What makes a good clinical student and teacher? An exploratory study

<b>Background</b> What makes a good clinical student is an area that has received little coverage in the literature and much of the available literature is based on essays and surveys. It is particularly relevant as recent curricular innovations have resulted in greater student autonomy. We also wished to look in depth at what makes a good clinical teacher. <p></p> <b>Methods</b> A qualitative approach using individual interviews with educational supervisors and focus groups with senior clinical students was used. Data was analysed using a “framework” technique. <p></p> <b>Results</b> Good clinical students were viewed as enthusiastic and motivated. They were considered to be proactive and were noted to be visible in the wards. They are confident, knowledgeable, able to prioritise information, flexible and competent in basic clinical skills by the time of graduation. They are fluent in medical terminology while retaining the ability to communicate effectively and are genuine when interacting with patients. They do not let exam pressure interfere with their performance during their attachments. <p></p> Good clinical teachers are effective role models. The importance of teachers’ non-cognitive characteristics such as inter-personal skills and relationship building was particularly emphasised. To be effective, teachers need to take into account individual differences among students, and the communicative nature of the learning process through which students learn and develop. Good teachers were noted to promote student participation in ward communities of practice. Other members of clinical communities of practice can be effective teachers, mentors and role models. <p></p> <b>Conclusions</b> Good clinical students are proactive in their learning; an important quality where students are expected to be active in managing their own learning. Good clinical students share similar characteristics with good clinical teachers. A teacher’s enthusiasm and non-cognitive abilities are as important as their cognitive abilities. Student learning in clinical settings is a collective responsibility. Our findings could be used in tutor training and for formative assessment of both clinical students and teachers. This may promote early recognition and intervention when problems arise

Savings Accounts and the Life-Cycle Approach to Social Insurance

Using Danish data, we find that about three fourths of the taxes levied to finance public transfers actually finance benefits that do not redistribute between people but redistribute income over the life cycle of individual taxpayers. This provides a rationale for financing part of social insurance via mandatory individual savings accounts. An account system that offers liquidity insurance and a lifetime income guarantee helps to alleviate the dilemma between insurance and incentives. To illustrate this, we analyse a specific proposal for reform of the Danish system of social insurance, involving the use of individual accounts. We estimate how the reform would affect the distribution of lifetime incomes, the public budget, and economic efficiency. Our analysis suggests that, even with conservative assumptions regarding labor supply elasticities, the proposed reform would generate a Pareto improvement and would imply only a minor increase in the inequality of lifetime income distribution.social insurance; individual accounts; lifetime income distribution

The relationship between health care users’ demand and the health care system’s response: a research on change observed in the health care system, in the hospital and in the territory

The present research study aims at exploring the representation of the health service within a group of hospital physicians and nurses. The objective is to identify how the symbolic dynamic of hospital workers shapes their own praxis. The texts of interviews with 25 hospital workers have been subjected to Emotional Text Analysis (ETA). Five clusters emerge from the analysis where the topic of giving life and avoiding death is central and where the hospital assumes a thaumaturgical and basically omnipotent role. This is in conflict with recognizing the limitations of therapy. Only in the background the culture of curing the patients appears, characterized by aggressive reactivity towards the crisis which leads patients to emergency intervention because crises are ascribed to deviances frommedical prescription. Emergency intervention is ultimately the kind of intervention which the hospital believes it is capable to provide. Another problem is the lack of filters provided by bureaucratized general practitioners, whose cooperation would be essential, but who are supposed to have no longer the necessary relationship with their patients

La relazione che organizza il contesto sanitario: domanda dell’utenza e risposta dei servizi sanitari, nel territorio e nell’ospedale - The relationship which organizes the healthcare context: users’ demand and response of healthcare services, in the territory and the hospital

Our intent is to present citizens’ demand of health care services in Italy through a research structured in three studies. We used the Emotional Text Analysis (ETA) to lead the three s tudies: the first study regarded the citizens’expectations of the healthcare services, the second study regarded the point of view of the hospital personnel (medical doctors and nurses), the third regarded the point of view of the General Practitioners onthe health care services. These three studies are briefly presented. Data and outcome of an Assumed Similarity Test applied to all experimental subjects of the three studies in order to make a comparison among them, are also presented. The findings of the Emotional Text Analysis show that citizens, potential users of health services, center their requests on their individual subjectivity, and seek answers both to their suffering and to the feeling of alienation that characterizes the being sick feeling that makes them go to a medical doctor. For their part, general practitioners and hospital doctors immediately transform this subjective feeling in an objective medical diagnosis. Here a first gap emerges between patient’s demand and medical response, leavingthe possibility of an alliance on the diagnosis in order to jointly fight the disease. It has long been in place though a change that has expelled the patient also from sharing the diagnostic process, increasingly taken from self-centered dynamics within the healthcare system. This widens the gap between the request of the citizens and the response of the health services, that contributes to that conflictual growth to which defensive medicine gives a dysfunctional answer. The Assumed Similarity Test contributes to the interpretation of the health care dynamic identified in the Emotional Text Analysis; particularly in regard to the unfolding conflict, given by the hypothesis emerging from the data analysis, that a feeling of closeness for the hospital personnel goes along with an emotional stance of overpowering the othe

Job performance and job satisfaction: an integrated survey

The empirical evidence from the econometrics of self-reported job satisfaction and from organisational psychology on job performance confronts economic theory with some puzzling results. Job performance is found to be positively correlated with job satisfaction, whereas effort is assumed to be a disutility in the theory. Economic incentives are not found to be the main motivations of job performance; in some cases, indeed, they are even counterproductive. Interest in the job is found to account better for job satisfaction. This paper proposes an integrated approach to these issues by (i) conducting an interdisciplinary critical survey, (ii) proposing a simple economic framework within which to explain the puzzles. The key idea behind this framework is that intrinsic motivations and self-esteem help explain both job satisfaction and job performance. The employer can thus adopt other, more friendly actions, besides using incentives and controls to enhance performance by employees.job performance, job satisfaction, intrinsic motivations

El impacto de la formación en línea en la transferencia de comportamiento y en el desempeño laboral en una gran organización

Este estudio analiza la efectividad de la formación en línea en una gran organización. Se ha probado la influencia de diferentes procesos de la formación, como las estrategias de aprendizaje, las reacciones, el apoyo a la transferencia y las barreras, en la transferencia del comportamiento y el desempeño laboral. Los participantes fueron 3,600 empleados de un banco público brasileño que participaron en una formación en línea en el trabajo. Seis meses después, sus supervisores evaluaron las influencias de la formación en el comportamiento laboral de sus subordinados. Los hallazgos indicaron que en la autoevaluación la transferencia del comportamiento se predijo mediante estrategias de aprendizaje de elaboración/aplicación práctica, reacciones a la formación, apoyo organizacional y de pares; las estrategias de control de la motivación, cognitivas/búsqueda de ayuda y elaboración/aplicación práctica, junto con las reacciones a la formación, se relacionaron significativamente con el desempeño laboral. En la heteroevaluación, el apoyo del supervisor contribuyó a explicar la transferencia del comportamiento y las estrategias cognitivas/búsqueda de ayuda explicaron el desempeño laboral. Se identificó el papel mediador de las reacciones a la formación y el apoyo a la transferencia mostró efectos moderadores marginales.This study analyzes the effectiveness of online training in a large organization. We tested the influence of different training processes, such as learning strategies, reactions, support of transfer, and barriers, on behavioral transfer and job performance. The participants were 3,600 employees of a Brazilian public bank after taking part in online training at work. Six months later, their supervisors evaluated the influences of the training on their subordinates’ work behaviors. Findings indicated that in self-evaluation behavioral transfer was predicted by elaboration/practical application learning strategies, trainees’ reactions to training, organizational, and peer support; motivation control, cognitive/help-seeking, and elaboration/practical application learning strategies, along with trainees’ reactions to training, were significantly related to job performance. In hetero-evaluation, supervisor support contributed to explaining behavioral transfer, and cognitive/help-seeking strategies explained job performance. The mediating role of reactions to training was identified, and support of transfer showed marginal moderating effects.Ministerio de Economía y Competitividad PSI2015-64894-

Constructing an understanding of mind : the development of children's social understanding within social interaction

Theories of children's developing understanding of mind tend to emphasize either individualistic processes of theory formation, maturation, or introspection, or the process of enculturation. However, such theories must be able to account for the accumulating evidence of the role of social interaction in the development of social understanding. We propose an alternative account, according to which the development of children's social understanding occurs within triadic interaction involving the child's experience of the world as well as communicative interaction with others about their experience and beliefs (Chapman 1991; 1999). It is through such triadic interaction that children gradually construct knowledge of the world as well as knowledge of other people. We contend that the extent and nature of the social interaction children experience will influence the development of children's social understanding. Increased opportunity to engage in cooperative social interaction and exposure to talk about mental states should facilitate the development of social understanding. We review evidence suggesting that children's understanding of mind develops gradually in the context of social interaction. Therefore, we need a theory of development in this area that accords a fundamental role to social interaction, yet does not assume that children simply adopt socially available knowledge but rather that children construct an understanding of mind within social interaction

On the Determinants of Social Capital in Greece Compared to Countries of the European Union

Social capital refers to the stock of social relations, based on norms and networks of cooperation and trust that spill over to the market and state to enhance collective action between actors and achieve improved social efficiency and economic growth. The aim of the present paper is to discuss the implications of contemporary literature and empirical findings on social capital for the growth prospects of Greece, compared to the member-states of the European Union. In order to examine the potential of social capital to enhance growth, we must look into the factors that determine the nature and context of trust, norms and networks that have emerged in our multinational, multiethnic and multicultural Europe.The contribution of this paper is to offer insight on the determinants of social capital in Greece, compared to the European Union (EU - former 15 member-states). For this purpose, we regress an index of individual group membership, derived from the European Community Household Panel (ECHP), on a set of individual as well as aggregate factors of social capital. Regression results provide evidence of the impact of both individual and institutional characteristics on group membership. Differences on the extent of group membership between countries might be indicative of the historical and cultural differences that have affected the evolution of social capital across Europe. Particularly in Greece, the relatively low level of group membership compared to the other EU countries might provide further evidence of its low levels of civicness. Historically, its weak civil society has been a result of a prior civic tradition of clientelism under arbitrary rule, the interference of special-interest groups and the lack of credibility and impartiality from the part of the state. And these factors might be responsible for the slow pace in reform and growth observed compared to the rest of the EU. Nevertheless, the findings on the determinants of social capital may direct us to possible means of rebuilding patterns of participatory and cooperative behavior, especially in countries with low levels of trust and civicness, such as Greece.Determinants, Social capital in Greece, European union, Diversity