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1 – 10 of over 2000Michelle Veyvoda, Thomas J. Van Cleave and Laurette Olson
This chapter draws from the authors’ experiences with service-learning pedagogy in allied health training programs, and illustrates ways in which community-engaged teaching and…
Abstract
This chapter draws from the authors’ experiences with service-learning pedagogy in allied health training programs, and illustrates ways in which community-engaged teaching and learning can prepare students to become ethical healthcare practitioners. The authors infuse examples from their own courses throughout the chapter, mostly from the clinical fields of speech-language pathology, audiology, and occupational therapy. However, the chapter is applicable and generalizable to faculty from a wide scope of allied health training programs. The chapter introduces considerations for establishing campus–community partnerships in an ethical manner, as well as ways to foster student self-reflection and critical thinking through an ethical lens. Principles from the codes of ethics of various allied health professions are incorporated throughout the chapter along with examples of how each can be applied in community-based clinical experiences. Through a review of relevant literature, analysis of professional codes of ethics, case-based examples, and a step-by-step guide to course development, this chapter provides readers with a mechanism to ground their courses in professional ethics in a way that is relatable and relevant to students.
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Purpose – The chapter describes how teacher preparation programs can design effective off-campus clinical programs. Information provided is applicable to clinical practicums…
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Purpose – The chapter describes how teacher preparation programs can design effective off-campus clinical programs. Information provided is applicable to clinical practicums, capstone experiences, and to individual course assignments at the undergraduate and graduate levels.
Methodology/Approach – The author describes the foundational components involved in designing a high-quality off-campus clinical-based program. These components include selecting and building a partnership with an off-campus site, using forms, fees, space, and materials, engaging families, aligning assignments to course content, grading, supervision, and acquiring funding.
Practical implications – In addition to the foundational components involved in designing an effective off-campus clinic, the chapters describes a university-based model that uses two different off-campus clinical-based experiences that support community-based programs and local area schools.
Social implications – The chapter addresses the need for teacher preparation programs to build partnerships with off-campus community-based programs to better prepare teachers to meet the literacy demands of all students, particularly students living and learning in urban communities.
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Svante Lifvergren, Ulla Andin, Tony Huzzard and Andreas Hellström
Purpose – This chapter examines the developmental journey toward a sustainable health care system in the West of Skaraborg County in Sweden from 2008 to the present by proposing…
Abstract
Purpose – This chapter examines the developmental journey toward a sustainable health care system in the West of Skaraborg County in Sweden from 2008 to the present by proposing and illustrating the concept of a clinical microsystem to capture the work of a mobile team to care for elderly people with multiple diseases in its embedded context.
Design – An action research approach was adopted that entailed four researchers, one of whom was also a health care practitioner, engaging in iterative dialogues with the mobile team. This aimed at catalyzing joint learning in repeated action-reflection cycles at least three times a year over a period of 3 years. Data from patient databases were also drawn upon as additional resources for reflection.
Findings – The outcome of the initial periods of the team's work in the microsystem dramatically improved the care of these patients, significantly increasing quality of life and stabilizing their medical situation. It has also led to decreased resource utilization, not just by the team, but elsewhere in the wider health system.
Originality/value – We draw on and develop the concept of clinical microsystems to argue that such systems have a team at their core, but their work practices and patient outcomes require us to look beyond the team itself and take into account its interactions with patients and actors in the wider health care system. We also draw on the framework of Christensen, Grossman, and Hwang (2009) to propose that each microsystem has three distinct value configurations, namely shops, a chain, and a network. In terms of design, we suggest that the clinical microsystem can be seen as a parallel learning structure to that of the established health care bureaucracy.
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Patricia Drentea, Beverly Rosa Williams, Karen Hoefer, F. Amos Bailey and Kathryn L. Burgio
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles…
Abstract
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles describing next-of-kins’ perceptions of end-of-life care in Veterans Affairs Medical Centers (VAMCs). The articles were based on the qualitative arm of the VA Health Services Research and Development (HSR&D) study entitled, “Best Practices for End-of-life Care and Comfort Care Order Sets for our Nation’s Veterans” (BEACON).
Design: The archival research consisted of an interactive methodological process of data immersion, analysis, and interpretation which resulted in the emergence of two overarching thematic frameworks called “losing control” and “holding on.”
Findings: “Losing control” is the process that occurs when the patient experiences a cascading sequence of deleterious biological events and situations rendering the caregiver no longer able to direct the timing or setting of the dying trajectory. The notion of “holding on” captures family member’s responses to the need to maintain control after relinquishing the patient’s care to the institutional setting. During the patient’s hospitalization, the dual dynamics of “losing control” and “holding on” unfolded in the spatial, temporal, and life narrative domains.
Originality: The findings not only contribute to better overall understanding of family members’ responses to death in the pre-COVID-19 hospital setting but also heighten the awareness of the complex spatial, temporal, and narrative issues faced by family members who lost a hospitalized loved one during the COVID-19 pandemic.
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Daved W. van Stralen, Racquel M. Calderon, Jeff F. Lewis and Karlene H. Roberts
This chapter describes the efforts of a team of health care workers to make a sub-acute health care facility (SCF) serving profoundly damaged children into a high reliability…
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This chapter describes the efforts of a team of health care workers to make a sub-acute health care facility (SCF) serving profoundly damaged children into a high reliability organization (HRO). To obtain this goal, the health care team implemented change in four behavioral areas: (1) risk awareness and acknowledgment; (2) defining care; (3) how to think and make decisions; and (4) information flow. The team focused on five reliability enhancement issues that emerged from previous research on banking institutions: (1) process auditing; (2) the reward system; (3) quality degradation; (4) risk awareness and acknowledgment; and (5) command and control. These HRO processes emerged from the change effort. Three additional HRO processes also emerged: high trust, and building a high reliability culture based on values and on beliefs. This case demonstrates that HRO processes can reduce costs, improve safety, and aid in developing new markets. Other experiences in implementing high reliability processes show that each organization must tailor make processes to its own situation (e.g. BP, U.S. Chemical Safety and Hazards Board, Federal Aviation Administration, U.S. Navy Aviation Program, and Kaiser Permanente Health Care System). Just as in the flexibility called for in organizing for high reliability operations, flexibility is called for in deciding which HRO processes work in specific situations.
Rebecca R. Kitzmiller, Reuben R. McDaniel, Constance M. Johnson, E. Allan Lind and Ruth A. Anderson
We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT…
Abstract
Purpose
We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project.
Design/methodology/approach
Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens.
Findings
We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger.
Practical implications
Leaders must enact voice-promoting behaviors and use them throughout a team’s engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation.
Social implications
Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking.
Research implications
Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes.
Value/originality
We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders’ behaviors might facilitate or impeded speaking up among project teams in health care settings.
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Sara Shostak and Miranda Waggoner
As the neurosciences endeavor to explain increasingly complex aspects of human biology and behavior, domains of human life that can only be assessed in social interaction become…
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As the neurosciences endeavor to explain increasingly complex aspects of human biology and behavior, domains of human life that can only be assessed in social interaction become ever more important, if formally unacknowledged, dimensions of scientific research. Drawing on semi-structured interviews with 14 researchers who study epilepsy genetics, this chapter examines how neuroscientists encounter ‘the social.’ We find that at the beginning of their careers, researchers are intrigued by epilepsy as a disease of the brain and a means of exploring “the last frontier in medicine.” However, as they begin their investigations, the importance of building social relationships, gleaning the subtleties of seizure experience available only in patient narratives, and engaging with families in the field quickly emerge as important parts of epilepsy genetics research. Some researchers hope for and work toward a day when new techniques or models will allow them to forgo the time consuming, painstaking, and often invisible work of gathering detailed histories, combing through patient narratives, and traveling to field sites to meet with families. However, these accounts make clear that, at the current moment, much of “the molecular work” of epilepsy genetics research is built upon social interactions, relationships, and experiences.
Anne R. Diekema, Elizabeth (Betsy) S. Hopkins, Brandon Patterson and Nena Schvaneveldt
Information literacy instruction in higher education tends to focus on a relatively small slice of the information literacy landscape: academic research skills. Students often…
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Information literacy instruction in higher education tends to focus on a relatively small slice of the information literacy landscape: academic research skills. Students often fail to see the relevance of these sessions beyond the direct application to their assignments. In addition, while this type of instruction helps students succeed academically, it does not necessarily prepare them for their future careers, which can lead to a lapse in student engagement. A prior exploratory survey study among alumni of four bachelor of nursing programs provided insight into current information practices of professional nurses and how librarians could have better prepared them for their eventual workplace. This chapter outlines how this evidence informed a change in information instruction, now preparing nursing students for professional as well as academic success. This evidence-based approach has the potential benefit of making instruction more relevant and engaging to students, while at the same time expanding their information literacy skills. Teaching nursing students professional information literacy skills, in addition to academic information literacy skills, leads to better-prepared nurses which ultimately benefits their patients. The chapter provides several implementation examples but also addresses the challenges that librarians face when pursuing evidence-based practice to increase student engagement.
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Soo-Hoon Lee, Thomas W. Lee and Phillip H. Phan
Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions…
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Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.
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Gina Dokko, Amit Nigam and Daisy Chung
The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, the authors show…
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The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, the authors show that the intellectual school of evidence-based medicine became an important meso-structure that facilitated the growth of the new logic in American healthcare. The new intellectual school was a community of scholars who generated shared rules and resources through intergenerational mentoring. The school engaged in advocacy to advance new intellectual paradigms for conceptualizing healthcare quality that, when connected with material practices in the field of American healthcare, came to form a new institutional logic.
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