Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-13T17:44:45Z No. of bitstreams: 1 ludsonrochamartins.pdf: 1806445 bytes, checksum: 620420c2562d29d438d01a3c62d0150f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T17:37:09Z (GMT) No. of bitstreams: 1 ludsonrochamartins.pdf: 1806445 bytes, checksum: 620420c2562d29d438d01a3c62d0150f (MD5) / Made available in DSpace on 2016-01-25T17:37:09Z (GMT). No. of bitstreams: 1 ludsonrochamartins.pdf: 1806445 bytes, checksum: 620420c2562d29d438d01a3c62d0150f (MD5) Previous issue date: 2014-12-16 / A Dissertação investiga as diferenças teórico-metodológicas entre os paradigmas mais relevantes da Sociologia das Profissões e as maiores elaborações contemporâneas que se debruçam sobre o estatuto do trabalho do assistente social. Nesse sentido propõe uma reflexão crítica sobre a legitimidade enquanto determinação central mobilizada pelas diversas correntes do profissionalismo, a partir de uma avaliação feita sobre bases marxistas. Assim, pontua o caráter arbitrário da abstração da legitimidade e pondera que tal discussão precisa ser melhor considerada a partir da sua ligação com o fenômeno da ideologia. Fornece também um quadro sintético sobre os principais lineamentos dos trabalhos de José Paulo Netto, Marilda Iamamoto e Vicente Faleiros no campo dos fundamentos do Serviço Social. A investigação destaca os elementos inovadores das ideias de tais estudiosos, defendendo que deles pode-se extrair algumas bases fundamentais para o tratamento da legitimidade no âmbito profissional. / The dissertation explores the theoretical and methodological differences between the most relevant paradigms of Professional Sociology and the more important contemporary conceptions about the statute of the Social Assistant’s work. It shows a critical reflection on legitimacy as a central determination taken by the different theories of professions, departing from an evaluation constructed on a Marxist base. Thus, it affirms the arbitrary character of legitimacy and it establishes that such discussion is more accurate if considered in its relation to the ideology phenomena. The dissertation also presents an analytical synthesis of main points of the works of José Paulo Netto, Marilda Iamamoto and Vicente Faleiros in the field of Social Work’s foundations. The research remarks the innovative elements of the ideas of such scholars, defending that they can provide the central bases to the understanding of legitimacy in the professional field.

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Magister Pharmaceuticae - MPharm / The World Health Organisation (WHO) has stated that “there is no health without a workforce” (Campbell et al., 2013). The health workforce is essential for every health care system. The availability, accessibility and quality of health care workers play an important role in improving and overcoming health system challenges, in particular the call to universal health coverage (UHC) as stipulated in sustainable development goal 3. It has been observed that there is limited collaboration between healthcare systems and academic institutions. According to an article by Frenk et al., 2010, this limited collaboration has resulted in a mismatch between health care graduates’ competencies (such as inter-professional collaboration) and the needs of the population that they serve. One of the problems of health education institutions is the emphasis on curriculum content and learning methods as opposed to social purpose and moral obligations. / 2021-08-30

Bakgrund och problem: Införandet av New Public Management har lett till förändringar inom hälso- och sjukvården. Förändringar som ska minska sjukvårdens kostnader samtidigt som den ska upprätthålla kvaliteten. Den offentliga sektorn har utmaningar som består av höga sjuktal, önskemål om högre lön och bättre arbetsmiljö. Inom hälso- och sjukvården finns det flera institutionella logiker som formar olika beteenden hos medarbetaren inom organisationen. När dessa möts kan det uppstå motstånd som resulterar i konflikter. Hur stor påverkan institutionella logiker har på medarbetarens dagliga arbete behöver studeras närmare för att på så vis öka kunskapen kring utmaningarna.Syfte: Syftet är att undersöka hur institutionella logiker kan visa sig i organisationen samt hur logiker kan påverka medarbetaren i det dagliga arbetet. Studien avser att ge organisationer inom hälso- och sjukvården en djupare bild över de två idealtyperna managementlogiken och professionslogiken och vilka effekter de kan få på medarbetaren.Metod: Eftersom studiens syfte är att få en insyn i hur medarbetaren påverkas av institutionella logiker baseras studien på kvalitativ metod. För att skapa en djupare bild kring medarbetares uppfattning av sin sociala kontext valdes en fallstudie att genomföras. Studien är baserad på nio stycken kvalitativa intervjuer med informanter som innehar olika professioner inom hälso- och sjukvården.Slutsats: Studien visar att de två idealtyperna av logiker, managementlogiken och professionslogiken existerar i verksamheten där professionslogiken är mest dominant. Den visar även att institutionella logiker påverkar medarbetaren i sitt dagliga arbete. Hur mycket beror på vilken logik medarbetaren identifierar sig med. Det gick även att urskilja att det existerar flera professionslogiker i verksamheten, vilket leder till spänningar mellan olika professionsgrupper. / Background and problem: The introduction of New Public Management has led to changes in healthcare. Changes in purpose to reduce healthcare costs while maintaining quality. However, on the contrary, this has resulted in challenges that consist of high rates of illness, a desire for higher wages and a better working environment. Within the healthcare organization, there are several institutional logics that shape different behaviors of employees within the organization. When they meet, resistance can result in conflicts. How much the impact of institutional logics has on the employee's daily work needs to be studied more closely in order to increase knowledge about the challenges.Purpose: The purpose is to investigate how institutional logics can manifest themselves in the organization as well as influence the employee in daily work. The study intends to give healthcare organizations a deeper picture of the two ideal types, management logic and professional logic and what effects they can have on the employee.Method: Since the purpose of the study is to gain an insight into how the employee is affected by institutional logic, the study is based on a qualitative method. In order to create a deeper understanding of employees' perceptions of their social context, a case study was chosen to be conducted. The study is based on nine qualitative interviews with informants who hold various healthcare professions.Conclusion: The study shows that the two ideal types of logics, management logic and professional logic exist in the business where professional logic is most dominant. It also shows that institutional logics influence the employee in their daily work. How much depends on which logic the employee identifies with. It was also possible to distinguish that there are several professional logics in the business, which leads to tensions between different professional groups.

Magister Chirurgiae Dentium (MChD) / Exodontia remains one of the most regularly done procedures in dentistry in South Africa (SA) and alveolar osteitis (AO) is considered one of the most common complications associated with exodontia. Despite the extensive research done on this clinical entity, the management of AO still remains controversial. Various management protocols have been suggested in the literature, varying from prophylactic to symptomatic management of AO (Blum,2002). However, none of these management protocols have to date shown any conclusive evidence on the effectiveness and benefit over another protocol. The author was of the opinion that general dental practitioners (GDPs) in South Africa generally use preventative and treatment protocols based on what they were taught at their alumni dental schools or use protocols modified from their own clinical experience in practice. The aim of this study was to assess which treatment protocols are routinely used by GDPs in South Africa for the management of AO and suggest a scientifically sound treatment protocol for AO. The study was done in the form of a questionnaire and the participants were randomly selected from the Health Professions Council's register. The results showed that most of the GDPs in South Africa continued to use the same treatment protocol as their alumni dental school. They were of the opinion that these protocols were still clinically the most effective. Despite the plethora of intra-alveolar medicaments available, Alvogyl®still remains the medicament of choice of GDPs. As there is no evidence in the scientific literature that suggests that one intra-alveolar medicament or antibiotic is more effective than the other, the author does not encourage the use of the medicaments or antibiotics in the treatment of AO. However, by following simple measures such as improving patients' oral hygiene and using a pre-operative 0.2% chlorhexidine mouth rinse, the incidence of AO can be reduced significantly.

This paper is about the perspective of street-level bureaucrats (SLB)' ethics in their work with clients, their discretion and role, and how that influences their actions. It is a qualitative study at Försäkringskassan (the Swedish Social Insurance Agency) using interviews with eight officials that investigates eligible for sickness benefit. The study uses the perspective of Bornemark (2018) about ethics of control and internal principles, which are explained with the logic of the bureaucrats and professionals. Because SLB both shall implement a general law (bureaucrats’ logic) and meet the unique needs of individuals (professional logic) they may experience ethical stress. Our result shows that both ethical perspectives (ethics of control of bureaucrats and professional internal principles) exist inside the SLB and therefor there are some ethical stress for the individual. Also, our result shows that they are handling it in Lipskys (2010) three different strategies. Some try to show more compassion by giving clients more time, service and information. Others hide more behind the law or in the worst case resign. Should the rules be as controlled as they are today? Or should it do society good to lose the control a little and give the SLB some room for discretion in unique situations?

While the body of evidence supporting the use of simulation-based learning in the education of health professionals is growing, howor why simulation-based learning works is not yet understood. There is a clear need for evidence, grounded in contemporary educational theory, to clarify the features of simulation instructional design that optimize learning outcomes and efficiency in health care professional students. Cognitive Load Theory (CLT) is a theoretical framework focused on a learner’s working memory capacity. One principle of CLT is example based learning. While this principle has been applied in both traditional classroom and laboratory settings, and has shown positive performance and learning outcomes, example based learning has not yet been applied to the simulation setting. This study had two main objectives: to explore if the example-based learning principle could successfully be applied to the simulation learning environment, and to establish response process validation evidence for a tool designed to measure types of cognitive load. Fifty-eight novice students from nursing, podiatric medicine, physician assistant, physical and occupational therapy programs participated in a blinded randomized control study. The dependent variable was the simulation brief. Participants were randomly assigned to either a traditional brief or a facilitated tutored problem brief. Performance outcomes were measured with verbal communications skill presented in the Introduction, Situation, Background, Assessment, Recommendation (I-SBAR) format. Response process evidence was collected from cognitive interviews of 11 students. Results indicate participation in a tutored problem brief led to statistically significant differences at t(52)=-3.259, p=.002 in verbal communication performance compared to students who participated in a traditional brief. Effect size for this comparison was d=(6.06-4.61)/1.63 = .89 (95% CI 0.32-1.44). Response process evidence demonstrated that additional factors unique to the simulationlearning environment should be accounted for when measuring cognitive load in simulation based learning (SBL). This study suggests that example based learning principles can be successfully applied to SBL and result in positive performance outcomes for health professions students. Additionally, measures of cognitive load do not appear to capture all contribution toload imposed by the simulation environment.

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Competence committees are groups of educators that monitor the progress of medical trainees and decide when they should be promoted to the next stage of training. They represent an important part of modern-day competency-based medical education programs, yet relatively little is known about their implementation and decision-making practices. This thesis seeks to fill a critical gap in the literature by generating empirical evidence with respect to competence committee implementation and decision-making practices across multiple programs. The first data chapter uses a multi-method approach to examine competence committee implementation practices at a Canadian institution over a three-year period. The second and third chapters examine how individuals and groups make promotion decisions, respectively. These chapters also consider the role of non-traditional data sources, such as anecdotal evidence, in competence committees’ decision-making processes. The final data chapter considers the role of social influences and power and examines how factors such as members’ position on the committee, gender, and race/ethnicity influence their contributions to the committee. This thesis provides insight into some of the challenges that exist with respect to competence committee implementation and offers potential solutions based on best practices across multiple programs. It also highlights factors that can influence competence committee decision making and discusses ways that their decision-making processes can be optimized. Broader implications of this thesis, including the role of groups in solving complex problems and the importance of diversity (both in terms of demographics and functional specialization) in ensuring good decision-making outcomes, are also discussed. / Thesis / Doctor of Philosophy (PhD) / Competence committees are groups of experienced health professionals and educators whose job is to determine whether physician learners (i.e., residents) are ready to progress to the next stage of training and responsibility. These committees are relatively new, and as a result, we do not know very much about how they make decisions. Given the importance of competence committees in ensuring that physicians are able to provide high-quality and safe patient care, the purpose of this thesis was to examine competence committee implementation and decision-making practices at a Canadian academic centre. This took place in two parts. First, we studied competence committees over a three-year period using surveys, interviews, and observations. This helped us understand some of their benefits and challenges. Next, we conducted a series of experiments to understand how competence committee members make decisions both individually and as part of a group. These experiments also helped us understand how competence committees make sense of different types of data, such as prior knowledge about a resident or their assessors. Finally, we examined how various aspects of members’ social identities, such as their position on the committee, their gender, and their race/ethnicity, influence their contributions to the committee. Collectively, the findings of this thesis help to advance the scientific literature in the areas of medical education and group decision making. They can also be used to optimize competence committee operations, which can in turn positively impact patients, healthcare, and society.