Canadian national survey of oncology residency program directors and trainees; randomized trial of medical education intervention / Purpose: This work addresses teaching communication skills for eliciting cardiopulmonary resuscitation (CPR) wishes, or code status discussions, with cancer patients. The objectives of this thesis include: 1) define current teaching practices for code status communication training in Canadian oncology residency programs, and 2) examine the effect of teaching a novel communication framework for code status discussions to oncology residents. Methods: All current residents and program directors in Canadian medical and radiation oncology residency programs were surveyed regarding education, perceived gaps in training, attitudes towards and patterns of clinical practice for code status discussions with cancer patients. We carried out a multicentre randomized trial to determine the effect of teaching a code status communication framework to oncology learners. Residents completed a training workshop and were evaluated in simulated patient encounters (observed structured clinical exam [OSCE]). Participants were randomized to complete the training before the OSCE (experimental arm), or after the OSCE (control arm). The primary outcome was objective rating of code status communication skills. Results: Current postgraduate oncology curricula lack formal teaching and evaluation of code status communication skills. Educators support the need for innovative teaching tools in this field. Accordingly, a novel six-step communication framework was created in which core themes were summarized by the mnemonic acronym PULSES (Prognosis, Underlying values, Long-term outcome and Short-term outcome of CPR, provision of an Educated recommendation, Summary, style and documentation). A total of 46 oncology residents from 3 training centres participated in the randomized trial. Overall, learners in the experimental group had higher mean content-specific, general communication, and global rating communication scores than those in the control group. The training program conferred the greatest benefit among junior residents. Scores across rating tools were highly correlated. Conclusions: Communication training for code status discussions in Canadian oncology residency programs is lacking. With use of a novel communication framework, we have shown that structured teaching on code status discussions can improve competence in this challenging communication task. Moreover, we have developed educational resources that can be implemented in current curricula. Building capacity for clear and effective code status communication with cancer patients will contribute to high quality end of life care in Canada. / Thesis / Master of Science (MSc) / Medical learners in oncology (cancer care) training programs often lead discussions with cancer patients about code status, that is, patients’ wishes for use or non-use of life-sustaining resuscitation interventions including CPR. Learners receive little training for these complex encounters; yet, decisions regarding resuscitation wishes can influence the quality of care received by cancer patients at end of life. In this study we conducted a survey of trainees and program directors in Canada to better understand current educational practices and attitudes towards education on this topic. Most trainees are not receiving formal teaching or evaluation, and new educational resources are needed. We then developed a 6-step communication guide for code status discussions. We studied the effect of a training workshop in which the communication guide was taught to learners in oncology. We found that the training program improved communication ability among learners with the greatest impact seen among junior learners.

Este trabalho teve como propósito a realização de um estudo que coloca no centro do debate a produção científica brasileira. Parte-se do princípio de que ela é um fator fundamental para um processo de desenvolvimento a partir do reconhecimento de que é por meio do conhecimento que as sociedades evoluem. Essa questão se torna ainda mais relevante quando se considera a necessidade imposta pelo modelo de produção vigente, de transformar conhecimento em riqueza. Este foi o ponto de partida para a realização de um estudo econométrico com o propósito de se formular um modelo que explicasse a produção científica brasileira no período de 1994 a 2014. O estudo mostrou que os programas de pós-graduação foram os que mais influenciaram o comportamento da publicação de artigos científicos, que é a variável que representa a produção científica. Por isso, se faz necessário o aparelhamento do sistema de pósgraduação brasileira. Ademais, como os resultados da produção científica são demorados, ou seja, no mínimo dois anos no mestrado e quatro anos no doutorado, concluiu-se que as crises econômicas ocorridas no período não interferiram diretamente no processo de geração do conhecimento no curto prazo. Outros fatores importantes que ajudaram a manter a produção científica no país foram a sólida estrutura acadêmica e o governo do período ter atuado nos momentos de crise para quebrar o ciclo econômico, diminuindo os efeitos das crises. / This work has purposed a study that placed at the core of the debate the Brazilian scientific production. It starts from the principle that scientific production is a key factor in a development process from the recognition that it is through knowledge that societies evolve. This question becomes even more relevant when considering the necessity imposed by the current production model, to transform knowledge into wealth. This was the starting point for leading an econometric study for the aim of formulating a model to explain the Brazilian scientific production from 1994 to 2014. The study shows that postgraduate programs were those that, statiscally, most influenced the behavior of the publication of Brazilian scientific articles. This last was the variable that represented the Brazilian scientific production in the econometric model. Therefore, it is necessary to equip the Brazilian postgraduate system to create the basis of a structure, which, in the near future, will produce knowledge in large scale and with high competitiveness. It was concluded that the economic crisis that occurred in the period did not directly interfere in the process of knowledge generation in the short term. Other important factors that helped maintaining scientific production in the country were the solid academic structure and the role of public policies that intervened in critical economic moments to break the economic cycle and to reduce the effects of the crisis.

Este trabalho teve como propósito a realização de um estudo que coloca no centro do debate a produção científica brasileira. Parte-se do princípio de que ela é um fator fundamental para um processo de desenvolvimento a partir do reconhecimento de que é por meio do conhecimento que as sociedades evoluem. Essa questão se torna ainda mais relevante quando se considera a necessidade imposta pelo modelo de produção vigente, de transformar conhecimento em riqueza. Este foi o ponto de partida para a realização de um estudo econométrico com o propósito de se formular um modelo que explicasse a produção científica brasileira no período de 1994 a 2014. O estudo mostrou que os programas de pós-graduação foram os que mais influenciaram o comportamento da publicação de artigos científicos, que é a variável que representa a produção científica. Por isso, se faz necessário o aparelhamento do sistema de pósgraduação brasileira. Ademais, como os resultados da produção científica são demorados, ou seja, no mínimo dois anos no mestrado e quatro anos no doutorado, concluiu-se que as crises econômicas ocorridas no período não interferiram diretamente no processo de geração do conhecimento no curto prazo. Outros fatores importantes que ajudaram a manter a produção científica no país foram a sólida estrutura acadêmica e o governo do período ter atuado nos momentos de crise para quebrar o ciclo econômico, diminuindo os efeitos das crises. / This work has purposed a study that placed at the core of the debate the Brazilian scientific production. It starts from the principle that scientific production is a key factor in a development process from the recognition that it is through knowledge that societies evolve. This question becomes even more relevant when considering the necessity imposed by the current production model, to transform knowledge into wealth. This was the starting point for leading an econometric study for the aim of formulating a model to explain the Brazilian scientific production from 1994 to 2014. The study shows that postgraduate programs were those that, statiscally, most influenced the behavior of the publication of Brazilian scientific articles. This last was the variable that represented the Brazilian scientific production in the econometric model. Therefore, it is necessary to equip the Brazilian postgraduate system to create the basis of a structure, which, in the near future, will produce knowledge in large scale and with high competitiveness. It was concluded that the economic crisis that occurred in the period did not directly interfere in the process of knowledge generation in the short term. Other important factors that helped maintaining scientific production in the country were the solid academic structure and the role of public policies that intervened in critical economic moments to break the economic cycle and to reduce the effects of the crisis.

Este trabalho teve como propósito a realização de um estudo que coloca no centro do debate a produção científica brasileira. Parte-se do princípio de que ela é um fator fundamental para um processo de desenvolvimento a partir do reconhecimento de que é por meio do conhecimento que as sociedades evoluem. Essa questão se torna ainda mais relevante quando se considera a necessidade imposta pelo modelo de produção vigente, de transformar conhecimento em riqueza. Este foi o ponto de partida para a realização de um estudo econométrico com o propósito de se formular um modelo que explicasse a produção científica brasileira no período de 1994 a 2014. O estudo mostrou que os programas de pós-graduação foram os que mais influenciaram o comportamento da publicação de artigos científicos, que é a variável que representa a produção científica. Por isso, se faz necessário o aparelhamento do sistema de pósgraduação brasileira. Ademais, como os resultados da produção científica são demorados, ou seja, no mínimo dois anos no mestrado e quatro anos no doutorado, concluiu-se que as crises econômicas ocorridas no período não interferiram diretamente no processo de geração do conhecimento no curto prazo. Outros fatores importantes que ajudaram a manter a produção científica no país foram a sólida estrutura acadêmica e o governo do período ter atuado nos momentos de crise para quebrar o ciclo econômico, diminuindo os efeitos das crises. / This work has purposed a study that placed at the core of the debate the Brazilian scientific production. It starts from the principle that scientific production is a key factor in a development process from the recognition that it is through knowledge that societies evolve. This question becomes even more relevant when considering the necessity imposed by the current production model, to transform knowledge into wealth. This was the starting point for leading an econometric study for the aim of formulating a model to explain the Brazilian scientific production from 1994 to 2014. The study shows that postgraduate programs were those that, statiscally, most influenced the behavior of the publication of Brazilian scientific articles. This last was the variable that represented the Brazilian scientific production in the econometric model. Therefore, it is necessary to equip the Brazilian postgraduate system to create the basis of a structure, which, in the near future, will produce knowledge in large scale and with high competitiveness. It was concluded that the economic crisis that occurred in the period did not directly interfere in the process of knowledge generation in the short term. Other important factors that helped maintaining scientific production in the country were the solid academic structure and the role of public policies that intervened in critical economic moments to break the economic cycle and to reduce the effects of the crisis.

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2017-04-25T17:43:27Z No. of bitstreams: 1 Fabiana Rodrigues Pereira Vidal.pdf: 3138124 bytes, checksum: 310750556e7c52b5fdcfabeceb55a812 (MD5) / Made available in DSpace on 2017-04-25T17:43:27Z (GMT). No. of bitstreams: 1 Fabiana Rodrigues Pereira Vidal.pdf: 3138124 bytes, checksum: 310750556e7c52b5fdcfabeceb55a812 (MD5) Previous issue date: 2017-03-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This research was carried out in the Postgraduate Program in Education, whose area of concentration is Education and Training, having chosen the Research Line II - Educational Institutions, History, Politics and Management Processes, for it has the historical perspective as the main reference. The object of the research was the concepts of corporate education that emerge from the theses and dissertations produced in stricto sensu postgraduate programs in the areas of Education and Administration, defended from 1990 to 2014. The key-question that guided the course was: What conceptions of corporate education emerge from the considered student production? In order to answer it, to date historical events, describing and grouping them in order to understand this student production, was essential, because according to the scholars who base this study, history is a field of possibilities, a representation of the real. In this sense, the interest of the researcher by a theme and the way in which he will dialogue with it have printed the vision he has at that moment on the questions that were investigated. When using the narrative as a method for the exposition of the syntheses, the objective was to explain the problem of each research analyzed here, contextualizing the object of investigation and seeking to identify the main theoretical references used by the researcher of each study. After syntheses, the analysis of the data in order to know thematic clipping, investigated questions, sources (in their primary and secondary forms), conceptions of corporate education and theoretical and methodological references. It also aimed to highlight similarities and differences between the production of postgraduate programs in Education and Administration. As a result, after analyzing 27 student productions, 15 in the area of Education and 12 in the Administration area, it was evidenced that there were three groups according to the understanding that the authors of the theses and dissertations have about corporate education from the references used: Group 1 ¿ Uncritical conception of corporate education, with the authors that define it as the conceptions of the main theoretical references used; Group 2 ¿ Specialized conception of corporate education, with those who consider the practices of this education as part of a whole, that is, of continuing education; and Group 3 ¿ Critical conception of corporate education, with authors who seek to contextualize it historically, evidencing the financial-economic focus, related to the organizational need to achieve competitive advantage, as opposed to the global formation, linked to the formation of the social being, able of forming reflexive and critical subjects. The reading of the student production, theses and dissertations, in the area of Education and Administration, indicates that the practice of corporate education is still under construction, since many companies were unable to implement in their practices the principles that were established by the main scholars of the subject. These surveys show that the employee training programs carried out by the companies focus on the development of competencies that are linked to the organizational need. / Esta pesquisa foi realizada no Programa de Pós-Graduação em Educação, cuja área de concentração é Educação e Formação, tendo sido escolhida a Linha de Pesquisa II - Instituições Educacionais, História, Política e Processos de Gestão, por ter a perspectiva histórica como principal referência. O objeto da pesquisa refere-se às concepções da educação corporativa que emergem das teses e dissertações produzidas em programas de pós-graduação stricto sensu, nas áreas da Educação e Administração, defendidas no período de 1990 a 2014. A pergunta-chave que norteou o percurso percorrido foi: Quais concepções de educação corporativa emergem da produção discente considerada? Para respondê-la, datar os acontecimentos históricos, descrevendo-os e agrupando-os, a fim de compreender essa produção discente, foi essencial, pois, em conformidade com os estudiosos que embasam este estudo, a História é um campo de possibilidades, uma representação do real. Nesse sentido, o interesse do pesquisador por um tema e a maneira como irá dialogar com ele são os elementos que imprimem a visão que possui, naquele momento, sobre as questões que foram investigadas. Ao utilizar a narrativa como método para a exposição das sínteses, objetivou-se explicar o problema de cada pesquisa aqui analisada, contextualizando o objeto de investigação e buscando identificar os principais referenciais teóricos utilizados pelo pesquisador de cada estudo. Após a realização das sínteses, foi elaborada a análise dos dados, no intuito de conhecer recortes temáticos, questões investigadas, fontes (nas suas formas primária e secundária) utilizadas, concepções de educação corporativa e referenciais teóricos e metodológicos. Buscou-se, ainda, destacar semelhanças e diferenças existentes entre a produção dos programas de pós-graduação em Educação e em Administração. Como resultado, após a análise de 27 produções discentes, sendo 15 na área de Educação e 12 na área de Administração, restou evidenciado que existem três grupos, de acordo com a compreensão que os autores das teses e dissertações possuem a respeito da educação corporativa, a partir dos referencias utilizados: Grupo 1 ¿ Concepção acrítica de educação corporativa, com os autores que a definem como as concepções dos principais referenciais teóricos utilizados; Grupo 2 ¿ Concepção particularizada de educação corporativa, com aqueles que consideram as práticas dessa educação como parte de um todo, ou seja, da educação continuada; e Grupo 3 ¿ Concepção crítica de educação corporativa, com os autores que buscam contextualizá-la historicamente, evidenciando o enfoque financeiro-econômico, relacionado à necessidade organizacional para atingir vantagem competitiva, em contraponto com a formação global, ligada à formação do ser social, capaz de formar sujeitos reflexivos e críticos. A leitura da produção discente, ou seja, teses e dissertações, na área de Educação e Administração, indica que a prática da educação corporativa ainda está em construção, posto que muitas empresas não conseguiram implementar, em suas práticas, os princípios que foram estabelecidos pelos principais estudiosos do assunto. Tais pesquisas evidenciam que os programas de capacitação de funcionários realizados pelas empresas possuem como foco o desenvolvimento de competências que estejam atreladas à necessidade organizacional.

This master thesis deals with the field of postgraduate medical education. The main goal of this thesis is deeper understanding of problems in the educational system. By means of a qualitative research the thesis explores the problems and causes of current postgraduate educational system from the perspective of young physicians. The research is based on a series of semi-structured interviews with physicians who are currently passing through a phase of postgraduate medical education. Results of the survey show the most questionable fact, according to participants, is the lack of the educational leadership which is supposed to be secured by the assigned supervisor. Despite the formal rules, this role is often ensured merely formally or is missing at all. Participants also mentioned difficulties related to accomplishing of specialized practical training and required procedures. Both of them are frequently subordinated to informal rules. The main findings are based on revealing the causes of problems mentioned above. The reasons of ascertained discrepancy are introduced with the theoretical help of the theory of informal institutions by G. Helmke and S. Levitsky. Through the lense of chosen theory the issue is that there is insufficient efficiency of formal institutions. Therefore, prospective solution should...

Magister Bibliothecologiae - MBibl / Research, aimed at strengthening the economy and driving development, with the view to address South Africa’s numerous challenges and/or advance knowledge, generally, exists in abundance. It has highlighted the crucial role played by institutions of higher learning, such as universities, in this regard. In particular, the contribution of academic libraries in supporting the country’s agenda, with regard to its teaching and research goals, has come to the fore. Academic libraries have been portrayed, quite correctly, as the legitimate heart of the university, for majority of scholars rely heavily on their collections and services in their quest to develop new knowledge. However, the role played by these important facilities in supporting postgraduate students and researchers in South Africa is yet to be comprehensively examined. With a view to partly address this existent knowledge gap, this study examines the interaction between the University of the Western Cape’s (UWC’s) library and the institution’s Faculty of Community and Health Sciences’ postgraduate students and researchers. In accomplishing this task, I explore the skill set and competencies required of the subject librarian to best support the research needs of postgraduate students and researchers at UWC’s Faculty of Community and Health Sciences. I also investigate the perceptions and expectations of postgraduate students and researchers vis-à-vis the institution’s library. Additionally, this study explores the innovative measures adopted by UWC’s library in its quest to provide competent and satisfactory services to its postgraduate students and researchers. For its theoretical framework, this study employs the Diffusion of Innovation (DOI), also known as Roger’s model. This framework has been used to explore how innovative research services can be established and offered to support postgraduate students and researchers’ needs. This study employs a mixed methods approach and makes use of various data collection instruments, namely, survey questionnaires and interviews. The collected data has been analyzed through the Statistical Package for the Social Sciences (SPSS). The transcribed interviews have been analyzed thematically. The findings indicated some gaps between postgraduate students’ and researchers’ expectations for library’s research support services, research workshops and skills and competencies of a subject librarian. The findings also revealed postgraduate students’ and researchers’ perception of the library’s research support services, research workshops and subject librarians’ skills and competencies to be fulfilled. Even though many of the identified needs are currently being addressed by UWC library, several potential areas for improvement were identified. One of the major challenges is the awareness of the library services and facilities the library offers to support research. Other challenges that postgraduates’ students and researchers are facing is that they are often not aware how to search for information, easy access to the library’s resources and the expertise of the subject librarians.

Published Article / This paper promotes the argument that although conventional postgraduate supervision is useful to address the research skills and competences of postgraduate students, a wider perspective is nonetheless required to educate and train any researcher (including postgraduate students upon their entrée into the world of research) to comprehend the demands made by research and how best these demands can be addressed. It is in this context that a more comprehensive concept of research education is promoted. The argument is based on the perspective that methodological understanding alone is not sufficient to assist a researcher in meeting the expectations of a research project. Research education refers to the training of researchers to be responsive to the research value chain. This includes aspects such as the formal research process, the importance of research ethics and integrity regarding the research project, the imperative to promote scholarship in research and the application of research results through technology transfer, innovation and incubation. Research education sensitizes the researcher to look beyond the scope of the academic research project and to extend the research to activities such as technology transfer, innovation, commercialization and partnerships. The aim of research education is to promote the wide range of aspects contributing to the understanding of what counts as research and its application.

The thesis draws on a mixed-methods study which empirically and theoretically investigates the ways in which postgraduate students engage in collaborative learning activities facilitated by technology. The research is both significant and distinct in its approach towards understanding how learners engage in real-life computer-supported collaborative learning (CSCL) settings; what enables or hinders learner engagement; and how engagement shapes the learning outcomes. The ensuing findings indicate that learner engagement is embodied in human behaviour, emotions, and reflection and therefore it is described as a multi-dimensional concept. Learner engagement also appears to be a socially distributed phenomenon – rather than a stable student characteristic – influenced by various personal, group-level, and other situational factors, the most prominent of which are captured by the Hierarchical Model of Enablers and Barriers. The study also reveals that learner engagement presupposes purposeful interaction which is presented as an integrative theme capturing the impact of pedagogical design on engagement. Another observation is that particular combinations of student actions, perspectives, and characteristics tend to resurface and therefore may be considered as strong predictors of potential engagement (or disengagement). This finding led to the development of the WISE Taxonomy of Learner Engagement Archetypes which portrays the most universal engagement approaches that emerged within the studied context. Finally, findings seem to suggest that the way students envisage their learning outcomes is driven by the engagement approach each student adopts, and vice-versa. When combined, the proposed model, taxonomy, and conceptualisation of learner engagement collectively define a holistic analytical framework labelled Distributed Engagement Theory. The purpose of this mixed-methods study is to explore, understand, and subsequently explain learner engagement aiming at making an original contribution to existing CSCL literature as well as informing the design of pedagogical models for enhancing learner engagement in CSCL environments within postgraduate education.

Thesis (Ph.D.), Faculty of Humanities, School of Education, University of the Witwatersrand, 2009 / People who hold doctoral degrees are considered valuable national resources able to produce knowledge to address pressing problems, and important sources of labour for the higher education sector. However, in 2006, only 1100 people graduated with doctoral degrees in South Africa. This limits the potential for research and improvements in higher education. In addition, 618 of those graduates were white, making it difficult to address equity concerns. Within the higher education sector there are debates about how to increase enrolments in doctoral education and the best way to run PhD programmes for effective learning, high quality research results and for efficiency. But there is little South African-based empirical research into what makes people undertake PhDs, how the programmes work and what learning and knowledge result. This study explores how different stakeholders – national and institutional policymakers, academic staff and doctoral people – understand the PhD; how these understandings influence the practice of doctoral education; and how different practices affect the PhD experience and the learning and knowledge produced. The primary research question I address is: “How do existing models and pedagogies of doctoral programmes shape the learning of doctoral people and the outcomes of doctoral programmes in South Africa?” The origins of the Doctor of Philosophy degree are often traced back to the nineteenth century reforms of German universities when the idea emerged that all scholars should be actively involved in research. But this is a simplistic view. By examining the evolution of the PhD in greater depth, it becomes clear that it has undergone continuous change and has always served both the high-minded pursuit of knowledge and the more prosaic pursuit of skills for employment. The literature reflects ongoing tension between the scholarly view of the PhD as knowledge generation by an emerging scholar, and the labour market view of the PhD as developing high-level research skills. In the South African context both of these views can be observed, but I also identified a view of the PhD as ongoing personal development through an engagement with knowledge. The three views of the PhD are underpinned by different discourses which inform the practice of doctoral education. In South Africa, the traditional model of individual supervision dominates, and it varies by discipline, department and supervisor. But patterns of practice can be discerned and I identify four of these and discuss how supervisors construct their individual supervision practice. Doctoral education is also a function of the people who do PhDs. Much of the research undertaken in the overdeveloped world focuses on younger people who are starting out on academic careers. However, in South Africa, many people doing PhDs are older and midway through careers which are often not academic. This leads me to propose a model of intersecting contexts, as an alternative to McAlpine and Norton‟s nested context model of doctoral education, which more accurately reflects the local situation. I discuss the PhD experience and make use of the intersecting contexts model to develop the notion of congruence between the PhD, the contexts and the PhD person with more positive experiences being related to higher degrees of congruence. Finally, I consider how the outcomes of doctoral education, the learning and knowledge which result, relate to the expectations of the different stakeholders. The research took the form of a qualitative study with a multiple case-study design employing theoretical replication. I examined doctoral education in four academic units at three South African universities with the units selected to represent different disciplines. All four units were in previously advantaged universities from the English-speaking tradition and all were successfully producing PhD graduates. These rich pictures of how doctoral education takes place contribute empirical evidence to current debates about the PhD in South Africa. At a conceptual level I identify the competing discourses about what a PhD is. I provide a more nuanced understanding of the practice of doctoral education within the overarching model of individual supervision. The intersecting contexts model provides a way to understand the expectations and circumstances of doctoral people and the notion of congruence illuminates their varied experiences. Finally, the study confirms that the outcomes of doctoral education, in terms of learning and knowledge generated, meet at least some of the expectations of policy-makers, supervisors and people who do PhDs.