Background: Accrual of continuing medical education credits is part of licensure in family medicine but opinions are mixed as to whether the training has an impact on clinical practice. Literature does suggest that practice change is most likely when training involves multiple interactive exposures, and when the benefit to patients is apparent. Aim: To determine whether an interactive peer-lead educational intervention for General Practitioners in British Columbia, the Practice Support Program Mental Health Module, resulted in measureable change in clinical practice of the Vancouver Island participants. Method: Administrative information from British Columbia Ministry of Health databases was obtained for analysis regarding physician billing and prescribing, and hospitalizations on Vancouver Island. Paired t-tests were used to compare physician-patient interactions among module participants before and after the training regarding a) initiation of antidepressants and anti-anxiety medication, and b) use of the mental health plan billing code, used to support patients who struggle with activities of daily living. In addition, mental health hospitalizations among participants' patients before and after training were used to measure its impact on patient outcomes. Results: One-hundred and ninety-seven General Practitioners on Vancouver Island completed the mental health module between 2008 and 2011. While no significant difference was found in the numbers of mental health patients seen during the pre- and post- periods (M=142.06, SD=97.45) and (M=144.44, SD=103.00); t(196)=-0.679, p=0.498, α=.05, the change in the proportion of new prescriptions between pre-period mean (M=0.0796, SD=.06527) and post-period means (M=.0530, SD=.03877); t(195)=6.668, p<0.001 was found to be significant and indicative of a relative decrease between 31.2 and 33.4%. The change in the proportion of mental health plans was also found to be significant between pre-period (M=0.1142, SD=.018598) and post-period means (M=.1674, SD=.23973); t(180)=-3.586, p<0.001. This indicated a relative increase between 42.0 and 46.6%. No significant change in patient hospitalizations was found between the pre- and post-period means: (M=0.039, SD=.0612) and (M=.0392, SD=.0978); t(192)=-0.055, p=0.956. Conclusion: This educational intervention appears to have resulted in significant changes in the practice patterns of the physician participants. Future research using better indicators may reveal more about the impact of physician training on patient outcomes. / Graduate

La formation professionnelle continue (FPC) s'est largement développée depuis les années 2000 et les salariés souhaitant maintenir leur employabilité n'ont d'autre choix que de participer à des formations, volontairement ou par obligation, cette dernière situation étant répandue. Mais, selon Deci et Ryan (2000), en cas de régulation externe la personne a moins tendance à s’engager. Nous nous interrogeons sur les processus individuels dans cette situation. Dans le cadre de la psychologie sociocognitive avec le modèle de la causalité triadique réciproque (Bandura, 1985), nous recourons aux concepts de valeur perçue de la formation (Eccles et Wigfield, 1989), d'engagement (Bourgeois, 2009 et Brault-Labbé et Dubé, 2009) et d’apprenance (Carré, 2005). Nous menons deux études empiriques. La première est basée sur des entretiens non directifs (n = 91) dont les verbatim font l’objet d’une analyse thématique manuelle complétée par une analyse lexicométrique. La seconde s’appuie sur la diffusion d’un questionnaire auprès d’un échantillon aléatoire (n = 581) et nous effectuons une analyse factorielle des correspondances des réponses. Ces études montrent l'influence de la valeur perçue sur l'engagement, ce dernier n'étant affecté qu’à la marge par la perception du statut obligatoire. Ainsi, le processus d’intériorisation décrit par Deci et Ryan (2000) peut se déplier en situation de régulation initiale exclusivement externe. En outre, la valeur perçue de la formation renforce la légitimité perçue du statut obligatoire. De plus, les stagiaires possédant une apprenance élevée justifient autant leur engagement que leur désengagement. Enfin, ceux dotés d’une apprenance plutôt fragile en situation formelle développent plus que les autres la composante comportementale de l’engagement. / Continuing vocational training (CVT) has largely developed since the 2000s and employees wishing to remain competitive in their field are required to participate in training courses, on a voluntary or mandatory basis, the latter situation being widespread. But according to Deci and Ryan (2000), in the case of external regulation, the person is less involded. We wonder about the individual processes in such a situation. In the framework of sociocognitive psychology with the model of reciprocal triadic causality (Bandura, 1985), we use the concepts of perceived value of training (Eccles and Wigfield, 1989), commitment (Bourgeois, 2009 and Brault-Labbé and Dubé, 2009) and learnance (Carré, 2005). We perform two empirical studies. The first is based on non-directive interviews (n = 91) and we conduct a thematic analysis and a lexicometric analysis on verbatim. The second is based on a questionnaire with a random sample (n = 581) and we perform a factorial correspondence analysis on the responses. These studies show the influence of the perceived value of training courses on the commitment, which is only marginally affected by perceived mandatory status. Thus, the internalization process described by Deci and Ryan (2000) can arise in a situation of exclusively external initial regulation. Furthermore, the perceived value of training courses supports perceived legitimacy of mandatory status. In addition, trainees with a high learnance justify both their commitment and their disengagement. Finally, those with a low disposition to learn in a formal situation develop the behavioral component of commitment more than others.

Essa dissertação de mestrado teve por objetivo analisar as experiências em gênero e diversidade sexual, com base em narrativas de professores e professoras que realizaram o curso Gênero e Diversidade na Escola (GDE). Buscou-se compreender, também, os processos de comprometimento com o tema no que tange à quebra do silenciamento dos temas gênero e diversidade sexual imposto nos âmbitos social, acadêmico e escolar. Desse modo, pretende-se contribuir com o debate sobre a formação docente em gênero e diversidade sexual, por meio da discussão da formação continuada oferecida no GDE. O GDE examinado foi oferecido pela UNESP campus de Rio Claro na cidade de Jaú, interior de São Paulo. A formação foi ofertada aos (as) professores (as) da educação básica da rede eestadual e da rede municipal duas vezes entre 2009 e 2010. Nessa pesquisa, são analisadas as discussões, realizadas em fóruns, e os memoriais entregues por 30 professores-cursistas de uma turma do polo de Jaú, no ano de 2009. Por meio de uma análise qualitativa e do método da análise de prosa (ANDRÉ, 1983), essa pesquisa analisa as marcas da experiência em gênero e diversidade sexual que esses (as) professores (as) revelaram durante o curso. Com base nos estudos de Jorge Larrosa (2002, 2011) examina-se o GDE enquanto experiência e verifica-se como essa experiência criou comprometimentos dos sujeitos envolvidos com o tema e deixou marcas em seu pensar e agir. Tais marcas revelaram que os (as) professores (as) buscaram a formação por meio de diferentes aspirações relacionadas a duas dimensões de comprometimento com o tema, a dimensão pessoal e a profissional. Desse modo, a pesquisa revela que a maneira pela qual cada um (uma) apreendeu os conceitos do curso e (trans)formou sua subjetividade a partir das reflexões realizadas foi única, tendo diferentes intensidades. Revelou, ainda, que os processos pelos quais se consolidam e reelaboram os próprios conceitos sobre gênero e diversidade sexual são contraditórios e marcados por pausas, avanços ou retrocessos. Contudo, o GDE demonstra ser um impulsionador para a reflexão acerca do gênero e da diversidade sexual, revelando ter potencial para iniciar (trans)formações das práticas escolares relacionadas a essas questões. / The purpose of this dissertation is to analyze the experiences on gender and sexual diversity based on narratives of teachers who attended the training program Gênero e Diversidade na Escola (Gender and Sexual Diversity) GDE. Additionally, I seek to understand the process of commitment to the issue considering the breach of the silence imposed in social, academic and school contexts about gender and sexual diversity. I intend to contribute to the debate about teachers training on gender and sexual diversity by discussing the continuing education offered by GDE. The training was offered twice between 2009 and 2010 to basic education teachers working in both city and state public education networks. In this research I analyze discussions held in forums and memorials written by 30 teachers who attended the course in Jaú São Paulo State, in 2009. Through qualitative research and prose analysis method (André, 1983), this investigation examines traces of experience in gender and sexual diversity revealed by teachers during the course. Based on Jorge Larrosas work (2002, 2011), I investigate GDE teachers training program as an experience, trying to explore the ways this experience constructed teachers commitments to the issue as well as what traces it may have left on their thinking and action abilities. Such traces indicated that teachers looked for this particular course inspired by different desires basically relating to two dimensions of commitment to the issue, the personal and the professional dimensions. Therefore the research indicates that the way each teacher learned the concepts discussed in the course - and transformed his/her subjectivity - was unique and had different levels of intensity. Results show that the process through which teachers consolidate and resignify their own concepts of gender and sexual diversity are contradictory and characterized by breaks, advances or regressions. However, GDE appears to promote the reflection about gender and sexual diversity, pointing out its potential to start off transformation of school practices on these issues.

In spite of a 2009 memorandum from senior Air Force leaders calling for civilian employees to participate in nonresident Professional Military Education (PME) courses, employees' PME completion rates have remained low. This qualitative study investigated the perceptions of nonresident PME held by 12 employees at an installation with a nonresident PME completion rate of less than 3% in 2013. The theories of reasoned action and planned behavior guided the 5 main questions that asked participants to describe their familiarity with nonresident PME course content, availability, and structure; as well as their perceptions of organizational support for PME course participation, their capacity to complete PME courses, the role of nonresident PME in their leadership development, and the importance of PME completion for attaining their career goals. The data were manually coded and organized according to the emergent themes and subthemes. None of the participants identified any external barriers to nonresident PME completion, but factors such as supervisor support, prior participation in enlisted PME, personal interest in PME course content, and inconsistent hiring practices influenced participants' perceptions of nonresident PME for their professional development and career progression. The findings and prior research suggest the Air Force should educate PME eligible civilians regarding the benefits of nonresident PME, conduct focus groups to discover employees' specific learning needs, and assist supervisors in establishing effective mentoring relationships. These actions have the potential to enhance employee motivation, to align employee development with organizational goals and objectives, and to increase supervisor-subordinate collaboration.

The ability to apply and follow mathematical reasoning is an ability students should develop according to Curriculum for the compulsory school, preeschool class and the leisure- time centre 2011. The purpose of this survey was to find out how teachers in compulsory school and preeschool class work with the ability to apply and follow mathematical reasoning. I was also interested in investigating if participation in continuing professional development in mathematics influence the teachers way of working with the students. The survey consisted of six qualitative interviewees in which three of the interviewees were part of continuing professional development in didactics for teachers educating mathematics. The result showed that all interviewees consider that it is importent to communicate mathematics, both between students as well as between teachers and students. The teachers included in continuing professinonal development showed a clear consciousness in their work to reason and follow mathematical reasoning. However, among some interviewees the consiousness appeared to come from their experience and which reflects their way of working. The student's age and how far they have developed their language also appeared to be significance to how capable they are of reasoning. The teachers analyze the ability to apply and follow mathematical reasoning, it's meaning and usage, differently.

This study investigated the effectiveness of staff training and development programmes and policies at the Unisa Library. The aim of the study was to establish how staff training and development needs were met and also how staff felt about the centralisation of the Human Resources Department. Self-administered questionnaires were distributed among the Unisa Library staff including the Unisa Branch Libraries. Interviews with four divisional managers were also conducted. Staff development is an ongoing process that, by means of a systematic approach, serves to orient, train, and develop each member of the library staff to work together and to serve their customers with the skills necessary to deliver a quality service. As a result, training can be viewed as an essential vehicle to efficient and effective performance by staff and also as a process that develops the skills, awareness or expertise of staff. This is important for both professional and non-professional employees. Chapter one of this dissertation provided the orientation of this study. Chapter two looked at how the study was conducted, including the research design and methods. Chapter three provided information on the legal aspects of training and development in the workplace and what employees need to be aware of and to know. Chapter four dealt with staff training and development and a literature survey. Chapter five gave an analysis and interpretation of the research findings. Chapter six described the situation at Unisa with respect to staff training and development, while in chapter seven recommendations were made based on the findings of this study. It was found that the personal development of staff was hindered as only job - related training is supported by the Library's STD workgroup. It is recommended that a training needs analysis be compiled in the Library based on the individual staff training requirements expressed during annual performance appraisals. Fifty percent of the staff who were surveyed thought it was good to centralise the Human Resources Department. / Information Science / M. A. (Information Science)

A Educação Permanente à Saúde (EPS) é um importante instrumento para garantir qualidade do cuidado em Atenção Primária à Saúde (APS). O Projeto Telessaúde RS objetiva avaliar as necessidades em EPS e qualificar a APS por meio de ferramentas de teleducação e teleassistência. Objetivo: Avaliar necessidades em EPS percebidas por médicos das equipes de Saúde da Família dos municípios participantes do Projeto Telessaúde RS. Método: Estudo transversal do censo de profissionais médicos de equipes da Estratégia Saúde da Família (ESF) de 32 municípios do Rio Grande do Sul e Estudo Delphi de docentes de disciplinas em APS, preceptores de Residências de Medicina de Família e Comunidade, pesquisadores, gestores e profissionais da APS do Rio Grande do Sul. Resultados: Os temas em EPS com maior necessidade percebida estão associados às áreas de saúde mental, doenças cardiovasculares e outras doenças crônico-degenerativas como Hipertensão e Diabetes. Observa-se concordância de leve à moderada (Kappa 0,2- 0,5) entre as necessidades em EPS de médicos do Projeto Telessaúde e o consenso do Estudo Delphi. A satisfação com o salário e a formação em Medicina de Família estão associados com maior concordância (p<0,05). Há pobre concordância entre necessidades percebidas e causas de internações por condições sensíveis à APS (ICSAP) mais freqüentes. Conclusão: O estudo Delphi constitui-se em ferramenta de apoio para condução de políticas de EPS. A avaliação da efetividade da APS por meio das ICSAPs deve ser incluída no processo de planejamento do cuidado em APS pelas equipes. / The Continuos Professional Development (CPD) is an important instrument to guarantee quality of care in Primary Health Care (PHC). The Telessaúde Project objective to evaluate the necessities in PHE and to qualifying the PHC through teleeducation tools and teleassistance. Goals: To evaluate necessities in CPD perceived by medical doctors of the Family Health teams of participant cities of the Telessaúde RS Project. Method: Crosssectional study with census of medical professionals of Family Health Strategy teams (FHS), within 33 cities of the Rio Grande do Sul and Delphi study with professors of disciplines about PHC, preceptores of residences of family practice, researchers, managers and medical professionals of Rio Grande do Sul PHC. Results: The subjects in CPD with major perceived necessity are associates to areas of mental health, cardiovascular disease and others chronic degenerative diseases like Diabetes and Hypertension . We observed fair to moderate agreement (Kappa 0,2-0,5) between the necessities in CPD of Telessaúde Project doctors and the consensus of Delphi Study. The wage satisfaction and the Family Medicine Graduate were associated with major agreement (p< 0,05). Poor agreement was detected between perceived necessities and Hospitalizations for ambulatory care Sensitive conditions (HACSC) more frequent. Conclusion: The Delphi study, consists in a tool of support for conduction of PHE policies. The evaluation of the effectivity of the PHC by through of the HACSC must be enclosed in the process of planning the PHC care. / Telemedicina

This study focussed on teacher training in the context of distance education. It investigated the impact on practice of an English methodology course offered by Unisa’s Department of English Studies at certificate level. The unit of analysis was a group of eight student teachers registered for the module ACEEN26 Teaching English: General Principles offered by Unisa’s Department of English Studies. This module aims to help students to understand the approaches that underpin Outcomes-based Education (OBE) and how these translate into practice in the English First Additional Language (FAL) classrooms. To investigate the participants’ classroom practices, the study adopted an open and inductive approach aimed at gauging their thinking with regard to teaching, learning, assessment and how these understandings reflected OBE practices. The aim was to determine how the eight students made sense of this phenomenon given their own epistemologies within the unique contexts in which they worked. Data collection consisted of a mix of lesson observations, in-depth audio-taped interviews and analysis of documents. The interview was the main data-gathering technique. All these instruments were supplemented by field notes based on informal observations which were entered in a reflective journal. The picture that emerged was of teachers who worked under demanding conditions as they tried to implement complex and sometimes contradictory policies and were constantly under the pressure of policy demands. Their practices were, to a large extent, inconsistent with the OBE approach to teaching and learning. Although they gained some theoretical surface knowledge from the course, the students’ practice remained traditional because of two main reasons emanating from the findings: their inability to internalise the theory to make it an integral part of their mental repertoire and the negative impact of disabling contextual factors.The study constituted an evaluation of the course and therefore fed directly into the whole concept of dialogue and student support which are necessary prerequisites for success in distance education. As a teacher educator, this research was also a way of illuminating my teaching practices through practical research that simultaneously informs the field of teacher education. Based on the training needs identified, a re-contextualised curriculum for the ACE English programme was proposed. This proposed new programme reflects my stance that instead of continuing to focus on pouring resources into dysfunctional schools, we should concentrate on the lowest denominator in the system — the teacher. / Educational Studies / D. Litt. et Phil (English)

The purpose of this study was to explore the practices, perceptions and needs of nurses in relation to their participation in continuing professional development. A quantitative descriptive study was conducted guided by Knowles’ Adult Learning Theory as the conceptual framework. Data collection was done using a structured self-administered questionnaire with a sample of 178 nurses. The findings revealed that the respondents perceived continuing professional development as important. However the study found minimal involvement of nurses during the initial stages of designing continuing professional development programmes and this may lead to incorrect identification of learning needs. Personal, organisational and professional factors were identified as barriers to nurses’ participation in continuing professional development. Preparation of nurses in advance and the use of teaching strategies that recognise past experience and adults as resources were found to increase nurses’ participation in continuing professional development programmes / Health Studies / M.A. (Health Studies)

The study sought to gain an in-depth understanding of the knowledge and skills regarding rehabilitation of mental health care users of nurses who work at a psychiatric rehabilitation centre, in order to design a continuing professional development plan for registered and enrolled nurses. The researcher used a qualitative, exploratory descriptive design to explore the knowledge and skills of nurses who practise in a psychiatric rehabilitation centre dealing with the rehabilitation of mental health care users. Four themes emerged from the data that were collected from four focus groups: knowledge of the rehabilitation process; the need for continuing professional development; nursing skills required for the implementation of psychiatric rehabilitation and means of communication within psychiatric rehabilitation. The researcher devised a continuing professional development plan, including topics on the management of the mentally ill, the problems associated with mental illness and rehabilitation appropriate to the mental illness. / Health Studies / M. A. (Health Studies)