Preceptor Facilitated Debriefing Improves Athletic Training Student’s Clinical Performance and Work Efficacy

Debriefing is an essential part of healthcare training that utilizes a planned conversation to allow clinicians to analyze their actions, thought processes, and emotions with the goal of improving patient care and outcomes. Debriefing requires two-way communications between the athletic training student and facilitating preceptor. The process is more than providing feedback on clinical performance, but a communication process that fosters reflective insight into of behaviors and decisions. Debriefing after patient care encounters has been shown to increase critical thinking, confidence, clinical skill and clinical reasoning. With this enhancement in cognition and behavior, debriefing allows the student to strengthen their own capabilities and efficacy, better preparing themselves for real time clinical practice. Facilitating effective debriefing is challenging for seasoned educators, as well as practitioners untrained to facilitate effective debriefing

Implementing advance care planning in routine nursing home care : the development of the theory-based ACP+ program

Background While various initiatives have been taken to improve advance care planning in nursing homes, it is difficult to find enough details about interventions to allow comparison, replication and translation into practice. Objectives We report on the development and description of the ACP+ program, a multi-component theory-based program that aims to implement advance care planning into routine nursing home care. We aimed to 1) specify how intervention components can be delivered; 2) evaluate the feasibility and acceptability of the program; 3) describe the final program in a standardized manner. Design To develop and model the intervention, we applied multiple study methods including a literature review, expert discussions and individual and group interviews with nursing home staff and management. We recruited participants through convenience sampling. Setting and participants Management and staff (n = 17) from five nursing homes in Flanders (Belgium), a multidisciplinary expert group and a palliative care nurse-trainer. Methods The work was carried out by means of 1) operationalization of key intervention components identified as part of a previously developed theory on how advance care planning is expected to lead to its desired outcomes in nursing homes into specific activities and materials, through expert discussions and review of existing advance care planning programs; 2) evaluation of feasibility and acceptability of the program through interviews with nursing home management and staff and expert revisions; and 3) standardized description of the final program according to the TIDieR checklist. During step 2, we used thematic analysis. Results The original program with nine key components was expanded to include ten intervention components, 22 activities and 17 materials to support delivery into routine nursing home care. The final ACP+ program includes ongoing training and coaching, management engagement, different roles and responsibilities in organizing advance care planning, conversations, documentation and information transfer, integration of advance care planning into multidisciplinary meetings, auditing, and tailoring to the specific setting. These components are to be implemented stepwise throughout an intervention period. The program involves the entire nursing home workforce. The support of an external trainer decreases as nursing home staff become more autonomous in organizing advance care planning. Conclusions The multicomponent ACP+ program involves residents, family, and the different groups of people working in the nursing home. It is deemed feasible and acceptable by nursing home staff and management. The findings presented in this paper, alongside results of the subsequent randomized controlled cluster trial, can facilitate comparison, replicability and translation of the intervention into practice

Beliefs in advance care planning among Chinese Americans: Similarities and differences between the younger and older generations

The purpose of this research is to explore behavioral, normative, and control beliefs in the discussion of advance care planning (ACP) among older and younger Chinese Americans. Ethnic minority groups have been identified as less engaged in ACP and this represents an ethnic and cultural gap. Older Chinese American adults often have different beliefs and values compared to the younger generation who are more acculturated to American mainstream culture. These differences may hinder the discussion of ACP with Chinese older adults. A qualitative design was used. The Theory of Planned Behavior guided the development of the interview guide. We recruited 60 Chinese Americans. Prior experience was identified as a theme that influenced attitudes about ACP. We found that older and younger Chinese participants had different beliefs in the norm and control related to ACP discussions, but not in the belief of attitudes about ACP discussions. Both younger and older Chinese American participants believed that ACP was important and necessary. Participants in both clusters expressed that they were ready and willing to engage in ACP discussions with their family members but hesitant to initiate these discussions. The reluctance in discussing ACP with Chinese older adults may be related to the expectations and obligations of Xiao (filial piety) in Chinese culture. This study describes the similarities and differences of beliefs in ACP between older and younger Chinese Americans. We identified barriers and facilitators in behavioral, normative, and control beliefs that can be used to promote ACP for Chinese Americans

Exploring the Behavior of Highly Effective CIOs Using Video Analysis

Although recently several studies have addressed the required skills of effective CIOs, little is known of the actual behavior successful CIOs. In this study, we explore the behavior of highly effective CIOs by video-recording CIOs at work. The two CIOs videotaped were nominated as CIO of the year. We analyze the data in an innovative and systematic way by developing and using a behavioral leadership coding scheme. The analysis indicates that highly effective CIOs are good listeners. They also often verify previously made agreements; structure the conversation; and provide subordinates with factual information. We also compare the behavior of the highly effective CIOs to a sample of 25 highly effective middle managers. Whereas the CIOs spend little time defending themselves against their subordinates and are mostly involved in steering, middle-managers spend much more time defending themselves and show more support for their subordinates. We conclude that our new video observation-and-coding method is viable to analyze and better understand the behavior of CIOs

Turn-boundary projection: Looking ahead

Coordinating with others is hard; and yet we accomplish this every day when we take turns in a conversation. How do we do this? The present study introduces a new method of measuring turn-boundary projection that enables researchers to achieve more valid, flexible, and temporally informative data on online turn projection: tracking an observer’s gaze from the current speaker to the next speaker. In this preliminary investigation, participants consistently looked at the current speaker during their turn. Additionally, they looked to the next speaker before her turn began, and sometimes even before the current speaker finished speaking. This suggests that observer gaze is closely aligned with perceptual processes of turn-boundary projection, and thus may equip the field with the tools to explore how we manage to take turns

Policy-driven planning in coalitions - A case study

(c)IFAAMASPeer reviewedPostprin