Search results for: teacher professional commitment

Authors: Chooi Fong Lee

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Background: Maternal psychological well-being has been investigated from various aspects, such as social support, employment status. However, a perspective from self-discrepancy theory has not been employed. Moreover, most were focused on young mothers. Less is understanding the middle-aged mother’s psychological well-being. Objective: To examine the influence of maternal self-discrepancy between actual and ideal self on maternal role achievement, state anxiety, trait anxiety, and subjective well-being among Japanese middle-aged mothers across their employment status. Method: A pilot study was conducted with 20 mother participants (aged 40-55, 9 regular-employed, 8 non-regular-employed, and 3 homemaker mothers) to assess the viability of survey questionnaires (Maternal Role Achievement Scale, State-Trait Anxiety Inventory, Subjective Well-being Scale, and a self-report). Participants were randomly selected voluntarily from the college students’ mothers. Participants accessed the survey via a designated URL. The self-report questionnaire prompted participants to list up to 3 ideal selves they aspired to be and rate the extent to which their actual selves deviated from their ideal selves on a 7-point scale (1= not at all; 4 = medium; 7 = extremely). The findings confirmed the validity of the survey questionnaires, indicating their appropriateness for use in subsequent research. Self-discrepancy scores were calculated by subtracting participants’ degree ratings from a 7-point scale, summing them up, and then dividing the total by 3. Setting: We ensured participants were randomly selected from the research firm to mitigate bias. The self-report questionnaire was adapted from a validated instrument and underwent rigorous modification and testing in the pilot study. The final sample consisted of 241 participants, 97 regular-employed, 87 non-regular employed, and 57 homemaker mothers. Result: The reliability coefficient for the discrepancy score is α=.75. The findings indicate that regular-employed mothers tend to exhibit lower self-discrepancy scores compared to non-regular employed and homemaker mothers. This discrepancy negatively impacts maternal role, state anxiety, and subjective well-being while positively affecting trait anxiety. Trait anxiety arises when one feels they did not meet their ideal self, as evidenced by higher levels in homemaker mothers, who experience lower state anxiety. Conversely, regular-employed mothers exhibit higher state anxiety but lower trait anxiety, suggesting satisfaction in their professional pursuits despite balancing work and family responsibilities. Full-time maternal roles contribute to lower state anxiety but higher trait anxiety among homemaker mothers due to a lack of personal identity achievement. Non-regular employed mothers show similarities to homemaker mothers. In self-reports, regular-employed mothers highlight support and devotion to their children’s development, while non-regular-employed mothers seek life fulfillment through part-time work alongside child-rearing duties. Homemaker mothers emphasize qualities like sociability, and communication skills, potentially influencing their self-discrepancy scores. Furthermore, the hierarchical multiple regression analysis revealed that the discrepancy scores significantly predict subjective well-being. Conclusion: There may be the need for broader generalizability beyond our sample of Japanese mothers; however, the findings offer valuable insights into the impact of maternal self-discrepancy on psychological well-being among middle-aged mothers across different employment statuses. Understanding these dynamics becomes crucial as contemporary women increasingly pursue higher education and depart from traditional motherhood norms.

Keywords: maternal employment, maternal role, self-discrepancy, state-trait anxiety, subjective well-being

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Authors: Yifeng Shi, Xingping Wang

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The Soviet Union-style of urban planning has produced a broad and profound influence on China’s urban planning system. The study on extendibility and development experience of Soviet planning in China helps to change the current embarrassing situation 'one-hand planning practice, second-hand planning theory', and also beneficial to facilitate the establishment of China's domestic urban planning theory from the planning source, especially the overseas cooperation parks rich in 'Chinese characteristics'. In practice, as the world’s major infrastructure country, China is exporting to the world especially countries along 'the Belt and Road' a development model featuring cooperation parks as Chinese characteristics. This is of great significance to evaluate and summarize the experiences of Soviet Union-style of planning for China's development objectively and rationally, from removing ideological factors and extracting positive factors to carry them forward in overseas cooperation parks. This article briefly reviews the Soviet influence on urban planning after the founding of China and divided the influences stages into 'guidance, internalization and absorption, selective learning, decline' four periods. The impact includes production-oriented planning and planning concepts continue to be implemented, the establishment of the regional planning, master planning, detailed planning of the basic framework of urban planning, and homogenized cellular structure of the space, as well as planning techniques, professional training, planning techniques and so on. China and even most socialist countries now still carry such planning genes. At present, in the process of implementing 'the Belt and Road' strategy, the planning and construction of China’s overseas cooperation parks generally encounter many problems as lack of strategic planning and systematic planning, lack of top-level design, uncoordinated planning and layout in parks, and redundant construction in some areas. After sublating the planning genes of the Soviet Union-style of urban planning for the development of the socialist countries, especially the industrial planning system, this paper puts forward some views as follows to realize the overseas output and development of China's planning model and technology. Firstly the future development of overseas cooperation park should be from a rational planning point of view. Secondly the government should not only rigidly and equitably allocate the resources of the parks but also closely integrate the national economic plans or economic development strategies. Lastly management department should frame the threshold of development rationally, give full play to the pragmatic planning style in accordance with the local land system and planning system. It has an important guiding and reference role for the development of China's overseas cooperation park under the 'go global' strategy, after objectively evaluating the impact of the Soviet Union-style urban planning and absorbing the beneficial components on China. However, we should also recognize that the cooperation parks and the urban industrial system behind it are only part of urban development. More attention should be payed on the design of the local and the general rules of urban development to take the lead effect of cooperation parks suitable. Foundation item: Under the auspices of the Specific Plan for Strategic International Cooperation in Scientific and Technological Innovation, the National Key Research and Development Plan 'Research Cooperation and Exemplary Application in Planning of Development of Overseas Industrial Parks' (No 2016YFE0201000).

Keywords: China cooperative parks, history of urban planning, output mode, The Soviet Union

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Authors: G. Senoga, D. Nakimuli, B. Ndagire, B. Lukwago, D. Kyamagwa

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Background: The COVID-19 epidemic affected the education sector, with some private schools closing while other children missed schooling for fear contracting COVID-19. Post COVID-19, PSIU in collaborated with Kampala City Council Authority Directorate of Education and Social Science, Water and Sanitation department, and Directorate of Public Health and Environment to improve sanitation and hygiene among pupils and staff in 50 public and private school system in Kampala city. The “Be Clean, Stay Healthy Campaign” used a behavioral change approach in educating, reinforcing and engaging learners on proper hand washing behaviors, proper toilet usage and garbage disposal. In April 2022, 40 Washa lots were constructed, to reduce the pupil - hand wash station ratio; distributed KCCA approved printed materials; oriented 50 teachers, WASH committees to execute and implement hygiene promotion. To ensure sustainability, WASH messages were memorized and practiced through hand washing songs, Pledge, prayer, Poems, Skits, Music, dance and drama, coupled with participatory, practical demonstrations using peer to peer approach, guest speakers at assemblies and in classes. This improved hygiene and sanitation practices. Premised on this, PSI conducted an end line assessment to explore the impact of a hand washing campaign in regards to improvements in hand washing practices and hand hygiene among pupils, accessibility, functionality and usage of the constructed hygiene and sanitation facilities. Method: A cross-sectional post intervention assessment using a mixed methods approach, targeting headteachers, wash committee members and pupils less <17 years was used. Quantitative approaches with a mix of open-ended questions were used in purposively selected respondents in 50 schools. Primary three to primary seven pupils were randomly selected, data was analyzed using the Statistical Package for Social Scientists (SPSS) Outcomes and Findings: 46,989 pupils (51% female), 1,127 and 524 teaching and non-teaching staff were reached by the intervention, respectively. 96% of schools trained on sanitation, sustainable water usage and hygiene constituted 17-man school WASH committees with teacher, parents and pupils representatives. (31%) of the WASH committees developed workplans, (78%) held WASH meetings monthly. This resulted into improved sanitation, water usage, waste management, proper use of toilets, and improved pupils’ health with reduced occurrences of stomach upsets, diarrhoea initially attributed to improper use of latrines and general waste management. Teachers reported reduced number of school absenteeism due to improved hygiene and general waste management at school, especially proper management of sanitary pads. School administrations response rate in purchase of hygiene equipment’s and detergents like soap improved. Regular WASH meetings in classes, teachers and community supervision ensured WASH facilities are used appropriately. Conclusion and Recommendations: Practical behaviour change innovations improves pupil’s knowledge and understanding of hygiene messages and usage. Over 70% of pupils had clear recall of key WASH Messages. There is need for continuous water flow in the Washa lots, harvesting rain water would reduce water bills while complementing National water supply coupled with increasing on Washa lots in densely populated schools.

Keywords: handwashing, hygyiene, sanitation, behaviour change

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Authors: Brooklyn Rushton, Michelle Rutty, Natalie Knowles, Daniel Scott

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As people are increasingly on the search for extraordinary experiences and connections with nature, adventure tourism is experiencing significant growth and providing tourists with life-changing experiences. Unlike built attraction-based tourism, adventure tourism relies entirely on natural heritage, which leaves communities dependent on adventure tourism extremely vulnerable to environmental and climatic changes. A growing body of evidence suggests that global climate change will influence the future of adventure tourism and mountain outdoor recreation opportunities on a global scale. Across Canada, more specifically, climate change is broadly anticipated to present risks for winter-snow sports, while opportunities are anticipated to arise for green season activities. These broad seasonal shifts do not account for the indirect impacts of climate change on adventure tourism, such as the cost of adaptation or the increase of natural hazards and the associated likelihood of accidents. While some research has examined the impact of climate change on natural environments that adventure tourism relies on, a very small body of research has specifically focused on guides’ perspectives or included hard adventure tourism activities. The guiding industry is unique, as guides are trained through an elegant blend of art and science to make decisions based on experience, observation, and intuition. While quantitative research can monitor change in natural environments, guides local knowledge can provide eye-witness accounts and outline what environmental changes mean for the future sustainability of adventure tourism. This research will capture the extensive knowledge of mountain guides to better understand the implications of climate change for mountain adventure and potential adaptive responses for the adventure tourism industry. This study uses a structured online survey with open and close-ended questions that will be administered using Qualtrics (an online survey platform). This survey is disseminated to current members of the Association of Canadian Mountain Guides (ACMG). Participation in this study will be exclusive to members of the ACMG operating in the outdoor guiding streams. The 25 survey questions are organized into four sections: demographic and professional operation (9 questions), physical change (4 questions), climate change perception (6 questions), and climate change adaptation (6 questions). How mountain guides perceive and respond to climate change is important knowledge for the future of the expanding adventure tourism industry. Results from this study are expected to provide important information to mountain destinations on climate change vulnerability and adaptive capacity. Expected results of this study include guides insight into: (1) experience-safety relevant observed physical changes in guided regions (i.e. glacial coverage, permafrost coverage, precipitation, temperature, and slope instability) (2) changes in hazards within the guiding environment (i.e. avalanches, rockfall, icefall, forest fires, flooding, and extreme weather events), (3) existing and potential adaptation strategies, and (4) key information and other barriers for adaptation. By gaining insight from the knowledge of mountain guides, this research can help the tourism industry at large understand climate risk and create adaptation strategies to ensure the resiliency of the adventure tourism industry.

Keywords: adventure tourism, climate change, environmental change, mountain hazards

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Authors: Tessa Heeren

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The following proposal pertains to the complex process of successfully implementing health policies that are based on public health research. A systematic review was conducted by myself and faculty at the Cluj School of Public Health in Romania. The reviewed articles covered a wide range of topics, such as barriers and facilitators to multi-sector collaboration, differences in professional cultures, and systemic obstacles. The reviewed literature identified communication, collaboration, user-friendly dissemination, and documentation of processes in the execution of applied research as important themes for the promotion of evidence in the public health decision-making process. This proposal fits into the Academy Health National Health Policy conference because it identifies and examines differences between the worlds of research and politics. Implications and new insights for federal and/or state health policy: Recommendations made based on the findings of this research include using politically relevant levers to promote research (e.g. campaign donors, lobbies, established parties, etc.), modernizing dissemination practices, and reforms in which the involvement of external stakeholders is facilitated without relying on invitations from individual policy makers. Description of how evidence and/or data was or could be used: The reviewed articles illustrated shortcomings and areas for improvement in policy research processes and collaborative development. In general, the evidence base in the field of integrating research into policy lacks critical details of the actual process of developing evidence based policy. This shortcoming in logistical details creates a barrier for potential replication of collaborative efforts described in studies. Potential impact of the presentation for health policy: The reviewed articles focused on identifying barriers and facilitators that arise in cross sector collaboration, rather than the process and impact of integrating evidence into policy. In addition, the type of evidence used in policy was rarely specified, and widely varying interpretations of the definition of evidence complicated overall conclusions. Background: Using evidence to inform public health decision making processes has been proven effective; however, it is not clear how research is applied in practice. Aims: The objectives of the current study were to assess the extent to which evidence is used in public health decision-making process. Methods: To identify eligible studies, seven bibliographic databases, specifically, PubMed, Scopus, Cochrane Library, Science Direct, Web of Science, ClinicalKey, Health and Safety Science Abstract were screened (search dates: 1990 – September 2015); a general internet search was also conducted. Primary research and systematic reviews about the use of evidence in public health policy in Europe were included. The studies considered for inclusion were assessed by two reviewers, along with extracted data on objective, methods, population, and results. Data were synthetized as a narrative review. Results: Of 2564 articles initially identified, 2525 titles and abstracts were screened. Ultimately, 30 articles fit the research criteria by describing how or why evidence is used/not used in public health policy. The majority of included studies involved interviews and surveys (N=17). Study participants were policy makers, health care professionals, researchers, community members, service users, experts in public health.

Keywords: cross-sector, dissemination, health policy, policy implementation

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Authors: Hsin-Yu Lee, Ming-Zhong Li, Wen-Hsi Chiu, Su-Fen Cheng, Shwu-Wen Lin

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Background: The use of medical terminology is essential to professional nurses on clinical practice. However, most nursing students consider traditional lecture-based teaching of medical terminology as boring and overly conceptual and lack motivation to learn. It is thus an issue to be discussed on how to enhance nursing students’ self-directed learning and improve learning outcomes of medical terminology. Digital game-based learning is a learner-centered way of learning. Past literature showed that the most common game-based learning for language education has been immersive games and teaching games. Thus, this study selected role-playing games (RPG) and digital puzzle games for observation and comparison. It is interesting to explore whether digital game-based learning has positive impact on nursing students’ learning of medical terminology and whether students can adapt well on this type of learning. Results can be used to provide references for institutes and teachers on teaching medical terminology. These instructions give you guidelines for preparing papers for the conference. Use this document as a template if you are using Microsoft Word. Otherwise, use this document as an instruction set. The electronic file of your paper will be formatted further at WASET. Define all symbols used in the abstract. Do not cite references in the abstract. Do not delete the blank line immediately above the abstract; it sets the footnote at the bottom of this column. Page margins are 1,78 cm top and down; 1,65 cm left and right. Each column width is 8,89 cm and the separation between the columns is 0,51 cm. Objective: The purpose of this research is to explore respectively the impact of RPG and puzzle game on nursing students’ self-directed learning and technology acceptance. The study further discusses whether different game types bring about different influences on students’ self-directed learning and technology acceptance. Methods: A quasi-experimental design was adopted in this study so that repeated measures between two groups could be conveniently conducted. 103 nursing students from a nursing college in Northern Taiwan participated in the study. For three weeks of experiment, the experiment group (n=52) received “traditional teaching + RPG” while the control group (n=51) received “traditional teaching + puzzle games”. Results: 1. On self-directed learning: For each game type, there were significant differences for the delayed tests of both groups as compared to the pre and post-tests of each group. However, there were no significant differences between the two game types. 2. On technology acceptance: For the experiment group, after the intervention of RPG, there were no significant differences concerning technology acceptance. For the control group, after the intervention of puzzle games, there were significant differences regarding technology acceptance. Pearson-correlation coefficient and path analysis conducted on the results of the two groups revealed that the dimension were highly correlated and reached statistical significance. Yet, the comparison of technology acceptance between the two game types did not reach statistical significance. Conclusion and Recommend: This study found that through using different digital games on learning, nursing students have effectively improved their self-directed learning. Students’ technology acceptances were also high for the two different digital game types and each dimension was significantly correlated. The results of the experimental group showed that through the scenarios of RPG, students had a deeper understanding of medical terminology, which reached the ‘Understand’ dimension of Bloom’s taxonomy. The results of the control group indicated that digital puzzle games could help students memorize and review medical terminology, which reached the ‘Remember’ dimension of Bloom’s taxonomy. The findings suggest that teachers of medical terminology could use digital games to assist their teaching according to their goals on cognitive learning. Adequate use of those games could help improve students’ self-directed learning and further enhance their learning outcome on medical terminology.

Keywords: digital game-based learning, medical terminology, nursing education, self-directed learning, technology acceptance model

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Authors: Dorota Winnicka-Jasłowska, Małgorzata Jastrzębska, Jan Kaczmarczyk, Beata Łaźniewska-Piekarczyk, Piotr Skóra, Beata Kobiałko, Agata Kołodziej, Błażej Mól, Ewelina Lasyk, Karolina Brzęczek, Michał Król

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Creating economical, comfortable, and healthy buildings which respect the environment is a necessity resulting from legal regulations, but it is also a response to the expectations of a modern investor. Developing the concept of a residential house based on the 4E and the 2+2+(1) IDEAs is a complex process that requires specialist knowledge of many trades and requires adaptation of comprehensive solutions. IDEA 4E assumes the use of energy-saving, ecological, ergonomics, and economic solutions. In addition, IDEA 2+2+(1) assuming appropriate surface and functional-spatial solutions for a family at different stages of a building's life, i.e. 2, 4, or 5 members, enforces certain flexibility of the designed building, which may change with the number and age of its users. The building should therefore be easy to rearrange or expand. The task defined in this way was carried out by an interdisciplinary team of students of the Silesian University of Technology as part of PBL. The team consisted of 6 undergraduate and graduate students representing the following faculties: 3 students of architecture, 2 civil engineering students, and 1 student of environmental engineering. The work of the team was supported by 3 academic teachers representing the above-mentioned faculties and additional experts. The project was completed in one semester. The article presents the successive stages of the project. At first pre-design studies were carried out. They allowed to define the guidelines for the project. For this purpose, the "Model house" questionnaire was developed. The questions concerned determining the utility needs of a potential family that would live in a model house - specifying the types of rooms, their size, and equipment. A total of 114 people participated in the study. The answers to the questions in the survey helped to build the functional programme of the designed house. Other research consisted in the search for optimal technological and construction solutions and the most appropriate building materials based mainly on recycling. Appropriate HVAC systems responsible for the building's microclimate were also selected, i.e. low, temperature heating, mechanical ventilation, and the use of energy from renewable sources was planned so as to obtain a nearly zero-energy building. Additionally, rainwater retention and its local use were planned. The result of the project was a design of a model residential building that meets the presented assumptions. A 3D VR spatial model of the designed building and its surroundings was also made. The final result was the organization of an exhibition for students and the academic community. Participation in the interdisciplinary project allowed the project team members to better understand the consequences of the adopted solutions for achieving the assumed effect and the need to work out a compromise. The implementation of the project made all its participants aware of the importance of cooperation as well as systematic and clear communication. The need to define milestones and their consistent enforcement is an important element guaranteeing the achievement of the intended end result. The implementation of PBL enables students to the acquire competences important in their future professional work.

Keywords: architecture and urban planning, civil engineering, environmental engineering, project-based learning, sustainable building

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Authors: Maayan Nakash

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The modern workplace is undergoing a revolution, with Generation Z (Gen-Z) at the forefront of this transformative shift. However, empirical investigations specifically targeting the workplace preferences of this generation remain limited. Through direct examination of their tendencies via a survey approach, this study offers vital insights for aligning organizational policies and practices. The results presented in this paper are part of a comprehensive study that explored Gen Z's viewpoints on various employment market aspects, likely to decisively influence the design of future work environments. Data were collected via an online survey distributed among a cohort of 461 individuals from Gen-Z, born between the mid-1990s and 2010, consisting of 241 males (52.28%) and 220 females (47.72%). Responses were gauged using Likert scale statements that probed preferences for teamwork versus individual work, virtual versus personal interactions, and open versus private workspaces. Descriptive statistics and analytical analyses were conducted to pinpoint key patterns. We discovered that a high proportion of respondents (81.99%, n=378) exhibited a preference for teamwork over individual work. Correspondingly, the data indicate strong support for the recognition of team-based tasks as a tool contributing to personal and professional development. In terms of communication, the majority of respondents (61.38%) either disagreed (n=154) or slightly agreed (n=129) with the exclusive reliance on virtual interactions with their organizational peers. This finding underscores that despite technological progress, digital natives place significant value on physical interaction and non-mediated communication. Moreover, we understand that they also value a quiet and private work environment, clearly preferring it over open and shared workspaces. Considering that Gen-Z does not necessarily experience high levels of stress within social frameworks in the workplace, this can be attributed to a desire for a space that allows for focused engagement with work tasks. A One-Sample Chi-Square Test was performed on the observed distribution of respondents' reactions to each examined statement. The results showed statistically significant deviations from a uniform distribution (p<.001), indicating that the response patterns did not occur by chance and that there were meaningful tendencies in the participants' responses. The findings expand the theoretical knowledge base on human resources in the dynamics of a multi-generational workforce, illuminating the values, approaches, and expectations of Gen-Z. Practically, the results may lead organizations to equip themselves with tools to create policies tailored to Gen-Z in the context of workspaces and social needs, which could potentially foster a fertile environment and aid in attracting and retaining young talent. Future studies might include investigating potential mitigating factors, such as cultural influences or individual personality traits, which could further clarify the nuances in Gen-Z's work style preferences. Longitudinal studies tracking changes in these preferences as the generation matures may also yield valuable insights. Ultimately, as the landscape of the workforce continues to evolve, ongoing investigations into the unique characteristics and aspirations of emerging generations remain essential for nurturing harmonious, productive, and future-ready organizational environments.

Keywords: workplace, future of work, generation Z, digital natives, human resources management

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Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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Authors: Benjamin Arazi

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Blockchain is the technology behind cryptocurrencies like Bitcoin. It revolutionizes the meaning of trust in the sense of offering total reliability without relying on any central entity that controls or supervises the system. The Wall Street Journal states: “Blockchain Marks the Next Step in the Internet’s Evolution”. Blockchain was listed as #1 in Linkedin – The Learning Blog “most in-demand hard skills needed in 2020”. As stated there: “Blockchain’s novel way to store, validate, authorize, and move data across the internet has evolved to securely store and send any digital asset”. GSMA, a leading Telco organization of mobile communications operators, declared that “Blockchain has the potential to be for value what the Internet has been for information”. Motivated by these seminal observations, this paper presents the foundations of a Blockchain-based “Internet of Assets” academic program that joins under one roof leading application areas that are characterized by the transfer of assets over communication lines. Two such areas, which are pillars of our economy, are Fintech – Financial Technology and mobile communications services. The next application in line is Healthcare. These challenges are met based on available extensive professional literature. Blockchain-based assets communication is based on extending the principle of Bitcoin, starting with the basic question: If digital money that travels across the universe can ‘prove its own validity’, can this principle be applied to digital content. A groundbreaking positive answer here led to the concept of “smart contract” and consequently to DLT - Distributed Ledger Technology, where the word ‘distributed’ relates to the non-existence of reliable central entities or trusted third parties. The terms Blockchain and DLT are frequently used interchangeably in various application areas. The World Bank Group compiled comprehensive reports, analyzing the contribution of DLT/Blockchain to Fintech. The European Central Bank and Bank of Japan are engaged in Project Stella, “Balancing confidentiality and auditability in a distributed ledger environment”. 130 DLT/Blockchain focused Fintech startups are now operating in Switzerland. Blockchain impact on mobile communications services is treated in detail by leading organizations. The TM Forum is a global industry association in the telecom industry, with over 850 member companies, mainly mobile operators, that generate US$2 trillion in revenue and serve five billion customers across 180 countries. From their perspective: “Blockchain is considered one of the digital economy’s most disruptive technologies”. Samples of Blockchain contributions to Fintech (taken from a World Bank document): Decentralization and disintermediation; Greater transparency and easier auditability; Automation & programmability; Immutability & verifiability; Gains in speed and efficiency; Cost reductions; Enhanced cyber security resilience. Samples of Blockchain contributions to the Telco industry. Establishing identity verification; Record of transactions for easy cost settlement; Automatic triggering of roaming contract which enables near-instantaneous charging and reduction in roaming fraud; Decentralized roaming agreements; Settling accounts per costs incurred in accordance with agreement tariffs. This clearly demonstrates an academic education structure where fundamental technologies are studied in classes together with these two application areas. Advanced courses, treating specific implementations then follow separately. All are under the roof of “Internet of Assets”.

Keywords: blockchain, education, financial technology, mobile telecommunications services

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Authors: Mumtaz Mooncey, Alexander Jolly, Megan Fisher, Kerry Robinson, Robert Lloyd, Dave Fielding

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Introduction: The integration of the WingFactors in-situ simulation programme has transformed the education landscape at the Whittington Health NHS Trust. To date, there have been a total of 90 simulations - 19 aimed at Paediatric trainees, including 2 Child and Adolescent Mental Health (CAMHS) scenarios. The opportunity for joint debriefs provided by clinical faculty and airline pilots, has created a new exciting avenue to explore human factors within psychiatry. Through the use of real clinical environments and primed actors; the benefits of high fidelity simulation, interdisciplinary and interprofessional learning has been highlighted. The use of in-situ simulation within Psychiatry is a newly emerging concept and its success here has been recognised by unanimously positive feedback from participants and acknowledgement through nomination for the Health Service Journal (HSJ) Award (Best Education Programme 2021). Methodology: The first CAMHS simulation featured a collapsed patient in the toilet with a ligature tied around her neck, accompanied by a distressed parent. This required participants to consider:; emergency physical management of the case, alongside helping to contain the mother and maintaining situational awareness when transferring the patient to an appropriate clinical area. The second simulation was based on a 17- year- old girl attempting to leave the ward after presenting with an overdose, posing potential risk to herself. The safe learning environment enabled participants to explore techniques to engage the young person and understand their concerns, and consider the involvement of other members of the multidisciplinary team. The scenarios were followed by an immediate ‘hot’ debrief, combining technical feedback with Human Factors feedback from uniformed airline pilots and clinicians. The importance of psychological safety was paramount, encouraging open and honest contributions from all participants. Key learning points were summarized into written documents and circulated. Findings: The in-situ simulations demonstrated the need for practical changes both in the Emergency Department and on the Paediatric ward. The presence of airline pilots provided a novel way to debrief on Human Factors. The following key themes were identified: -Team-briefing (‘Golden 5 minutes’) - Taking a few moments to establish experience, initial roles and strategies amongst the team can reduce the need for conversations in front of a distressed patient or anxious relative. -Use of checklists / guidelines - Principles associated with checklist usage (control of pace, rigor, team situational awareness), instead of reliance on accurate memory recall when under pressure. -Read-back - Immediate repetition of safety critical instructions (e.g. drug / dosage) to mitigate the risks associated with miscommunication. -Distraction management - Balancing the risk of losing a team member to manage a distressed relative, versus it impacting on the care of the young person. -Task allocation - The value of the implementation of ‘The 5A’s’ (Availability, Address, Allocate, Ask, Advise), for effective task allocation. Conclusion: 100% of participants have requested more simulation training. Involvement of airline pilots has led to a shift in hospital culture, bringing to the forefront the value of Human Factors focused training and multidisciplinary simulation. This has been of significant value in not only physical health, but also mental health simulation.

Keywords: human factors, in-situ simulation, inter-professional, multidisciplinary

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Authors: Casey Keenan Joiner, Shayna Tayloe

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Classical voice training for the novice singer has long relied on the guidance and instruction of vocalise collections, such as those written and compiled by Marchesi, Lütgen, Vaccai, and Lamperti. These vocalise collections purport to encourage healthy vocal habits and instill technical longevity in both aspiring and established singers, though their scope has long been somewhat confined to the classical idiom. For pedagogues and students specializing in other vocal genres, such as musical theatre and CCM (contemporary commercial music,) low-impact and pertinent vocal training aids are in short supply, and much of the suggested literature derives from classical methodology. While the tenants of healthy vocal production remain ubiquitous, specific stylistic needs and technical emphases differ from genre to genre and may require a specified extension of vocal acuity. As musical theatre continues to grow in popularity at both the professional and collegiate levels, the need for specialized training grows as well. Pedagogical literature geared specifically towards musical theatre (MT) singing and vocal production, while relatively uncommon, is readily accessible to the contemporary educator. Practitioners such as Norman Spivey, Mary Saunders Barton, Claudia Friedlander, Wendy Leborgne, and Marci Rosenberg continue to publish relevant research in the field of musical theatre voice pedagogy and have successfully identified many common MT vocal faults, their subsequent diagnoses, and their eventual corrections. Where classical methodology would suggest specific vocalises or training exercises to maintain corrected vocal posture following successful fault diagnosis, musical theatre finds itself without a relevant body of work towards which to transition. By analyzing the existing vocalise literature by means of a specialized set of parameters, including but not limited to melodic variation, rhythmic complexity, vowel utilization, and technical targeting, we have composed a set of vocalises meant specifically to address the training and conditioning of adult musical theatre voices. These vocalises target many pedagogical tenants in the musical theatre genre, including but not limited to thyroarytenoid-dominant production, twang resonance, lateral vowel formation, and “belt-mix.” By implementing these vocalises in the musical theatre voice studio, pedagogues can efficiently communicate proper musical theatre vocal posture and kinesthetic connection to their students, regardless of age or level of experience. The composition of these vocalises serves MT pedagogues on both a technical level as well as a sociological one. MT is a relative newcomer on the collegiate stage and the academization of musical theatre methodologies has been a slow and arduous process. The conflation of classical and MT techniques and training methods has long plagued the world of voice pedagogy and teachers often find themselves in positions of “cross-training,” that is, teaching students of both genres in one combined voice studio. As MT continues to establish itself on academic platforms worldwide, genre-specific literature and focused studies are both rare and invaluable. To ensure that modern students receive exacting and definitive training in their chosen fields, it becomes increasingly necessary for genres such as musical theatre to boast specified literature and a collection of musical theatre-specific vocalises only aids in this effort. This collection of musical theatre vocalises is the first of its kind and provides genre-specific studios with a basis upon which to grow healthy, balanced voices built for the harsh conditions of the modern theatre stage.

Keywords: voice pedagogy, targeted methodology, musical theatre, singing

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Authors: Irina Alexandra Paun, Mona Mihailescu, Marian Zamfirescu, Catalin Romeo Luculescu, Adriana Maria Acasandrei, Cosmin Catalin Mustaciosu, Roxana Cristina Popescu, Maria Dinescu

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A major concern in bone tissue engineering is to develop complex 3D architectures that mimic the natural cells environment, facilitate the cells growth in a defined manner and allow the flow transport of nutrients and metabolic waste. In particular, porous structures of controlled pore size and positioning are indispensable for growing human-like bone structures. Another concern is to monitor both the structures and the seeded cells with high spatial resolution and without interfering with the cells natural environment. The present approach relies on laser-based technologies employed for fabricating porous biomimetic structures that support the growth of osteoblast-like cells and for their non-invasive 3D imaging. Specifically, the porous structures were built by two photon polymerization –direct writing (2PP_DW) of the commercially available photoresists IL-L780, using the Photonic Professional 3D lithography system. The structures consist of vertical tubes with micrometer-sized heights and diameters, in a honeycomb-like spatial arrangement. These were fabricated by irradiating the IP-L780 photoresist with focused laser pulses with wavelength centered at 780 nm, 120 fs pulse duration and 80 MHz repetition rate. The samples were precisely scanned in 3D by piezo stages. The coarse positioning was done by XY motorized stages. The scanning path was programmed through a writing language (GWL) script developed by Nanoscribe. Following laser irradiation, the unexposed regions of the photoresist were washed out by immersing the samples in the Propylene Glycol Monomethyl Ether Acetate (PGMEA). The porous structures were seeded with osteoblast like MG-63 cells and their osteogenic potential was tested in vitro. The cell-seeded structures were analyzed in 3D using the digital holographic microscopy technique (DHM). DHM is a marker free and high spatial resolution imaging tool, where the hologram acquisition is performed non-invasively i.e. without interfering with the cells natural environment. Following hologram recording, a digital algorithm provided a 3D image of the sample, as well as information about its refractive index, which is correlated with the intracellular content. The axial resolution of the images went down to the nanoscale, while the temporal scales ranged from milliseconds up to hours. The hologram did not involve sample scanning and the whole image was available in one frame recorded going over 200μm field of view. The digital holograms processing provided 3D quantitative information on the porous structures and allowed a quantitative analysis of the cellular response in respect to the porous architectures. The cellular shape and dimensions were found to be influenced by the underlying micro relief. Furthermore, the intracellular content gave evidence on the beneficial role of the porous structures in promoting osteoblast differentiation. In all, the proposed laser-based protocol emerges as a promising tool for the fabrication and non-invasive imaging of porous constructs for bone tissue engineering. Acknowledgments: This work was supported by a grant of the Romanian Authority for Scientific Research and Innovation, CNCS-UEFISCDI, project PN-II-RU-TE-2014-4-2534 (contract 97 from 01/10/2015) and by UEFISCDI PN-II-PT-PCCA no. 6/2012. A part of this work was performed in the CETAL laser facility, supported by the National Program PN 16 47 - LAPLAS IV.

Keywords: biomimetic, holography, laser, osteoblast, two photon polymerization

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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: Enwin Anthony Dornubari, Visigah Kpobari Peter

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This research has developed a framework for the provision of sustainable and affordable housing to accommodate the low-income population of Greater Port Harcourt City. The objectives of this study among others, were to: examine UN-Habitat guidelines for acceptable and sustainable social housing provision, describe past efforts of the Rivers State Government and the Federal Government of Nigeria to provide housing for the poor in the Greater Port Harcourt City area; obtain a profile of prospective beneficiaries of the social housing proposed by this research as well as perceptions of their present living conditions, and living in the proposed self-sustaining social housing development, based on the initial simulation of the proposal; describe the nature of the framework, guideline and management of the proposed social housing development and explain the modalities for its implementation. The study utilized the mixed methods research approach, aimed at triangulating findings from the quantitative and qualitative paradigms. Opinions of professional of the built environment; Director, Development Control, Greater Port Harcourt City Development Authority; Directors of Ministry of Urban Development and Physical Planning; Housing and Property Development Authority and managers of selected Primary Mortgage Institutions were sought and analyzed. There were four target populations for the study, namely: members of occupational sub-groups for FGDs (Focused Group Discussions); development professionals for KIIs (Key Informant Interviews), household heads in selected communities of GPHC; and relevant public officials for IDI (Individual Depth Interview). Focus Group Discussions (FGDs) were held with members of occupational sub-groups in each of the eight selected communities (Fisherfolk). The table shows that there were forty (40) members across all occupational sub-groups in each selected community, yielding a total of 320 in the eight (8) communities of Mgbundukwu (Mile 2 Diobu), Rumuodomaya, Abara (Etche), Igwuruta-Ali(Ikwerre), Wakama(Ogu-Bolo), Okujagu (Okrika), Akpajo (Eleme), and Okoloma (Oyigbo). For key informant interviews, two (2) members were judgmentally selected from each of the following development professions: urban and regional planners; architects; estate surveyors; land surveyors; quantity surveyors; and engineers. Concerning Population 3-Household Heads in Selected Communities of GPHC, a stratified multi-stage sampling procedure was adopted: Stage 1-Obtaining a 10% (a priori decision) sample of the component communities of GPHC in each stratum. The number in each stratum was rounded to one whole number to ensure representation of each stratum. Stage 2-Obtaining the number of households to be studied after applying the Taro Yamane formula, which aided in determining the appropriate number of cases to be studied at the precision level of 5%. Findings revealed, amongst others, that poor implementation of the UN-Habitat global shelter strategy, lack of stakeholder engagement, inappropriate locations, undue bureaucracy, lack of housing fairness and equity and high cost of land and building materials were the reasons for the failure of past efforts towards social housing provision in the Greater Port Harcourt City area. The study recommended a public-private partnership approach for the implementation and management of the framework. It also recommended a robust and sustained relationship between the management of the framework and the UN-Habitat office and other relevant government agencies responsible for housing development and all investment partners to create trust and efficiency.

Keywords: development, framework, low-income, sustainable, social housing

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Authors: Stephanie Ann Houghton

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SDG-driven intercultural citizenship education through performing arts and history research, combined with dance-fitness development inspired by performing arts, can provide a third space in which performing arts, local history, and contemporary society drive educational and social development, supporting the performing arts in student-generated ways, reflecting their sense, priorities, and goals. Within a string of rugged volcanic peninsulas along the north-western coastline of the Ariake Sea, Kyushu, southern Japan, are found a range of traditional performing arts endangered in Japan’s ageing society, including Menburyu mask dance. From 2017, Menburyu culture and history were explored with Menburyu veterans and students within Houghton’s FURYU Educational Program (FEP) at Saga University. Through collaboration with professional fitness instructor Kazuki Miyata, basic Menburyu movements and concepts were blended into aerobics routines to generate Menburyu-Inspired Dance-Fitness (MIDF). Drawing on history, legends, and myths, three important storylines for understanding Menburyu, captured in students’ bilingual (English/Japanese) exhibition panels, emerged: harvest, demons and gods, and the Battle of Tadenawate 1530. Houghton and Miyata performed the first MIDF routine at the 22nd Traditional Performing Arts Festival at Yutoku Inari Shrine, Kashima, in September 2019. FEP exhibitions, dance-fitness events, and MIDF performance have been reported in the media locally and nationally. In an action research case study, a classroom research project was conducted with four female Japanese students over fifteen three-hour online lessons (April-July 2020). Part 1 of each lesson focused on Menburyu history. This included a guest lecture by Kensuke Ryuzoji. The three Menburyu storylines served as keys for exploring Menburyu history from international standpoints.Part 2 focused on the development of MIDF basic steps and an online MIDF event with outside guests. Through post-lesson reflective diaries and reports/videos documenting their experience, students engaged in heritage management, intercultural dialogue, health/fitness, technology and art generation activities within the FEP, centring on UN Sustainable Development Goals (SDGs) including health and wellness (SDG3), and quality education (SDG4), taking a glocal approach. In this presentation, qualitative analysis of student-generated reflective diary and reports will be presented to reveal educational processes, learning outcomes,and apparent areas of (potential) social impact of this classroom research project. Data will be presented in two main parts: (1) The mutually beneficial relationship between local traditional performing arts research and local history researchwill be addressed. One has the power both inform and illuminate the other given their deep connections. This can drive the development of students’ intercultural history competence related to and through the performing arts. (2) The development of dance-fitness inspired by traditional performing arts provides a third space in which performing arts, local history and contemporary society can be connected through SDG-driven education inside the classroom in ways that can also drive social innovation outside the classroom, potentially supporting the performing arts itself in student-generated ways, reflecting their own sense, priorities and social goals. Links will be drawn with intercultural citizenship, strengths and weaknesses of this teaching approach will be highlighted, and avenues for future research in this exciting new area will be suggested.

Keywords: cultural traditions, dance-fitness performance and participation, intercultural communication approach, mask dance origins

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Authors: Julie M. Novak, Simone K. Brennan, Lacey Brim

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Undergraduate medical education (UME) curriculum notably addresses micro-level communications (e.g., patient-provider, intercultural, inter-professional), yet frequently under-examines the role and impact of organizational communication, a more macro-level. Organizational communication, however, functions as foundation and through systemic structures of an organization and thereby serves as hidden curriculum and influences learning experiences and outcomes. Yet, little available research exists fully examining how students experience organizational communication while in medical school. Extant literature and best practices provide insufficient guidance for UME programs, in particular. The purpose of this study was to map and examine current organizational communication systems and processes in a UME program. Employing a phenomenology-grounded and participatory approach, this study sought to understand the organizational communication system from medical students' perspective. The research team consisted of a core team and 13 medical student co-investigators. This research employed multiple methods, including focus groups, individual interviews, and two surveys (one reflective of focus group questions, the other requesting students to submit ‘examples’ of communications). To provide context for student responses, nonstudent participants (faculty, administrators, and staff) were sampled, as they too express concerns about communication. Over 400 students across all cohorts and 17 nonstudents participated. Data were iteratively analyzed and checked for triangulation. Findings reveal the complex nature of organizational communication and student-oriented communications. They reveal program-impactful strengths, weaknesses, gaps, and tensions and speak to the role of organizational communication practices influencing both climate and culture. With regard to communications, students receive multiple, simultaneous communications from multiple sources/channels, both formal (e.g., official email) and informal (e.g., social media). Students identified organizational strengths including the desire to improve student voice, and message frequency. They also identified weaknesses related to over-reliance on emails, numerous platforms with inconsistent utilization, incorrect information, insufficient transparency, assessment/input fatigue, tacit expectations, scheduling/deadlines, responsiveness, and mental health confidentiality concerns. Moreover, they noted gaps related to lack of coordination/organization, ambiguous point-persons, student ‘voice-only’, open communication loops, lack of core centralization and consistency, and mental health bridges. Findings also revealed organizational identity and cultural characteristics as impactful on the medical school experience. Cultural characteristics included program size, diversity, urban setting, student organizations, community-engagement, crisis framing, learning for exams, inefficient bureaucracy, and professionalism. Moreover, they identified system structures that do not always leverage cultural strengths or reduce cultural problematics. Based on the results, opportunities for productive change are identified. These include leadership visibly supporting and enacting overall organizational narratives, making greater efforts in consistently ‘closing the loop’, regularly sharing how student input effects change, employing strategies of crisis communication more often, strengthening communication infrastructure, ensuring structures facilitate effective operations and change efforts, and highlighting change efforts in informational communication. Organizational communication and communications are not soft-skills, or of secondary concern within organizations, rather they are foundational in nature and serve to educate/inform all stakeholders. As primary stakeholders, students and their success directly affect the accomplishment of organizational goals. This study demonstrates how inquiries about how students navigate their educational experience extends research-based knowledge and provides actionable knowledge for the improvement of organizational operations in UME.

Keywords: medical education programs, organizational communication, participatory research, qualitative mixed methods

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