Clinical practice guidelines (CPGs) are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. CPGs’ recommendations have traditionally focused on informing clinicians and patients on the best options, i.e., supporting decisions that occur at the clinical encounter level. Considering all their advantages (a systematic and comprehensive review of the evidence, a multidisciplinary team assessing the evidence and balancing benefits and harms, and the additional considerations such as patients’ preferences, implementability and feasibility of interventions and their costs) CPGs have also become powerful tools to inform decisions and activities outside the clinical encounter. This, because the clinical encounter cannot be completely separated from other decisions that indirectly affect that level, such as those related to quality improvement activities and economic decisions in healthcare. Moreover, activities that are not directly related to the clinical encounter can benefit from CPGs, like education and licensing activities and research prioritization processes, or judicial decisions. The role of CPGs in all these activities has been neglected in the literature. In this study, I performed a critical interpretive synthesis of the literature to summarize the different roles CPGs play outside the clinical encounter and to understand how, and under what conditions CPGs are used in these roles. I also conducted an international survey to describe how frequent these roles exist, from the CPGs developers' perspectives. Lastly, I conducted a multiple case study to understand how and under what conditions CPGs play one of the main roles outside the clinical encounter (drug funding decisions), in two different settings (Colombia and Canada/Ontario). Based on the results, I developed a framework to describe and categorize the roles of CPGs outside the clinical encounter and to determine how and under what conditions CPGs are used in these roles. I highlighted the key areas that require additional methodological research and categorize the roles in main, secondary and unanticipated roles. I also described how international developers reported that CPGs play these roles and how these roles are part of their CPGs final aims in the second study. Lastly, in the case study, I revealed that CPGs were instrumentally used to inform one of the main roles, drug funding decisions, in the Colombian case, and they had a minor conceptual use in the case of Canada/Ontario. / Thesis / Doctor of Philosophy (PhD)

The purpose of the study was to evaluate the continuous improvement process of the Tennessee Center for Performance Excellence (TNCP). Results of surveys conducted annually by the TNCPE from postapplicants provided data from the state award applicants. Their responses offered indicators of satisfaction among different industry sectors (education, government, healthcare, manufacturing, nonprofit, and service) with the TNCPE services (criteria booklet, feedback report, site visit policy, TNCPE staff, and team of examiners). The survey data were obtained from the TNCPE office in Nashville, Tennessee in which award applicants were provided a series of survey questions. These questions involved the overall award program and the site visit experiences. Within the program award, data included 26 applicant responses while the site visit surveys included 107 applicant responses. In addition, an alpha level of .05 was used for all statistical tests. The major conclusions were: (1) there are differences in the industry sectors with the length of the site visit, team of examiners' team leader's leadership, and the clarity of the feedback report (control vs. influence). Other tests were not statistically significant.

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Bakgrund: Konkurrensen inom banksektorn har på senare tid ökat, då digitaliseringen av tjänster har möjliggjort för nya aktörer likt neobanker att etablera sig på marknaden. Kvaliteten på tjänsteerbjudandet har stor påverkan på tjänsteföretagens framgång på marknaden. För att möta kundernas ökande krav på kvalitet bör bankerna ha ett kontinuerligt kvalitetsförbättringsarbete. Det finns därför ett behov att undersöka hur bankkunder ser på kvalitet samt hur banker bör prioritera sitt förbättringsarbete. Syfte: Denna studie syftar till att utforska hur svenska bankkunder upplever tjänstekvaliteten på internetbanken. Syftet är också att utreda vilka delar av internetbanken svenska banker bör prioritera i sitt förbättringsarbete. Metod: Studien har antagit en kvantitativ forskningsstrategi med en tvärsnittsdesign. Forskningsansatsen var deduktiv. Datan samlades in genom en digital enkätstudie baserad på frågor SSTQUAL samt WebQual. Strukturen med frågor kring upplevd och faktisk tjänstekvalitet baserades på SERVQUAL-ramverket. Studien använde sig av partial least square structural equation modelling (PLS-SEM) samt importance performance matrix analysis (IPMA) för att analysera den insamlade datan. Resultat: Studiens resultat visar att dimensionerna Design samt Bekvämlighet uppvisar den högsta upplevda tjänstekvaliteten. Dimensionerna Kommunikation samt Information uppvisar den lägsta upplevda tjänstekvaliteten. Samtliga dimensioner har ett negativt tjänstekvalitetsgap, vilket indikerar att kundernas förväntningar är högre ställda än vad de upplever att internetbanken faktiskt levererar. Sett till prioriteringsordningen för bankernas förbättringsarbete föreslår studiens resultat följande ordning: 1. Innovation, 2. Kommunikation, 3. Information, 4. Design, 5. Funktionalitet, 6. Säkerhet och 7. Bekvämlighet. Kunskapsbidrag: Denna studie har bidragit till en ökad förståelse för vilka dimensioner av internetbankens tjänsteerbjudande som är viktiga för kunderna och hur kunderna upplever tjänstekvaliteten inom dessa dimensioner. För banker kan studien ge värdefulla insikter om hur kunderna ser på kvaliteten och vilka dimensioner som bör prioriteras i ett förbättringsarbete. / Background: Competition in the banking sector has increased in recent years because of the digitalization of services which has enabled new players like neobanks to enter the market. A company’s service offering has significant impact on the firm’s success. In order to meet customers’ increasing demands for quality service, banks should continuously improve their service offerings. Therefore, there is a need to investigate how bank customers view quality and how banks should prioritize their improvement efforts. Aim: This study aims to investigate how Swedish bank customers experience the quality of service on the internet bank. The purpose is also to analyze which parts of the internet bank Swedish banks should prioritize in their improvement efforts. Methodology: The study has adopted a quantitative research strategy with a cross-sectional design. The research approach was deductive. The data was collected through a digital survey based on questions from the SSTQUAL and WebQual frameworks. The study's survey questions about perceived and actual quality of service were based on the SERVQUAL framework. The study used partial least square structural equation modeling (PLS-SEM) and importance-performance matrix analysis (IPMA) to analyze the collected data. Results: The study results show that the dimensions of Design and Convenience have the highest perceived quality of service. The dimensions Communication and Information show the lowest perceived quality of service. All dimensions have a negative service quality gap, which indicates that customer expectations are higher than what they feel the internet bank delivers. Regarding the order of priority for the banks' improvement efforts, the study results suggest the following order: 1. Innovation, 2. Communication, 3. Disclosures, 4. Design, 5. Functionality, 6. Security and 7. Convenience. Research contribution: This study has contributed to an increased understanding of which dimensions of the internet bank's service offering that are fundamental to customers and how customers experience the quality of service within these dimensions. The study provides valuable insights into how customers view quality and which dimensions banks should prioritize in its improvement efforts.

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Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience. As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research was interested in understanding students’ perceptions of virtual and in-person experiential learning activities. The primary goal of this study is to compare medical students’ perceptions of the quality and value of in-person versus virtual experiential learning during their pediatric clerkship.

Large Scale Additive Manufacturing (LSAM) technology has emerged as a transformative force in the manufacturing industry. Using robots and advanced material deposition systems, LSAM facilitates the efficient creation of large-scale components with exceptional precision and reduced production times. Beyond its capacity to manufacture complex structures, this technology drives innovation by fostering the exploration of new materials and designs, opening new frontiers in the aerospace, automotive, and construction sectors. The synergy between robotics and additive manufacturing in LSAM represents a significant advancement toward the future of manufacturing, where customization, efficiency, and sustainability are paramount.  Within the framework of this research, conducted in collaboration with ABB and RISE, a series of tests have been developed to optimize printing parameters when transitioning from one material to another. This study showcases how simple adjustments in the workflow of robotic stations can lead to significant improvements in print quality and increased resource efficiency, paving the way for more precise and sustainable manufacturing.  This research has not only generated valuable insights into the behavior of LSAM under different operating conditions but also provided practical solutions for its continuous improvement. These findings are relevant for the continuous improvement of large-scale additive manufacturing processes and provide important insights for future research in the fields of robotics and advanced manufacturing. Additionally, a systematic methodology has been developed to evaluate and validate results, ensuring the reliability and reproducibility of findings. These achievements solidify the role of LSAM as a fundamental technology in the evolution of the manufacturing industry toward a more efficient and sustainable future.

This research focuses on assessing the extent to which the Principles of Aid Effectiveness were followed and translated into action by taking the General Education Quality Improvement Programme (GEQIP) in Ethiopia as an example. Outcomes of the secondary reviews conducted on the selected government institutions and development partners documents demonstrate that these Principles are taken as overarching strategies to guide the undertakings on GEQIP. The study attests that a number of factors influence the realization of aid effectiveness in Ethiopia. These include, at the recipient level, existence of strong national development plans while demanding improvement on absorptive capacity. At the level of development partners, compliance with pledges made on the provision of resources and better coordination is needed. A common country framework to guide the aid effectiveness process including mutual accountably is important. The study most importantly identifies that beyond sector specific reviews, emphasis should also be given to assess the contribution of the Principles of Aid Effectiveness for efficient delivery of support to the GEQIP. / Development Studies / M.A. (Development Studies)