing the relationship between knowledge, language, and human-resource, social and economic development within the global cultural economy. It then considers the situation in South Africa and, in particular, the implications of that country’s colonial and neo-colonial past for attempts to implement the new policy. Drawing on the linguistic-diversity-in-education debate in the United Kingdom of the past three decades, it assesses the first phase of an in-service teacher-education programme that was carried out at the Project for Alternative Education in South Africa (PRAESA) based at the University of Cape Town. The authors identify key short- and long-term issues related to knowledge exchange in education in multilingual societies, especially concerning the use of African languages as mediums for teaching and learning.

Two Faces of AIDS in Hong Kong: Culture and the Construction of the `AIDS Celebrity'

Since the first reported case of HIV infection in Hong Kong in 1985, only two HIV-positive individuals in the territory have voluntarily made public their seropositivity: a British dentist named Mike Sinclair, who disclosed his condition to the media in 1992 and died in 1995, and J.J. Chan, a local Chinese disc-jockey, who came forward in 1995 and died just a few months later. When they made their revelations, both became instant media personalities and were invited by the Hong Kong Government to act as spokespeople for AIDS awareness and prevention. Mike Sinclair worked as an education officer for the Hong Kong AIDS Foundation, and J.J. Chan appeared in Government television commercials about AIDS. This article explores how the public identities of these two figures were constructed in the cultural context of Hong Kong where both Eastern and Western values exist side by side and interact. It argues that the construction of `AIDS celebrities' is a kind of `identity project' negotiated among the players involved: the media, the Government, the public, and the person with AIDS (PWA) himself, each bringing to the construction their own `theories' regarding the self and communication. When the players in the construction hold shared assumptions about the nature of the self and the role of communication in enacting it, harmonious discourses arise, but when cultural models among the players differ, contradictory or ambiguous constructions result. The effect of culture on the way `AIDS celebrities' are constructed has implications for the way societies view the issue of AIDS and treat those who have it. It also helps reveal possible sites of difficulty when individuals of different cultures communicate about the issue.

Discourse strategies and power roles in student-led distance learning

The assertion of identity and power via computer-mediated communication in the context of distance or web-based learning presents challenges to both teachers and students. When regular, face-to-face classroom interaction is replaced by online chat or group discussion forums, participants must avail themselves of new techniques and tactics for contributing to and furthering interaction, discussion, and learning. During student-only chat sessions, the absence of teacher-led, face-to-face classroom activities requires the students to assume leadership roles and responsibilities normally associated with the teacher. This situation raises the questions of who teaches and who learns; how students discursively negotiate power roles; and whether power emerges as a function of displayed expertise and knowledge or rather the use of authoritative language. This descriptive study represents an examination of a corpus of task-based discussion logs among Vietnamese students of distance learning courses in English linguistics. The data reveal recurring discourse strategies for 1) negotiating the progression of the discussion sessions, 2) asserting and questioning knowledge, and 3) assuming or delegating responsibility. Power is defined ad hoc as the ability to successfully perform these strategies. The data analysis contributes to a better understanding of how working methods and materials can be tailored to students in distance learning courses, and how such students can be empowered by being afforded opportunities and effectively encouraged to assert their knowledge and authority.

Immigration, security and the public debate on US language policy : a critical discourse analysis of language attitudes in the United States of America

The narrative of the United States is of a "nation of immigrants" in which the language shift patterns of earlier ethnolinguistic groups have tended towards linguistic assimilation through English. In recent years, however, changes in the demographic landscape and language maintenance by non-English speaking immigrants, particularly Hispanics, have been perceived as threats and have led to calls for an official English language policy.This thesis aims to contribute to the study of language policy making from a societal security perspective as expressed in attitudes regarding language and identity originating in the daily interaction between language groups. The focus is on the role of language and American identity in relation to immigration. The study takes an interdisciplinary approach combining language policy studies, security theory, and critical discourse analysis. The material consists of articles collected from four newspapers, namely USA Today, The New York Times, Los Angeles Times, and San Francisco Chronicle between April 2006 and December 2007.Two discourse types are evident from the analysis namely Loyalty and Efficiency. The former is mainly marked by concerns of national identity and contains speech acts of security related to language shift, choice and English for unity. Immigrants are represented as dehumanised, and harmful. Immigration is given as sovereignty-related, racial, and as war. The discourse type of Efficiency is mainly instrumental and contains speech acts of security related to cost, provision of services, health and safety, and social mobility. Immigrants are further represented as a labour resource. These discourse types reflect how the construction of the linguistic 'we' is expected to be maintained. Loyalty is triggered by arguments that the collective identity is threatened and is itself used in reproducing the collective 'we' through hegemonic expressions of monolingualism in the public space and semi-public space. The denigration of immigrants is used as a tool for enhancing societal security through solidarity and as a possible justification for the denial of minority rights. Also, although language acquisition patterns still follow the historical trend of language shift, factors indicating cultural separateness such as the appearance of speech communities or the use of minority languages in the public space and semi-public space have led to manifestations of intolerance. Examples of discrimination and prejudice towards minority groups indicate that the perception of worth of a shared language differs from the actual worth of dominant language acquisition for integration purposes. The study further indicates that the efficient working of the free market by using minority languages to sell services or buy labour is perceived as conflicting with nation-building notions since it may create separately functioning sub-communities with a new cultural capital recognised as legitimate competence. The discourse types mainly represent securitising moves constructing existential threats. The perception of threat and ideas of national belonging are primarily based on a zero-sum notion favouring monolingualism. Further, the identity of the immigrant individual is seen as dynamic and adaptable to assimilationist measures whereas the identity of the state and its members are perceived as static. Also, the study shows that debates concerning language status are linked to extra-linguistic matters. To conclude, policy makers in the US need to consider the relationship between four factors, namely societal security based on collective identity, individual/human security, human rights, and a changing linguistic demography, for proposed language intervention measures to be successful.