Student problem behavior continues to be a major issue in schools for both teachers and students. Teachers often feel they are not provided with enough resources to help them manage this problem behavior. Students who engage in problem behavior tend to struggle socially and academically. When classified with an emotional disturbance, students are especially at risk due to the severity of the problem behavior they exhibit (Brauner & Stephens, 2006). This study examined how function-based interventions can help both teachers and students better manage the effects of problem behavior. There are several factors believed to hinder the effectiveness of function-based interventions, including time available, training, parental involvement, and fidelity of implementation (Ingram et al., 2005). The study used the critical incident technique (CIT) qualitative methodology to identify helping and hindering factors in the implementation of behavior intervention programs (BIP). Participants of the study include BIP implementers, defined as any school personnel who directly participates in the implementation of an effective BIP with a student. Using the CIT qualitative methodology and semi-structured interviews, the research team determined which events are most prevalent in the hindering and helping of BIP implementation. Research concluded that ongoing collaboration with colleagues, in- and out-of-class support, consistent data tracking, reward systems, calming down strategies, and relationships were the most helpful factors reported by teachers. Unexpected events, severity of behaviors, inconsistent reward systems, differing opinions amongst team members, inconsistent communication, and insufficient training were factors that hindered BIP efficacy based on the results of this study. The findings suggest that the implementation of BIPs can be improved with greater consistency in consequences, clear communication among stakeholders, and building meaningful relationships of trust.

No description available.

Remote usability evaluation is a usability evaluation method (UEM) where the experimenter, performing observation and analysis, is separated in space and/or time from the user. There are several approaches by which to implement remote evaluation, limited only by the availability of supporting technology. One such implementation method is RECITE (the REmote Critical Incident TEchnique), an adaptation of the user-reported critical incident technique developed by Castillo (1997). This technique requires that trained users, working in their normal work environment, identify and report critical incidents. Critical incidents are interactions with a system feature that prove to be particularly easy or difficult, leading to extremely good or extremely poor performance. Critical incident reports are submitted to the experimenter using an on-line reporting tool, who is responsible for their compilation into a list of usability problems. Support for this approach to remote evaluation has been reported (Hartson, H.R., Castillo, J.C., Kelso, J., and Neale, W.C., 1996; Castillo, 1997). The purpose of this study was to quantitatively assess the effectiveness of RECITE with respect to traditional, laboratory-based applications of the critical incident technique. A 3x2x 5 mixed-factor experimental design was used to compare the frequency and severity ratings of critical incidents reported by remote versus laboratory-based users. Frequency was measured according to the number of critical incident reports submitted and severity was rated along four dimensions: task frequency, impact on task performance, impact on satisfaction, and error severity. This study also compared critical incident data reported by trained users versus by usability experts observing end-users. Finally, changes in critical incident data reported over time were evaluated. In total, 365 critical incident reports were submitted, containing 117 unique usability problems and 50 usability success descriptions. Critical incidents were classified using the Usability Problem Inspector (UPI). A higher number of web-based critical incidents occurred during Planning than expected. The distribution of voice-based critical incidents differed among participant groups: users reported a greater than expected number of Planning incidents while experts reported fewer than expected Assessment incidents. Usability expert performance was not correlated, requiring that separate analyses be conducted for each expert data set. Support for the effectiveness in applying critical incidents to remote usability was demonstrated, with all research hypotheses at least partially supported. Usability experts gave significantly different ratings of impact on task performance than did user reporters. Remote user performance versus laboratory-based users failed to reveal differences in all but one measure: laboratory-based users reported more positive critical incidents for the voice interface than did remote users. In general, the number of negative critical incidents decreased over time; a similar result did not apply to the number of positive critical incidents. It was concluded that RECITE is an effective means of capturing problem-oriented data over time. Recommendations for its use as a formative evaluation method applied during the latter stages of product development (i.e. when a high fidelity prototype is available) are made. Opportunities for future research are identified. / Master of Science

This study was designed to determine the ability of the Critical Incident Technique (CIT) to advise changes to training regiments offered to Resident Advisers (RAs). The CIT was devised as a tool in the field of organizational psychology. Its purpose is to assist in analyzing the success of individual team members by examining the self-reported occurrence of incidents on the job, which are deemed critical. The Critical Incident Technique has been implemented with success in business and military applications. This powerful tool allows researchers to make valuable observations about the realities faced by individuals on the job. These observations make it possible to devise and improve existing training methods capitalizing on these realities. Data for this study came from an examination of incident reports (IRs). RAs generate IRs in response to different kinds of issues faced working with resident college students. Three regional institutions agreed to participate in this study and helped to diversify the data collected. This study addresses the following questions: What are the critical incidents RAs experience most often on the job? Is there a difference between the critical incident types reported in residence halls by institutional type? Is there a difference between the critical incident types reported by hall types? Is there a difference between the critical incident types reported by gender? What implications do the findings have for future RA training? Four types of demographic information were collected from the IRs: institution type (large public, midsize public, and small private), hall type (male, female, or coed), RA gender, and incident type. Conducting a survey of the literature concerning RA training and the CIT, generated five general categories of incidents on which RAs report. Crisis situations Policy enforcement Facilities management Administrative procedures Advising Specific measures including coding, and excision of sensitive information (such as sexual assaults sexual identity situations) from documents were used to protect the confidentiality and anonymity of the parties involved. When data collection was complete, a chi-squared test of significance was used to examine the relationships between the incident types reported and each of the other three variables (gender, institution type, and hall type). After analyzing the data using the statistical research methods described above, it was possible to make recommendations for future RA training. This study examines the impact of institutional environment, department philosophy, and personal bias on the training of RAs. The results suggest that each of these factors influences the success of RAs, and defines the environments in which resident students live. / Master of Arts

How to best conduct a mentoring relationship has been confounded by the lack of a consistent definition of “mentoring” and the scarcity of studies addressing how to achieve a positive outcome. This study contributes new, operationalized definitions of “mentoring,” “mentor,” and “protégé,” and a modified version of the Critical Incident Technique and the Enhanced Critical Incident Technique, called the Adapted Critical Incident Technique (ACIT), which is more consistent with a qualitative methodology. The researcher interviewed 18 self-described mentors and protégés to obtain 207 quotes about what critical behaviours helped or hindered mentoring relationship outcomes. Independent judges confirmed the placement of quotes into 13 categories of behaviours that helped mentors and protégés to reach the mentoring goals and 10 categories of behaviours that hindered the mentoring outcome. The findings contribute to an increased understanding of the foundation upon which mentors and protégés in all fields may potentially build better programs and training under the guise of mentorship. / Graduate / 2018-12-01

Bakgrund: Sjuksköterskor driver självständigt egna mottagningar inom primärvården. Det bidrar till ökad livskvalité och hälsa för patienter. När en sjuksköterskeledd mottagning ställs in kan såväl patientens situation som sjuksköterskans arbetssituation påverkas. Det var därför angeläget att undersöka hur sjuksköterskor erfar och hanterar när sjuksköterskeledd mottagning ställs in.    Syfte: Syftet var att beskriva hur sjuksköterskor erfar och hanterar kritiska incidenter vid inställd sjuksköterskeledd mottagning inom primärvården.    Metod: En kvalitativ studie med Critical Incident Technique (CIT) genomfördes med induktiv ansats där 28 sjuksköterskor som är yrkesverksamma inom primärvården i Region Skåne besvarade utformat frågeformulär.    Resultat: Sjuksköterskorna erfor att inställda sjuksköterskeledda mottagningar skapade merarbete. De beskrev stress, irritation, ilska men även till viss del förståelse. Inställd sjuksköterskeledd mottagning drabbade inte bara patienterna utan även deras anhöriga samt sjuksköterskestudenter. Sjuksköterskorna hanterade inställd sjuksköterskeledd mottagning genom att de prioriterade sitt arbete och att de använde sin yrkeserfarenhet för att lösa situationen. De anpassade sig till underbemanningen och lyfte detta i arbetsgruppen för att förbättra arbetsmiljön.   Slutsats: Region Skåne hade arbetsvilliga och kompetenta sjuksköterskor. När sjuksköterskeledd mottagning ställdes in fick patienterna minskad kontinuitet och ibland fördröjd diagnossättning. Detta berodde till stor del på underbemanning inom primärvården och arbetsgivaren kunde inte ge den arbetsmiljö som sjuksköterskorna behövde. / Background: Nurses independently run their own clinics within primary care. It contributes to increased lifequality and health for patients. When a nurse-led clinical appointments is cancelled, both the patient situation and the nurse's work situation can be affected. Therefore, important to investigate how nurses experience and manage when nurse-led clinical appointments are cancelled. Purpose: The purpose was to describe how nurses experience and handle critical incidents during cancelled nurse-led clinical appointments in primary care.       Method: A qualitative study with the Critical Incident Technique (CIT) was carried out with an inductive approach where 28 nurses who are professionals in primary care in Region Skåne answered a designed questionnaire.   Results: The nurses' experience of cancelled nurse-led clinical appointments was that it created extra work. They described stress, irritation, anger but also to some extent understanding. Cancelled nurse-led appointments affected not only the patients but also their relatives and nursingstudents. The nurses managed cancelled nurse-led appointments by prioritizing their work and using their professional experience to resolve the situation. They adapted to the understaffing and raised this in the work group to improve the work environment.     Conclusion: Region Skåne had willing and competent nurses. When nurse-led clinical appointments were cancelled, patients experienced reduced continuity and sometimes delayed diagnosis. This was largely due to understaffing in primary care and the employer could not provide the working environment that the nurses needed.

Introduction: Incident reporting systems have been implemented in health care for over a decade and contain reports of critical incidents (CI). These must be analyzed in order to suggest, implement and evaluate solutions for minimizing the risk of future CIs to occur, thereby increasing patient safety. Drug-related CIs (DRCI) are one type of CI which may represent up to 1/3rd of all CIs, therefore this CI-type is characterized in this study. Aim: To categorize and characterize DRCIs reported in the Critical Incident Reporting System North Rhine-Westphalia (CIRS-NRW). Materials & Methods: In this explorative, retrospective, descriptive study, 553 reports from the CIRS-NRW, reported between the 1st of January 2019 and the 15th of September 2021, were analyzed. These were categorized by setting, medication use process stage, ATC-code, patient age and look-alike, sound-alike (LASA), and then analyzed via descriptive statistics. Various subgroup analyses were also conducted. Results: DRCIs occurred mostly in the hospital (48,5%) and pharmacy (40,7%) settings, during the prescribing (33,8%) and administration (33,5%) of drugs and the ATC-codes N02 (9,4%), B01 (6,9%) and N05 (5,4%) were commonly involved. Patient age contained >50% missing data and LASA was involved in 16,5% of DRCIs. Subgroups were often small, likely resulting in low statistical power. Conclusion: By successfully characterizing the DRCIs, some potential areas of improvement for reducing future DRCIs were highlighted, however there are many more variables of relevance for patient safety than those analyzed in this study, underlining the need for further studies characterizing more DRCIs including additional variables.

Bakgrund: Vetenskapliga artiklar visar att patienter som får stroke under sin sjukhusvistelse får sämre omhändertagande än strokepatienter som direktinläggs. Litteraturen visar även att det behövs mer kunskap om vilka förbättringar som kan behöva göras för att få en säker, kunskapsbaserad och effektiv stroke sjukvård. Syfte: Studiens syfte är att identifiera händelser som har varit kritiska i omhändertagandet av inneliggande patienter som insjuknar i stroke. Metod: CIT (Critical Incident Technique) har använts som datainsamlingsmetod, denna har använts inom flygvapnet men har på senare tid fått större användning i bl. a hälso- och sjukvården. Kvalitativ innehållsanalys enligt Burnard (1996) ligger till grund för bearbetning av materialet. Analysen utgick ifrån 10 intervjuer med sjuksköterskor som har erfarenhet av patienter som insjuknat i stroke på vårdavdelning. Intervjuer är genomförda på 5 (fem) olika typer av avdelningar inom Sahlgrenska sjukhuset under våren 2016. Resultat: Kritiska händelser förekommer i samband med omhändertagande inom alla delar av vården av patienter som insjuknar i stroke under sin sjukhusvistelse. Övergripande kategorier är: oförutsedd händelse, bristande resurser riskerar patientsäkerheten och specialistvårdens baksida/organisatoriska hinder. Kategorierna identifieras inom mikro-, meso- och makrosystem för sig samtidigt som de interagerar mellan de olika systemen. Slutsatser: Tillgång till aktuella mätningar är viktig för att få en överblick över det aktuella läget för inneliggande strokepatienter i form av antal och var de inträffar. Studien visar att det finns ett stort behov av en välfungerande strokekedja för inneliggande strokepatienter och att det finns genomförda projekt i USA som kan vara till hjälp för framtida förbättringar i stroke vården. Det är även viktigt att lägga fokus kommunikation och information till anhöriga. / Background: Scientific articles has shown that patients that have had a stroke during their hospitalization receive lesser degree of care, than patients that has been admitted with a stroke. Literature has shown we need more knowledge how to improve stroke care to get a secure, knowledge based and effective stroke care in hospitals. Aim: The study aims to identify the events that have been critical in the management of hospitalized patients who suffer a stroke. Method: CIT has been used as a data collection method to bring in information, it has been used in the airforce and more recently has been used more widely in national healthcare. Qualitative contents analysis, according to Burnard (1996), gives basis for analyzing the material. The analysis was based on 10 interviews with nurses who have experience of patients diagnosed with stroke during hospitalization. Interviews were conducted at 5 (five) different departments within the Sahlgrenska Hospital in spring 2016. Result: Critical events occur in connection with care in all parts of the care of in-hospital patients who suffer a stroke. Overall categories: unexpected event, the safety of patients affected by department resources and the backside of specialist care. The categories identified in the micro, meso and macro systems are interacting between the different systems. Conclusion: Access to current measurements is important to get an overview of the current state of in-hospital stroke patients in the form of numbers and where they occur. The study shows that there is a great need for a well-functioning stroke chain for in-hospital stroke patients and that there are implemented projects in the US that could be helpful for future improvements in stroke care. It is also important to focus on communication and information to relatives.

<p>There are great expectations that collaboration among professions and various sectors will further develop health care and thus lead to improved public health. In the World Health Organization’s declaration “Health 21” the designated goal for health professions in the member nations in Europe by the year 2010 is to have developed health promotional competence, including teamwork and cooperation based on mutual respect for the expertise of various professions. The challenges faced by the interprofessional teams are, however, multifaceted, and these challenges place demands upon society, which, in turn, determines the fundamental conditions for collaboration among the health professions within the health care organizations.</p><p>This licentiate dissertation contains discourse and content analyses of interprofessional teamwork in health care. The major objective of this dissertation is to study and describe how the team members construct and create the content and significance of teams and teamwork among health professions. One specific goal has been to study how the members of a multi-professional health care team refer to their team, especially the discursive patterns that emerge and the function that these patterns has (I). The second specific goal has been to identify and describe the difficulties that the health professionals have experienced within their interprofessional teamwork. One purpose has been to enable discussions of the implications for interprofessional learning (II).</p><p>Focused group interviews with team members (n=32) from six teams were studied using discursive social psychological research approach. The analysis concentrated on the use of the pronouns “I”, “we” and “them”. The results were then analyzed in relation to theories on discursive membership and discursive communities (I). Individual semi-structured interviews with team members (n=18) from four of the six teams were carried out using critical incident techniques. The interviews were analysed via latent qualitative content analysis and the results were interpreted in the light of theories on sociology of professions and learning at work (II).</p><p>The findings showed that two discursive patterns emerged in the team members’ constructions of “we the team”. These patterns were designated knowledge synergy and trustful support (I). The following three themes that touched upon the difficulties of interprofessional teamwork were identified in the personal interviews: (A) difficulties concerning the teams’ dynamics that arose when the team members acted as representatives for their respective professions; (B) difficulties when the various contributions of knowledge interacted in the team; and (C) difficulties that were related to the surrounding organisation’s influence on the team (II).</p><p>The conclusion was reached that the discursive pattern provided rhetorical resources for the team members, both in order to reaffirm membership in the team and to promote their views with other care providers, but also to deal with difficulties regarding, for example, lack of unity in outlook. The conclusion was also drawn that, in addition to the individual consequences, one outcome of the perceived difficulties was that they caused limitations of the use of collaborative resources to arrive at a holistic view of the patient’s problems. Thus the patients could not be met in the desired manner.</p><p>The practical implications of the research project concern the development of teams in which various forms of interprofessional learning can influence the continued development of the team and the management of health care in regard to the importance of implementation processes and organisational learning.</p> / <p>Stora förväntningar ställs på att samarbete mellan yrkesgrupper och mellan sektorer ska utveckla hälso- och sjukvården och leda till en förbättrad folkhälsa. I Världshälsoorganisationens policydokument “Health21” anges exempelvis målsättningen att hälsoprofessionerna i de europeiska medlemsländerna till år 2010 ska ha utvecklat en hälsofrämjande kompetens som bland annat innefattar teamarbete och samarbete på basis av ömsesidig respekt för de olika professionernas expertis. Det interprofessionella teamets utmaningar är dock mångfacetterade och kräver uppmärksamhet från det samhälle som skapar villkoren för hälsoprofessionernas samarbete inom hälso- och sjukvårdens organisationer.</p><p>Denna licentiatavhandling innehåller diskurs- och innehållsanalytiska studier om interprofessionellt teamarbete i vården. Avhandlingens övergripandet syfte var att undersöka och beskriva hur teammedlemmar konstruerar och skapar innebörder av team och teamarbete mellan flera hälsoprofessioner. Det ena specifika syftet var att undersöka hur medlemmar i multiprofessionella vårdteam talar om sitt team, särskilt avseende de diskursiva mönster som framträdde och vilken funktion dessa mönster hade (studie I). Det andra specifika syftet var att identifiera och beskriva svårigheter som hälsoprofessioner har uppfattat vid interprofessionellt teamarbete, där avsikten även var att möjliggöra en diskussion om implikationer för interprofessionellt lärande (studie II).</p><p>Fokusgruppintervjuer med teammedlemmar (n=32) från sex team analyserades utifrån en diskursiv socialpsykologisk forskningsansats och fokuserade på användningen av pronomina ”jag”, ”vi” och ”de”. Fynden relaterades sedan till teorier om diskursivt medlemskap och diskursiva samhällen (studie I). Individuella semistrukturerade intervjuer med teammedlemmar (n=18) från fyra av de sex teamen genomfördes med critical incident-teknik. Intervjuerna analyserades via latent kvalitativ innehållsanalys och fynden tolkades utifrån teorier om professionssociologi och lärande i arbetet (studie II).</p><p>Resultaten visade att två diskursiva mönster framträdde i teammedlemmarnas konstruktioner av ”vi-som-team”. Dessa mönster benämndes kunskapssynergi och tillitsfullt stöd (studie I). Vid individuella intervjuer med teammedlemmar identifierades följande tre teman som rörde svårigheter vid interprofessionellt teamarbete; (i) svårigheter som gällde den teamdynamik som uppstod när teammedlemmarna agerade som företrädare för sina professioner i relation till teamet, (ii) svårigheter när medlemmarnas olika kunskapsbidrag interagerade i teamet och (iii) svårigheter som rörde den omgivande organisationens påverkan på teamet (studie II).</p><p>Konklusionen gjordes att de diskursiva mönstren utgjorde retoriska resurser för teammedlemmarna, både för att bekräfta medlemskapet i teamet, för att hävda sina åsikter i kontakter med andra vårdgivare (”de andra”) och även för att hantera uppfattade svårigheter beträffande exempelvis bristande samsyn. Vidare drogs slutsatsen att en konsekvens av de uppfattade svårigheterna var, förutom individuella konsekvenser, begränsningar i användandet av de gemensamma resurserna för att nå en helhetssyn på patientens problem och att patienterna inte kunde bemötas på det sätt som önskades.</p><p>Forskningsprojektets praktiska implikationer rörde teamutveckling där olika former av interprofessionellt lärande påverkar teamets fortsatta utveckling, samt ledning av hälso- och sjukvården avseende betydelsen av imple-menteringsprocesser och organisatoriskt lärande.</p>

Syftet med denna studie är att utvärdera ett HVB-hem vilket bedriver miljö- och individualte-rapeutisk behandling av ungdomar i åldrarna 16-19 år. Vidare syftar studien till att utvärdera verksamhetens arbetssätt vid kritiska händelser enligt critical incident-metoden. Således fin-ner författarna följande frågeställningar relevanta för utvärderingen: Vilka slags kritiska hän-delser uppstår i verksamheten enligt personalens upplevelser? Hur löses/slutar de kritiska händelserna i verksamheten? Är lösningarna av de kritiska händelserna förankrade i miljöte-rapeutisk teori? Utvärderingen grundas i uppgifter från nio respondenter, varav en av respondenterna är utvärderingens författare. Datainsamlingen utgörs i sin tur av observationer, frågeformulär och kompletterande intervjuer. Materialet består av 50 stycken kritiska händel-ser varav 47 händelser redovisas i tabeller under resultat och analys samt kopplas till miljöte-rapeutisk teori och tidigare forskning. I materialet framkommer sex stycken kärnproblem: hot och våld, yrkesroll och arbetsgrupp, alkohol och narkotika, bryter mot verksamhetens struk-tur, ungdomar mot arbetsgruppen samt förändring hos enskild ungdom. Analysen av resultatet visar på att samtliga lösningar i utvärderingen är förankrade i miljöterapeutisk teori. / The purpose of this study is to evaluate an institution which carries out milieu and individual therapy regarding youth. Furthermore, the purpose of this study is to evaluate the way of working in critical situations according to critical incident-method. Therefore, the author found the following questions relevant to this evaluation: Which sort of critical situations arise according to employee’s experiences? How can we solve these critical situations within the operation? Are the solutions of these critical situations anchored to the milieu therapeutic theory? The evaluation is based upon information from 9 respondents, of which one of the respondents is the evaluator’s writer. The collected information represents observation, question formulas and supplementary interviews. The material consists of 50 critical situations in which 47 situations account for tables under the result of analysis plus connection to the milieu therapeutic theory and earlier research. In the material 6 core problems emerge: threats and violence, occupational roll, and work groups, alcohol and nar-cotics break towards the operational structure, youth towards work groups and shifts in indi-vidual youths. The result shows that all solutions are supportive of the milieu therapeutic theory.