Implementing Change: How, Why, and When Teachers Change Their Classroom Practices

Teacher implementation of school reforms varies widely and often results in inconsistent student outcomes. Teachers adopt or resist change for complex reasons that are not fully understood. This qualitative study explored how veteran teachers described their experiences with school reform and changes in classroom practices that occurred over the course of their careers; it also examined factors that teachers identified as having positive and negative influences on their adoptions of change. The conceptual framework was based on Senge\u27s systems theory as applied to learning organizations and Goleman\u27s emotional intelligence theory. The research questions focused on: (a) How veteran teachers described their experiences with various school reforms and changes in classroom practices that have occurred over the course of their careers, and (b) What internal and external factors veteran teachers identified as having a positive or negative influence on their adoptions of change. Eight veteran K-12 public school teachers from a northeastern state were interviewed using a semi-structured, open-ended questionnaire. Data were analyzed using first and second level coding in order to identify emerging patterns and themes and discrepant data. Key findings indicated that the teachers who reported successful implementation of school reforms also reported that the internal factors of self-assessment, self-confidence, initiative, adaptability, and empathy, and the external factors of shared vision, team learning, and systems thinking were important to implementing change. When administrators supported teachers through quality professional development, adequate collaboration time, and respect for their professional judgment, participants embraced school reforms and changed their classroom practices

Words that make pills easier to swallow: a communication typology to address practical and perceptual barriers to medication intake behavior

Annemiek J Linn,1 Julia CM van Weert,1 Barbara C Schouten,1 Edith G Smit,1 Ad A van Bodegraven,2 Liset van Dijk31Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands; 2VU University Medical Center, Amsterdam, The Netherlands; 3Netherlands Institute for Health Services Research, Utrecht, The NetherlandsPurpose: The barriers to patients’ successful medication intake behavior could be reduced through tailored communication about these barriers. The aim of this study is therefore (1) to develop a new communication typology to address these barriers to successful medication intake behavior, and (2) to examine the relationship between the use of the typology and the reduction of the barriers to successful medication intake behavior.Patients and methods: Based on a literature review, the practical and perceptual barriers to successful medication intake behavior typology (PPB-typology) was developed. The PPB-typology addresses four potential types of barriers that can be either practical (memory and daily routine barriers) or perceptual (concern and necessity barriers). The typology describes tailored communication strategies that are organized according to barriers and communication strategies that are organized according to provider and patient roles. Eighty consultations concerning first-time medication use between nurses and inflammatory bowel disease patients were videotaped. The verbal content of the consultations was analyzed using a coding system based on the PPB-typology. The Medication Understanding and Use Self-efficacy Scale and the Beliefs about Medicine Questionnaire Scale were used as indicators of patients’ barriers and correlated with PPB-related scores.Results: The results showed that nurses generally did not communicate with patients according to the typology. However, when they did, fewer barriers to successful medication intake behavior were identified. A significant association was found between nurses who encouraged question-asking behavior and memory barriers (r = −0.228, P = 0.042) and between nurses who summarized information (r = −0.254, P = 0.023) or used cartoons or pictures (r = −0.249, P = 0.026) and concern barriers. Moreover, a significant relationship between patients’ emotional cues about side effects and perceived concern barriers (r = 0.244, P = 0.029) was found as well.Conclusion: The PPB-typology provides communication recommendations that are designed to meet patients’ needs and assist providers in the promotion of successful medication intake behavior, and it can be a useful tool for developing effective communication skills training programs.Keywords: interpersonal communication, tailoring, adherence, coding provider-patient interaction, beliefs, self-efficac

Prototype evaluation of a self-management Internet diary for patients with ulcerative colitis

Lucia Snoei1, Ad van Bodegraven2, Bas Oldenburg3, Theo Stijnen4, Ad A Kaptein11Unit of Psychology, Leiden University Medical Center, Leiden, The Netherlands; 2Department of Gastroenterology, VU University Medical Center, Amsterdam, The Netherlands; 3Department of Gastroenterology, University Medical Center Utrecht, The Netherlands; 4Department of Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The NetherlandsObjective: To evaluate content, navigation, usability, and impact measurability of a prototype Internet-based self-management intervention for patients with ulcerative colitis.Material and methods: Analysis of 52 Internet diaries that were used in a six-month test trial. Analysis was done using an evaluation framework for eHealth applications that incorporates goals from theory and empirical studies on living with chronic illness, the software design industry, and health services research.Results: Content of the diary covered the intended functions of the Internet-based self-management intervention. The evaluation led to several refinement suggestions concerning navigation, usability, and impact measurability of the Internet diary.Conclusion: Psychosocial, medical, and scientific content as well as interface and design are equally important in the development of effective eHealth interventions. Keywords: self-management, Internet diary, ulcerative colitis, eHealth, prototype&nbsp

Grijs vernuft in groene jaren: Reflecties op auteurschapsontwikkeling bij vrouwen in vroegmoderne voorwerkteksten

Early modern literary careers are generally perceived as progressive: inadequate young authors gradually develop their literary skills and knowledge while growing old. In this article, we analyse how young authorship and career development of early modern Dutch women writers was represented in front matter in their literary print-publications. We demonstrate that front matter’s praise of young women’s authorship was connected to both male and female flavoured qualities. These qualities turn out to be connected to the ways in which female careers were represented. When young female authorship was mainly legitimated based on intellectual capacities considered typically masculine, the women’s career is perceived as progressive. However: when this legitimation is rather based on qualities considered as typically feminine, such as virtuousness and handiwork skills, the women’s authorship at an early age is sometimes represented as already fully-grown and complete

Mineralenbalans op verschillende schapenbedrijven

Uit berekeningen blijkt dat naarmate de schapenhouderij intensiever wordt, ook het overschot op de mineralenbalans toeneemt. Jaarrondproduktie heeft het hoogste overschot aan mineralen, maar daarnaast ook het hoogste saldo

Cost effectiveness of clinical associates : a case study for the Mpumalanga province in South Africa

BACKGROUND : The National Department of Health of South Africa decided to start a programme to train mid-level healthcare workers, called clinical associates, as one of the measures to increase healthcare workers at district level in rural areas. Unfortunately, very little is known about the cost effectiveness of clinical associates. AIMS : To determine, on a provincial level, the cost effectiveness of training and employing clinical associates and medical practitioners compared to the standard strategy of training and employing only more medical practitioners. METHODS : A literature study was performed to answer several sub questions regarding the costs and effectiveness of clinical associates. The results were used to present a case study. RESULTS : The total cost for a province to pay for the full training of a clinical associate is R 300 850. The average employment cost per year is R196 329 and for medical practitioners these costs are R 730 985 and R 559 397, respectively. EFFECTIVENESS : Clinical associates are likely to free up the time of a medical practitioner by 50–76%. They can provide the same quality of care as higher level workers, provided that they receive adequate training, support and supervision. Furthermore, they seem more willing to work in rural areas compared to medical practitioners. CONCLUSIONS : The case study showed that training and employing clinical associates is potentially a cost-effective strategy for a province to meet the increasing demand for rural healthcare workers. This strategy will only succeed when clinical associates receive adequate training, support and supervision and if the province keeps investing in them.http://www.phcfm.orgam2017Family Medicin