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An evaluative study of a health team development intervention in a state training center for the mentally retardedEwart, Carole January 1982 (has links)
A one sample pre-post design was used simultaneously with three work groups to study the effects of a health team development intervention on interdisciplinary (ID) team processes. Effects were measured by participant questionnaires, managerial diagnostic and follow-up interviews, and by direct observation of team meetings. The intervention, as conducted by internal facilitators, was published in Improving the Coordination of Care: A Program for Health Team Development by Rubin, Plovnick, and Fry. Positive changes were found in members' perceptions of their team's general effectiveness, their leader's approachability, and the value of their meetings. No changes were found in member participation and influence, however, when pre-post differences were compared using the Dunn-Bonferroni approach to multiple t-tests on nine Mean Factor Difference Scores of the Group Behavior Inventory. Structured observation data showed increases in proportional frequencies of Interpretative statements, Alternatives suggested, and Decisions made during teams' meetings. Questions asked and Information given categories on the Team Observation Protocol data showed decreases. No change occurred on the two seldom-used categories, affective statements about Client and Team. Pre-intevention diagnostic interviews had shown that senior management's and team facilitators' expectations were congruent with the goals, roles and procedural areas targeted for change by the team development program. However, Follow-up interviews corroborated prior organization development research. That is, a comprehensive organizational diagnosis of teamwork problems was needed prior to the selection and implementation of team development with ID teams. Especially sensitive areas for management-consultant negotiation in future efforts to implement HTD should include the use of internal or external third party facilitators, the selection of teams, role of team leaders, and the adaptation of materials and activities to suit ID team tasks. Where conflict exists between senior management and team leaders, other interventions may be needed before team development can be expected to affect positively, ID team members' participation and involvement. Recommendations were made for structural changes to strengthen ID teamwork at the training center. The absence of an empirically-derived theory of ID team performance effectiveness continues to be a barrier to the demonstration of intervention effects and to education for teamwork. Research is needed to describe empirically relations between problem-solving processes in ID team meetings and treatment decisions. Research is also needed to delineate team-role competencies required by members and leaders as prerequisites to establishing indicators of ID team performance effectiveness. / Ed. D.
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The Institutional Context that Supports Team-Based Care for Older AdultsTresidder, Anna Foucek 03 January 2013 (has links)
The aging population in the U.S. is dramatically increasing; it is predicted that not only will individuals live longer but also that they will live with multiple chronic diseases that could require high levels of medical and social resources. While the aging population increases, the number of health care providers choosing to specialize in caring for the elderly is decreasing just as dramatically. Teams are believed to be a possible response to more efficiently use the providers available, take advantage of alternative provider types, and integrate a range of health and social services to meet patient needs more effectively. Interdisciplinary teams are the best practice in the care of older adults, who require both medical and social services. However, maintaining functional collaborative teams has been an ever-present challenge to health and social care organizations. Research has found that institutional support is critical for teams to benefit patients and organizations alike.
This study examined the role of institutional context in supporting interdisciplinary teams (IDT) in the care of older adults through interviews of the management and staff of the Program for All-Inclusive Care of the Elderly (PACE) in six states. PACE organizations must commit to an interdisciplinary model of care consisting of 11 different disciplines from across the professional spectrum. The research question posed for this study was: What elements of institutional context support the use of interdisciplinary teams in the care of older adults? Due to the standardized team structure used, PACE was selected as the model to see how institutions at macro and micro levels support the work done by PACE teams and possibly highlight where support is still lacking. A case study approach drawing upon qualitative methods was used to examine policy-regulative, cultural-cognitive, normative, relational, and procedural elements of institutional context and the extent to which they support collaborative teamwork. Thirty-two interviews were conducted with administrators and team members from seven PACE programs across the country. For these PACE programs, five elements and 14 categories of support were identified by the interviewees. Policy and regulatory elements constrain and systematize behavior. PACE IDT experience these constraints and systems through regulatory body practices, resource allocation, and quality measurement. Cultural-cognitive elements mediate between an IDT's external environmrder to make sense of what is happening. PACE IDTs create meaning through their interactions with their external environments through interdependence, demographic characteristics, and organizational structure. Normative findings constrain behavior and confer the rights and duties of IDT members, which arise from organizational mission and values, leadership, and professient and the response of the IDT in oonal boundaries. Relational elements emphasize relationships among IDT members and team interaction with the organization's environment. Social constructs within the team affect role definition and communication, which support IDT practice. Procedural support standardizes practices to maintain highly functional teams. In order to support IDT practice, PACE organizations highlighted recruitment and retention, time and space, and training and education as the primary ways to support IDTs. These categories illustrate the complexity of supporting teams and actualizing teamwork in practice. These findings suggest that PACE is succeeding in supporting the IDT model and provides lessons for other organizations that wish to do the same.
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The dual role of a clinical educator as mentor and assessor : influence on the teaching-learning relationshipMeyer, Ilse S. 12 1900 (has links)
Thesis (MPhil)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: At the core of clinical education, within the allied health professions, is the teaching-learning
relationship between the clinical educator and the student which is reinforced by and grounded in
the explanatory theories of socio-constructivism, experiential learning and positioning. A good
teaching-learning relationship is fundamental to the success of the students’ learning in the clinical
environment. Clinical educators fulfil a dual role as mentors and assessors to students. The
purpose of this study is to explore the students’ and clinical educators’ perceptions of the dual role
of a clinical educator of students in the physiotherapy clinical environment, and how the
perceptions of both parties influence the teaching-learning relationship. By following a
phenomenological qualitative research approach with an interpretivist paradigm the researcher
obtained data from focus groups and individual interviews. Data analysis involved a contextualised
interpretive content analysis paradigm. The perceptions of the participants in the teaching-learning
relationship, their particular expectations, challenges and preferences, reflect their experiences
and are presented in the findings of the study. The findings of this study are comprehensively
discussed and recommendations are made to transform the teaching-learning relationship by
repositioning the participants (both students and clinical educators) in order to enhance the quality
of the clinical learning experience within the physiotherapy clinical environment. / AFRIKAANSE OPSOMMING: Die onderrig-leerproses-verhouding tussen die kliniese dosent en die student vorm die kern van
kliniese onderrig, ondersteun deur en op grond van die verduidelikende teorieë van sosiale
konstruktivisme, leerervaring en posisionering, vir verwante gesondheidsberoepe. Die onderrigleerproses-
verhouding word daarom beskou as die grondslag vir die sukses van leergeleenthede,
aangesien die kwalitiet van die verhouding deurslagggewend is om studente se leerproses in die
kliniese omgewing te ondersteun. Kliniese dosente speel ‘n dubbele rol as mentors en assessore
vir studente. Die doel van die studie is om studente en kliniese dosente se sienings van die
dubbele rol van ‘n kliniese dosent van studente binne die kliniese onderrigveld van fisioterapie in
die kliniese omgewing te ondersoek, asook hoe die persepsies van albei partye die onderigleerproses-
verhouding beinvloed. Die data word verkry van fokusgroepe en individuele
onderhoude deur ‘n fenomenologiese kwalitatiewe navorsingsbenadering met ‘n interpreterende
paradigma te volg. Die data is ontleed volgens ‘n kontekstuele interpreterende
inhoudsontledingsproses. Die persepsies van die deelnemers aan die onderrig-leerprosesverhouding,
hul spesifieke verwagtinge, uitdagings en voorkeure as drie breë temas van hierdie
tesis, weerspieël hul ervarings en word weergegee in die bevindings van die studie. Die navorsing
bespreek hierdie bevindings en doen regstellende aanbevelings oor die bevindings. Hierdeur kan
die onderrig-leerproses-verhouding, deur herposisionering van albei partye (studente sowel as
kliniese dosente), getransformeer word en die gehalte van die kliniese leerervaring in die
fisioterapeutiese kliniese omgewing verbeter word.
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Multi-disciplinary teamwork in an admission unit of a psychiatric institutionGanyaza, Thulisile Zioner 04 1900 (has links)
Thesis (MA)--Stellenbosch University, 2000.
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Die lewensgehalte van versorgingspersoneel by 'n fasiliteit vir individue met intellektuele gestremdheidWahl, Sindi 03 1900 (has links)
Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2007. / Research regarding caregivers in institutions for people with intellectual impairment
has traditionally focussed on aspects of pathology, such as stress and burnout. In
the past three decades there has been a shift towards a stronger focus on
individuals' competencies and strengths. This paradigm shift has contributed to the
development of the term ‘Quality of Life’.
This study focuses on the perceptions of formal caregivers in an institution for the
intellectually impaired about their Quality of Life. The aim was to understand the selfperceived
quality of life of staff caring for adults with intellectual disabilities using
Positive Psychology theories. Based on fortigenic assumptions regarding human
functioning, the influence of stress on formal caregivers and also positive
experiences and the factors that enable these caregivers to rise above hardships of
their occupation, were investigated.
This qualitative interpretive study was conducted in an institution for adults with
intellectually impairment and twelve caregivers at the institution willingly participated.
Data were generated through structured open-ended, informal and a focus group
interview and later analysed thematically. The themes discussed in the study evolve
around the caregivers’ perception of 1) their definition of quality of life, 2) their
current quality of life, 3) the negative factors, stressors, positive experiences and
psychofortological factors impacting on their quality of life, and 4) possibilities for
improving their quality of life.
Based on the relation between the above mentioned themes, the quality of life of the
caregivers appears to be a product of their relationship with the adults with
intellectual disabilities. Therefore, the findings indicate a paradox of care-giving
where the participants not only report on care-giving, but also on care-receiving
within their relationship with the adults with intellectual disabilities. In this relationship
care-giving seems to be a fortigenic factor for the most of the participants and also a
means for interpersonal flourishing.
On the basis of these findings several recommendations are made for further
research, with a view to striving towards improving the quality of life of staff caring for
adults with intellectual disabilities.
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Élaboration d'une proposition d'implantation d'une équipe multidisciplinaire au Centre d'accueil Duhamel de Ville-Marie /Chaumont, Marcelin. January 1989 (has links)
Mémoire (M.P.M.O.)--Université du Québec en Abitibi-Témiscamingue, 1989. / Ce mémoire à été réalisé à l'Université du Québec en Abitibi-Témiscamingue dans le cadre du programme de la Maîtrise en gestion des petites et moyennes organisation, extensionne de l'Université du Québec à Chicoutimi. CaQCU Document électronique également accessible en format PDF. CaQCU
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A business model for medical subspecialty training in South AfricaDalmeyer, Johannes Paulus Franciscus January 2015 (has links)
The shortage of healthcare workers and doctors in the developing world compared to the developed world is a problem, and will continue to be so, due to the continual migration of qualified professionals and the inability of the state to remedy these shortfalls. A shortage of healthcare workers and specialist doctors will seriously hamper the Government’s National Health Insurance (NHI) plan, as well as the sustainability of the private health care sector. In addition, the duration of medical training in South Africa is exceptionally long. The three major hospital groups and other private corporates have over the last number of years taken limited initiative to fund education projects in conjunction with the academic institutions. However, these projects have been poorly focused and have been managed in an unstructured and detached manner. There is a desire from the private sector to get involved in these projects on a much larger scale through more formalised structures. Given this background, the primary objective of this research is to develop a business model for medical subspecialty training to complement the current academic subspecialty training in South Africa. A trial model for training subspecialists in reproductive medicine was developed as a first attempt to address the threatening shortages and training duration. This trial programme is the basis of this research. A two-phased process was used in collecting data. In Phase 1 data was collected from stakeholder groups. The results of this survey assisted in generating variables to include in the measuring instrument for the survey in Phase 2. In Phase 2 the perceptions and expectations of sub-specialists (reproductive subspecialists and cardiologists) regarding sub-specialty training was collected. The results of the demographic variables confirm the aging profile of subspecialist and the need to ensure succession. The results further showed that cardiologists and reproductive subspecialist expectations of the training of subspecialists are very similar except for their expectations on the training duration. Reproductive subspecialist respondents agreed more than cardiology subspecialist respondents that the training duration is too long. The biggest gap between perceptions and expectations is also with the factor training. The results showed that the expectations of subspecialists are not met for training. From these results a business model for the training of medical subspecialists is proposed. This proposed business model can play a complementary role to the existing state controlled system and form the bases of Public Private Partnerships (PPP) in medical training. This proposed business model will fit a developing country were the focus is on primary healthcare, with financial and capacity constraints. The proposed model would require role players to bring about change to accommodate a larger scale Public Private Partnership (PPP) to ensure the implementation of the model. The proposed decentralised business model for training subspecialists would allow the trainee subspecialist to practise as a specialist thus maintaining an acceptable income, and enable an expedited completion and lead to a wider dissemination of medical expertise that can be delivered in a wider national foot print. It further will provide for a structured Public Private Partnership.
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Elevhälsan från insidan : En kvalitativ studie av elevhälsans salutogena och förebyggande förändringsarbeteSoxbo, Linn January 2022 (has links)
All schools must have access to a pupil health care team where dilemmas that arise in pedagogical practice must be treated with the aim of preventing students from getting into school difficulties. Pupil health care teams must have access to multiple professions who, based on their professional perspective, must nuance the perceived problem and find a consensus on how this should be handled in the best way. Based on guidelines from the School Act, this work must now take place from a salutogenic (health-promoting) and preventive perspective. This entails a work of change within the pupil health team that affects the school as an organization. The study has investigated how the salutogenic and preventive work of change imposed on schools affects pupil health's work in dealing with school difficulties. This qualitative study has used semi-structured interviews and observations as a method, in order to gain knowledge about the work of the pupil health teams. Six interviews were conducted with professions that belongs to pupil health team (principal, special education need teacher, school psychologist). In addition, six observations of student health meetings were carried out at three different schools. Collected data were then analyzed based on concepts related to organizational learning to create an understanding of how change of work develops. The results of the study show that there is an awareness among the pupil health professions that they are expected to work salutogenically and preventively, but they express difficulties in how this should be carried out in practice. There are questions about who should do it, how it should be structured, whether it is already being done and if they already work in this way, there is a risk of not taking care of the children who are already in school difficulties. The pupil health teams that are investigated have access to several different professions and strive for cooperation and that the different professional perspectives are taken into account. However, the interviews show that this cooperation does not always work fully and that the different professional languages can make cooperation difficult. The principal's role as the one who contributes with visions, structure and the release of resources is noticed in the study as essential for the change work to be able to lead to organizational learning and competence development for the entire organization and not just individual employees. Ways of adding competence within the college are noticed in the study such as tutoring time with a special education needs teacher or the presence of the pupil health team's professions at ”årskurslags”-meetings. The responsibility for students who have found themselves in school difficulties should not be left to the individual teacher, but should be handled in consensus with the pupil health professions.
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Reflecting team supervision (RTS): reflexivity in therapy, supervision and researchScott, William R. 02 October 2007 (has links)
Informed by constructivist and social constructionist theory, a qualitative research study was conducted applying Andersen’s (1991) reflecting team model to explore use of self themes in the supervision process. A male and female Supervisor were paired with a male and female therapist to form two person supervision and reflecting teams. Four RTS sessions were conducted. Each RTS session involved three phases: 1) supervision of a case with the reflecting team observing, 2) reflecting team discussion of their observations with the supervision team observing, and 3) supervision follow-up by the supervision team with the reflecting team observing. The three phases of the RTS process led to three derivations of the original therapist story. The RTS process was discussed after each session in the post-session discussion.
Utilizing the reflections of the reflecting team from Phase 2, a difference that makes a difference was introduced into the supervision story. In Phase 3, the supervision follow-up, the supervisor helped the therapist explore previously non-conscious use of self themes in the supervision narrative and construct a different narrative about him/herself and the case brought for supervision. The nature of the points of connection established in the socially constructed conversation between the therapist and client(s) was pertinent to the establishment of a "relational distance" between the client and the therapist that was too close or too distant. The supervisor not only helped the therapist become aware of the points of connection but also helped introduce a difference that allowed the therapist to be more maneuverable.
All three phases of RTS are important to a supervision process. The role of the reflecting team in uncovering the "unsaid," and the supervisor in creating a difference possibly become less critical as supervisors develop reflexivity and incorporate these two phases into their typical supervision process. / Ph. D.
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'n Studentgesentreerde opleidingsraamwerk vir kliniese verpleegpraktisyns in Noord-Kaapse plattelandse gemeenskappe.Van der Walt, Stephanie 12 1900 (has links)
Thesis (PhD (Education))--University of Stellenbosch, 2006. / During the past twelve years of democracy health care services in South Africa have been
influenced by political, social and economic change. As a result of the transformation of health
care services and the change of political policy, the focus on primary health care increased.
During the early stages of the transformation of health care services stakeholders realized that in
order to provide an extensive health care service specialized training is required. Various
educational institutions provided formal and informal programmes in order to meet the new
challenges of the nursing profession. Although minimum requirements of the content and clinical
practice have been established by the nursing council, the mode of presentation, costs, duration
and type of qualification awarded to clinical nursing practitioners differed substantially.
Uniformity in terms of programme content was lacking, neither were any scientifically founded
attempts made to establish whether these programmes fulfilled the needs of the student in the
rural community. Although a variety of training programmes exist the number of trained clinical
nursing practitioners is still inadequate. In addition training is focused on the urban community.
The objective of the research was to determine the opinion of the rural nurse on clinical nursing
education, and to develop a training framework based on their input which would meet their
needs. This research was conducted from an explanatory-descriptive paradigm. The case study
was used as research design.
A literature study on the development of primary health care both internationally and nationally
was done. The literature study revealed the development of training programmes for clinical
nurses. Chapter three of the literature study is dedicated to the theoretical aspects of the design of
a student centered training framework for the adult student.
A student centered training framework has created from data gathered via questionnaires
completed by clinical nurses and semi-structured interviews with semi-qualified nurses. Semistructured
interviews have also been conducted with the supervisors of nurses working in clinics
and community health centres in the Northern Cape.
The conclusion that respondents showed a positive attitude towards training in clinical nursing
was encouraging. The majority of respondents indicated that they would welcome an additional
qualification which will improve their knowledge and would result in better patient care. The
respondents highlighted staff shortages, financial constraints and family responsibility as the
main obstacles towards these qualifications. During the research it became clear that no formal
training is currently available in Kimberley. This is as a result of the absence of mentors. Although the respondents have limited access to computers they indicated that they would prefer
computer supported training in conjunction with physical contact sessions.
The research indicated that no formal policy on the training of clinical nurses exists in the rural
Northern Cape. In the absence of a training framework the research further contributed towards
the development of a student centered training framework for clinical nurses in rural Northern
Cape. The research succeeded in highlighting the necessity for formal policy on the training of
clinical nurses in rural Northern Cape.
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