Applying evidence-based medicine in general practice : a video-stimulated interview study on workplace-based observation

BACKGROUND: Evidence-based medicine (EBM) in general practice involves applying a complex combination of best-available evidence, the patient's preferences and the general practitioner's (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other's consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other's EBM behaviour through observation, and by identifying aspects that influence their recognition. METHODS: We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner's consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner's actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other's considerations well with those who did not, we developed a model describing the aspects that influence the observer's recognition of an actor's EBM behaviour. RESULTS: Overall, there was moderate similarity between an actor's EBM behaviour and the observer's recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role. CONCLUSIONS: GP trainees and supervisors do not fully recognise EBM behaviour through observing each other's consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decision-making is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines

Now what? First year student teachers' reflective journal writing.

With the increasing focus for New Zealand teachers on reflective practice, initial teacher educators must take increasing responsibility in scaffolding students' critical writing, developing reflection skills for working in schools, the teacher registration process and ongoing professional learning. This article reports a study of journal writing practices of a sample of student teachers in their first year of an undergraduate degree at the University of Waikato. Of particular interest in the findings are the sophistication of the students' writing, choice of topic for each entry and the impact of feedback and support provided

Joint observation of student teaching and related tripartite dialogue during field experience : Partner perspectives

Peer reviewedPostprin

Creating a culture of coaching: upskilling the school workforce in times of change

Research Associate Full report, Spring 2011. "Within an education culture striving for continuous improvement, there is a constant need to ensure the appropriate skills, knowledge and actions of staff match the changing needs of the system. Coaching can assist in this process of ‘upskilling’. This research study explored how a small cross-phase sample of eight schools in one local authority area went about the process of creating a culture of coaching, the logistics of so doing, and the impact that this had on professional development and pupil progress." - Page 3

Learning relationships from theory to design

This paper attempts to bridge the psychological and anthropological views of situated learning by focusing on the concept of a learning relationship, and by exploiting this concept in our framework for the design of learning technology. We employ Wenger's (1998) concept of communities of practice to give emphasis to social identification as a central aspect of learning, which should crucially influence our thinking about the design of learning environments. We describe learning relationships in terms of form (one‐to‐one, one‐to‐many etc.), nature (explorative, formative and comparative), distance (first‐, second‐order), and context, and we describe a first attempt at an empirical approach to their identification and measurement

The Effect of Walkthrough Observations on Teacher Perspectives in Christian Schools

This study investigated the effects on teacher perceptions of frequent, brief classroom observations in Christian schools. Teachers (N=111) responded to 13 belief and value statements prior to and after the term during which administrators conducted weekly, brief, unannounced observations in their classes. Teachers reported significant positive change regarding (a) analyzing reasons for selecting methods to assess learning, (b) being encouraged after class observations, and (c) being encouraged after receiving feedback related to the observations

Design Process and Organisational Strategy: A Storytelling Perspective

This paper explores the relationship between design process and organisational strategy through a storytelling perspective by providing a literature review; firstly, in relation to society in general; establishing a contextual background to the research. Secondly, by relating this to a) how designers and design researchers examine storytelling within design process, and b) how organisational strategists theorise storytelling. Then finally, through comparing and contrasting the literature, unearth the relevancies of using a storytelling perspective and uncover opportunities for understanding how design process impacts organisational strategy. It is apparent that certain underlying principles in adopting a storytelling perspective when employing organisational strategy and design process coexist. Foremost are the human centred focuses; in particular building relationships and constructing identities. Concerning the approaches to storytelling, a shared desire to elicit emotional resonance with audiences exists in the use of characterisation. During collaboration between designers and organisations, stories resulting from the design process will incontrovertibly have the potential to impact that company’s peoples. Examining collaborations between designers and organisations from the perspective of storytelling could lead to a deeper understanding of the impact design can have in an organisation, particularly along the themes of a sense of community, constructing meaning and affecting change within organisations

Why is finance critical? A dialogue with a women's community in Sri Lanka

The busrt of the bubble has given momentum to the search of escape routes from the current transnational financial system and its underlying principles. For the past century, The transnational financial system has relied heavily on currency exchange, security backed loans, stocks and shares - all operated through banks, investment agencies, insurance brokers and stock markets. This global financial architecture centred on monetray values. It strived for financial wealth and achieved it for few out of many. This study shows that the practice of finance can create a wealth of a different - a scoial- nature. Applying an ethnographic approach to financial practices, this study tries to uncover how the sociocultural aspects of finance practiced among the poor rural women in Sri Lanka lead to the creation of social wealth beyond financial wealth. It discovers how finance is critical to such communities becauise it is creating wealth beyond financial measurement. Finance comes to Sinalhese women's everyday lives through traditional savings systems - seettu, household and group saving and it operates through frienships, kin relationships and social realtions. These community organisation develop social wealth through their thrifts, based on traditional practices of saving.Since transnational finance is driven by monetary values only, it overlays structures and that ignores local cultures, social networks and community identies necessary for the creation of social wealth. As a consequence, encounters with transnational finance inspire resistance in citizens of developing nations such as Sri Lanka. In an attempt to preserve their more tradional ways of exchange, communities find themselves workign agianst finance. Therefore in this paper I am interested in engaging in a dialogue with a rural community, to learn their ways of organising finance and the extent to which finance becomes critical to their everyday live