How can we teach EBM in clinical practice? : an analysis of barriers to implementation of on-the-job EBM teaching and learning.

Introduction: Evidence-based medicine (EBM) improves the quality of health care. Courses on how to teach EBM in practice are available, but knowledge does not automatically imply its application in teaching. We aimed to identify and compare barriers and facilitators for teaching EBM in clinical practice in various European countries. Methods: A questionnaire was constructed listing potential barriers and facilitators for EBM teaching in clinical practice. Answers were reported on a 7-point Likert scale ranging from not at all being a barrier to being an insurmountable barrier. Results: The questionnaire was completed by 120 clinical EBM teachers from 11 countries. Lack of time was the strongest barrier for teaching EBM in practice (median 5). Moderate barriers were the lack of requirements for EBM skills and a pyramid hierarchy in health care management structure (median 4). In Germany, Hungary and Poland, reading and understanding articles in English was a higher barrier than in the other countries. Conclusion: Incorporation of teaching EBM in practice faces several barriers to implementation. Teaching EBM in clinical settings is most successful where EBM principles are culturally embedded and form part and parcel of everyday clinical decisions and medical practice.

A multimethod examination of contributors to successful on-the-job learning for vocational students

Rapid changes in working life and competence requirements of different professions have increased interest in workplace learning. It is considered an effective way to learn and update professional skills by performing daily tasks in an authentic environment. Especially, ensuring a supply of skilled future workers is a crucial issue for firms facing tight competition and a shortage of competent employees due to the retirement of current professionals. In order to develop and make the most of workplace learning, it is important to focus on workplace learning environments and the individual characteristics of those participating in workplace learning. The literature has suggested various factors that influence adults' and professionals’ workplace learning of profession-related skills, but lacks empirical studies on contextual and individual-related factors that positively affect students' workplace learning. Workers with vocational education form a large group in modern firms. Therefore, elements of vocational students’ successful workplace learning during their studies, before starting their career paths, need to be examined. To fill this gap in the literature, this dissertation examines contributors to vocational students’ workplace learning in Finland, where students’ workplace learning is included in the vocational education and training system. The study is divided into two parts: the introduction, comprised of the overview of the relevant literature and the conclusion of the entire study, and five separate articles. Three of the articles utilize quantitative methods and two use qualitative methods to examine factors that contribute to vocational students’ workplace learning. The results show that, from the students’ perspective, attitudinal, motivational, and organizationrelated factors enhance the student’s development of professionalism during the on-the-job learning period. Specifically, the organization-related factors such as innovative climate, guidance, and interactions with seniors have a strong positive impact on the students’ perceived development of professional skills because, for example, the seniors’ guidance and provision of new viewpoints for the tasks helps the vocational students to gain autonomy at work performance. A multilevel analysis shows that of those factors enhancing workplace learning from the student perspective, innovative climate, knowledge transfer accuracy, and the students’ performance orientation were significantly related to the workplace instructors’ assessment regarding the students’ professional performance. Furthermore, support from senior colleagues and the students’ self-efficacy were both significantly associated with the formal grades measuring how well the students managed to learn necessary professional skills. In addition, the results suggest that the students’ on-the-job learning can be divided into three main phases, of which two require efforts from both the student and the on-the-job learning organization. The first phase includes the student’s application of basic professional skills, demonstration of potential in performing daily tasks, and orientation provided by the organization at the beginning of the on-the-job learning period. In the second phase, the student actively develops profession-related skills by performing daily tasks, thus learning a fluent working style while observing the seniors’ performance. The organization offers relevant tasks and follows the student’s development. The third level indicates a student who has reached the professional level described as a full occupation. The results suggest that constructing the vocational students’ successful on-the-job learning period requires feedback from seniors, opportunities to learn to manage entire work processes, self-efficacy on the part of the students, proactive behavior, and initiative in learning. The study contributes to research on workplace learning in three ways: firstly, it identifies the key individual- and organization-based factors that influence the vocational students’ successful on-the-job learning from their perspective and examines mutual relationships between these factors. Second, the study provides knowledge of how the factors related to the students’ view of successful workplace learning are associated with the workplace instructors’ perspective and the formal grades. Third, the present study finds elements needed to construct a successful on-the-job learning for the students.

Munkahelyi tanulást befolyásoló tényezők – humán-számítógép együttműködés vizsgálata (Influencing factors of on-the-job learning – Analysis of human-computer collaboration)

A komplex, dinamikus, tudásalapú társadalomban nemcsak a tanulás formái, hanem a tanulás helyszínei is módosulnak, s a munkahely tanulásban betöltött szerepe felértékelődött. A munkahelyi környezet is számos átalakuláson esett át, az információs és kommunikációs technológiák (IKT) fejlődésével egyidejűleg lehetővé vált többek között a távmunka, jelentősen átformálva a munkavégzés és a munkahelyi interakciók módját. A kutatók arra keresték a választ kutatásukban, hogy a szervezeten belül milyen tényezők támogatják vagy gátolják a munkahelyi tanulást. A kutatás fő üzenete, hogy a tanulás keretrendszere, az egyéni képességek és az észlelt tanulási szituáció együttesen határozza meg a munkahelyi tanulást. A kutatók eredményüket kvalitatív kutatással feltárt három esettanulmányon keresztül ismertetik. ____ In a knowledge-based society not only the forms of learning have been changed but also the places of learning. The role of workplace in the learning process is becoming more important. Meantime, there has been a substantial change in the working conditions as the development in information and communication technologies (ICTs) makes it possible to telecommute transforming remarkably the way of working and the interactions at the workplace. The central question of the research is which intra-organizational factors support or hinder onthe- job learning. The main message of the research is that the learning framework, the individual cognitive competences and the perceived learning situation influence collectively on-the-job learning. Authors present the results of the qualitative research though three case studies.

Applying Trained Skills on the Job: The Importance of the Work Environment

The influence of the work environment on the transfer of newly trained supervisory skills was examined. Participants were 505 supermarket managers from 52 stores. The work environment was operationalized in terms of transfer of training climate and continuous-learning culture. Climate and culture were hypothesized to have both direct and moderating effects on posttraining behaviors. Accounting for pretraining behaviors and knowledge gained in training, the results from a series of LISREL analyses showed that both climate and culture were directly related to posttraining behaviors. In particular, the social support system appeared to play a central role in the transfer of training. Moderating effects were not found. Implications for enhancing the transfer of training are discussed.

An effective on-the-job training model-to facilitate strategy execution

Strategy execution has been a heated topic in the management world in recent years. However, according to a survey done by the Conference Board (2014), the chief executives are so concerned about the execution in their companies and have rated it as the No.1 or No.2 most challenging issue. Many of them choose to invest in training with a purpose to harvest the most for strategy execution. Therefore, this research is trying to find out a model to design training programs that can at most contribute to the success of strategy execution with three real-life training cases done by BTS Consulting Service. It was found that strategy execution could be greatly supported by training programs that take into consideration the four factors, namely Alignment, Mindset to Change, Capability and Organization Support. Main implications of the findings are presented and discussed. Key

The Impact of Personality and Culture on the Job Demands-Control Model of Job Stress

Among the various work stress models, one of the most popular has been the job demands-control (JDC) model developed by Karasek (1979), which postulates that work-related strain is highest under work conditions characterized by high demands and low autonomy. The absence of social support at work further increases negative outcomes. This model, however, does not apply equally to all individuals and to all cultures. This review demonstrates how various individual characteristics, especially some personality dimensions, influence the JDC model and could thus be considered buffering or moderator factors. Moreover, we review how the cultural context impacts this model as suggested by results obtained in European, American, and Asian contexts. Yet there are almost no data from Africa or South America. More crosscultural studies including populations from these continents would be valuable for a better understanding of the impact of the cultural context on the JDC model.

The effect of learning on the evolution of new courtship behavior: a simulation model

The fact that individuals learn can change the relationship between genotype and phenotype in the population, and thus affect the evolutionary response to selection. Here we ask how male ability to learn from female response affects the evolution of a novel male behavioral courtship trait under pre-existing female preference (sensory drive). We assume a courtship trait which has both a genetic and a learned component, and a two-level female response to males. With individual-based simulations we show that, under this scenario, learning generally increases the strength of selection on the genetic component of the courtship trait, at least when the population genetic mean is still low. As a consequence, learning not only accelerates the evolution of the courtship trait, but also enables it when the trait is costly, which in the absence of learning results in an adaptive valley. Furthermore, learning can enable the evolution of the novel trait in the face of gene flow mediated by immigration of males that show superior attractiveness to females based on another, non-heritable trait. However, rather than increasing monotonically with the speed of learning, the effect of learning on evolution is maximized at intermediate learning rates. This model shows that, at least under some scenarios, the ability to learn can drive the evolution of mating behaviors through a process equivalent to Waddington's genetic assimilation.

Sector-Specific on-the-Job Training: Evidence from U.S. Data.

Using data from the National Longitudinal Survey of Youth (NLSY), we re-examine the effect of formal on-the-job training on mobility patterns of young American workers. By employing parametric duration models, we evaluate the economic impact of training on productive time with an employer. Confirming previous studies, we find a positive and statistically significant impact of formal on-the-job training on tenure with the employer providing the training. However, the expected net duration of the time spent in the training program is generally not significantly increased. We proceed to document and analyze intra-sectoral and cross-sectoral mobility patterns in order to infer whether training provides firm-specific, industry-specific, or general human capital. The econometric analysis rejects a sequential model of job separation in favor of a competing risks specification. We find significant evidence for the industry-specificity of training. The probability of sectoral mobility upon job separation decreases with training received in the current industry, whether with the last employer or previous employers, and employment attachment increases with on-the-job training. These results are robust to a number of variations on the base model.

The Effect of Direct Instruction versus Discovery Learning on the Understanding of Science Lessons by Second Grade Students

This study examined the effectiveness of discovery learning and direct instruction in a diverse second grade classroom. An assessment test and transfer task were given to students to examine which method of instruction enabled the students to grasp the content of a science lesson to a greater extent. Results demonstrated that students in the direct instruction group scored higher on the assessment test and completed the transfer task at a faster pace; however, this was not statistically significant. Results also suggest that a mixture of instructional styles would serve to effectively disseminate information, as well as motivate students to learn.

Program of on-the-job training facilities for veterans; list of approved establishments.

Mode of access: Internet.

Program of on-the-job training facilities for veterans; list of approved establishments

Mode of access: Internet.

Program of on-the-job training facilities for veterans; establishments eliminated from the lists of approved facilities.

Mode of access: Internet.