Professional autonomy of Victorian surgeons in the context of law and ethics

An analysis of legislation and court decisions demonstrates that the privilege of autonomous decision making by surgeons in Victoria has become progressively constrained. Factors that have led to this include workforce issues and the protection of the public combined with increasing involvement of the courts in questions involving medical ethics.

Professional Autonomy. Key Competence for Teachers in Commercial Education

The way in which the teaching autonomy is materialized, considered as part of the path traveled by the teaching community on their way to become owners of the disciplinary knowledge and the required pedagogical competencies to practice their role has motivated this paper.  For success, Commercial Education requires the urgent transformation of the teaching role and the development of key competences to promote interdisciplinary integration, academic and administrative leadership and the use of contemporary pedagogies.  The level of awareness reached by the teaching group about the impact of the learning that is promoted within the educational context will allow the empowerment of the knowledge that comes from the relationship between theory and practice-key element for professional autonomy.

The corporatization of community pharmacy:implications for service provision, the public health function, and pharmacy's claims to professional status in the United Kingdom

Background Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization. Objectives The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent). Methods A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Results The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services. Conclusions A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.

Let's take a closer look at teacher professionalism

Professional standards have been adopted by many Western countries, including Australia, as a mechanism for improving teacher quality and enhancing 'professionalism’. But what does the term 'professionalism' actually mean? This article briefly outlines different definitions of professionalism that have been advanced through many decades, and concludes with a 'new’ type of professionalism coined by the authors -'compliance professionalism’. They see this type of professionalism as a means for teachers to maintain a degree of professional autonomy, whilst at the same time allowing them to deal with ever increasing accountability regimes. The authors ask the question: What can principals do to make their teachers aware of 'professionalism’ in education?

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Uncovering the evidence of non-expert nephrology nursing practice

Expertise in nursing has been widely studied although there have been no previous studies into what constitutes expertise in nephrology (renal) nursing. This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, provides evidence of the characteristics and practices of non-expert nephrology nurses. Using the grounded theory method, the study took place in one renal unit in New South Wales, Australia, and involved six non-expert and 11 expert nurses. Sampling was purposive then theoretical. Simultaneous data collection and analysis using participant observation, review of nursing documentation and semistructured interviews was undertaken. The study revealed a three-stage skills-acquisitive process that was identified as non-expert, experienced non-expert and expert stages. Non-expert nurses showed superficial nephrology nursing knowledge and limited experience; they were acquiring basic nephrology nursing skills and possessed a narrow focus of practice.

Mediating conflict and control : practice challenges for nurses working in palliative care

A work-based professional development program was offered to a group of registered nurses working in palliative care. The goal of the program was to improve skills in psychosocial care (Yates et al., 1996). Participants were encouraged to reflect critically on their practice experience within a group setting. The focus of the group discussion and reflection were shared practice incidents. Each participant was given the opportunity to identify and describe an incident from their professional practice that presented a challenging issue within palliative nursing. This paper explores the themes of conflict and control, evident within the collection of fifteen practice incidents and discusses the nurses role as mediator. The concepts of patient advocacy and professional autonomy are challenged through the nurses experience of providing care within a hierarchical and bureaucratic health service. The outcome of reflection for the organization is most effective when shared experience and collective action (rather than individual practice) are the focus.

As instituições formadoras e a identidade profissional da enfermagem : mimetismo ou metamorfose

O objeto do presente estudo consiste nos papéis exercidos pelas instituições formadoras de profissionais de enfermagem, pelo mercado de trabalho e pelas entidades de classe da enfermagem no processo de profissionalização e de construção de sua identidade profissional. Este estudo tem por objetivo reescrever o processo de construção da identidade profissional da enfermagem a partir das discussões travadas pelos profissionais, nas instituições formadoras, acerca de sua especialização, a luz dos fatos sócio-históricos que desencadearam, ao longo do tempo, a passagem de uma enfermagem generalista para outra especialista. O trabalho discute o processo de profissionalização da enfermagem nas instituições formadoras tendo como pano de fundo as idéias clássicas da sociologia das profissões. Para ela, a enfermagem é vista coma uma semiprofissão, uma vez que não possui os quatro atributos fundamentais de uma verdadeira profissão: autonomia, corpo esotérico de conhecimentos, ideal de serviço e monopólio de saber e do fazer. Na tentativa de conquistar estes quatro atributos, ou alguns deles, para, então, ascender ao patamar de profissão, a enfermagem hoje vive um momento de transição na formação de seus profissionais: generalistas (tradicionais) ou especialistas (modernos). Em um outro aspecto, concluímos que, até o momento, o processo de legitimação, ou melhor, de construção social da identidade profissional da enfermagem especializada ainda não se consolidou, ou seja, as instituições formadoras, construtoras sociais do campo profissional da enfermagem, ainda não se definiram pela figura de um só perfil - generalista ou especialista - e, por isso, esta construção ainda encontra-se inacabada.

Entre o princípio da emancipação e o fardo da institucionalização: dilemas do projeto ético-político profissional na busca de caminhos para intervenção

O objetivo desse estudo é refletir sobre questões pertinentes aos limites e às possibilidades que permeiam o exercício profissional de assistentes sociais comprometidos com o que se convencionou chamar, no meio profissional, de Projeto Ético-Político do Serviço Social brasileiro. O que, em nossa compreensão, requer considerar os impactos da intervenção profissional em relação aos diferentes projetos societários. Para a realização desse estudo, retomamos debates que consideramos centrais para pensarmos a intervenção do assistente social, enfatizando os dilemas e pretensões postos a esse profissional, partindo dos interesses burgueses que conformaram o Projeto institucional que lhe traz requisições. Buscamos pensar a tensão presente entre esse Projeto Institucional e o referido Projeto Ético-Político, considerando as relações de oposição e poder, e possíveis negociações estabelecidas entre ambos, pois, assim, pudemos mergulhar nesse universo e avaliarmos o conceito de autonomia profissional, em busca de possibilidades interventivas pertinentes à materialização (ainda que relativa) do Projeto Ético-Político do Serviço Social brasileiro. Para enriquecer esse debate, realizamos uma pesquisa empírica que recorreu instrumentalmente a questionários e a entrevistas. O primeiro teve a finalidade de contribuir para a escolha dos profissionais a serem entrevistados e enriquecer alguns dados de análise. A entrevista foi realizada com assistentes sociais que atuam na área da saúde, empregados pelo Estado, em processo de formação continuada e que alegaram compromisso com o referido Projeto Ético-Político Profissional.

‘Nothing will prevent me from doing a good job’. The professionalisation of part-time teaching staff in further and adult education

Approximately 85,000 part-time teaching staff working in further education (FE) and adult and community learning (ACL) are often seen as ‘a problem’. The intrinsic ‘part-timeness’ of these staff tends to marginalise them: they remain under-recognised and largely unsupported. Yet this picture is over-simplified. This article examines how part-time staff make creative use of professional autonomy and agency to mitigate problematic ‘casual employment’ conditions, reporting on results from Learning and Skills Development Agency-sponsored research (2002–2006) with 700 part-time staff in the learning and skills sector. The question of agency was reported as a key factor in part-time employment. Change is necessary for the professional agency of part-timers to be harnessed as the sector responds to ambitious sectoral ‘improvement’ agendas following the Foster Report and FE White Paper. Enhanced professionalisation for part-time staff needs greater recognition and inclusion in change agendas.

Advocacy in pain management: the role of the anaesthetic nurse specialist

Peri-operative nursing practice is constantly changing and demanding specialist knowledge, skills and expertise to embrace these changes. All patients in need of anaesthesia are entitled to the same high quality peri-operative care and therefore those assisting the anaesthetist must be competent and effective practitioners. With this in mind the authors shall give a reflective account highlighting the role of Anaesthetic Nurse Specialist (ANS) in promoting leadership within the peri-operative environment and how it can be nurtured and facilitated to achieve professional autonomy and promote patient advocacy.

SWOT analysis of a pediatric rehabilitation programme : a participatory evaluation fostering quality improvement

Purpose. To present the results of a strengths, weaknesses, opportunities and threats (SWOT) analysis used as part of a process aimed at reorganising services provided within a pediatric rehabilitation programme (PRP) in Quebec, Canada and to report the perceptions of the planning committee members regarding the usefulness of the SWOT in this process. Method. Thirty-six service providers working in the PRP completed a SWOT questionnaire and reported what they felt worked and what did not work in the existing model of care. Their responses were used by a planning committee over a 12- month period to assist in the development of a new service delivery model. Committee members shared their thoughts about the usefulness of the SWOT. Results. Current programme strengths included favourable organisational climate and interdisciplinary work whereas weaknesses included lack of psychosocial support to families and long waiting times for children. Opportunities included working with community partners, whereas fear of losing professional autonomy with the new service model was a threat. The SWOT results helped the planning committee redefine the programme goals and make decisions to improve service coordination. SWOT analysis was deemed as a very useful tool to help guide service reorganisation. Conclusions. SWOT analysis appears to be an interesting evaluation tool to promote awareness among service providers regarding the current functioning of a rehabilitation programme. It fosters their active participation in the reorganisation of a new service delivery model for pediatric rehabilitation.

Esferas de influência na avaliação de professores : das políticas avaliativas às conceções e práticas de avaliação numa escola básica e secundária

Tese de doutoramento, Educação (Supervisão e Orientação da Prática Profissional), Universidade de Lisboa, Instituto de Educação, 2014

La cultura nacional como espacio emergente de articulación entre el Estado y las letras en la Argentina del centenario (Estudios)

En la Argentina del Centenario de la Revolución de Mayo, al tiempo que se recorta la especificidad de la labor intelectual en relación con el área de las actividades del “espíritu” y se especializan las funciones de la política estatal, emerge una nueva representación de la cultura nacional como espacio de intervenciones estratégicas dirigidas a atender tanto de las nuevas necesidades del Estado oligárquico en crisis como los requerimientos de los escritores que aspiran a la autonomía profesional. La convergencia de las respuestas de los escritores involucrados en esta nueva alianza con el Estado no responde a una coartación de su autonomía, sino a la coincidencia entre los interrogantes que el Estado les formula y las preguntas que, desde la situación histórica específica de la actividad literaria, han venido planteándose.