Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Trainee-therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training

Objective Contemporary research demonstrates the feasibility of assessing therapeutic performance of trainee-therapists through the use of objective measures of client treatment outcome. Further, significant variation between individual therapists based on their client treatment outcomes has been demonstrated. This study sets out to determine whether a reliable composite measure of therapeutic efficiency, effectiveness and early dropout can be developed and used to objectively compare trainee-therapists against each other. Design and methods Treatment outcomes of 611 clients receiving treatment from 58 trainee-therapists enrolled in a professional training programme were tracked with the OQ-45.2 over a 6-year period to assess therapeutic efficiency, therapeutic effectiveness and early client dropout. Results Significant variation between trainee-therapists was observed for each index. Findings of a moderately strong correlation between therapeutic efficiency and effectiveness enabled the ranking of trainee-therapists based upon a composite measure of these indexes. A non-significant correlation was found between early client dropout and measures of therapeutic effectiveness and efficiency. Conclusions The findings stress the importance of utilizing objective measures to track the treatment outcomes. Despite all trainee-therapists being enrolled in the same training programme, significant variation between trainee-therapists' therapeutic efficiency and effectiveness was found to exist. Practitioner points Developing of potential benchmarking tools that enable trainee-therapists, supervisors and educational institutions to quickly assess therapeutic performance can become part of a holistic assessment of a trainee-therapist's clinical development. Despite an inherent optimistic belief that therapists do not cause harm, there appears to be a small and significant proportion of trainee-therapists who consistently evidence little therapeutic change. Considerable variability in trainee-therapists' therapeutic efficiency and effectiveness can exist in the one training programme. Early client dropout may not be associated with therapists' therapeutic effectiveness and efficiency.

Service-learning through multiple client-sponsored projects in an MBA marketing course

This paper outlines an approach for teaching Marketing Principles in an MBA course through service-learning to enable adult learners to connect the lectures’ marketing content to a real-world marketing project. During the course, 40 students in groups of four to five individuals were involved in eight different client-sponsored marketing projects executed simultaneously. The rationale, planning and management of this approach utilised current research on service-learning, living cases and client-sponsored projects in marketing education. The experimental curriculum design is presented in a timeline that mirrors the preparation and management of the group projects and the considerations to be taken into account when initiating and facilitating the projects. Reflections from this iteration of the service-learning design suggest the importance of: detailed project planning, the involvement of students in choosing the projects, the introduction of forms and feedback loops, the role of the instructor in facilitating the students and managing expectations, and the role of the company representative in supporting the groups.

Client learning and the performance of collaborative infrastructure projects

Australia is a leading user of collaborative procurement methods, which are used to deliver large and complex infrastructure projects. Project alliances, Early Contractor Involvement (ECI), and partnering are typical examples of collaborative procurement models. In order to increase procurement effectiveness and value for money (VfM), clients have adopted various learning strategies for new contract development. However client learning strategies and behaviours have not been systematically analysed before. Therefore, the current paper undertakes a literature review addressing the research question “How can client learning capabilities be effectively understood?”. From the resource-based and dynamic capability perspectives, this paper proposes that the collaborative learning capability (CLC) of clients drives procurement model evolution. Learning routines underpinning CLC carry out exploratory, transformative and exploitative learning phases associated with collaborative project delivery. This learning improves operating routines, and ultimately performance. The conceptualization of CLC and the three sequential learning phases is used to analyse the evidence in the construction management literature. The main contribution of this study is the presentation of a theoretical foundation for future empirical studies to unveil effective learning strategies, which help clients to improve the performance of collaborative projects in the dynamic infrastructure market.

Caught in the act of collaboration: Students’ experiences of collective learning within a real-world design studio context

This study is an evaluation of design students’ perceptions of the benefits of collective learning in a real-world collaborative design studio. Third year students worked in inter-disciplinary teams representing architecture, interior design, landscape architecture, and industrial design. Responding to a real-world brief and in consultation with an industry partner client and early childhood education pre-service teachers, the teams were required to collectively propose a design response for a community-based child and family centre, on an iconic koala sanctuary site. Data were collected using several methods including a participatory action research method, through the form of a large analogue, collaborative jigsaw puzzle. Using a grounded theory methodology, qualitative data were thematically analysed to reveal six distinct aspects of collaboration, which positively impacted the students’ learning experience. The results of this study include recommendations for improving real world collaboration in the design studio in preparation for students’ transition into professional practice.

Pioneering use of narrative method in a first-year law course to provide an authentic, inquiry-based entry into the discipline of law

Law is saturated with stories. People tell their stories to lawyers; lawyers tell their client's stories to courts; and legislators develop regulation to respond to their constituent's stories of injustice or inequality. My approach to first-year legal education respects this narrative tradition. Both my curriculum design and assessment scheme in the compulsory first-year subject Australian Legal System deploy narrative methodology as the central teaching and learning device. Throughout the course, students work on resolving the problems of four hypothetical clients. Like a murder mystery, pieces of the puzzle come together as students learn more about legal institutions and the texts they produce, the process of legal research, the analysis and interpretation of primary legal sources, the steps in legal problem-solving, the genre conventions of legal writing style, the practical skills and ethical dimensions of professional practice, and critical inquiry into the normative underpinnings and impacts of the law. The assessment scheme mirrors this design. In their portfolio-based assignment, for example, students devise their own client profile, research the client's legal position and prepare a memorandum of advice.

Monte Carlo analysis of a puzzle game

When a puzzle game is created, its design parameters must be chosen to allow solvable and interesting challenges to be created for the player. We investigate the use of random sampling as a computationally inexpensive means of automated game analysis, to evaluate the BoxOff family of puzzle games. This analysis reveals useful insights into the game, such as the surprising fact that almost 100% of randomly generated challenges have a solution, but less than 10% will be solved using strictly random play, validating the inventor’s design choices. We show the 1D game to be trivial and the 3D game to be viable.

Jean-Pierre Durand, Patrick Matthiesen, unidentified woman and Serge Donabedian working on a puzzle at Aenny's 80th birthday; London.

Digital Image

Jean-Pierre Durand, Patrick Matthiesen, unidentified woman and Serge Donabedian working on a puzzle at Aenny's 80th birthday; London.

Digital Image

The puzzle of falling enrolments in physics and chemistry courses: Putting some pieces together

This paper reports and discusses the principal findings of an Australian study exploring the decisions of high achieving Year 10 students about taking physics and chemistry courses (Lyons, 2003). The study used a ‘multiple worlds’ framework to explore the diverse background characteristics that previous quantitative research had shown were implicated in these decisions. Based on analyses of questionnaire and interview data, the study found that the students’ decisions involved the complex negotiation of a number of cultural characteristics within their school science and family worlds. Many of the students regarded junior high school science as irrelevant, uninteresting and difficult, leaving them with few intrinsic reasons for enrolling in senior science courses. The study found that decisions about taking physical science courses were associated with the resources of cultural and social capital within their families, and the degree to which these resources were congruent with the advantages of choosing these courses. The paper concludes that the low intrinsic value of school science and the erosion of its strategic value contribute to the reluctance of students to choose physical science courses in the senior school.

Missing pieces in the puzzle of plant microRNAs

Plant microRNAs (miRNAs) are important regulatory switches. Recent advances have revealed many regulatory layers between the two essential processes, miRNA biogenesis and function. However, how these multilayered regulatory processes ultimately control miRNA gene regulation and connects miRNAs and plant responses with the surrounding environment is still largely unknown. In this opinion article, we propose that the miRNA pathway is highly dynamic and plastic. The apparent flexibility of the miRNA pathway in plants appears to be controlled by a number recently identified proteins and poorly characterized signaling cascades. We further propose that altered miRNA accumulation can be a direct consequence of the rewiring of interactions between proteins that function in the miRNA pathway, an avenue that remains largely unexplored.

Caution, helping may be hazardous: Client abuse, threats and assaults

The shooting of a social worker by a client on the Gold Coast in 1991 graphically illustrated the issue of physical assaults and violence by service users against social workers. In this article we look at the incidence of physical assault, threats of violence, abuse of agency property and verbal abuse to social and other welfare workers by clients, using data from a survey in Melbourne. We then look at probable causes of menacing behaviour, such as issues involved in work with involuntary clients' and we discuss options for preventing and coping with violence and abuse in the welfare work place.

Online client-AP association in WLANs

In many IEEE 802.11 WLAN deployments, wireless clients have a choice of access points (AP) to connect to. In current systems, clients associate with the access point with the strongest signal to noise ratio. However, such an association mechanism can lead to unequal load sharing, resulting in diminished system performance. In this paper, we first provide a numerical approach based on stochastic dynamic programming to find the optimal client-AP association algorithm for a small topology consisting of two access points. Using the value iteration algorithm, we determine the optimal association rule for the two-AP topology. Next, utilizing the insights obtained from the optimal association ride for the two-AP case, we propose a near-optimal heuristic that we call RAT. We test the efficacy of RAT by considering more realistic arrival patterns and a larger topology. Our results show that RAT performs very well in these scenarios as well. Moreover, RAT lends itself to a fairly simple implementation.

Optimizing Multimedia Experience in a Thin Client Environment for a Resource Constrained Processor

In this paper, we study how TCP and UDP flows interact with each other when the end system is a CPU resource constrained thin client. The problem addressed is twofold, 1) the throughput of TCP flows degrades severely in the presence of heavily loaded UDP flows 2) fairness and minimum QoS requirements of UDP are not maintained. First, we identify the factors affecting the TCP throughput by providing an in-depth analysis of end to end delay and packet loss variations. The results obtained from the first part leads us to our second contribution. We propose and study the use of an algorithm that ensures fairness across flows. The algorithm improves the performance of TCP flows in the presence of multiple UDP flows admitted under an admission algorithm and maintains the minimum QoS requirements of the UDP flows. The advantage of the algorithm is that it requires no changes to TCP/IP stack and control is achieved through receiver window control.