Medical error:a discussion of the medical construction of error and suggestions for reforms of medical education to decrease error

Introduction: There is a growing public perception that serious medical error is commonplace and largely tolerated by the medical profession. The Government and medical establishment's response to this perceived epidemic of error has included tighter controls over practising doctors and individual stick-and-carrot reforms of medical practice. Discussion: This paper critically reviews the literature on medical error, professional socialization and medical student education, and suggests that common themes such as uncertainty, necessary fallibility, exclusivity of professional judgement and extensive use of medical networks find their genesis, in part, in aspects of medical education and socialization into medicine. The nature and comparative failure of recent reforms of medical practice and the tension between the individualistic nature of the reforms and the collegiate nature of the medical profession are discussed. Conclusion: A more theoretically informed and longitudinal approach to decreasing medical error might be to address the genesis of medical thinking about error through reforms to the aspects of medical education and professional socialization that help to create and perpetuate the existence of avoidable error, and reinforce medical collusion concerning error. Further changes in the curriculum to emphasize team working, communication skills, evidence-based practice and strategies for managing uncertainty are therefore potentially key components in helping tomorrow's doctors to discuss, cope with and commit fewer medical errors.

Who is really in charge of contemporary education? People and technologies in, against and beyond the neoliberal university

This article reflects on the position of people in, against and beyond information and communication technologies. Firstly, using Jandrić and Kuzmanić’s work on digital postcolonialism, Raymond Williams's work on residual and emergent cultures, and Deleuze and Guattari's insights into the dynamics between territorialization, de-territorialization and re-territorialization, it develops a theoretical framework for inquiry into the hybrid identity of the contemporary university. Then, through critical discourse analysis (CDA), the article moves on to analyse the ways in which technology discourse resides in the dominating ideology of technological determinism and co-opts with neoliberal agendas by omitting humans from explicit mention in UK policy documents. It shows that true counter-hegemonic practice against dominating social practices is possible only through reinvigorating the central position of human beings in regards to information and communication technologies. Within the developed theoretical framework, it seeks openings to intervene subversively into current relationships between technologies, people, and (higher) education, and to identify opportunities for building a non-determinist identity of the contemporary university that reaches beyond the single-minded logic of techno-scientific development. In the process, it situates Paulo Freire's insights into critical pedagogy in the context of the network society, and places the relationships between human beings, language and information and communication technologies amongst central questions of today's (higher) education and society at large.

The Automation of Adaptive Processes in the System of Distance Education and Knowledge Control

The article reveals a new technological approach to the creation of adaptive systems of distance learning and knowledge control. The use of the given technology helps to automate the learning process with the help of adaptive system. Developed with the help of the quantum approach of knowledge setting, a programming module-controller guarantees the support of students’ attention and the adaptation of the object language, and this helps to provide the effective interaction between learners and the learning system and to reach good results in the intensification of learning process.

Special Features of Musical Education in Distant Learning (Training of Intonation Thinking)

The problem of using modern technologies in distant learning of intonation thinking is described in this article. An importance of intonation learning for musician students and the possibilities, provided by World Wide Web and multimedia technologies are the main point of this article.

Felsőoktatási intézmények közbeszerzési sajátosságai = Public Procurement Characteristics of Higher Education Institutions

A kutatók a 2000-es évek eleje óta foglalkoznak a közbeszerzés és a versenyképesség kapcsolatával. A két terület közötti összefüggés egyértelmű, melyet vizsgálatainak is megerősítenek. Az Európai Unió tagállamainak jogalkotón folyamatos a nyomás, hogy a közbeszerzést különböző célokra használják fel. Mindez segít a közbeszerzés értelmezési körének kitágításában, de felhívja a figyelmet arra, hogy a jogalkotóknak elsősorban néhány kiemelt témára kell összpontosítaniuk, mint az innováció vagy a fenntarthatóság. A felsőoktatási intézmények közbeszerzésben betöltött szerepén túl fontosságuk a konzorciális beszerzések, a közbeszerzés képzés, továbbá az innovatív termékek, technológiák beszerzési gyakorlatában betöltött szerepük miatt kiemelkedő. Hazánkban ez az első alkalom, hogy feltárjuk kifejezetten nagy közbeszerző felsőoktatási intézményeik piaci szerepét és elemezzük közbeszerzési gyakorlatuk sajátosságait, viszonyítjuk eddigi kutatási eredményeinkhez. ______ Researchers have focused on the relation between public procurement and competitiveness since the early 2000s. The relation between corporate competitiveness and public procurement is beyond doubt, evidenced by our research findings. There is growing pressure on the legislators of EU Member States to use public procurement for certain purposes. This helps to widen the scope of procurement, but the regulators have to focus on several priorities like innovation and sustainability. The importance of universities in the development of consortial purchasing, purchasing education, procurement of innovative goods and technologies is unquestionable. It is the first opportunity in Hungary to analyze the role of large contracting authorities, participants of the higher educational market in public procurement and to explore the characteristics of their public procurement practice in order to make comparison between universities and other public procurement market players.

The internationalisation of the Spanish SME sector

As part of a wider research program, we analysed the theoretical framework and the recent developments of the process of internationalisation (transnationalisation) of the small- and medium-sized enterprises in Spain. The paper highlights the main trends and barriers of this internationalisation process. Methodology included document analyses, interviews, and the analyses of statistical databases.

A tudományterületi sajátosságok következményei a kutatásban, az oktatásban és a felsőoktatási intézmények vezetésében (The consequences of disciplinary difference on teaching, research and institutional management of higher education)

A szerző tanulmányában vizsgálja a tudományterületek különbségeinek következményeit az oktatásban, a kutatásban és a felsőoktatási intézmények irányításában. A tanulmány első felében a tudományterületek episztemológiai és közösségi különbségeit tárgyalja Becher és Trowler (2001) népszerű kategorizálása alapján. A tanulmány második felében a tudományszerveződésre, a publikációs gyakorlatra, a doktori képzésre, az oktatás céljára és formáira, a diákok tudásképére, valamint a menedzsmentfelfogásra gyakorolt hatást mutatja be. A konklúzióban egyrészt a minőség- és teljesítményértékelési rendszerek differenciált megközelítésének szükségességére hívja fel a figyelmet, másrészt arra, hogy a Bologna-rendszer és az élethosszig tartó tanulás erősödésének következményeként egy-egy mesterszakon nemcsak a hallgatóság háttere, előismerete lesz sokszínű, hanem a tudásról alkotott képe is. Ez újfajta oktatói szerepeket és oktatási megközelítéseket tesz szükségessé. ________ In the article the consequences of disciplinary difference on teaching, research and institutional management is examined. In the first part of the paper the epistemological and sociological differences of scientific disciplines are summarized based on the popular typology of Becher and Trowler (2001). In the second part the influence of differences on organisation of sciences, publication practices, PhD studies, the goal and form of teaching, students’ conception of knowledge as well as on the understanding on management and leadership are discussed. In the conclusions, attention is drawn on the necessity of differentiation in quality and performance management processes. Another conclusion is that new roles for teachers and approaches for teaching is required if students’ conception of knowledge become more heterogeneous which is the result of result of life long learning and Bologna-reform.

Recent Developments in the Autonomy and Governance of Higher Education Institutions in Hungary: the Introduction of the Chancellor System

After the change of regime in 1989, Hungarian higher education started to return to its Humboldtian tradition. It was widely accepted that academic freedom could be guaranteed by high degree of institutional autonomy manifested especially in structures of self-governance and avoidance of direct state supervision/interventions. Attempts to introduce boards and other supervising bodies were successfully resisted until 2011. The new government coming into power in 2010, however, introduced new mechanisms of supervision and changed institutional governance and reduced institutional autonomy considerably. Changes in the selection of rectors, the appearance of state-appointed financial inspectors and the newly appointed Chancellors responsible for the finance, maintenance and administration of institutions are important milestones in this process. In the paper I review these developments focusing especially on the analysis of the Chancellor system.

Horizontal diversity of higher education institutions. The case of Hungary – in European context

In the European Higher Education Area the diversification of higher education is considered to be an emphasized value, a guarantee of creativity. The various institutional rankings are the displays of vertical diversity, but in parallel with these, there is an increasing attention directed at horizontal diversity, the entirety of the institutions' activities. The European Mapping Project (U-map) undertook this challenge. The paper presents the research program, which is an attempt to adapt the U-map model to Hungary. According to the results, the U-map method which was intended for application on an international level, is very useful in the identification of the main groups of institutions in a specific national higher education system as well, and may provide a basis for the creation of institutional strategies and the development of the institutions’ network.

Public school administrators' knowledge of special education law

The purpose of this study was to assess the knowledge of public school administrators with respect to special education (ESE) law. The study used a sample of 220 public school administrators. A survey instrument was developed consisting of 19 demographic questions and 20 situational scenarios. The scenarios were based on ESE issues of discipline, due process (including IEP procedures), identification, evaluation, placement, and related services. The participants had to decide whether a violation of the ESE child's rights had occurred by marking: (a) Yes, (b) No, or (c) Undecided. An analysis of the scores and demographic information was done using a two-way analysis of variance, chi-square, and crosstabs after a 77% survey response rate.^ Research questions addressed the administrators' overall level of knowledge. Comparisons were made between principals and assistant principals and differences between the levels of schooling. Exploratory questions were concerned with ESE issues deemed problematic by administrators, effects of demographic variables on survey scores, and the listing of resources utilized by administrators to access ESE information.^ The study revealed: (a) a significant difference was found when comparing the number of ESE courses taken and the score on the survey, (b) the top five resources of ESE information were the region office, school ESE department chairs, ESE teachers, county workshops, and county inservices, (c) problematic areas included discipline, evaluation procedures, placement issues, and IEP due process concerns, (d) administrators as a group did not exhibit a satisfactory knowledge of ESE law with a mean score of 12 correct and 74% of responding administrators scoring in the unsatisfactory level (below 70%), (e) across school levels, elementary administrators scored significantly higher than high school administrators, and (f) a significant implication that assistant principals consistently scored higher than principals on each scenario with a significant difference at the high school level.^ The study reveals a vital need for administrators to receive additional preparation in order to possess a basic understanding of ESE school law and how it impacts their respective schools and school districts so that they might meet professional obligations and protect the rights of all individuals involved. Recommendations for this additional administrative preparation and further research topics were discussed. ^

The Central Agency for Jewish Education: Fifty years of Jewish education in Dade County

The purpose of the study was to provide a historical record of the Bureau of Jewish Education/Central Agency for Jewish Education and its role in Jewish education in Miami since its inception in 1944 as well as to provide a sociological context within which to view the growth and development of the community. During the past 50 years of the Agency's existence, Dade County's Jewish population has undergone many changes including a huge population increase in the 1960s and 1970s and then a decrease in the 1980s and 1990s, and a shift from postwar business class of store owners to turn of the century professional class.^ The methodology used in this study was threefold. First, document analysis of formal and informal documents dating from 1944 to the present was conducted. Second, personal interviews were conducted with the Executive Directors of the B.J.E./C.A.J.E., long-time B.J.E./C.A.J.E. staff, present staff, Greater Miami Jewish Federation leaders, and lay leadership of C.A.J.E. Third, national trends in Jewish education were cited as a basis for the comparison and contrast of the achievements of C.A.J.E.^ The historiography concluded that the Agency had come full circle in its programs. Analysis of the services provided to religious and day schools, early childhood education, the High Schools, teacher services, adult education, and the library indicated that in some areas C.A.J.E. was an innovator, in other areas it followed national trends, and in others it was deficient. Recommendations included a reeducative process for the community with Jewish education made top priority, more visibility and publicity for the work of C.A.J.E. that would enhance its prestige and improve support, and holistic planning of programs for the future. ^

The effect of vocational education on high school students in a large urban multicultural school district

The completion of and graduation from high school is a major problem that must be resolved. A 6% random sample of the students (1,059) who were in the 9th grade in Miami-Dade Public Schools, a large urban school district, September 1992, were selected for this study. The sample was divided into 2 groups, advanced academic and general track students. Each group was then divided into vocational and non-vocational. A causal comparative design was used to evaluate the results for graduate vs. non-graduate. The indicators were the program of study, attendance, standardized test scores, grade point average, ethnicity and gender. It was found that both advanced academic and general track students had significantly higher graduation rates at the .01 level when a vocational education program was part of their studies. All of the other indicators did not show any significant differences. If we arc to improve students educational outcomes and reduce the dropout rate, vocational education should be part of every student's education.^

Differences in perceptions of teachers' and students' values of physical education programs in private universities in Taipei City, Taiwan

After the New University Code was issued in 1994, the university physical education program was at a crossroad in Taiwan. Physical education teachers are facing changes in the curriculum. The purpose of this study is to find a direction for the future in physical education by using a revised Value Orientation Inventory to investigate the teachers' and students' value orientations. Based on these findings, results could identify a value-based philosophy for physical education curriculum innovation at the private university in Taiwan. ^ The subjects of this study included forty-two physical education teachers and ninety-four current students in five private universities in Taipei City, Taiwan. Value Orientation Inventory were developed by Ennis and Chen (1993), was used to assess subjects on five items five value orientations. VOI data were collected and analyzed by using T-test, ANOVA, and a set of special contrasts. ^ The findings of this study indicated that ninety-four percent of the private university students and physical education teachers made consistent curricular decisions within one or more of the value orientations. Teachers perceived Disciplinary Mastery (DM) and Learning Process (LP) value orientations as the most important values. Students perceived Ecological Integration (EI) and Disciplinary Mastery as the most important values. Both teachers and students placed Social Reconstruction value orientation as the lowest value. There were significant differences between teachers' and students' value orientations. Differences were found in DM, LP, and SA (Self-Actualization). There also were significant differences between teachers' and students' value orientation based on students' gender and year at university. These findings lead to the conclusion that private university students' values are incongruent with the physical education teachers' values. The finding suggests that unless physical education teachers address students' values on EI and SA, conflict may occur. ^

The democratization of higher education in Jamaica: The role of the University of the West Indies

The University of the West Indies (UWI), established in the British colony of Jamaica in 1948, was mandated to serve the “brightest and the best” of the British colonies. Unfortunately, the austerity of Jamaica's economy has not helped to augment an “open door” access to higher education, and UWI is often criticized for not implementing policies to sustain the democratization of higher education; it is accused of functioning as an elitist institution. ^ The purpose of this qualitative study was to determine whether UWI functions democratically as an institution to influence the equity of higher education in Jamaica. A review of the literature reveals many interpretations of the democratization of higher education. Three of Spaulding and Kargodorian's four criteria were utilized to analyze this research. They were (1) equality of access to higher education, (2) equality of participation within the institution of higher education, and (3) equality of educational results. Multiple sources of written data augmented by interviews in Jamaica and Miami were utilized. ^ The analysis revealed that UWI functions in a collaborative relationship with Jamaica's Centralized Educational System as well as with the country's political, economic, and social realms to impact the democratization of higher education. Documentation suggests that, although strong traditional influences continue to exist, UWI has deviated from its original mandate and instead, flexible admittance policies and diversification of expanded programs have contributed to greater accessibility. ^ Despite UWI's reports of improvements which have contributed to more access, UNESCO and some interviewees have not been impressed. A World Bank report on enrollment ratio at the university level in English speaking Caribbean countries reflects less than one percent of the age cohort. The Jamaicans interviewed, especially those from the lower class, felt that their democratic right to receive higher education was not met. UNESCO regards UWI's efforts as just putting a “dent” in the problem. ^ Recommendations include continuing efforts towards developing curricula more relevant to the Jamaican society, increasing distance education in order to ease UWI's load, expanding financial partnerships with private sectors, and extending research in collaboration with large local and foreign private companies. ^

Teachers' perceptions of the usefulness of Individual Education Plans (IEP)

Since 1997 federal special education policy mandated that all classroom teachers take part in planning and implementation of Individualized Education Plans (IEP) for students with disabilities. This legislation has given teachers new responsibilities because it requires greater participation in the IEP process. The purpose of this study was to examine teachers' perceptions of the usefulness of Individualized Education Plans (IEP). ^ Eighty seven certified Miami-Dade County Public School teachers, 60 general education teachers and 27 special education teachers were surveyed using an updated version of Rheams' (1989) The Teacher Perceptions of the Usefulness of IEPs. Subjects completed a survey form containing a demographic cover page, 18 Likert-scale statements and 3 open ended questions. This study looked at differences in perceptions by teacher group affiliation (general and special), grade level taught (elementary and secondary), and years of experience (<=5 and >5 years). The dependent variables were teacher preparedness; feasibility of IEP implementation; relevancy of IP to classroom instruction; and legal, professional and personal accountability with regard to the IEP. ^ Results of the Multivariate Analysis of Variance (MANOVA) revealed that (a) special education teachers held a more positive perception of overall IEP usefulness than general education teachers, (b) special educators held more positive perceptions concerning issues of feasibility and preparedness, (c) elementary level teachers viewed the IEP more positively than secondary level teachers, specifically in the areas of preparedness and feasibility. ^ Findings of this study indicate that general and secondary educators have not embraced the legislation and incorporated it into their planning and instruction. These findings provide policymakers, institutions of higher education, and school administrators with insight as to how to better translate policy into classroom instructional practice. Consideration should be given to implementing (a) honest communication and shared decision making with regard to IEP directed curriculum and instruction, (b) updated pre and in-service IEP development and implementation training, and (c) opportunities for collaboration and increased plan time, especially on the secondary level. ^