Learning outcomes for students whose education takes place in the physical field are, among others, knowledge and skills to implement the occupational therapy process. In this process patients’ problems are assessed and recorded, treatment planned, implemented, continuously evaluated, and the progress of each such patient professionally recorded. Since this is a process which requires distinct clinical reasoning skills on the part of the student various factors can influence the development of such skills during their training. Many authors are of the opinion that it is the interpersonal communication between supervisor and student which underpins successful fieldwork education. In this study the purpose therefore was to investigate how the interpersonal communication factors in the supervisory relationship play a role in enhancing occupational therapy students’ clinical reasoning during physical fieldwork education. At the outset a partially mixed, sequential dominant, status-qualitative design was employed. An inter-subjective or interactional epistemological position was adopted in order to generate data from the participants’ subjective experiences, and an interpretive approach was used to understand how occupational therapy students and supervisors perceive the supervisory relationship during the formers’ learning of their clinical reasoning skills. Data was generated from four sources. First of all, from focus groups conducted separately with students and their supervisors on completion of the fieldwork block; secondly from semi-structured one-on-one interviews held with students as well as supervisors on completion of the formers’ fieldwork block; thirdly from students’ Work Habits Reports, and finally by recording the practical exam grades students obtained in the physical field. To analyse the data both qualitative and quantitative research methods were employed. Information obtained from the focus groups and one-on-one interviews were audio-taped and transcribed. After this process, transcribed data was coded and analysed following both a bottom-up and top down approach. The former was carried out by an independent coder and the latter by the researcher herself to determine which interpersonal communication themes and patterns might emerge from the collected data. A clinical psychologist using the Interpersonal Pattern Analysis, a diagnostic instrument, analysed the audio tapes of 14 supervisors who participated in the focus groups and one-on-one interviews. The themes which emerged from the thematic-content analysis and the Interpersonal Pattern Analysis were compared with the grades students obtained for their clinical reasoning skills in the final practical exam in the physical field. The findings of this study indicated that supervisors of students who received high grades solved problems effectively, were predominately linear in their approach, showed only limited empathy, were rigid in their expectations and gave only limited confirmation. In line with these findings supervisors of students who received lower grades were also effective in terms of problem solving skills and also gave limited confirmation, but were circular in their approach, showed partial empathy and were flexible. Finally in respect of the interpersonal approach to human behaviour there is no one role or pattern of interaction that is more effective in all contexts. A style or a pattern that may be highly effective in one kind of relationship may be ineffective in another. What is emerging here though is that a style which is characterised by flexibility and empathy may not necessarily be an effective teaching style, whereas a style characterised by a linear approach and limited empathy did indeed prove to be significantly more effective. / Thesis (PhD)--University of Pretoria, 2011. / Occupational Therapy / unrestricted

Contexte : Les personnes atteintes de troubles des conduites alimentaires (TCA) auraient un meilleur pronostic s’ils étaient pris en charge précocement pour cette maladie. Le médecin généraliste (MG) est souvent cité dans les recommandations internationales comme un acteur principal de dépistage et de prise en charge précoce des patients atteints de TCA. Les études de prévalence effectuées dans un contexte de soins primaires (SP) ne retrouvent pourtant que peu de patients atteints de TCA, voire aucun. Aucune étude de prévalence en MG en France n’a encore été effectuée. La dépression est souvent étudiée comme une comorbidité fréquente des TCA.Objectif : Etudier la place du MG dans la prise en charge des patients atteints de TCA1)Evaluer l’efficacité d’un dépistage systématique des patients atteints de TCA par des MG sur leur pronostic et leur taux de guérison.2)Décrire les caractéristiques des patients atteints de TCA et suivi en MG et d’étudier la temporalité entre la survenue d’une prise en charge pour dépression et prise en charge pour TCA3)Décrire les perceptions des MG et des patients de la place du MG dans la prise en charge de ces patientsMéthodes1)Revue systématique de la littérature selon les critères PRISMA2)Etude de cohorte à partir de la prise en charge en médecine générale de patients atteints de TCA avec analyse de différents groupes de suivi comparant les patients TCA pris en charge pour dépression et ceux non pris en charge pour dépression.3)Etude qualitative en miroir de patients atteints de TCA et de MG sélectionnés dans la cohorte disponible des MG, avec analyse par théorisation ancrée et phénoménologique en miroir, avec double codage d’entretiens semi directifsRésultats : La revue systématique de la littérature n’a pas permis de conclure à l’efficacité d’un dépistage systématique des TCA par les MG, du fait d’une littérature hétérogène, composée en grande majorité d’articles d’opinion dans un contexte de SP.1310 patients (sur 350 000 patients suivis) ont eu au moins une prise en charge pour TCA par des MG de l’OMG entre 1994 et 2007. 80 % étaient des femmes, âgées de 35,19 ans en moyenne. Seuls 39 % avaient une amorce de suivi pour TCA. 67,1 % avaient une première prise en charge pour TCA. 32,3 % d’entre eux avaient eu au moins une fois une prise en charge pour dépression, dont 62,41 % pour la première fois. Les patients ayant une dépression étaient plus âgés, plus suivis pour TCA que les autres. Un cinquième des patients TCA ont eu au moins une fois une prescription d’antidépresseurs dans leur suivi, un peu moins de la moitié des anxiolytiques. La prise en charge pour DEP ne précédait pas la prise en charge du TCA.Dans l’étude qualitative, les 24 MG et les 8 patientes décrivaient la prise en charge comme difficile et longue. L’enjeu d’une bonne prise en charge dépendait d’une relation de confiance des deux acteurs, d’un côté une patiente prête à se livrer en dépassant le déni et le sentiment de honte, de l’autre côté, un médecin prêt à écouter, en dépassant son sentiment d’impuissance.Discussion : Il s’agit de la première étude en France s’intéressant à la prise en charge des patients en SP, utilisant des méthodes complémentaires. Les enjeux de prise en charge des TCA en SP restent à définir. La dépression et les TCA étaient concomitants et semblent devoir être pris en charge dans une approche globale. Cette approche devra tenir compte de situations retrouvées dans les deux syndromes : la mauvaise estime de soi, une image négative de son corps, des antécédents de maltraitance, des antécédents familiaux psychiatriques de dépression ou de TCA au premier degré. / Background : People suffering from eating disorders (ED) may have a better prognosis if they benefit from early management for their disease. GPs are often quoted in international guidelines as the main actors of screening and early management of ED patients. Prevalence studies in a primary care setting however find few ED patients and sometimes none. No study in GP has been done in France. Depressive disorders are often related as a comorbidity of ED. Aim: to study the GP role of ED patients management. 1) To evaluate the efficacy of systematic screening of ED patients conducted by GPs on prognosis and recovery. 2) To describe the characteristics of ED patients followed by their GPs and study the temporality between depression management and ED management. 3) To describe GPs and patients' views of the role of GPs management of ED patients. Methods 1)Systematic review according to PRISMA statement 2)Cohort study in a French GP setting of ED patients with analysis of different follow up groups comparing ED patients with depression to ED patients without depression. 3)Qualitative study of ED patients comparing GPs and patients' views selected in the cohort study, with a grounded theory approach and a phenomenological approach, double coding of semi directive interviews. Results : the systematic review found no evidence of efficacy of systematic screening of ED patients by GPs. The literature is too heterogeneous and contains mainly opinion papers in primary care. 1310 patients (out of 350,000) had at least one consultation for ED by GPs in the French database between 1994 and 2007. 80 % were women, mean age of 35.19 years. Only 39 % benefited from a follow up for ED. 67.1 % were taken in charge for the first time. 32.3 % of ED patients had at least one consultation for depression, 62.41 % for the first time. ED patients with depression were older, followed longer for ED then the others. One fifth of patients had at least one prescription of antidepressants during their follow up period, half of them had anxiolytics. Depression management did not precede ED management. In the qualitative study, 24 GPs and 8 patients described the management as difficult and long. The key to a good management depended on trust, with a patient willing to talk about her disease; overcoming shame and denial, and a GP ready to listen, overcoming his helplessness feeling.Discussion : it was the first study about this subject in France, using complementary methods. Management points are to be defined in primary care. Depression and ED are cofactors and should be managed in a global approach. This approach will have to take into account signs found in those two syndroms: low self esteem, negative body image, abuse background, pscyhiatric diseases in family (depression and ED) in first degree relatives.

Neuropathy is a nerve disorder found in HIV disease and diabetes mellitus that indicates damage in the peripheral nervous system. Burning, tingling, stabbing, shooting, and painful sensations in the hands and feet are common symptoms of this chronic disorder, and no treatments are available that repair the nerves. The approved pain treatments are few and only available for the diabetic neuropathy population. A mixed-methods study of archival data was performed to compare patients with painful neuropathy (PN) associated with 2 diseases: HIV (HIV-PN) and diabetes mellitus (DPN). This study examined the similarities and differences of the pain narratives and common pain questionnaires from 12 HIV-PN and 11 DPN subjects. An independent t test of the Visual Analog Scale, Numeric Rating Scale, Brief Pain Intensity subscale, and the Short Form McGill Pain questionnaire failed to reject the null hypothesis that HIV-PN and DPN have equal pain levels. The qualitative analysis revealed 8 shared themes in both groups, with footwear challenges reported as the primary theme. This finding supports the many shared themes between these groups, yet education addressing these themes is minimal. One contrasting theme, privacy, was detected in the HIV-PN group, correlating statistically with the Beck Depression Inventory findings of guilt feelings. The theme of exercise was unique for the DPN group. Both groups had paralinguistic and nonverbal elements discovered in the recordings demonstrating the need for future research to explore these components. Results of education and research themes of privacy in the HIV-PN group and pain communication strategies for both groups will increase understanding of etiology, intervention, and patterns of pain for those diagnosed with neuropathy.

Literacy coaching is a widely implemented method for increasing teacher effectiveness and student learning. However, literacy coaches, teachers, and administrators from various countries have expressed confusion and concerns regarding this method. In the current research setting, literacy coaching was implemented to improve reading test scores with inconsistent results. Cultural historical activity theory was used as the theoretical framework for this sequential explanatory mixed-methods research that explored literacy coaching relationships in the research site from the teachers' perspectives. Phase 1 research questions examined (a) differences between the amount of time coaches spent with teachers, (b) components of coaching teachers found most/least effective, (c) how effective the teachers found literacy coaching, and (d) the correlation between the amount of time teachers spent with coaches and their effectiveness ratings. Phase 2 concerned teachers' experiences with coaching, and teachers' ideal literacy coaching situations. Twenty-two teachers completed surveys in Phase 1. Overall, teachers rated literacy coaching between ineffective and very effective. The median scores for individual components of literacy coaching were between neutral and effective. Significant correlations were found between effectiveness ratings and time spent with literacy coaches in a group, r (20) = .34, p = .01, and time spent one-on-one, r (20) = .54, p = .01. Phase 2 consisted of interviews with 9 teachers. Four themes resulted from framework qualitative analysis: what teachers want from coaches and coaching, teacher concerns, how teachers view the coaches, and coaching in practice. Three trainings were created to provide administrators, literacy coaches, and teachers with strategies and local data that may improve their practice and student reading capabilities.

The problem addressed in this study was the lack of a model for technology integration in social work education to meet the needs of graduate social workers in the field. Extant research has focused on the efficacy of online or blended learning, but not on social work educators' technology literacy. The purpose of this study was to explore social work educators' self efficacy related to technology use in curriculum and pedagogy. Digitally immigrant educators, defined as those over the age of 35, were studied since this group struggles in adjustment to technology, commonly used by younger students. The conceptual framework synthesized von Bertalanffy's general systems theory and Bandura's self-efficacy construct to understand the relationship between social work educators and technology. In this concurrent mixed methods and grounded theory study, participants (n = 396) provided quantitative responses about self-efficacy to the Computer Technology Integration Survey and answered additional questions about technology integration in the classroom. Findings from the correlational analysis revealed a model that connects positive self-efficacy to the number of digital tools used in the classroom, technology integration in pedagogy and curriculum, and teaching the concept of a 'digital divide.' Qualitative data from open-ended questions (n = 260) and 4 individual interviews were analyzed by thematic content analysis. Findings included issues that inhibit technology integration: personal motivation, time, and lack of institutional support. This study may contribute to positive social change by proposing a technology integration model for social work educators to use as an innovative strategy for preparing future professionals in the practice of social work.

Media exercises incredible influence on the public; in India media appears to interfere with court proceedings. The purpose of this mixed-methods quasi-experimental study was to explore the effect of media trials on the Indian criminal justice system and to examine the relationship between court verdicts and media trials in India. The narrative policy framework was used to guide the study. Qualitative data were gathered from a variety of sources, including the court cases and the related verdicts reported by the media as media trials from 2005 to 2015. Subsequently, interviews were also conducted to collect qualitative data. Quantitative data were sourced from a survey using Likert scales. Survey and interview data were collected from 450 India-based practicing attorneys. Qualitative data were coded and themes developed. Quantitative data were analyzed using Pearson's correlation analysis. Findings indicated that media interference affects the Indian criminal justice system, often adversely. Findings may be used to help public policy making bodies formulate media guidelines about reporting crime and the justice system in India. Findings may also be used to bolster public confidence in the judicial system in India.

>Evaluating the Effectiveness of a Leadership Studies Program. James P. Hopkins, 2013. Applied Dissertation, Nova Southeastern University, Abraham S. Fischler School of Education. ERIC Descriptors: Undergraduate Study, Student Experience, Program Effectiveness, Program Evaluation, Leadership. This case study reported on the effectiveness of the Jepson School of Leadership Studies program of instruction at the University of Richmond. The research extended and replicates research of a similar nature completed by Brungardt (1997) at Fort Hays State University and Funk (2005) at Kansas State University. The study investigated if the academic programming was an effective change agent were the attitudes, behaviors, or knowledge of the graduating seniors affected, and, if so, how. The study also reviewed which curriculum components pedagogy, course content, or service learning were most effective. This mixed-methods study focused on the perennial question surrounding academically based leadership studies programs are they effective? While effectiveness and causation are the main themes of this research, the study also addressed the utility of mixed-methods research on leadership topics and the need for further research into programs offering leadership studies degrees. The results suggested that students changed by growing in leadership capacity and efficacy through their Jepson School academic experiences. Quantitative instruments reflect growth in leadership behaviors from the sophomore to senior years and an overall satisfaction with the Jepson academic programming. The qualitative instruments added weight and meaning to quantitative results by explaining program impacts and benefits from a student, alumni, and key staff perspective. The results of this study matched the results of previous research and suggested that academic leadership studies programs are effective change agents.

PURPOSE: This sequential embedded mixed methods study first identified the ways in which occupational therapy leaders experience leadership, then explored the ways in which those same leaders utilized their professional training as occupational therapists within their practice of leadership. METHODS: The twelve participants held formal leadership positions in either academia, clinical practice, or professional associations. The ecology of human performance model of practice was utilized to frame the research study. Data was collected through an initial interview with all 12 participants and through leadership artifacts and a second interview with six participants. RESULTS: Three themes resulted from thematic analysis of initial interview: leadership journey, leadership deconstructed, and personal approach to leadership. The leadership artifacts were analyzed using a coding frame, which included four dimensions: occupational perspective of leadership, connections, leadership approach, and team mindset. Thematic analysis of the second round of interviews resulted in three themes: how they do leadership, leadership interaction, and reflection on leadership action. CONCLUSIONS: The participants described the construct of leader as a role consisting of contextually discrete leadership occupations. A number of parallels were identified between the practice of occupational therapy and the practice of leadership. The development of a personal leadership identity was found to occur over time and required some form of either internal or external recognition of leadership ability or outcome. The structure of this mixed methods design included a combination of two qualitative methods, which was novel to the occupational therapy literature.

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