Search results for: reformation teamwork

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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Authors: Y. Salfati, D. Sharef Bussel, J. Zamir

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In this paper, we present an Evaluation Case Study implementing the eight principles of Collaborative Approaches to Evaluation (CAE) as designed by Brad Cousins in the past decade. The focus of this paper is sharing a rich experience in which we achieved two main goals. The first was the development of a valuable and meaningful new teacher training program, and the second was a successful implementation of the CAE principles. The innovative teacher training program is based on the idea of including physical movement during the process of teaching and learning academic themes. The program is called Learning through Movement. This program is a response to a call from the Ministry of Education, claiming that today children sit in front of screens and do not exercise any physical activity. In order to contribute to children’s health, physical, and cognitive development, the Ministry of Education promotes learning through physical activities. Research supports the idea that sports and physical exercise improve academic achievements. The Learning through Movement program is operated by Kaye Academic College. Students in the Elementary School Training Program, together with students in the Physical Education Training Program, implement the program in collaboration with two mentors from the College. The program combines academic learning with physical activity. The evaluation began at the beginning of the program. During the evaluation process, data was collected by means of qualitative tools, including interviews with mentors, observations during the students’ collaborative planning, class observations at school and focus groups with students, as well as the collection of documentation related to the teamwork and to the program itself. The data was analyzed using content analysis and triangulation. The preliminary results show outcomes relating to the Teacher Training Programs, the student teachers, the pupils in class, the role of Physical Education teachers, and the evaluation. The Teacher Training Programs developed a collaborative approach to lesson planning. The students' teachers demonstrated a change in their basic attitudes towards the idea of integrating physical activities during the lessons. The pupils indicated higher motivation through full participation in classes. These three outcomes are indicators of the success of the program. An additional significant outcome of the program relates to the status and role of the physical education teachers, changing their role from marginal to central in the school. Concerning evaluation, a deep sense of trust and confidence was achieved, between the evaluator and the whole team. The paper includes the perspectives and challenges of the heads and mentors of the two programs as well as the evaluator’s conclusions. The evaluation unveils challenges in conducting a CAE evaluation in such a complex setting.

Keywords: collaborative evaluation, training teachers, learning through movement

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Authors: Anne Bubriski

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Despite improvements in gender inequalities, women and girls continue to face glass ceilings, underrepresentation, and harmful stereotypes that can limit their aspirations and opportunities in STEM. While girls are taking similar high school math and science classes, boys are more likely to take physics and six times more likely to take an engineering course. The gap becomes even larger for minority or low-income girls. This gender gap is not due to biology; rather, it is due to cultural, social, and institutional forces. As girls get older, these forces often ‘teach’ them ‘STEM is more for boys’. The STEM gender gap widens in college, with only 20% of engineering degrees being awarded to women, and by the time women enter the workforce, they only occupy about 13% of engineering jobs. At the University of Central Florida, the Women’s and Gender Studies Program has developed a unique mentoring program to address these issues, Science Leadership and Mentoring (SLAM). What is unique about the approach of SLAM is that we look to address this problem through leadership and STEM. We look to help girls make connections between leadership and STEM—that young women can be leaders as scientists and that scientists are leaders making a change. This is particularly needed and relevant to our community because while there are mentoring programs to our knowledge, SLAM is one of the only, if not only, mentoring programs pairing college women and 7th-grade girls that includes a focus both on STEM and leadership in the United States. SLAM is a curriculum-based mentoring program pairing one 7th-grade girl with one UCF undergraduate STEM major. SLAM empowers young women to be assertive, brave, confident, independent, inquisitive and proud leaders in STEM. SLAM seeks to promote young women’s inspiration and excitement into STEM fields and careers while also building leadership abilities such as problem-solving, teamwork and cooperation, cultural identity and ethnic pride, advocacy for positive change, and goals for the future. SLAM serves about fifteen 7th-grade girls for the academic year and about 20 UCF students. SLAM holds weekly mentoring meetings lasting about 90 minutes, covering topics on leadership, STEM majors and careers, and STEM leadership. This past year, SLAM received a Community Action Grant from the American Association of University Women (AAUW) to run a sub-program, SLAM-Space. SLAM-Space focused on exposing SLAM participants to aerospace engineering and other space-related STEM fields, such as physics and astronomy, through guest speakers, workshops and field trips, including the Kenndy Space Center. The proposed paper presentation will present an overview of SLAM-Space and the data findings from pre and post-surveys, in-depth interviews and focus groups from the SLAM participants' experiences in the program.

Keywords: gender, leadership, STEM, empowerment

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Authors: Bartosz Piechowicz, Stanislaw Sadlo, Przemyslaw Grodzicki, Magdalena Podbielska

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Apples are popular fruits. They are eaten freshly and/or after processing. For instance Golden Delicious is an apple variety commonly used in production of foods for babies and toddlers. It is no wonder that complex analyses of the pesticide residue levels in those fruits have been carried out since eighties, and continued for the next years up to now. The results obtained were presented, usually as a teamwork, at the scientific sessions organised by the (IOR) Institute of Plant Protection-National Research Institute in Poznań and published in Scientific Works of the Institute (now Progress in Plant Protection/ Postępy w Ochronie Roślin) or Journal of Plant Protection Research, and in many non-periodical publications. These reports included studies carried out by IOR Laboratories in Poznań, Sośnicowice, Rzeszów and Bialystok. First detailed studies on the presence of pesticide residues in apple fruits by the laboratory in Rzeszów were published in 1991 in the article entitled 'The presence of pesticides in apples of late varieties from the area of south-eastern Poland in the years 1986-1989', in Annals of National Institute of Hygiene in Warsaw. These surveys gave the scientific base for business contacts between the Polish company Alima and the American company Gerber. At the beginning of XXI century, in Poland, systematic and complex studies on the deposition of pesticide residues in apples were initiated. First of all, the levels of active ingredients of plant protection products applied against storage diseases at 2-3 weeks before the harvest were determined. It is known that the above mentioned substances usually generate the highest residue levels. Also, the assessment of the fungicide residues in apples during their storage in controlled atmosphere and during their processing was carried out. Taking into account the need of actualisation the Maximum Residue Levels of pesticides, in force in Poland and in other European countries, and rationalisation of the ways of their determination, a lot of field tests on the behaviour of more important fungicides on the mature fruits just before their harvesting, were carried out. A rate of their disappearance and mathematical equation that showed the relationship between the residue level of any substance and the used dose, have been determined. The two parameters have allowed to evaluate the Maximum Residue Levels (MRLs) of pesticides, which were in force at that time, and to propose a coherent model of their determination in respect to the new substances. The obtained results were assessed in terms of the health risk for adult consumers and children, and to such determination of terms of treatment that mature apples could meet the rigorous level of 0.01 mg/kg.

Keywords: apple, disappearance, health risk, MRL, pesticide residue, research

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Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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Authors: Nathaniel Oladimeji Dixon, Adekemi Dorcas Fadun

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Educational managers have observed a downward trend in the administrative effectiveness of non-teaching staff in federal universities in South-west Nigeria. This is evident in the low-quality service delivery of administrators and unaccomplished institutional goals and missions of higher education. Scholars have thus indicated the need for the deployment and adoption of a practice that encourages information collection and sharing among stakeholders with a view to improving service delivery and outcomes. This study examined the extent to which knowledge management correlated with the administrative effectiveness of non-teaching staff in federal universities in South-west Nigeria. The study adopted the survey design. Three federal universities (the University of Ibadan, Federal University of Agriculture, Abeokuta, and Obafemi Awolowo University) were purposively selected because administrative ineffectiveness was more pronounced among non-teaching staff in government-owned universities, and these federal universities were long established. The proportional and stratified random sampling was adopted to select 1156 non-teaching staff across the three universities along the three existing layers of the non-teaching staff: secretarial (senior=311; junior=224), non-secretarial (senior=147; junior=241) and technicians (senior=130; junior=103). Knowledge Management Practices Questionnaire with four sub-scales: knowledge creation (α=0.72), knowledge utilization (α=0.76), knowledge sharing (α=0.79) and knowledge transfer (α=0.83); and Administrative Effectiveness Questionnaire with four sub-scales: communication (α=0.84), decision implementation (α=0.75), service delivery (α=0.81) and interpersonal relationship (α=0.78) were used for data collection. Data were analyzed using descriptive statistics, Pearson product-moment correlation and multiple regression at 0.05 level of significance, while qualitative data were content analyzed. About 59.8% of the non-teaching staff exhibited a low level of knowledge management. The indices of administrative effectiveness of non-teaching staff were rated as follows: service delivery (82.0%), communication (78.0%), decision implementation (71.0%) and interpersonal relationship (68.0%). Knowledge management had significant relationships with the indices of administrative effectiveness: service delivery (r=0.82), communication (r=0.81), decision implementation (r=0.80) and interpersonal relationship (r=0.47). Knowledge management had a significant joint prediction on administrative effectiveness (F (4;1151)= 0.79, R=0.86), accounting for 73.0% of its variance. Knowledge sharing (β=0.38), knowledge transfer (β=0.26), knowledge utilization (β=0.22), and knowledge creation (β=0.06) had relatively significant contributions to administrative effectiveness. Lack of team spirit and withdrawal syndrome is the major perceived constraints to knowledge management practices among the non-teaching staff. Knowledge management positively influenced the administrative effectiveness of the non-teaching staff in federal universities in South-west Nigeria. There is a need to ensure that the non-teaching staff imbibe team spirit and embrace teamwork with a view to eliminating their withdrawal syndromes. Besides, knowledge management practices should be deployed into the administrative procedures of the university system.

Keywords: knowledge management, administrative effectiveness of non-teaching staff, federal universities in the south-west of nigeria., knowledge creation, knowledge utilization, effective communication, decision implementation

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Authors: Chang Liu, Rui Xing, Liyan Tang, Guohong Wang

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Entrepreneurial actions are based on entrepreneurial decisions. The quality of decisions influences entrepreneurial activities and subsequent new venture performance. Uncertainty of surroundings put heightened demands on the team as a whole, and each team member. Diverse team composition provides rich information, which a team can draw when making complex decisions. However, team heterogeneity may cause emotional conflicts, which is adverse to team outcomes. Thus, the effects of team heterogeneity on team outcomes are complex. Although team heterogeneity is an essential factor influencing entrepreneurial decision-making, there is a lack of empirical analysis on under what conditions team heterogeneity plays a positive role in promoting decision-making quality. Entrepreneurial teams always struggle with complex tasks. How a team shapes its teamwork is key in resolving constant issues. As a collective regulatory process, team reflexivity is characterized by continuous joint evaluation and discussion of team goals, strategies, and processes, and adapt them to current or anticipated circumstances. It enables diversified information to be shared and overtly discussed. Instead of hostile interpretation of opposite opinions team members take them as useful insights from different perspectives. Team reflexivity leads to better integration of expertise to avoid the interference of negative emotions and conflict. Therefore, we propose that team reflexivity is a conditional factor that influences the impact of team heterogeneity on high-quality entrepreneurial decisions. In this study, we identify team heterogeneity as a crucial determinant of entrepreneurial decision quality. Integrating the literature on decision-making and team heterogeneity, we investigate the relationship between team heterogeneity and entrepreneurial decision-making quality, treating team reflexivity as a moderator. We tested our hypotheses using the hierarchical regression method and the data gathered from 63 teams and 205 individual members from 45 new firms in China's first-tier cities such as Beijing, Shanghai, and Shenzhen. This research found that both teams' education heterogeneity and teams' functional background heterogeneity were significantly positively related to entrepreneurial decision-making quality, and the positive relation was stronger in teams with a high level of team reflexivity. While teams' specialization of education heterogeneity was negatively related to decision-making quality, and the negative relationship was weaker in teams with a high level of team reflexivity. We offer two contributions to decision-making and entrepreneurial team literatures. Firstly, our study enriches the understanding of the role of entrepreneurial team heterogeneity in entrepreneurial decision-making quality. Different from previous entrepreneurial decision-making literatures, which focus more on decision-making modes of entrepreneurs and the top management team, this study is a significant attempt to highlight that entrepreneurial team heterogeneity makes a unique contribution to generating high-quality entrepreneurial decisions. Secondly, this study introduced team reflexivity as the moderating variable, to explore the boundary conditions under which the entrepreneurial team heterogeneity play their roles.

Keywords: decision-making quality, entrepreneurial teams, education heterogeneity, functional background heterogeneity, specialization of education heterogeneity

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Authors: Majed A. Alsalem

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In our contemporary world, literacy is an essential skill that enables students to increase their efficiency in managing the many assignments they receive that require understanding and knowledge of the world around them. In addition, literacy enhances student participation in society improving their ability to learn about the world and interact with others and facilitating the exchange of ideas and sharing of knowledge. Therefore, literacy needs to be studied and understood in its full range of contexts. It should be seen as social and cultural practices with historical, political, and economic implications. This study aims to rebuild and reorganize the instructional designs that have been used for deaf and hard-of-hearing (DHH) students to improve their literacy level. The most critical part of this process is the teachers; therefore, teachers will be the center focus of this study. Teachers’ main job is to increase students’ performance by fostering strategies through collaborative teamwork, higher-order thinking, and effective use of new information technologies. Teachers, as primary leaders in the learning process, should be aware of new strategies, approaches, methods, and frameworks of teaching in order to apply them to their instruction. Literacy from a wider view means acquisition of adequate and relevant reading skills that enable progression in one’s career and lifestyle while keeping up with current and emerging innovations and trends. Moreover, the nature of literacy is changing rapidly. The notion of new literacy changed the traditional meaning of literacy, which is the ability to read and write. New literacy refers to the ability to effectively and critically navigate, evaluate, and create information using a range of digital technologies. The term new literacy has received a lot of attention in the education field over the last few years. New literacy provides multiple ways of engagement, especially to those with disabilities and other diverse learning needs. For example, using a number of online tools in the classroom provides students with disabilities new ways to engage with the content, take in information, and express their understanding of this content. This study will provide teachers with the highest quality of training sessions to meet the needs of DHH students so as to increase their literacy levels. This study will build a platform between regular instructional designs and digital materials that students can interact with. The intervention that will be applied in this study will be to train teachers of DHH to base their instructional designs on the notion of Technology Acceptance Model (TAM) theory. Based on the power analysis that has been done for this study, 98 teachers are needed to be included in this study. This study will choose teachers randomly to increase internal and external validity and to provide a representative sample from the population that this study aims to measure and provide the base for future and further studies. This study is still in process and the initial results are promising by showing how students have engaged with digital books.

Keywords: deaf and hard of hearing, digital books, literacy, technology

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Authors: Noa Nelson, Orit Appel, Rachel Ben-ari

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Organizational Citizenship Behavior (OCB) is voluntary employee behavior that contributes to the organization beyond formal job requirements. It can take different forms, such as helping teammates (OCB toward individuals; hence, OCB-I), or staying after hours to attend a task force (OCB toward the organization; hence, OCB-O). Generally, OCB contributes substantially to organizational climate, goals, productivity, and resilience, so organizations need to understand what encourages it. This is particularly challenging in security organizations. Security work is characterized by high levels of stress and burnout, which is detrimental to OCB, and security organizational design emphasizes formal rules and clear hierarchies, leaving employees with less freedom for voluntary behavior. The current research explored the role of Perceived Procedural Justice (PPJ) in enhancing OCB in a security organization. PPJ refers to how fair decision-making processes are perceived to be. It involves the sense that decision makers are objective, attentive to everyone's interests, respectful in their communications and participatory - allowing individuals a voice in decision processes. Justice perceptions affect motivation, and it was specifically suggested that PPJ creates an attachment to one's organization and personal interest in its success. Accordingly, PPJ had been associated with OCB, but hardly any research tested their association with security organizations. The current research was conducted among prison guards in the Israel Prison Service, to test a correlational and a causal association between PPJ and OCB. It differentiated between perceptions of direct commander procedural justice (CPJ), and perceptions of organization procedural justice (OPJ), hypothesizing that CPJ would relate to OCB-I, while OPJ would relate to OCB-O. In the first study, 336 prison guards (305 male) from 10 different prisons responded to questionnaires measuring their own CPJ, OPJ, OCB-I, and OCB-O. Hierarchical linear regression analyses indicated the significance of commander procedural justice (CPJ): It associated with OCB-I and also associated with OPJ, which, in turn, associated with OCB-O. The second study tested CPJ's causal effects on prison guards' OCB-I and OCB-O; 311 prison guards (275 male) from 14 different prisons read scenarios that described either high or low CPJ, and then evaluated the likelihood of that commander's prison guards performing OCB-I and OCB-O. In this study, CPJ enhanced OCB-O directly. It also contributed to OCB-I, indirectly: CPJ enhanced the motivation for collaboration with the commander, which respondents also evaluated after reading scenarios. Collaboration, in turn, associated with OCB-I. The studies demonstrate that procedural justice, especially commander's PJ, promotes OCB in security work environments. This is important because extraordinary teamwork and motivation are needed to deal with emergency situations and with delicate security challenges. Following the studies, the Israel Prison Service implemented personal procedural justice training for commanders and unit level programs for procedurally just decision processes. From a theoretical perspective, the studies extend the knowledge on PPJ and OCB to security work environments and contribute evidence on PPJ's causal effects. They also call for further research, to understand the mechanisms through which different types of PPJ affect different types of OCB.

Keywords: organizational citizenship behavior, perceived procedural justice, prison guards, security organizations

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Authors: Lik Hang Gary Wong

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Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

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Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

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Authors: Giacoma Pace

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The research seeks to evaluate whether students with impairments can achieve enhanced academic progress by actively engaging in collaborative problem-solving activities with teachers and peers, to overcome the obstacles rooted in socio-economic disparities. Furthermore, the research underscores the significance of fostering students' self-awareness regarding their learning process and encourages teachers to adopt a more interactive teaching approach. The research also posits that reducing conventional face-to-face lessons can motivate students to explore alternative learning methods, such as collaborative teamwork and peer education within the classroom. To address socio-cultural barriers it is imperative to assess their internet access and possession of technological devices, as these factors can contribute to a digital divide. The research features a case study of a Flipped Classroom Learning Unit, administered to six third-year high school classes: Scientific Lyceum, Technical School, and Vocational School, within the city of Turin, Italy. Data are about teachers and the students involved in the case study, some impaired students in each class, level of entry, students’ performance and attitude before using Flipped Classrooms, level of motivation, family’s involvement level, teachers’ attitude towards Flipped Classroom, goal obtained, the pros and cons of such activities, technology availability. The selected schools were contacted; meetings for the English teachers to gather information about their attitude and knowledge of the Flipped Classroom approach. Questionnaires to teachers and IT staff were administered. The information gathered, was used to outline the profile of the subjects involved in the study and was further compared with the second step of the study made up of a study conducted with the classes of the selected schools. The learning unit is the same, structure and content are decided together with the English colleagues of the classes involved. The pacing and content are matched in every lesson and all the classes participate in the same labs, use the same materials, homework, same assessment by summative and formative testing. Each step follows a precise scheme, in order to be as reliable as possible. The outcome of the case study will be statistically organised. The case study is accompanied by a study on the literature concerning EFL approaches and the Flipped Classroom. Document analysis method was employed, i.e. a qualitative research method in which printed and/or electronic documents containing information about the research subject are reviewed and evaluated with a systematic procedure. Articles in the Web of Science Core Collection, Education Resources Information Center (ERIC), Scopus and Science Direct databases were searched in order to determine the documents to be examined (years considered 2000-2022).

Keywords: flipped classroom, impaired, inclusivity, peer instruction

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Authors: Jimena Alarcon, Andrea Llorens, Gabriel Hernandez, Maritza Palma, Lucia Navarrete

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The research has funding from the Government of Chile and is focused on defining the design of rural primary classroom that stimulates creativity. The relevance of the study consists of its capacity to define adequate educational spaces for the implementation of the design-based learning (DBL) methodology. This methodology promotes creativity and teamwork, generating a meaningful learning experience for students, based on the appreciation of their environment and the generation of projects that contribute positively to their communities; also, is an inquiry-based form of learning that is based on the integration of design thinking and the design process into the classroom. The main goal of the study is to define the design characteristics of rural primary school classrooms, associated with the implementation of the DBL methodology. Along with the change in learning strategies, it is necessary to change the educational spaces in which they develop. The hypothesis indicates that a change in the space and equipment of the classrooms based on the emotions of the students will motivate better learning results based on the implementation of a new methodology. In this case, the pedagogical dynamics require an important interaction between the participants, as well as an environment favorable to creativity. Methodologies from Kansei engineering are used to know the emotional variables associated with their definition. The study is done to 50 students between 6 and 10 years old (average age of seven years), 48% of men and 52% women. Virtual three-dimensional scale models and semantic differential tables are used. To define the semantic differential, self-applied surveys were carried out. Each survey consists of eight separate questions in two groups: question A to find desirable emotions; question B related to emotions. Both questions have a maximum of three alternatives to answer. Data were tabulated with IBM SPSS Statistics version 19. Terms referred to emotions are grouped into twenty concepts with a higher presence in surveys. To select the values obtained as part of the implementation of Semantic Differential, a number expected of 'chi-square test (x2)' frequency calculated for classroom space is considered lower limit. All terms over the N expected a cut point, are included to prepare tables for surveys to find a relation between emotion and space. Statistic contrast (Chi-Square) represents significance level ≥ 0, indicator that frequencies appeared are not random. Then, the most representative terms depend on the variable under study: a) definition of textures and color of vertical surfaces is associated with emotions such as tranquility, attention, concentration, creativity; and, b) distribution of the equipment of the rooms, with emotions associated with happiness, distraction, creativity, freedom. The main findings are linked to the generation of classrooms according to diverse DBL team dynamics. Kansei engineering is the appropriate methodology to know the emotions that students want to feel in the classroom space.

Keywords: creativity, design-based learning, education spaces, emotions

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Authors: Lata Shakya, Toshio Otsuki, Saori Imoto, Bijaya Krishna Shrestha, Umesh Bahadur Malla

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2015 Gorkha Nepal earthquake have damaged the human settlements in 14 districts of Nepal. Historic core areas of three principal cities namely Kathmandu, Lalitpur and Bhaktapur including numerous traditional ‘newari’ settlements in the peripheral areas have been either collapsed or severely damaged. Despite Government of Nepal and (international) non-government organisations’ attempt towards disaster risk management through the preparation of policies and guidelines and implementation of community-based activities, the recent ‘Gorkha’ earthquake has demonstrated the inadequate preparedness, poor implementation of a legal instrument, resource constraints, and managerial weakness. However, the social capital through community based institutions, self-help attitude, and community bond has helped a lot not only in rescue and relief operation but also in a post-disaster temporary shelter living thereby exhibiting the resilient power of the local community. Conducting a detailed case study of ‘Kaminani’ community with 42 houses at ward no. 16 of Bhaktapur municipality, this paper analyses the local community’s response and activities on the Gorkha earthquake in rescue and relief operation as well as in post disaster work. Leadership, the existence of internal/external aid, physical and human support are also analyzed. Social resource and networking are also explained through critical review of the existing community organisation and their activities. The research methodology includes literature review, field survey, and interview with community leaders and residents based on a semi-structured questionnaire. The study reveals that community carried their recovery process in four different phases: (i) management of emergency evacuation, (ii) constructing community owed temporary shelter for individuals, (iii) demolishing upper floors of the damaged houses, and (iv) planning for collaborative housing reconstruction. As territorial based organization, religion based agency and aim based institution exist in the survey area from pre-disaster time, it can be assumed that the community activists including leaders are well experienced to create aim-based group and manage teamwork to deal with various issues and problems collaboratively. Physical and human support including partial financial aid from external source as a result of community leader’s personal networking is extended to the community members. Thus, human/social resource and personal/social network play a crucial role in the recovery process. And to build such social capital, community should have potential from pre-disaster time.

Keywords: Gorkha Nepal earthquake, local community, recovery process, social resource, social network

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Authors: Signe Svensson, Remy Rey, Anna-Lisa Osvalder, Henrik Artman, Lars Nordström

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The electric power system is undergoing significant changes. Thereby, the operation and control are becoming partly modified, more multifaceted and automated, and thereby supplementary operator skills might be required. This paper discusses developing operational challenges in future power system control rooms, posed by the evolving landscape of sustainable power systems, driven in turn by the shift towards electrification and renewable energy sources. A literature review followed by interviews and a comparison to other related domains with similar characteristics, a descriptive analysis was performed from a human factors perspective. Analysis is meant to identify trends, relationships, and challenges. A power control domain taxonomy includes a temporal domain (planning and real-time operation) and three operational domains within the power system (generation, switching and balancing). Within each operational domain, there are different control actions, either in the planning stage or in the real-time operation, that affect the overall operation of the power system. In addition to the temporal dimension, the control domains are divided in space between a multitude of different actors distributed across many different locations. A control room is a central location where different types of information are monitored and controlled, alarms are responded to, and deviations are handled by the control room operators. The operators’ competencies, teamwork skills, team shift patterns as well as control system designs are all important factors in ensuring efficient and safe electricity grid management. As the power system evolves with sustainable energy technologies, challenges are found. Questions are raised regarding whether the operators’ tacit knowledge, experience and operation skills of today are sufficient to make constructive decisions to solve modified and new control tasks, especially during disturbed operations or abnormalities. Which new skills need to be developed in planning and real-time operation to provide efficient generation and delivery of energy through the system? How should the user interfaces be developed to assist operators in processing the increasing amount of information? Are some skills at risk of being lost when the systems change? How should the physical environment and collaborations between different stakeholders within and outside the control room develop to support operator control? To conclude, the system change will provide many benefits related to electrification and renewable energy sources, but it is important to address the operators’ challenges with increasing complexity. The control tasks will be modified, and additional operator skills are needed to perform efficient and safe operations. Also, the whole human-technology-organization system needs to be considered, including the physical environment, the technical aids and the information systems, the operators’ physical and mental well-being, as well as the social and organizational systems.

Keywords: operator, process control, energy system, sustainability, future control room, skill

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Authors: Meilan Jin, Mary Jane Moran

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This study aims to introduce the framework of culturally responsive home visiting (CRHV) to head start teacher professional sessions in the Southeastern of the US and investigate its influence on the evolving beliefs of teachers about their roles and relationships with families in-home visits. The framework orients teachers to an effective way of taking on the role of learner to listen for spoken and unspoken needs and look for family strengths. In addition, it challenges the deficit model that is grounded on 'cultural deprivation,' and it stresses the value of family cultures and advocates equal, collaborative parent-teacher relationships. The home visit reflection papers and focus group transcriptions of eight teachers have been collected since 2010 throughout a five-year longitudinal collaboration with them. Reflection papers were written by the teachers before and after introducing the CRHV framework, including the details of visit purposes and actions and their plans for later home visits. Particularly, the CRHV framework guided the teachers to listen and look for information about family-living environments; parent-child interactions; child-rearing practices; and parental beliefs, values, and needs. Two focus groups were organized in 2014 by asking the teachers to read their written reflection papers and then discussing their shared beliefs and experiences of home visits in recent years. The average length of the discussions was one hour, and the discussions were audio-recorded and transcribed verbatim. Moreover, the data were analyzed using constant comparative analysis, and the analysis was verified through (a) the uses of multiple data sources, (b) the involvement of multiple researchers, (c) coding checks, and (d) the provisions of the thick descriptions of the findings. The study findings corroborate that the teachers become to reposition themselves as 'knowledge seekers' through reorienting their cynosure toward 'setting stones' to learn, grow, and change rather than framing their home visits. The teachers also continually engage in careful listening, observing, questioning, and dialoguing, and these actions reflect their care toward parents. The value of teamwork with parents is advocated, and the teachers recognize that when parents feel empowered, they are active and committed to doing more for their children, which can further advantage proactive long-term parent-teacher collaborations. The study findings also validate that the framework is influential for educators to provide the experiences of home visiting that is culturally responsive and to share collaborative relationships with caregivers. The long-term impact of the framework further implies that teachers continue to put themselves in the position of evolving, including beliefs and actions, to better work with children and families who are culturally, ethnically, and linguistically different from them. This framework can be applicable to educators and professionals who are looking for avenues to bridge the relationship between home and school and parents and teachers.

Keywords: culturally responsive home visit, early childhood education, parent–teacher collaboration, teacher professional development

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Authors: Margit Kastner

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To overcome the negative consequences associated with large class sizes and to support students in developing the necessary competences (e.g., critical thinking, problem-solving, or team-work skills) a marketing course has been redesigned by implementing project-based learning with peer assessment (PBL&PA). This means that students can voluntarily take advantage of this supplementary offer and explore -in addition to attending the lecture where clicker questions are asked- a real-world problem, find a solution, and assess the results of peers while working in small collaborative groups. In order to handle this with little further effort, the process is technically supported by the university’s e-learning system in such a way that students upload their solution in form of an assignment which is then automatically distributed to peer groups who have to assess the work of three other groups. Finally, students’ work is graded automatically considering both, students’ contribution to the project and the conformity of the peer assessment. The purpose of this study is to evaluate students’ perception of PBL&PA using an online-questionnaire to collect the data. More specifically, it aims to discover students’ motivations for (not) working on a project and the benefits and problems students encounter. In addition to the survey, students’ performance was analyzed by comparing the final grades of those who participated in PBL&PA with those who did not participate. Among the 260 students who filled out the questionnaire, 47% participated in PBL&PA. Besides extrinsic motivations (bonus credits), students’ participation was often motivated by learning and social benefits. Reasons for not working on a project were connected to students’ organization and management of their studies (e.g., time constraints, no/wrong information) and teamwork concerns (e.g., missing engagement of peers, prior negative experiences). In addition, high workload and insufficient extrinsic motivation (bonus credits) were mentioned. With regards to benefits and problems students encountered during the project, students provided more positive than negative comments. Positive aspects most often stated were learning and social benefits while negative ones were mainly attached to the technical implementation. Interestingly, bonus credits were hardly named as a positive aspect meaning that intrinsic motivations have become more important when working on the project. Team aspects generated mixed feelings. In addition, students who voluntarily participated in PBL&PA were, in general, more active and utilized further course offers such as clicker questions. Examining students’ performance at the final exam revealed that students without participating in any of the offered active learning tasks performed poorest in the exam while students who used all activities were best. In conclusion, the goals of the implementation were met in terms of students’ perceived benefits and the positive impact on students’ exam performance. Since the comparison of the automatic grading with faculty grading showed valid results, it is possible to rely only on automatic grading in the future. That way, the additional workload for faculty will be within limits. Thus, the implementation of project-based learning with peer assessment can be recommended for large classes.

Keywords: automated grading, large classes, peer assessment, project-based learning

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Authors: C. Fortin, D. Tokmeninova, O. Ushakova

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Among 500 Russian universities Skolkovo Institute of Science and Technology (Skoltech) is one of the youngest (established in 2011), quite small and vastly international, comprising 20 percent of international students and 70 percent of faculty with significant academic experience at top-100 universities (QS, THE). The institute has emerged from close collaboration with MIT and leading Russian universities. Skoltech is an entirely English speaking environment. Skoltech curriculum plans of ten Master programs are based on the CDIO learning outcomes model. However, despite the Institute’s unique focus on industrial innovations and startups, one of the main challenges has become an evident large proportion of nearly half of MSc graduates entering PhD programs at Skoltech or other universities rather than industry or entrepreneurship. In order to increase the share of students joining the industrial sector after graduation, Skoltech started implementing a number of unique practices with a focus on employers’ expectations incorporated into the curriculum redesign. In this sense, extended knowledge exchange with industrial partners via collaboration in learning activities, industrial projects and assessments became essential for students’ headway into industrial and entrepreneurship pathways. Current academic curriculum includes the following types of components based on extended knowledge exchange with industrial partners: innovation workshop, industrial immersion, special industrial tracks, MSc defenses. Innovation workshop is a 4 week full time diving into the Skoltech vibrant ecosystem designed to foster innovators, focuses on teamwork, group projects, and sparks entrepreneurial instincts from the very first days of study. From 2019 the number of mentors from industry and startups significantly increased to guide students across these sectors’ demands. Industrial immersion is an exclusive part of Skoltech curriculum where students after the first year of study spend 8 weeks in an industrial company carrying out an individual or team project and are guided jointly by both Skoltech and company supervisors. The aim of the industrial immersion is to familiarize students with relevant needs of Russian industry and to prepare graduates for job placement. During the immersion a company plays the role of a challenge provider for students. Skoltech has started a special industrial track comprising deep collaboration with IPG Photonics – a leading R&D company and manufacturer of high-performance fiber lasers and amplifiers for diverse applications. The track is aimed to train a new cohort of engineers and includes a variety of activities for students within the “Photonics” MSc program. It is expected to be a successful story and used as an example for similar initiatives with other Russian high-tech companies. One of the pathways of extended knowledge exchange with industrial partners is an active involvement of potential employers in MSc Defense Committees to review and assess MSc thesis projects and to participate in defense procedures. The paper will evaluate the effect and results of the above undertaken measures.

Keywords: Curriculum redesign, knowledge exchange model, learning outcomes framework, stakeholder engagement

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Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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Authors: Daniela Velichová

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Plenty of ideas on how to adopt active learning methods in education are available nowadays. Mathematics is a subject where the active involvement of students is required in particular in order to achieve desirable results regarding sustainable knowledge and deep understanding. The present article is based on the outcomes of an Erasmus+ project DrIVE-MATH, that was aimed at developing a novel and integrated framework to teach maths classes in engineering courses at the university level. It is fundamental for students from the early years of their academic life to have agile minds. They must be prepared to adapt to their future working environments, where enterprises’ views are always evolving, where all collaborate in teams, and relations between peers are thought for the well-being of the whole - workers and company profit. This reality imposes new requirements on higher education in terms of adaptation of different pedagogical methods, such as project-based and active-learning methods used within the course curricula. Active learning methodologies are regarded as an effective way to prepare students to meet the challenges posed by enterprises and to help them in building critical thinking, analytic reasoning, and insight to the solved complex problems from different perspectives. Fostering learning-by-doing activities in the pedagogical process can help students to achieve learning independence, as they could acquire deeper conceptual understanding by experimenting with the abstract concept in a more interesting, useful, and meaningful way. Clear information about learning outcomes and goals might help students to take more responsibility for their learning results. Active learning methods implemented by the project team members in their teaching practice, eduScrum and Jigsaw in particular, proved to provide better scientific and soft skills support to students than classical teaching methods. EduScrum method enables teachers to generate a working environment that stimulates students' working habits and self-initiative as they become aware of their responsibilities within the team, their own acquired knowledge, and their abilities to solve problems independently, though in collaboration with other team members. This method enhances collaborative learning, as students are working in teams towards a common goal - knowledge acquisition, while they are interacting with each other and evaluated individually. Teams consisting of 4-5 students work together on a list of problems - sprint; each member is responsible for solving one of them, while the group leader – a master, is responsible for the whole team. A similar principle is behind the Jigsaw technique, where the classroom activity makes students dependent on each other to succeed. Students are divided into groups, and assignments are split into pieces, which need to be assembled by the whole group to complete the (Jigsaw) puzzle. In this paper, analysis of students’ perceptions concerning the achievement of deeper conceptual understanding in mathematics and the development of soft skills, such as self-motivation, critical thinking, flexibility, leadership, responsibility, teamwork, negotiation, and conflict management, is presented. Some new challenges are discussed as brought by introducing active learning methods in the basic mathematics courses. A few examples of sprints developed and used in teaching basic maths courses at technical universities are presented in addition.

Keywords: active learning methods, collaborative learning, conceptual understanding, eduScrum, Jigsaw, soft skills

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Authors: Prince Chukwuneme Enwereji, Annelien Van Rooyen

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In recent years, technology integration in education has transformed the learning landscape, particularly in online institutions. One technological advancement that has gained popularity is e-tutoring, which offers personalised academic support to students through online platforms. While e-tutoring has become well-known and has been adopted to promote collaborative learning, there are still students who do not use these services for various reasons. However, little attention has been given to understanding the perspectives of students who have not utilized these services. The research objectives include identifying the perceived benefits that non-e-tutoring students believe e-tutoring could offer, such as enhanced academic support, personalized learning experiences, and improved performance. Additionally, the study explored the potential drawbacks or concerns that non-e-tutoring students associate with e-tutoring, such as concerns about efficacy, a lack of face-to-face interaction, and platform accessibility. The study adopted a quantitative research approach with a descriptive design to gather and analyze data on non-e-tutoring students' perspectives. Online questionnaires were employed as the primary data collection method, allowing for the efficient collection of data from many participants. The collected data was analyzed using the Statistical Package for the Social Sciences (SPSS). Ethical concepts such as informed consent, anonymity of responses and protection of respondents against harm were maintained. Findings indicate that non-e-tutoring students perceive a sense of control over their own pace of learning, suggesting a preference for self-directed learning and the ability to tailor their educational experience to their individual needs and learning styles. They also exhibit high levels of motivation, believe in their ability to effectively participate in their studies and organize their academic work, and feel comfortable studying on their own without the help of e-tutors. However, non-e-tutoring students feel that e-tutors do not sufficiently address their academic needs and lack engagement. They also perceive a lack of clarity in the roles of e-tutors, leading to uncertainty about their responsibilities. In terms of communication, students feel overwhelmed by the volume of announcements and find repetitive information frustrating. Additionally, some students face challenges with their internet connection and associated cost, which can hinder their participation in online activities. Furthermore, non-e-tutoring students express a desire for interactions with their peers and a sense of belonging to a group or team. They value opportunities for collaboration, teamwork in their learning experience, the importance of fostering social interactions and creating a sense of community in online learning environments. This study recommended that students seek alternate support systems by reaching out to professors or academic advisors for guidance and clarification. Developing self-directed learning skills is essential, empowering students to take charge of their own learning through setting objectives, creating own study plans, and utilising resources. For HEIs, it was recommended that they should ensure that a variety of support services are available to cater to the needs of all students, including non-e-tutoring students. HEIs should also ensure easy access to online resources, promote a supportive community, and regularly evaluate and adapt their support techniques to meet students' changing requirements.

Keywords: online-tutor;, student support;, online education, educational practices, distance education

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Authors: Ma Chu Jui

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Culture plays a pivotal role in shaping societal responses to change and fostering adaptability. In the realm of healthcare provision, hospitals serve as dynamic settings molded by the cultural consciousness of healthcare professionals. This intricate interplay extends to their expectations of leadership, communication styles, and attitudes towards patient care. Recognizing the cultural inclinations of healthcare professionals becomes imperative in navigating this complex landscape. This study will utilize Hofstede's Value Survey Module 2013 (VSM 2013) as a comprehensive analytical tool. The targeted participants for this research are in-service nursing professionals with a tenure of at least three months, specifically employed in the nursing department of an Eastern hospital. This quantitative approach seeks to quantify diverse cultural tendencies among the targeted nursing professionals, elucidating not only abstract cultural concepts but also revealing their cultural inclinations across different dimensions. The study anticipates gathering between 400 to 500 responses, ensuring a robust dataset for a comprehensive analysis. The focused approach on nursing professionals within the Eastern hospital setting enhances the relevance and specificity of the cultural insights obtained. The research aims to contribute valuable knowledge to the understanding of cultural tendencies among in-service nursing personnel in the nursing department of this specific Eastern hospital. The VSM 2013 will be initially distributed to this specific group to collect responses, aiming to calculate scores on each of Hofstede's six cultural dimensions—Power Distance Index (PDI), Individualism vs. Collectivism (IDV), Uncertainty Avoidance Index (UAI), Masculinity vs. Femininity (MAS), Long-Term Orientation vs. Short-Term Normative Orientation (LTO), and Indulgence vs. Restraint (IVR). the study unveils a significant correlation between different cultural dimensions and healthcare professionals' tendencies in understanding leadership expectations through PDI, grasping behavioral patterns via IDV, acknowledging risk acceptance through UAI, and understanding their long-term and short-term behaviors through LTO. These tendencies extend to communication styles and attitudes towards patient care. These findings provide valuable insights into the nuanced interconnections between cultural factors and healthcare practices. Through a detailed analysis of the varying levels of these cultural dimensions, we gain a comprehensive understanding of the predominant inclinations among the majority of healthcare professionals. This nuanced perspective adds depth to our comprehension of how cultural values shape their approach to leadership, communication, and patient care, contributing to a more holistic understanding of the healthcare landscape. A profound comprehension of the cultural paradigms embraced by healthcare professionals holds transformative potential. Beyond a mere understanding, it acts as a catalyst for elevating the caliber of healthcare services. This heightened awareness fosters cohesive collaboration among healthcare teams, paving the way for the establishment of a unified healthcare ethos. By cultivating shared values, our study envisions a healthcare environment characterized by enhanced quality, improved teamwork, and ultimately, a more favorable and patient-centric healthcare landscape. In essence, our research underscores the critical role of cultural awareness in shaping the future of healthcare delivery.

Keywords: hofstede's cultural, cultural dimensions, cultural values in healthcare, cultural awareness in nursing

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Authors: Karen Chad, Louise Humbert, Kenzie Friesen, Dave Sandomirsky

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Background: The pandemic of COVID-19 presented many historical challenges to the sporting community. For organizations and individuals, sport was put on hold resulting in social, economic, physical, and mental health consequences for all involved. High school sports are seen as an effective and accessible pathway for students to receive health, social, and academic benefits. Studies examining sport cessation due to COVID-19 found substantial negative outcomes on the physical and mental well-being of participants in the high school setting. However, the pandemic afforded an opportunity to examine sport participation and the value people place upon their engagement in high school sport. Study objectives: (1) Examine the experiences of students, parents, administrators, officials, and coaches during a year without high school sports; (2) Understand why participants are involved in high school sports; and (3) Learn what supports are needed for future involvement. Methodology: A mixed method design was used, including semi-structured interviews and a survey (SurveyMonkey software), which was disseminated electronically to high school students, coaches, school administrators, parents, and officials. Results: 1222 respondents completed the survey. Findings showed: (1) 100% of students participate in high school sports to improve their mental health, with >95% said it keeps them active and healthy, helps them make friends and teaches teamwork, builds confidence and positive self-perceptions, teaches resiliency, enhances connectivity to their school, and supports academic learning; (2) Top three reasons teachers coach is their desire to make a difference in the lives of students, enjoyment, and love of the sport, and to give back. Teachers said what they enjoy most is contributing to and watching athletes develop, direct involvement with student sport success, and the competitiveatmosphere; (3) 90% of parents believe playing sports is a valuable experience for their child, 95% said it enriches student academic learning and educational experiences, and 97% encouraged their child to play school sports; (4) Officials participate because of their enjoyment and love of the sport, experience, and expertise, desire to make a difference in the lives of children, the competitive/sporting atmosphere and growing the sport. 4% of officials said it was financially motivated; (5) 100% of administrators said high school sports are important for everyone. 80% believed the pandemic will decrease teachers coaching and increase student mental health and well-being. When there was no sport, many athletes got a part-time job and tried to stay active, with limited success. Coaches, officials, and parents spent more time with family. All participants did little physical activity, were bored; and struggled with mental health and poor physical health. Respondents recommended better communication, promotion, and branding of high school sport benefits, equitable funding for all sports, athlete development, compensation and recognition for coaching, and simple processes to strengthen the high school sport model. Conclusions: High school sport is an effective vehicle for athletes, parents, coaches, administrators, and officials to derive many positive outcomes. When it is taken away, serious consequences prevail. Paying attention to important success factors will be important for the effectiveness of high school sports.

Keywords: physical activity, high school, sports, pandemic

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Authors: Shoba Rathilal

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High unemployment rates and a shortage of experienced and qualified employees appear to be a paradox that currently plagues most countries worldwide. In a developing country like South Africa, the rate of unemployment is reported to be approximately 35%, the highest recorded globally. At the same time, a countrywide deficit in experienced and qualified potential employees is reported in South Africa, which is causing fierce rivalry among firms. Employers have reported that graduates are very rarely able to meet the demands of the job as there are gaps in their knowledge and conceptual understanding and other 21st-century competencies, attributes, and dispositions required to successfully negotiate the multiple responsibilities of employees in organizations. In addition, the rates of unemployment and suitability of graduates appear to be skewed by race and social class, the continued effects of a legacy of inequitable educational access. Higher Education in the current technologically advanced and dynamic world needs to serve as an agent of transformation, aspiring to develop graduates to be creative, flexible, critical, and with entrepreneurial acumen. This requires that higher education curricula and pedagogy require a re-envisioning of our selection, sequencing, and pacing of the learning, teaching, and assessment. At a particular Higher education Institution in South Africa, Design Thinking and Project Based learning are being adopted as two approaches that aim to enhance the student experience through the provision of a “distinctive education” that brings together disciplinary knowledge, professional engagement, technology, innovation, and entrepreneurship. Using these methodologies forces the students to solve real-time applied problems using various forms of knowledge and finding innovative solutions that can result in new products and services. The intention is to promote the development of skills for self-directed learning, facilitate the development of self-awareness, and contribute to students being active partners in the application and production of knowledge. These approaches emphasize active and collaborative learning, teamwork, conflict resolution, and problem-solving through effective integration of theory and practice. In principle, both these approaches are extremely impactful. However, at the institution in this study, the implementation of the PBL and DT was not as “smooth” as anticipated. This presentation reports on the analysis of the implementation of these two approaches within higher education curricula at a particular university in South Africa. The study adopts a qualitative case study design. Data were generated through the use of surveys, evaluation feedback at workshops, and content analysis of project reports. Data were analyzed using document analysis, content, and thematic analysis. Initial analysis shows that the forces constraining the implementation of PBL and DT range from the capacity to engage with DT and PBL, both from staff and students, educational contextual realities of higher education institutions, administrative processes, and resources. At the same time, the implementation of DT and PBL was enabled through the allocation of strategic funding and capacity development workshops. These factors, however, could not achieve maximum impact. In addition, the presentation will include recommendations on how DT and PBL could be adapted for differing contexts will be explored.

Keywords: design thinking, project based learning, innovative higher education pedagogy, student and staff capacity development

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Authors: Nitika Sharma, Yogesh Jain

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Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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Authors: Jennifer Wheeldon, Nick de Viggiani, Nikki Cotterill

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Background: Urinary and fecal incontinence affect a significant proportion of older adults aged 65 and over who permanently reside in residential and nursing home facilities. Incontinence symptoms have been linked to comorbidities, an increased risk of infection and reduced quality of life and mental wellbeing of residents. However, continence care provision can often be poor, further compromising the health and wellbeing of this vulnerable population. Objectives: To identify experiences and perceptions of continence care provision in older adult residential care settings and to identify factors that help or hinder good continence care provision. Settings included both residential care homes and nursing homes for older adults. Methods: A qualitative evidence synthesis using systematic review methodology established the current evidence-base. Data from 20 qualitative and mixed-method studies was appraised and synthesized. Following the review process, 10* qualitative interviews with staff working in older adult residential care settings were conducted across six* sites, which included registered managers, registered nurses and nursing/care assistants/aides. Purposive sampling recruited individuals from across England. Both evidence synthesis and interview data was analyzed thematically, both manually and with NVivo software. Results: The evidence synthesis revealed complex barriers and facilitators for continence care provision at three influencing levels: macro (structural and societal external influences), meso (organizational and institutional influences) and micro (day-to-day actions of individuals impacting service delivery). Macro-level barriers included negative stigmas relating to incontinence, aging and working in the older adult social care sector, restriction of continence care resources such as containment products (i.e. pads), short staffing in care facilities, shortfalls in the professional education and training of care home staff and the complex health and social care needs of older adult residents. Meso-level barriers included task-centered organizational cultures, ageist institutional perspectives regarding old age and incontinence symptoms, inadequate care home management and poor communication and teamwork among care staff. Micro-level barriers included poor knowledge and negative attitudes of care home staff and residents regarding incontinence symptoms and symptom management and treatment. Facilitators at the micro-level included proactive and inclusive leadership skills of individuals in management roles. Conclusions: The findings of the evidence synthesis study help to outline the complexities of continence care provision in older adult care homes facilities. Macro, meso and micro level influences demonstrate problematic and interrelated barriers across international contexts, indicating that improving continence care in this setting is extremely challenging due to the multiple levels at which care provision and services are impacted. Both international and national older adult social care policy-makers, researchers and service providers must recognize this complexity, and any intervention seeking to improve continence care in older adult care home settings must be planned accordingly and appreciatively of the complex and interrelated influences. It is anticipated that the findings of the qualitative interviews will shed further light on the national context of continence care provision specific to England; data collection is ongoing*. * Sample size is envisaged to be between 20-30 participants from multiple sites by Spring 2023.

Keywords: continence care, residential and nursing homes, evidence synthesis, qualitative

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Authors: Priyanka Botny Srinath, Alessandro Suglia, Mel McKendrick

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Background: Organizational cultural studies integrate sociology and anthropology, portraying man as a creator of symbols, languages, beliefs, and ideologies -essentially, a creator and manager of meaning. In our research, we leverage analytical measures to discern whether an organization embodies a singular culture or a myriad of subcultures. Fast-forward to 2023, our research thesis focuses on digitally measuring culture, coining it as the "Work Culture Quotient." This entails conceptually mapping common experiential patterns to provide executives insights into the digital organization journey, aiding in understanding their current position and identifying future steps. Objectives: Finding the new age skills that help in defining the culture; understand the implications of post-COVID effects; derive a digital framework for measuring skillsets. Method: We conducted two comprehensive Delphi studies to distill essential insights. Delphi 1: Through a thematic analysis of interviews with 20 high-level leaders representing companies across diverse regions -India, Japan, the US, Canada, Morocco, and Uganda- we identified 20 key skills critical for cultivating a robust organizational culture. The skills are -influence, self-confidence, optimism, empathy, leadership, collaboration and cooperation, developing others, commitment, innovativeness, leveraging diversity, change management, team capabilities, self-control, digital communication, emotional awareness, team bonding, communication, problem solving, adaptability, and trustworthiness. Delphi 2: Subject matter experts were asked to complete a questionnaire derived from the thematic analysis in stage 1 to formalise themes and draw consensus amongst experts on the most important workplace skills. Results: The thematic analysis resulted in 20 workplace employee skills being identified. These skills were all included in the Delphi round 2 questionnaire. From the outputs, we analysed the data using R Studio for arriving at agreement and consensus, we also used sum of squares method to compare various agreements to extract various themes with a threshold of 80% agreements. This yielded three themes at over 80% agreement (leadership, collaboration and cooperation, communication) and three further themes at over 60% agreement (commitment, empathy, trustworthiness). From this, we selected five questionnaires to be included in the primary data collection phase, and these will be paired with the digital footprints to provide a workplace culture quotient. Implications: The findings from these studies bear profound implications for decision-makers, revolutionizing their comprehension of organizational culture. Tackling the challenge of mapping the digital organization journey involves innovative methodologies that probe not only external landscapes but also internal cultural dynamics. This holistic approach furnishes decision-makers with a nuanced understanding of their organizational culture and visualizes pivotal skills for employee growth. This clarity enables informed choices resonating with the organization's unique cultural fabric. Anticipated outcomes transcend mere individual cultural measurements, aligning with organizational goals to unveil a comprehensive view of culture, exposing artifacts and depth. Armed with this profound understanding, decision-makers gain tangible evidence for informed decision-making, strategically leveraging cultural strengths to cultivate an environment conducive to growth, innovation, and enduring success, ultimately leading to measurable outcomes.

Keywords: leadership, cooperation, collaboration, teamwork, work culture

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Authors: Lolwa Alansari, Hanen Mrabet, Kholoud Khaled, Abdelhamid Azhaghdani, Sufia Athar, Aska Kaima, Zaineb Mhamdia, Zubaria Altaf, Almunzer Zakaria, Tamara Alshadafat

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Introduction: The Obstetrics and Gynecology Emergency Department at Alwakra Hospital has faced significant challenges, which have been further worsened by the impact of the COVID-19 pandemic. These challenges involve issues such as overcrowding, extended wait times, and a notable surge in demand for emergency care services. Moreover, prolonged waiting times have emerged as a primary factor contributing to situations where patients leave without receiving attention, known as left without being seen (LWBS), and unexpectedly abscond. Addressing the issue of insufficient patient mobility in the obstetrics and gynecology emergency department has brought about substantial improvements in patient care, healthcare administration, and overall departmental efficiency. These changes have not only alleviated overcrowding but have also elevated the quality of emergency care, resulting in higher patient satisfaction, better outcomes, and operational rewards. Methodology: The COVID-19 pandemic has served as a catalyst for substantial transformations in the obstetrics and gynecology emergency, aligning seamlessly with the strategic direction of Hamad Medical Corporation (HMC). The fundamental aim of this initiative is to revolutionize the operational efficiency of the OB-GYN ED. To accomplish this mission, a range of transformations has been initiated, focusing on essential areas such as digitizing systems, optimizing resource allocation, enhancing budget efficiency, and reducing overall costs. The project utilized the Plan-Do-Study-Act (PDSA) model, involving a diverse team collecting baseline data and introducing throughput improvements. Post-implementation data and feedback were analysed, leading to the integration of effective interventions into standard procedures. These interventions included optimized space utilization, real-time communication, bedside registration, technology integration, pre-triage screening, enhanced communication and patient education, consultant presence, and a culture of continuous improvement. These strategies significantly reduced waiting times, enhancing both patient care and operational efficiency. Results: Results demonstrated a substantial reduction in overall average waiting time, dropping from 35 to approximately 14 minutes by August 2023. The wait times for priority 1 cases have been reduced from 22 to 0 minutes, and for priority 2 cases, the wait times have been reduced from 32 to approximately 13.6 minutes. The proportion of patients spending less than 8 hours in the OB ED observation beds rose from 74% in January 2022 to over 98% in 2023. Notably, there was a remarkable decrease in LWBS and absconded patient rates from 2020 to 2023. Conclusion: The project initiated a profound change in the department's operational environment. Efficiency became deeply embedded in the unit's culture, promoting teamwork among staff that went beyond the project's original focus and had a positive influence on operations in other departments. This effectiveness not only made processes more efficient but also resulted in significant cost reductions for the hospital. These cost savings were achieved by reducing wait times, which in turn led to fewer prolonged patient stays and reduced the need for additional treatments. These continuous improvement initiatives have now become an integral part of the Obstetrics and Gynecology Division's standard operating procedures, ensuring that the positive changes brought about by the project persist and evolve over time.

Keywords: overcrowding, waiting time, person centered care, quality initiatives

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