Managing the complexity of doing it all : an exploratory study on students' experiences when trained stepwise in conducting consultations

Background: At most medical schools the components required to conduct a consultation, medical knowledge, communication, clinical reasoning and physical examination skills, are trained separately. Afterwards, all the knowledge and skills students acquired must be integrated into complete consultations, an art that lies at the heart of the medical profession. Inevitably, students experience conducting consultations as complex and challenging. Literature emphasizes the importance of three didactic course principles: moving from partial tasks to whole task learning, diminishing supervisors' support and gradually increasing students' responsibility. This study explores students' experiences of an integrated consultation course using these three didactic principles to support them in this difficult task. Methods: Six focus groups were conducted with 20 pre-clerkship and 19 clerkship students in total. Discussions were audiotaped, transcribed and analysed by Nvivo using the constant comparative strategy within a thematic analysis. Results: Conducting complete consultations motivated students in their learning process as future physician. Initially, students were very much focused on medical problem solving. Completing the whole task of a consultation obligated them to transfer their theoretical medical knowledge into applicable clinical knowledge on the spot. Furthermore, diminishing the support of a supervisor triggered students to reflect on their own actions but contrasted with their increased appreciation of critical feedback. Increasing students' responsibility stimulated their active learning but made some students feel overloaded. These students were anxious to miss patient information or not being able to take the right decisions or to answer patients' questions, which sometimes resulted in evasive coping techniques, such as talking faster to prevent the patient asking questions. Conclusion: The complex task of conducting complete consultations should be implemented early within medical curricula because students need time to organize their medical knowledge into applicable clinical knowledge. An integrated consultation course should comprise a step-by-step teaching strategy with a variety of supervisors' feedback modi, adapted to students' competence. Finally, students should be guided in formulating achievable standards to prevent them from feeling overloaded in practicing complete consultations with simulated or real patients

When Can Employees Have a Family Life? The Effects of Daily Workload and Affect on Work-Family Conflict and Social Behaviors at Home

This article presents a longitudinal examination of antecedents and outcomes of work-to-family conflict. A total of 106 employees participating in an experience-sampling study were asked to respond to daily surveys both at work and at home, and their spouses were interviewed daily via telephone for a period of 2 weeks. Intraindividual analyses revealed that employees ’ perceptions of workload predicted work-to-family conflict over time, even when controlling for the number of hours spent at work. Workload also influenced affect at work, which in turn influenced affect at home. Finally, perhaps the most interesting finding in this study was that employees ’ behaviors in the family domain (reported by spouses) were predicted by the employees ’ perceptions of work-to-family conflict and their positive affect at home

Reduction of Low-Thrust Continuous Controls for Trajectory Dynamics

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76670/1/AIAA-40619-128.pd

Work-Unit Absenteeism: Effects of Satisfaction, Commitment, Labor Market Conditions, and Time

Prior research is limited in explaining absenteeism at the unit level and over time. We developed and tested a model of unit-level absenteeism using five waves of data collected over six years from 115 work units in a large state agency. Unit-level job satisfaction, organizational commitment, and local unemployment were modeled as time-varying predictors of absenteeism. Shared satisfaction and commitment interacted in predicting absenteeism but were not related to the rate of change in absenteeism over time. Unit-level satisfaction and commitment were more strongly related to absenteeism when units were located in areas with plentiful job alternatives

THE ROLE OF INTERDEPENDENCE IN THE MICRO-FOUNDATIONS OF ORGANIZATION DESIGN: TASK, GOAL, AND KNOWLEDGE INTERDEPENDENCE

Interdependence is a core concept in organization design, yet one that has remained consistently understudied. Current notions of interdependence remain rooted in seminal works, produced at a time when managers’ near-perfect understanding of the task at hand drove the organization design process. In this context, task interdependence was rightly assumed to be exogenously determined by characteristics of the work and the technology. We no longer live in that world, yet our view of interdependence has remained exceedingly task-centric and our treatment of interdependence overly deterministic. As organizations face increasingly unpredictable workstreams and workers co-design the organization alongside managers, our field requires a more comprehensive toolbox that incorporates aspects of agent-based interdependence. In this paper, we synthesize research in organization design, organizational behavior, and other related literatures to examine three types of interdependence that characterize organizations’ workflows: task, goal, and knowledge interdependence. We offer clear definitions for each construct, analyze how each arises endogenously in the design process, explore their interrelations, and pose questions to guide future research

UvA-DARE (Digital Academic Repository) Facing differences with an open mind: Openness to experience, salience of intra-group differences, and performance of diverse work groups

. (2008). Facing differences with an open mind: Openness to experience, salience of intra-group differences, and performance of diverse work groups

Facing differences with an open mind: Openness to Experience, salience of intra-group differences, and performance of diverse groups.

This study examined how the performance of diverse teams is affected by member openness to experience and the extent to which team reward structure emphasizes intragroup differences. Fifty-eight heterogeneous four-person teams engaged in an interactive task. Teams in which reward structure converged with diversity (i.e., "faultline" teams) performed more poorly than teams in which reward structure cut across differences between group members or pointed to a "superordinate identity." High openness to experience positively influenced teams in which differences were salient (i.e., faultline and "cross-categorized" teams) but not teams with a superordinate identity. This effect was mediated by information elaboration