Purpose. The requirements for training teachers for the general education system in the Russian Federation are defined by the Federal State Educational Standard for Higher Education in the field of ..."Pedagogical Education". The standard document defines universal and general professional competencies that are mandatory for all education (preschool, primary, basic general education and others). Professional competencies are defined on the basis of the professional standard "Teacher", specifically for each field and type of professional activity. The subject of the analysis is the search for an approach to forming the future primary school teachers' professional competencies. The main purpose of the article is to describe the technology of forming the future primary school teachers' professional competencies within a specific academic discipline. Methods. The research is based on a regulatory documents review, psychological and pedagogical literature analysis, and educational process examination. Results. The article presents the experience in organizing the study of a particular discipline. The discipline provides emotional and personal immersion of the future teachers into the professional activity and practical skills development. The author describes the ways to implement and apply effective teaching methods when organizing various types of classes in higher education institution. Practical application of the results. The findings are of direct practical relevance as can be useful for organizing the educational process in higher educational institutions in terms of the successful completion of basic educational programs and programs of additional education (specifically, retraining).
Technical debt (TD) requires the management of several technical and nontechnical aspects. Based on 10 years of research and practice, we have created an effective approach, TD Pulse, to assess TD ...management in large software companies and find critical improvement areas.
Complex medication regimens pose self-management challenges, particularly among populations with low levels of health literacy.
To test medication management tools delivered through a commercial ...electronic health record (EHR) with and without a nurse-led education intervention.
This 3-group cluster randomized clinical trial was performed in community health centers in Chicago, Illinois. Participants included 794 patients with hypertension who self-reported using 3 or more medications concurrently (for any purpose). Data were collected from April 30, 2012, through February 29, 2016, and analyzed by intention to treat.
Clinics were randomly assigned to to groups: electronic health record-based medication management tools (medication review sheets at visit check-in, lay medication information sheets printed after visits; EHR-alone group), EHR-based tools plus nurse-led medication management support (EHR plus education group), or usual care.
Outcomes at 12 months included systolic blood pressure (primary outcome), medication reconciliation, knowledge of drug indications, understanding of medication instructions and dosing, and self-reported medication adherence. Medication outcomes were assessed for all hypertension prescriptions, all prescriptions to treat chronic disease, and all medications.
Among the 794 participants (68.6% women; mean SD age, 52.7 9.6 years), systolic blood pressure at 12 months was greater in the EHR-alone group compared with the usual care group by 3.6 mm Hg (95% CI, 0.3 to 6.9 mm Hg). Systolic blood pressure in the EHR plus education group was not significantly lower compared with the usual care group (difference, -2.0 mm Hg; 95% CI, -5.2 to 1.3 mm Hg) but was lower compared with the EHR-alone group (-5.6 mm Hg; 95% CI, -8.8 to -2.4 mm Hg). At 12 months, hypertension medication reconciliation was improved in the EHR-alone group (adjusted odds ratio OR, 1.8; 95% CI, 1.1 to 2.9) and the EHR plus education group (adjusted odds ratio OR, 2.0; 95% CI, 1.3 to 3.3) compared with usual care. Understanding of medication instructions and dosing was greater in the EHR plus education group than the usual care group for hypertension medications (OR, 2.3; 95% CI, 1.1 to 4.8) and all medications combined (OR, 1.7; 95% CI, 1.0 to 2.8). Compared with usual care, the EHR tools alone and EHR plus education interventions did not improve hypertension medication adherence (OR, 0.9; 95% CI, 0.6-1.4 for both) or knowledge of chronic drug indications (OR for EHR tools alone, 1.0 95% CI, 0.6 to 1.5 and OR for EHR plus education, 1.1 95% CI, 0.7-1.7).
The study found that EHR tools in isolation improved medication reconciliation but worsened blood pressure. Combining these tools with nurse-led support suggested improved understanding of medication instructions and dosing but did not lower blood pressure compared with usual care.
ClinicalTrials.gov identifier: NCT01578577.
This paper draws on a study of the implementation of business process reengineering (BPR) in a UK National Health Service (NHS) hospital to examine the challenge of effecting a transformatory shift ...to a new form of process organization in a large and complex public service organization. The paper’s theoretical and empirical interests go beyond BPR by bringing together literatures about organizational transformation, new organizational forms and the new public management (NPM) in a novel way. Data reveal important limits to intended organizational transformation and develop findings about sedimented rather than transformational change and the limitations of radical top-down change strategies in professionalized public service organizations. Within the domain of public service organizations, the paper also advances a new argument about why intended moves to post-NPM forms may remain contained in scope.
Nursing home patients often have multiple diagnoses and a high prevalence of polypharmacy and are at risk of experiencing adverse drug events. The study aims to explore the dynamic interactions of ...stakeholders and work system elements in the medication administration process in a nursing home ward. Data were collected using observations and interviews. A deductive content analysis led to a SEIPS-based process map and an accompanying work system analysis. The study increases knowledge of the complexity of the medication administration process by portraying the dynamic interactions between the major stakeholders in the work system, and the temporal flow of the activities involved. Secondly, it identifies facilitators and barriers in the work system linked to the medication administration process. Most barriers and facilitators are associated with the work system elements – tools & technology, organisation and tasks – and occur early in the medication administration process.
•Nurses are the only professional stakeholders involved in all the stages of the MAP.•Most barriers are associated with ordering, the first stage of the MAP.•A novel description of the MAP by using SEIPS as a conceptual model is introduced.
The article is dedicated to the issue of student involvement in higher education quality assurance and evaluation – a vital and highly relevant issue in today’s higher education of Ukraine. Changes ...instigated by the Law of Ukraine «On Higher Education» of 2014, foresee an active role of students in the formation and evaluation of higher education quality as 1) final beneficiaries, 2) interviewees and participants in accreditation of study programmes, 3) external evaluation experts during study programmes accreditation, as ruled by current legislation. Taking into account the significance of students’ role in quality assurance, it is necessary to find out:
how university students interpret quality of higher education and higher education quality assurance;
how students perceive their role in the formation and enhancement of higher education quality;
to what extend they are ready and committed to influence and improve the quality of higher education.
Accordingly, the aim of this article is to investigate students’ opinion on the quality of Ukraine’s higher education. To this end, students’ survey was conducted with the focus on the following:
what is quality and quality assurance in students’ opinion;
how respondents assess the quality of education in their HEI and in Ukraine in general;
whether students can influence the quality of study programmes and quality of higher education;
what hinders improvement of study programmes and enhancement of quality of higher education.
The survey was conducted in May – October 2020; the respondents were 115 students of five Ukrainian universities (years three and four of bachelor programmes and master students) who volunteered to take part in the survey.
The research resulted in the following conclusions:
1) There is no integral, holistic understanding of higher education quality among student community. Representatives of different HEIs interpret higher education quality differently, though in total 60% of respondents interpret quality as « new, relevant information and knowledge».
2) On the whole, respondents value the quality of higher education rather low: only 25% of students regard it as high. At the same time, most of surveyed students rate the quality of their study programme higher, than the quality of higher education in their university or the quality of educational services in Ukraine in general.
3) Students of different HEIs are rather diverse in their interpretation of quality assurance of higher education and choice of different means for quality enhancement. On the whole, respondents give preference to those tools that anticipate active students’ participation in quality assurance, like asking the teacher to change the manner of teaching, or leaving a complaint with student self-government, discussing the quality of teaching in a focus group, or filling in an evaluation questionnaire.
4) Students who participated in the survey demonstrated critical thinking and fair judgement of their negative impact on the quality of higher education by stating that low student motivation is the most significant factor that obstructs quality enhancement. Other factors cited by respondents include low teacher motivation, underdeveloped infrastructure at HEIs, teacher workload.
5) The positive finding of the survey is that the majority of students are confident in their capability to influence the quality of higher education in their HEI and only 21% responded they are deprived of the possibility improve higher education quality.
(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role ...providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients’ perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40–69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.
Aims and objectives
To explore which knowledge sources newly graduated nurses’ use in clinical decision‐making and why and how they are used.
Background
In spite of an increased educational focus on ...skills and competencies within evidence‐based practice, newly graduated nurses’ ability to use components within evidence‐based practice with a conscious and reflective use of research evidence has been described as being poor. To understand why, it is relevant to explore which other knowledge sources are used. This may shed light on why research evidence is sparsely used and ultimately inform approaches to strengthen the knowledgebase used in clinical decision‐making.
Design and methods
Ethnographic study using participant‐observation and individual semistructured interviews of nine Danish newly graduated nurses in medical and surgical hospital settings.
Results
Newly graduates use of knowledge sources was described within three main structures: ‘other’, ‘oneself’ and ‘gut feeling’. Educational preparation, transition into clinical practice and the culture of the setting influenced the knowledge sources used. The sources ranged from overt easily articulated knowledge sources to covert sources that were difficult to articulate. The limited articulation of certain sources inhibited the critical reflection on the reasoning behind decisions. Reflection is a prerequisite for an evidence‐based practice where decisions should be transparent in order to consider if other evidentiary sources could be used.
Conclusion and relevance to clinical practice
Although there is a complexity and variety to knowledge sources used, there is an imbalance with the experienced nurse playing a key role, functioning both as predominant source and a role model as to which sources are valued and used in clinical decision‐making. If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources.
Aims
The aim of this study was to develop and psychometrically evaluate a three‐dimensional questionnaire suitable for evaluating personal and organizational accountability in nurses.
Background
...Accountability is defined as a three‐dimensional value, directing professionals to take responsibility for their decisions and actions, to be willing to explain them (transparency), and to be judged according to society's accepted values (answerability). Despite the relatively clear definition, measurement of accountability lags well behind. Existing self‐report questionnaires do not fully capture the complexity of the concept nor do they capture the different sources of accountability (e.g., personal accountability, organizational accountability).
Design
A three‐stage measure development.
Methods
Data were collected during 2015–2016. In Phase 1, an initial database of items (N = 74) was developed, based on literature review and qualitative study, establishing face and content validity. In Phase 2, the face, content, construct, and criterion‐related validity of the initial questionnaires (19 items for personal and organizational accountability questionnaire) were established with a sample of 229 nurses. In Phase 3, the final questionnaires (19 items each) were validated with a new sample of 329 nurses and established construct validity.
Results
The final version of the instruments comprised 19 items, suitable for assessing personal and organizational accountability. The questionnaire referred to the dimensions of responsibility, transparency, and answerability. The findings established the instrument's content, construct, and criterion‐related validity as well as good internal reliability.
Conclusion
The questionnaire portrays accountability in nursing, by capturing nurses’ subjective perceptions of accountability dimensions (responsibility, transparency, answerability), as demonstrated by personal and organizational values.
摘要
目的
本研究的目的是开发适用于评估个人和组织的护理责任的三维问卷,并从心理测量学的角度对其进行评估。
背景
问责制被定义为三维价值观,指导专业人员对其决策和行动负责,愿意对其决策和行动作出解释(透明度),并根据社会的公认价值观(负责任)对专业人员进行评判。尽管问责制的定义相对明确,但其衡量却远远落后。现有的自我报告调查表不能完全反映概念的复杂性,也不能明确不同的问责来源(例如个人责任,组织责任)。
设计
分三阶段衡量发展情况。
方法
2015 年至‐2016年期间收集数据。在第1阶段,基于文献综述和定性研究创建了各个项目的初始数据库(N = 74),建立了表面效度和内容效度。在第2阶段,采用229名护士的样本建立了初始问卷的表面效度、内容效度、结构效度和效标效度(用于个人责任问卷和组织责任问卷的19个项目)。在第3阶段,采用329名护士的新样本验证了最终问卷(每份问卷设计19个项目),并确定了结构效度。
结果
这些文书的最终版本包括19个项目,适用于评估个人和组织的责任。调查问卷涉及责任,透明度和可回答性等方面。研究结果确定了仪器的内容,构造和标准相关的有效性以及良好的内部可靠性。
结论
问卷通过了解护士对问责维度(责任、透明度、负责任)的主观感知来描述护理中的问责制,如个人价值观和组织价值观所阐述的一样。
Aims and objectives. The aim of this paper was to review the current literature clinical decision‐making models and the educational application of models to clinical practice. This was achieved by ...exploring the function and related research of the three available models of clinical decision making: information‐processing model, the intuitive‐humanist model and the clinical decision‐making model.
Background. Clinical decision making is a unique process that involves the interplay between knowledge of pre‐existing pathological conditions, explicit patient information, nursing care and experiential learning. Historically, two models of clinical decision making are recognized from the literature; the information‐processing model and the intuitive‐humanist model. The usefulness and application of both models has been examined in relation the provision of nursing care and care related outcomes. More recently a third model of clinical decision making has been proposed. This new multidimensional model contains elements of the information‐processing model but also examines patient specific elements that are necessary for cue and pattern recognition.
Design. Literature review.
Methods. Evaluation of the literature generated from MEDLINE, CINAHL, OVID, PUBMED and EBESCO systems and the Internet from 1980 to November 2005.
Results. The characteristics of the three models of decision making were identified and the related research discussed.
Conclusions. Three approaches to clinical decision making were identified, each having its own attributes and uses. The most recent addition to the clinical decision making is a theoretical, multidimensional model which was developed through an evaluation of current literature and the assessment of a limited number of research studies that focused on the clinical decision‐making skills of inexperienced nurses in pseudoclinical settings. The components of this model and the relative merits to clinical practice are discussed.
Relevance to clinical practice. It is proposed that clinical decision making improves as the nurse gains experience of nursing patients within a specific speciality and with experience, nurses gain a sense of saliency in relation to decision making. Experienced nurses may use all three forms of clinical decision making both independently and concurrently to solve nursing‐related problems. It is suggested that O'Neill's clinical decision‐making model could be tested by educators and experienced nurses to assess the efficacy of this hybrid approach to decision making.
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