Promotion of professional skills in engineering education: strategies and challenges

Basic engineering skills are not the only key to professional development, particularly as engineering problems are everyday more and more complex and multifaceted, hence requiring the implementation of larger multidisciplinary teams, in many cases working in an international context and in a continuously evolving environment. Therefore other outcomes, sometimes referred to as professional skills, are also necessary for our students, as most universities are already aware. In this study we try to methodically analyze the main strategies for the promotion of professional skills, mainly linked to actuations which directly affect students or teachers (and teaching methodologies) and which take advantage of the environment and available resources. From an initial list of 51 strategies (in essence aimed at promotion of different drivers of change, linked to students, teachers, environment and resources), we focus on the 11 drivers of change considered more important after an initial evaluation. Subsequently, a systematic analysis of the typical problems linked to these main drivers of change, enables us to find and formulate 12 major and usually repeated and unsolved problems. After selecting these typical problems, we put forward 25 different solutions, for short-term actuation, and discuss their effects, while bearing in mind our team’s experience, together with the information from the studies carried out by numerous teaching staff from other universities.

Modelo de taxonomia baseada nas competências profissionais de cirurgiões-dentistas que atuam na estratégia da saúde da família: uma ferramenta para planejamento instrucional

A pesquisa visa desenvolver solução para facilitar o planejamento e elaboração de ações educacionais por meio de uma taxonomia das competências profissionais em saúde que tem como base dois conceitos-chave: competências profissionais para a saúde e objetivos educacionais. Esses conceitos são explorados na perspectiva do desenvolvimento de uma taxonomia para ser utilizada como referencial de planejamento e elaboração dos cursos por professores e profissionais de educação em geral, no âmbito de Instituições de Ensino Superior (IES). Na multiplicidade de profissionais de saúde que atuam na estratégia de Saúde da Família no âmbito da Atenção Primária, foi necessário escolher uma das profissões para a construção do modelo, sendo assim, foi escolhida a Odontologia. Entretanto, o modelo poderá ser aplicado para o desenvolvimento de taxonomias que contemplem as competências de outros profissionais, entre os quais os enfermeiros e os médicos. A questão no centro da pesquisa é: será que nas práticas das equipes multiprofissionais envolvidas no desenvolvimento de ações educacionais, limitadas pelos exíguos prazos que geralmente lhes são impostos, é possível potencializar a integração entre o estado da arte dos conhecimentos desenvolvidos no mundo acadêmico com as necessidades de aprendizagem dos profissionais de saúde? O resultado que se espera da pesquisa é uma taxonomia relacionando as competências profissionais dos cirurgiões dentistas com a Taxonomia dos objetivos educacionais de Bloom, (1).

Avaliação da percepção sobre interdisciplinaridade nas unidades de saúde USF Paranapiacaba, US Vila Helena e CEO Vila Guilherme

É necessário compreender que o indivíduo, no processo saúde-doença, precisa receber atenção completa, que envolva várias disciplinas atuando de forma conjunta, numa visão que envolve integralidade de ações (Saupe et al., 2007; Salvador et al., 2011). Uma das principais características dos serviços de saúde hoje em dia no país é o atendimento feito por equipes multiprofissionais, cujo entrosamento, entendimento e troca de saberes entre seus membros levam à interdisciplinaridade (Salvador et al., 2011), tema central deste trabalho de pesquisa. Atendimento interdisciplinar envolve trabalho recíproco, criando relações sociais horizontais, contrariamente ao que ocorre no modelo de assistência tradicional, hegemônico. Exige que o saber do outro seja ouvido e pensado, inclusive dos indivíduos e das comunidades assistidos (Leite; Veloso, 2008). Este estudo, do tipo quali-quantitativo, tem por objetivo analisar as percepções que trabalhadores e usuários de três unidades de saúde, com estratégias distintas de atendimento, apresentam sobre interdisciplinaridade. Busca-se destacar dificuldades e possíveis meios facilitadores para sua prática diária na perspectiva de profissionais de saúde e usuários dessas três unidades de saúde. Foram aplicados questionários com perguntas fechadas semiestruturadas e abertas, cujos resultados foram submetidos à análise quantitativa, pela técnica descritiva de análise de frequência, e análise qualitativa pela técnica hermenêutica dialética, conforme preconizada por Minayo (2004). À luz dessa modalidade qualitativa de pesquisa aplicada aos profissionais surgiram três categorias: Meios para aumento da interdisciplinaridade; Fatores que afetam a interdisciplinaridade, subdivididos em Incentivadores, Desmotivadores e Ambíguos; e Resultados da interdisciplinaridade. Em relação aos usuários, as categorias emergentes foram: Desinteresse; Visão assistencial individualista e Vantagens da interdisciplinaridade. Os resultados encontrados foram: todas as categorias profissionais sentiram falta de outros profissionais em grupos educativos. A ausência mais sentida foi assistente social (18,75%). A estratégia interdisciplinar mais lembrada foi \"reuniões\" (38,6%). Falta noção de que é necessário trocar informações de forma efetiva, compreensível e satisfatória para todos. Mostrou-se importante aproveitar esses momentos para discutir protocolos e rotinas. Instrumento relevante para aumentar as trocas entre os profissionais foi a capacitação (13,6%) que melhora o relacionamento em equipe ao diminuir inseguranças. Trocas de informações em equipe multidisciplinar podem transformála em interdisciplinar. Pertencimento foi fato importante para a interdisciplinaridade, assim como dialogar, tolerar, respeitar, ouvir, ser flexível e enxergar o que está além de si, com interação social, horizontal. Número reduzido de profissionais, tomar conhecimento dos resultados das decisões em equipe e corresponsabilidade também foram fatores de destaque. Mais de 70% dos usuários relatou não participar de grupos educativos, evidenciando o curativismo. Os usuários valorizaram o atendimento por mais de um profissional. Acolhimento prescinde da ação interdisciplinar. Nenhum modo de atendimento foi sugerido pelos usuários. A interdisciplinaridade favorece a relação entre a equipe e o usuário, diminui espera e aumenta resolução. Na US Vila Helena, a interdisciplinaridade prescindiu de reuniões de equipe para acontecer.

Development of the DORI-TBI: An Investigation to Develop a New Screening Measure to Determine Consultation with a School-Based Brain Injury Resource Team

Brain injury is the leading cause of disability and death in children in the United States. Student re-entry into the school setting following a traumatic brain injury is crucial to student success. Multidisciplinary teams within the school district comprised of individuals with expertise in brain injury are ideal in implementing student specific treatment plans given their specialized training and wide range of expertise addressing student needs. Therefore, the purpose of this study is to develop and initially validate a quantitative instrument that school personnel can use to determine if a student, identified as having a traumatic brain injury, will benefit from district-level consultation from a brain injury team. Three studies were designed to investigate the research questions. In study one, the planning and construction of the DORI-TBI was completed. Study two addressed the content validity of the DORI-TBI through a comparison analysis with other referral forms, content review with experts in the field of TBI, and cognitive interviews with professionals to test the usability of the new screening tool. In study three, a field administration was conducted using vignettes to measure construct validity. Results produced a valid and reliable new screening instrument that can aid school-based teams to more efficiently utilize district level consultation with a brain injury support team.

Teaching-learning process of historical heritage: a Journey as a beginning, path and end

The implantation of new university degrees within the European Higher Education Area implies the need of innovative methodologies in teaching and learning to improve the skills and competencies of students and to answer the growing needs that society continuously demands to heritage management experts. The present work shows an application of the teaching methodology proposed during the international workshop entitled “I International Planning Preservation Workshop. Learning from Al Andalus”, which included the participation of the University of Alicante and Granada, Università Politecnico di Milano and Hunter College City University of New York; where we tried to dissolve traditional boundaries derived of interuniversity cooperation programs. The main objective of the workshop was to discuss and debate the role of urban Historical Centers within the Global Heritage by the integrated work through multidisciplinary teams and the creation of a permanent international working group between these universities to both teach and research. The methodology of this workshop was very participatory and considered the idea of a new learning process generated by "a journey experience." A trip from global to local (from the big city to the small village) but also a trip from the local (historical) part of a big city to the global dimension of contemporary historical villages identified by the students through a system of exhibition panels in affinity groups, specific projects proposed by lecturers and teachers or the generation of publications in various areas (texts, photographs, videos, etc.). So, the participation of the students in this multidisciplinary meeting has enhanced their capacity for self-criticism in several disciplines and has promoted their ability to perform learning and research strategies in an autonomous way. As a result, it has been established a permanent international work structure for the development of projects of the Historical City. This relationship has generated the publication of several books whose contents have reflected the conclusions developed in the workshop and several teaching proposals shared between those institutions. All these aspects have generated a new way of understanding the teaching process through a journey, in order to study the representative role of university in the historical heritage and to make students (from planning, heritage management, architecture, geography, sociology, history or engineering areas) be compromised on searching strategies for sustainable development in the Contemporary City.

Actual and preferred work activites of mental health Occupational Therapists: Congruence or Discrepancy

The reform of Australian mental health services has resulted in new models of care and changed work practices for all mental health professionals. Occupational therapists today are as likely to be working in multidisciplinary teams performing a range of generic clinical roles as they are to be working in specialist rehabilitation units. These kinds of changes have taken place in other countries, with anecdotal and some empirical evidence that the changes have resulted in concerns about loss of professional identity and roles. This study sought to identify the current work activities carried out by occupational therapists and to determine whether there was a discrepancy between their actual and desired work activities. It was expected that, overall, they would indicate a preference to do more specialist rehabilitation focused work and less generic case management work. A survey of 196 occupational therapists investigated their actual and preferred work activities in 55 specific roles across four broad categories (senior administration, specialist clinical, general clinical and community development). As expected, the participants indicated that they would prefer to be undertaking more specialist rehabilitation oriented work activities than they were actually doing. Contrary to expectations, they also wished to undertake more rather than less generic clinical work activities, to be more engaged in community development work and to take on more senior and administrative roles. They indicated a preference for less rather than more activity on only 5 of the 55 work roles examined. On examining a subset of 113 participants who reported that 50% or more of their time was spent in case management, there was greater evidence of resistance to generic clinical roles. It was therefore concluded that occupational therapists in Australia are seeking to deploy their specialist skills to a greater degree than the current practice environment permits. They have broadly accepted the generic roles required in multidisciplinary community case management, but those who are actually working in these roles are most likely to have reservations about this kind of work.

Evaluation of a pilot second-opinion child telepsychiatry service

A second-opinion child psychiatry service was piloted for six months in the northern-most two-thirds of Queensland. It provided specialist expertise by telehealth to local multidisciplinary teams of mental health staff. During the study period, 28 videoconferences were performed by the service: nine for administrative purposes, two for educational purposes, and 17 for direct and indirect clinical applications. The mean time between a referral being made and a consultation being performed was 4.7 days (range 1-13), A survey administered to referring and non-referring mental health workers showed that the major barriers to service implementation included the limited allied health applications that were offered, a perceived lack of communication during the implementation phase of the service, and the creation of a new referral network that did not conform to traditional referral patterns in the north of Queensland.

A pre-post test evaluation of the impact of the PELICAN MDT-TME development programme on the working lives of colorectal cancer team members

Background - The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. Methods - The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Results - Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Conclusions - Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.

Patients' and physicians' experiences of atrial fibrillation consultations and anticoagulation decision-making:a multi-perspective IPA design

OBJECTIVE: To explore patients' and physicians' experiences of atrial fibrillation consultations and oral anticoagulation decision-making. DESIGN: Multi-perspective interpretative phenomenological analyses. METHODS: Participants included small homogeneous subgroups: AF patients who accepted (n=4), refused (n=4), or discontinued (n=3) warfarin, and four physician subgroups (n=4 each group): consultant cardiologists, consultant general physicians, general practitioners and cardiology registrars. Semi-structured interviews were conducted. Transcripts were analysed using multi-perspective IPA analyses to attend to individuals within subgroups and making comparisons within and between groups. RESULTS: Three themes represented patients' experiences: Positioning within the physician-patient dyad, Health-life balance, and Drug myths and fear of stroke. Physicians' accounts generated three themes: Mechanised metaphors and probabilities, Navigating toward the 'right' decision, and Negotiating systemic factors. CONCLUSIONS: This multi-perspective IPA design facilitated an understanding of the diagnostic consultation and treatment decision-making which foregrounded patients' and physicians' experiences. We drew on Habermas' theory of communicative action to recommend broadening the content within consultations and shifting the focus to patients' life contexts. Interventions including specialist multidisciplinary teams, flexible management in primary care, and multifaceted interventions for information provision may enable the creation of an environment that supports genuine patient involvement and participatory decision-making.

A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress

Purpose: The purpose of this study was toinvestigate moral distress in Irish psychiatric nurses. Design: A qualitative descriptive methodology was used. Findings: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings. Practice Implications: The findings indicate that while multidisciplinary teams appear to function well on the surface, situations that give rise to moral distress are not always acknowledged or dealt with effectively. Furthermore, unresolved moral conflict impacts upon the quality of clinical decision-making by not allowing open and transparent discussions that allow clinicians the opportunity to address their concerns adequately.

The role of stimulating employees creativity and idea generation in encouraging innovation behaviour in Irish firms

This paper analyses the impact of stimulating staff creativity and idea generation on the likelihood of innovation. Using data for over 3,000 firms, obtained from the Irish Community Innovation Survey 2008-10, we examine the impact of six creativity generating stimuli on product, process, organisational, and marketing innovation. Our results indicate that the stimuli impact the four forms of innovation in different ways. For instance brainstorming and multidisciplinary teams are found to stimulate all forms of innovation, rotation of employees is found to stimulate organisational innovation, while financial and non-financial incentives are found to have no effect on any form of innovation. We also find that the co-introduction of two or more stimuli increases the likelihood of innovation more than implementing stimuli in isolation. These results have important implications for management decisions in that they suggest that firms should target their creative efforts towards specific innovation outcomes.

Chemotherapy patient perception regarding communication with the healthcare staff

Purpose: To qualitatively explore the communication between healthcare professionals and oncology patients based on the perception of patients undergoing chemotherapy.Method: Qualitative and exploratory design. Participants were 14 adult patients undergoing chemotherapy at different stages of the disease. A socio-demographic and clinical data form was utilized along with semi-structured interviews. The interviews were audio-recorded, transcribed and content analysis was performed. Two independent judges evaluated the interview content in regards to emerging categories and obtained a Kappa index of 0.834.Results: Three categories emerged from the data: 1) Technical communication without emotional support, in which the information provided is composed of strictly technical information regarding the diagnosis, treatment and/or prognosis; 2) Technical communication, in which the information provided is oriented towards the technical aspects of the patient’s physical condition, while also providing psychological support for the patients’ subjective needs; and 3) Insufficient technical communication, win which there are gaps in the information provided causing confusion and suffering to the patient.Conclusions: Communication with emotional support contributes to greater satisfaction of chemotherapy patients. Practical implications: the results provide elements for the training of healthcare professionals regarding the importance of the emotional support that can be offered to cancer patients during their treatment.

Buenas prácticas de los centros de rehabilitación laboral (CRL) para personas con enfermedad mental grave de la Comunidad de Madrid a tener en cuenta para el diseño de un nuevo modelo de gestión de los servicios de empleo

El presente artículo tiene como objetivo principal identificar las variables que explican por qué los Centros de Rehabilitación Laboral (CRL) para personas con enfermedad mental grave y duradera de la Comunidad de Madrid consiguen tasas de inserción sociolaboral cercanas al 50%, siendo un colectivo que presenta unas tasas de desempleo superiores al 80%. La metodología empleada en la investigación del recurso (documental, cualitativa y cuantitativa) demuestra que estos resultados son posibles gracias a la conjunción de varios elementos: financiación sostenible, método de trabajo, fuerte liderazgo político, trabajo con el tejido empresarial (presentando a las empresas, perfiles profesionales basados en un certero análisis de las competencias), trabajo en red, plazo de intervención marcado por la persona y la composición de los equipos multiprofesionales, entre otros factores.

Aconselhamento de produtos de apoio para alunos com NEE: levantamento das estratégias e modelos utilizados pelos CRTIC

Na senda do contexto legislativo de outros países, também Portugal criou uma conjuntura legislativa, no âmbito da Educação Especial, que consagrou a possibilidade de utilização de produtos de apoio, como um recurso ao serviço dos alunos com Necessidades Educativas Especiais (NEE). Entre outras iniciativas, o Ministério da Educação lançou, em 2007, uma rede constituída por 25 centros, designados por Centro de Recursos TIC para Educação Especial (CRTIC) que, entre outras missões, são responsáveis pela avaliação de alunos com NEE tendo em vista a implementação dos produtos de apoio na intervenção educativa junto deste tipo de discentes. É neste contexto que surge a proposta de, com o estudo aqui apresentado, investigar e compreender as práticas atualmente em curso nos CRTIC, nomeadamente no que respeita às estratégias e os modelos aplicados nas avaliações de alunos com NEE, para efeitos de atribuição de produtos de apoio. O referencial teórico que sustentou este estudo foi analisado considerando o contexto legislativo nacional e internacional, que enquadra a utilização deste tipo de recursos junto destes alunos. Considerámos ainda as classificações existentes que caracterizam a diversidade dos produtos de apoio disponíveis no mercado, tendo a presente investigação sido focada no âmbito do aconselhamento tipicamente realizado pelos CRTIC. Por último, fez-se uma reflexão acerca dos processos implicados na prestação de serviços, analisando alguns indicadores de qualidade de serviço aconselhados pela literatura da especialidade. Do ponto de vista metodológico, e atendendo à finalidade desta investigação, delineou-se uma estratégia que permitiu recolher dados provenientes de diferentes fontes, tendo-se desenvolvido um estudo do tipo survey, sustentado por um paradigma pluri-metodológico, cujo corpus de análise proveio da análise documental de relatórios oficiais e de inquéritos por entrevista e por questionário. Estes últimos foram aplicados a todo o universo dos CRTIC (25 centros), tendo-se obtido uma taxa de resposta de 100%. A análise dos dados obtidos revelou que o processo de avaliação desenvolvido por estes centros já tem em conta alguns dos aspetos destacados na literatura, tais como: equipas multidisciplinares; tomada de decisão colaborativa e observação dos fatores ambientais do aluno. Porém, verifica-se que são escassos os CRTIC que disponibilizam um apoio sistemático e continuo aos intervenientes educativos na fase de implementação/utilização dos produtos atribuídos. Sustentados na constatação deste facto, conceptualizámos e prototipámos uma proposta de uma plataforma de apoio à avaliação e monitorização dos produtos de apoio, designada por “Rede NEE”, que visa facilitar a comunicação entre os intervenientes. Esta proposta revela-se inovadora no modo como os pedidos podem ser realizados, contemplando ainda estratégias que poderão facilitar a monitorização dos produtos de apoio atribuídos.

Mediação na redução de riscos e minimização de danos na toxicodependência: práticas e desafios

Trabalho de Projeto apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de Mestre em Intervenção Comunitária, especialização em Educação Para a Saúde