scholarly journals An ethnographic study on leadership-as-practice in trauma simulation training

2020 ◽  
Vol 33 (2) ◽  
pp. 185-200
Author(s):  
Hanna Vuojärvi ◽  
Saana Korva
Keyword(s):  
Simulation Training ◽  
Medical Training ◽  
Historical Context ◽  
Trauma Team ◽  
Skills Training ◽  
Ethnographic Study ◽  
Content Type ◽  
Contextual Elements ◽  
Cultural Historical Activity

Purpose This study aims to discover how leadership emerges in a hospital’s trauma team in a simulated trauma care situation. Instead of investigating leadership from a leader-centric perspective, or using a metrics-based approach to reach generalizable results, the study aims to draw from post-heroic theories by applying leadership-as-practice and sociomaterial perspectives that emphasize the cultural-historical context and emergent nature of leadership. Design/methodology/approach The study was conducted in a Finnish central hospital through ethnographic observations of 14 in situ trauma simulation trainings over a period of 13 months. The data consist of vignettes developed and written from field notes. The analysis was informed by the cultural-historical activity theory. Findings Leadership in a trauma team during an in situ simulation training emerges from a complex system of agencies taking place simultaneously. Contextual elements contributed to the goal. Clarity of roles and task division, strong execution of leadership at critical points, active communication and maintenance of disciplined communication helped to overcome difficulties. The team developed coordination of the process in conjunction with the care. Originality/value The study considers trauma leadership to be a practical phenomenon emerging from the trauma team’s sociomaterial context. The results can be used to develop non-technical skills training within the field of simulation-based medical training.

scholarly journals Insider or outsider? Exploring the fluidity of the roles through social identity theory

2019 ◽  
Vol 8 (2) ◽  
pp. 159-170 ◽  
Author(s):  
Signe Bruskin
Keyword(s):  
Social Identity Theory ◽  
Design Methodology ◽  
A Priori ◽  
Ethnographic Study ◽  
Relational Identity ◽  
Content Type ◽  
It Department ◽  
Empirical Material

Purpose The purpose of this paper is to explore the fluidity of the fieldwork roles “insider” and “outsider.” The paper aims to move the discussion of insiders from an a priori categorized status and contribute to the literary insider–outsider debate by unfolding the micro process of how the role of an insider is shaped in situ. Grounded in empirical examples, the paper illustrates how the researcher’s role is shaped through interactions with organizational members and by context. Design/methodology/approach The paper is based on an ethnographic study in an IT department of a Nordic bank and draws on empirical material generated through a combination of data: shadowing, interviews, observations and documents. Excerpts from fieldnotes are included to invite the reader into “the scenes” played out in the field and are analyzed in order to illustrate the shaping of roles in situ. Findings The study finds that, independent of the researcher’s role as sponsored by the organization, the interactions with organizational members and context determine whether the researcher is assigned a role as insider or outsider, or even both within the same context. Originality/value The paper contributes with a new discussion of how the roles of insiders and outsiders are fluid by discussing the shaping of the roles in situ. By drawing on relational identity theories, the paper illustrates how interactions and context influence the researcher’s role, grounded in empirical examples. In addition, the paper discusses what the assigned roles enable and constrain for the ethnographer in that particular situation.

Preparing academic medical department physicians to successfully lead

2015 ◽  
Vol 28 (4) ◽  
pp. 317-331 ◽  
Author(s):  
Lee Revere ◽  
Arlin Robinson ◽  
Lynn Schroth ◽  
Osama Mikhail
Keyword(s):  
Medical Training ◽  
Department Chairs ◽  
Medical Center ◽  
Skills Training ◽  
Medical Department ◽  
Content Type ◽  
Course Structure ◽  
Academic Medical ◽  
Physician Leaders ◽  
Stakeholder Input

Purpose – The purpose of this paper is to present a case study which details the successful development, design and deployment of a leadership course for academic medical department chairs. The course provides a needed local and contextual alternative to the lengthy and often theoretical MBA/MHA. Design/methodology/approach – Faculty developers used a multi-tiered methodology for developing the physician leadership course. The methodology consisted of literature findings, needs assessment, stakeholder input and structured interviews with administrative leaders. Findings – The research, stakeholder input and interviews revealed an increasing number of physician leaders with a general lack of fundamental administrative leadership skills. These shortfalls are largely because of underexposure to core management competencies during medical school and limited contextual knowledge outside their organization. There is an urgent need for leadership development opportunities aimed at current and future academic medical department chairs. Research limitations/implications – This research is limited by the assumptions that the curriculum meets the ever-changing needs of health-care leaders, the course’s focus on academic medical department chairs within the Texas Medical Center and the lack of long range follow-up data to substantiate the effectiveness of the curriculum content and course structure. Practical implications – The Academic Medical Department Leadership course offers valuable management skills training which complements standard medical training. Much of the course structure and content is adaptable to physician administrative and leadership positions in all settings. Originality/value – Although the Academic Medical Department Leadership course is a response to a local concern, the study offers a generalizable approach to addressing the demand for skilled physician leaders.

Rethinking the role of roadmaps in strategic planning

2014 ◽  
Vol 9 (4) ◽  
pp. 308-331 ◽  
Author(s):  
Senem Güney ◽  
James R. Taylor
Keyword(s):  
Project Management ◽  
Corporate Strategy ◽  
Mapping Function ◽  
Ethnographic Study ◽  
Strategic Choices ◽  
Management Tools ◽  
Content Type ◽  
Communicative Constitution

Purpose – The purpose of this paper is to explore the problem of reconfiguring epistemic boundaries and the authority relationships that these boundaries represent in corporate R&D. The authors focus the analysis on the mediation of this reconfiguration by project management tools, specifically the development plan and its subsidiary roadmaps and timelines. Design/methodology/approach – The authors analyze discourse data from an ethnographic study to show in situ the communication about and through project management tools in collaborative project development. The concepts of organizational map and mapping from the perspective of the communicative constitution of organization (CCO) frame the close-up analysis of this communication. Findings – The analysis reveals how the plan and its subsidiary texts participate in the negotiation and legitimation of epistemic ownership and authority for a collaborative strategy to be implemented. The authors illustrate the material agency of these texts in the objectification and prioritization of strategic choices in this implementation. Research limitations/implications – To conclude, the authors discuss the significance of exploring the mapping function of supposedly mundane representational tools used in project management. Originality/value – The originality of this study comes from applying the organizational map concept to demonstrate the politically charged materiality of project management tools in the discursive establishment of authority and accomplishment of corporate strategy.

scholarly journals Short 2-H in Situ Trauma Team Simulation Training Effectively Improves Non-Technical Skills of Hospital Trauma Teams

2018 ◽  
Vol 108 (2) ◽  
pp. 117-123 ◽  
Author(s):  
E. Rosqvist ◽  
S. Lauritsalo ◽  
J. Paloneva
Keyword(s):  
Decision Making ◽  
Situation Awareness ◽  
Simulation Training ◽  
Trauma Team ◽  
Technical Skills ◽  
Coping With Stress ◽  
Training Course ◽  
Resuscitation Guidelines ◽  
Trauma Teams

Background and Aims: As conducting the regular trauma team simulation training is expensive and time-consuming, its effects must be explored. The objective was to evaluate the efficacy of a structured 2-h in situ multiprofessional trauma team simulation training course on non-technical skills. Materials and Methods: This prospective study comprised 90 trauma teams with 430 participants. The structured, 2-h course consisted of an introductory lecture and two different simulations with debriefings. Data were collected using a pre–post self-assessment questionnaire. In addition, the expert raters used the T-NOTECHS scale. Results: The following non-technical skills improved significantly among both medical doctors and nurses: knowledge of the trauma resuscitation guidelines, problem identification, decision making, situation awareness/coping with stress, communication and interaction, time management, being under authority, and confidence in one’s role in a team. The teams improved significantly in leadership, cooperation and resource management, communication and interaction, assessment and decision making, and situation awareness/coping with stress. Conclusion: A short, structured 2-h in situ trauma team simulation training course is effective in improving non-technical skills.

Reflexive professional development in reflective practice: what lesson study can offer

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Özgehan Uştuk ◽  
İrem Çomoğlu
Keyword(s):  
Professional Development ◽  
Foreign Language ◽  
Lesson Study ◽  
Ethnographic Study ◽  
Bottom Up ◽  
Content Type ◽  
Field Notes ◽  
Cultural Historical Activity ◽  
Transformative Impact ◽  
Collection Methods

PurposeIn response to the top-down professional development (PD) practice, this study conceptualizes lesson study (LS) as a bottom-up approach to foreign language teacher PD in the Turkish context. Relatedly, the authors seek to empower teachers so that they can engage in reflexive PD and claim voice over their practices.Design/methodology/approachAn LS project including four teachers was implemented at a higher education language centre and conducted as a critical ethnographic study. Using ethnographic research qualitative data collection methods such as field notes, interviews and artefacts, the data were analysed with a thematic analytic approach.FindingsDrawing on cultural-historical activity theory (CHAT), findings revealed that LS was a meta-activity that allowed teachers to be agents of the PD practices. More significantly, LS empowers teachers to have a situated impact on their development activities in addition to the meta-activity's impact on them.Originality/valueThis study is one of the few that goes beyond the reflective value of LS and gives contextual evidence of how reflexive PD can occur in LS. The reflexive relationship between the agent (participant–teachers) and the process (LS practice) provides a strong implication revealing the transformative impact of bottom-up PD activit(ies).

Class, Control, and Classical Music

2019 ◽  
Author(s):  
Anna Bull
Keyword(s):  
Music Education ◽  
Cultural Production ◽  
Classical Music ◽  
Historical Context ◽  
Ethnographic Study ◽  
Middle Classes ◽  
Class Culture ◽  
White Middle Class ◽  
Music Ensembles ◽  
The Aesthetic

Through an ethnographic study of young people playing and singing in classical music ensembles in the south of England, this book analyses why classical music in England is predominantly practiced by white middle-class people. It describes four ‘articulations’ or associations between the middle classes and classical music. Firstly, its repertoire requires formal modes of social organization that can be contrasted with the anti-pretentious, informal, dialogic modes of participation found in many forms of working-class culture. Secondly, its modes of embodiment reproduce classed values such as female respectability. Thirdly, an imaginative dimension of bourgeois selfhood can be read from classical music’s practices. Finally, its aesthetic of detail, precision, and ‘getting it right’ requires a long-term investment that is more possible, and makes more sense, for middle- and upper-class families. Through these arguments, the book reframes existing debates on gender and classical music participation in light of the classed gender identities that the study revealed. Overall, the book suggests that inequalities in cultural production can be understood through examining the practices that are used to create a particular aesthetic. It argues that the ideology of the ‘autonomy’ of classical music from social concerns needs to be examined in historical context as part of the classed legacy of classical music’s past. It describes how the aesthetic of classical music is a mechanism through which the middle classes carry out boundary-drawing around their protected spaces, and within these spaces, young people’s participation in classical music education cultivates a socially valued form of self-hood.

The dialectics of authoring expansive learning: tracing the long tail of a Change Laboratory

2016 ◽  
Vol 28 (4) ◽  
pp. 245-262 ◽  
Author(s):  
Annalisa Sannino ◽  
Yrjö Engeström ◽  
Johanna Lahikainen
Keyword(s):  
Large Scale ◽  
Scale Transformation ◽  
Dialectical Tensions ◽  
Content Type ◽  
Organization Model ◽  
Expansive Learning ◽  
Conceptual Argument ◽  
University Library ◽  
Dialectical Process ◽  
Cultural Historical Activity

Purpose The paper aims to examine organizational authoring understood as a longitudinal, material and dialectical process of transformation efforts. The following questions are asked: To which extent can a Change Laboratory intervention help practitioners author their own learning? Are the authored outcomes of a Change Laboratory intervention futile if a workplace subsequently undergoes large-scale organizational transformations? Does the expansive learning authored in a Change Laboratory intervention survive large-scale organizational transformations, and if so, why does it survive and how? Design/methodology/approach The paper develops a conceptual argument based on cultural–historical activity theory. The conceptual argument is grounded in the examination of a case of eight years of change efforts in a university library, including a Change Laboratory (CL) intervention. Follow-up interview data are used to discuss and illuminate our argument in relation to the three research questions. Findings The idea of knotworking constructed in the CL process became a “germ cell” that generates novel solutions in the library activity. A large-scale transformation from the local organization model developed in the CL process to the organization model of the entire university library was not experienced as a loss. The dialectical tension between the local and global models became a source of movement driven by the emerging expansive object. Practitioners are modeling their own collective future competences, expanding them both in socio-spatial scope and interactive depth. Originality/value The article offers an expanded view of authorship, calling attention to material changes and practical change actions. The dialectical tensions identified serve as heuristic guidelines for future studies and interventions.

scholarly journals Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sally Byford ◽  
Sarah Janssens ◽  
Rachel Cook
Keyword(s):  
Early Pregnancy ◽  
Confidence Level ◽  
Simulation Training ◽  
Systematic Approach ◽  
Transvaginal Ultrasound ◽  
Skills Training ◽  
Ultrasound Simulation ◽  
Learning Gap ◽  
Assessment Scores ◽  
Simulation Based

Abstract Background Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Results Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. Conclusion The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.

Pituitary adenoma producing growth hormone and adrenocorticotropin: a histological, immunocytochemical, electron microscopic, and in situ hybridization study

1998 ◽  
Vol 88 (6) ◽  
pp. 1111-1115 ◽  
Author(s):  
Kalman Kovacs ◽  
Eva Horvath ◽  
Lucia Stefaneanu ◽  
Juan Bilbao ◽  
William Singer ◽  
...  
Keyword(s):  
Growth Hormone ◽  
In Situ Hybridization ◽  
Pituitary Adenoma ◽  
Immunoelectron Microscopy ◽  
Secretory Granules ◽  
Cell Types ◽  
Content Type ◽  
Separate Cell ◽  
Fine Print

✓ The authors report on the morphological features of a pituitary adenoma that produced growth hormone (GH) and adrenocorticotropic hormone (ACTH). This hormone combination produced by a single adenoma is extremely rare; a review of the available literature showed that only one previous case has been published. The tumor, which was removed from a 62-year-old man with acromegaly, was studied by histological and immunocytochemical analyses, transmission electron microscopy, immunoelectron microscopy, and in situ hybridization. When the authors used light microscopy, the tumor appeared to be a bimorphous mixed pituitary adenoma composed of two separate cell types: one cell population synthesized GH and the other ACTH. The cytogenesis of pituitary adenomas that produce more than one hormone is obscure. It may be that two separate cells—one somatotroph and one corticotroph—transformed into neoplastic cells, or that the adenoma arose in a common stem cell that differentiated into two separate cell types. In this case immunoelectron microscopy conclusively demonstrated ACTH in the secretory granules of several somatotrophs. This was associated with a change in the morphological characteristics of secretory granules. Thus it is possible that the tumor was originally a somatotropic adenoma that began to produce ACTH as a result of mutations that occurred during tumor progression.

scholarly journals Competition between Metals for Binding to Methanobactin Enables Expression of Soluble Methane Monooxygenase in the Presence of Copper

2014 ◽  
Vol 81 (3) ◽  
pp. 1024-1031 ◽  
Author(s):  
Bhagyalakshmi Kalidass ◽  
Muhammad Farhan Ul-Haque ◽  
Bipin S. Baral ◽  
Alan A. DiSpirito ◽  
Jeremy D. Semrau
Keyword(s):  
Methane Monooxygenase ◽  
High Specificity ◽  
Copper Uptake ◽  
Content Type ◽  
Soluble Methane Monooxygenase ◽  
Sds Page ◽  
Genes Encoding ◽  
Key Factor ◽  
Membrane Bound

ABSTRACTIt is well known that copper is a key factor regulating expression of the two forms of methane monooxygenase found in proteobacterial methanotrophs. Of these forms, the cytoplasmic, or soluble, methane monooxygenase (sMMO) is expressed only at low copper concentrations. The membrane-bound, or particulate, methane monooxygenase (pMMO) is constitutively expressed with respect to copper, and such expression increases with increasing copper. Recent findings have shown that copper uptake is mediated by a modified polypeptide, or chalkophore, termed methanobactin. Although methanobactin has high specificity for copper, it can bind other metals, e.g., gold. Here we show that inMethylosinus trichosporiumOB3b, sMMO is expressed and active in the presence of copper if gold is also simultaneously present. Such expression appears to be due to gold binding to methanobactin produced byM. trichosporiumOB3b, thereby limiting copper uptake. Such expression and activity, however, was significantly reduced if methanobactin preloaded with copper was also added. Further, quantitative reverse transcriptase PCR (RT-qPCR) of transcripts of genes encoding polypeptides of both forms of MMO and SDS-PAGE results indicate that both sMMO and pMMO can be expressed when copper and gold are present, as gold effectively competes with copper for binding to methanobactin. Such findings suggest that under certain geochemical conditions, both forms of MMO may be expressed and activein situ. Finally, these findings also suggest strategies whereby field sites can be manipulated to enhance sMMO expression, i.e., through the addition of a metal that can compete with copper for binding to methanobactin.

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