scholarly journals Developing a collaborative, humanistic interprofessional healthcare culture: a multi-site study

2022 ◽  
Vol 9 (1) ◽  
pp. 29-30
Author(s):  
Elizabeth A. Rider ◽  
Calvin Chou ◽  
Peter Weissman ◽  
Corrine Abraham ◽  
William T. Branch, Jr.
Keyword(s):  
Transformative Learning ◽  
Comparative Method ◽  
Cultural Norms ◽  
Healthcare Team ◽  
Self Awareness ◽  
Role Clarity ◽  
Interprofessional Healthcare ◽  
Interpersonal Learning ◽  
Relational Capacities ◽  
Relational Skills

Introduction:Developing a collaborative, humanistic interprofessional healthcare culture requires optimal relational skills, respect, interpersonal cohesion, and role clarity. We developed a longitudinal curriculum to engender these skills and values in institutional leaders. We report results of a qualitative study at seven US-based academic health centers to identify participants’ learning. Methods:At each institution, participants from at least three different professions met in small group sessions twice-monthly over nine months. Sessions focused on relational capacities to enhance leadership and professionalism, and utilized critical reflection and experiential learning to promote teamwork, self-knowledge, communication skills, and address challenges encountered by a healthcare team. Participants completed reflective responses to open-ended questions asking what knowledge, insights, or skills they gained by working in this interprofessional group and applications of their learning. Five investigators analyzed the anonymized responses using the constant comparative method. Results:Overarching themes centered on relationships and the strength of the relational nature of the learning. We observed learning on three levels: a) Intrapersonal learning included self-awareness, mindfulness, and empathy for self that translated to reflections on application of these to teamwork and teaching; b) Interpersonal learning concerned relational skills and teaching about listening, understanding others’ perspectives, appreciation/respect for colleagues, and empathy for others; c) Systems level learning included teaching skills about resilience, conflict management, team dynamics and cultural norms, and appreciation of resources from interprofessional colleagues. Discussion:A curriculum focusing on humanistic teaching for leaders led to new insights and positive changes in relational perspectives. Learning occurred on multiple levels. Many learners reported revising previous assumptions, a marker for transformative learning. Humanistic faculty development can facilitate deep bonds between professions.  

scholarly journals Learning in Struggle: Argentina’s New Worker Cooperatives as Transformative Learning Organizations

2014 ◽  
Vol 69 (1) ◽  
pp. 186-218 ◽  
Author(s):  
Marcelo Vieta
Keyword(s):  
Transformative Learning ◽  
Workplace Learning ◽  
Social Relations ◽  
Social Action ◽  
Learning Organizations ◽  
Action Learning ◽  
Self Awareness ◽  
Learning Approaches ◽  
Economic Crises ◽  
Worker Cooperatives

SummaryThis article considers Argentina’sempresas recuperadas por sus trabajadores(worker-recuperated enterprises, or ERTs) astransformative learning organizations. ERTs are illustrative of how workers’ conversions of capitalist firms into worker cooperatives—especially conversions emerging from troubled firms and in moments of deep socio-economic crises—transform workers (from managed employees to self-managed workers), work organizations (from capitalist businesses to labour-managed firms), and communities (from depleted to revitalized and self-provisioning localities).Theoretically, the study is grounded in class-struggle, workplace learning, and social action learning approaches. These theoretical perspectives help the study work through how workplace conversions by workers, when converting troubled investor-owned or proprietary firms into worker coops, act as catalysts for contesting workplace exploitation and capitalist crises, while also beginning to move beyond them by forging new social relations of production and exchange. In the case of Argentina’s ERTs, crises in the political economy and micro-economic crises at the point of production during the collapse of the neoliberal model at the turn of the millennium heightened workers’ self-awareness of their situations of exploitation and motivated collective action. As a result, new worker cooperatives were created that also stimulated the social, cultural, and economic renewal of surrounding communities.The study’s research method relies on extended case studies of four diverse ERTs, which included ethnographic observation and in-depth interviews. Observations of daily workflows were conducted, as well as interviews and informal conversations with founding and newer ERT workers. In a more structured portion of the interview protocol, key-informants were asked to reflect on how they had personally changed after being involved in the ERT, and how production practices and involvement with the community had transformed in the process of conversion.The article concludes by outlining how worker, organizational, and community transformations emerge from workers’ processes ofinformal learningandlearning in struggleas they collectively strive to overcome macro- and micro-economic crises and learn to become cooperators. This learning, the study shows, occurs in two ways:intra-cooperativelyvia informal workplace learning, andinter-cooperativelybetween workers from different ERTs and with surrounding communities. The self-management forged by ERTs thus embodies new, cooperative, and community-centered values and practices for these workers that, in turn, sketch out different possibilities for economic and productive life in Argentina.

scholarly journals Training interprofessional faculty in humanism and professionalism: a qualitative analysis of what is most important

2022 ◽  
Vol 9 (1) ◽  
pp. 46-47
Author(s):  
Elizabeth A Rider ◽  
Deborah D. Navedo ◽  
William T. Branch, Jr.
Keyword(s):  
Identity Formation ◽  
Learning Environments ◽  
Interprofessional Education ◽  
Well Being ◽  
Care Quality ◽  
Self Awareness ◽  
Use Of Self ◽  
Important Thing ◽  
Relational Capacities ◽  
The Impact

Introduction: The capacity of healthcare professionals to work collaboratively influences faculty and trainees’ professional identity formation, well-being, and care quality. Part of a multi-institutional project*, we created the Faculty Fellowship for Leaders in Humanistic Interprofessional Education at Boston Children’s Hospital/ Harvard Medical School. We aimed to foster trusting relationships, reflective abilities, collaboration skills, and work together to promote humanistic values within learning environments. Objective: To examine the impact of the faculty fellowship from participants’ reports of “the most important thing learned”. Methods: We studied participants’ reflections after each of 16 1½ hour fellowship sessions. Curriculum content included: highly functioning teams, advanced team formation, diversity/inclusion, values, wellbeing/renewal/burnout, appreciative inquiry, narrative reflection, and others. Responses to “What was the most important thing you learned?” were analyzed qualitatively using a positivistic deductive approach. Results: Participants completed 136 reflections over 16 sessions–77% response rate (136/176). Cohort was 91% female; mean age 52.6 (range 32-65); mean years since completion of highest degree 21.4; 64% held doctorates, 36% master’s degrees. 46% were physicians, 27% nurses, 18% social workers, 9% psychologists. 27% participated previously in a learning experience focusing on interprofessional education, collaboration or practice. Most important learning included: Relational capacities/ Use of self in relationships 96/131 (73%); Attention to values 46/131 (35%); Reflection/ Self-awareness 44/131 (34%); Fostering humanistic learning environments 21/131 (16%). Discussion: Results revealed the importance of enhancing relational capacities and use of self in relationships including handling emotions; attention to values; reflection/self-awareness and recognition of assumptions; and fostering humanistic learning environments. These topics should receive more emphasis in interprofessional faculty development programs and may help identify teaching priorities. *Supported in part by a multi-institutional grant from the Josiah Macy, Jr. Foundation (Dr. Branch as PI; Dr. Rider as site PI).

scholarly journals Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025299
Author(s):  
Udagedara Mudiyanselage Jayami Esha Samaranayake ◽  
Yasith Mathangasinghe ◽  
Anura Sarath Kumara Banagala
Keyword(s):  
Informed Consent ◽  
Qualitative Study ◽  
Tertiary Care Hospital ◽  
Comparative Method ◽  
Tertiary Care ◽  
Lifestyle Changes ◽  
Cultural Norms ◽  
Sri Lankan ◽  
Care Hospital ◽  
Asking Questions

ObjectiveTo identify the different perceptions on informed surgical consent in a group of Sri Lankan patients.MethodsA qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations.ResultsThirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood.ConclusionThe informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society.

Interprofessional Shared Decision Making in the NICU: A Survey of an Interprofessional Healthcare Team

2013 ◽  
Vol 3 (1) ◽  
Author(s):  
Sandra Dunn ◽  
Betty Cragg ◽  
Ian D. Graham ◽  
Jennifer Medves ◽  
Isabelle Gaboury
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Neonatal Intensive Care ◽  
Influencing Factor ◽  
Decision Making Process ◽  
Healthcare Team ◽  
Strong Positive Correlation ◽  
Shared Decision ◽  
Respiratory Therapists ◽  
Interprofessional Healthcare

Background: The purpose of this study was to determine how different membersof an interprofessional (IP) team (nurses, physicians, respiratory therapists, and other professionals) perceived collaboration and satisfaction with the decisionmaking process across three decision types (triage, chronic condition management, values-sensitive decisions) in a neonatal intensive care unit (NICU).Methods and Findings: All members of the team at a tertiary NICU in Canada who consented to the study received a modified version of the Collaboration and Satisfaction about Care Decisions (CSACD) instrument. A total of 96 completed surveys were returned (response rate of 81.4). Collaboration scores were calculatedfor each participant, professional group, and the IP team. The Pearson product-moment correlation coefficient was used to investigate the relationship between perceived collaboration about decision making and satisfaction with the decision-making process. Inter-group comparisons across different decision types were also calculated. The majority of statistically significant differences in professional perspectives about decision making were about triage decisions. Nurses and respiratory therapists were more likely than other groups to feel the decision-making process was inadequate. There was a strong, positive correlation between perceived collaboration in decision making, satisfaction with the decision-making process, and satisfaction with the decision.Conclusions: Findings from this survey suggest that healthcare professionals' views differ about what constitutes optimum interprofessional shared decision making(IPSDM), and the decision type is an important influencing factor for IPSDM.

scholarly journals SYSTEMIC REFLEXIVITY IN RESIDENTIAL CHILD CARE: A PEDAGOGICAL FRAME TO EMPOWER PROFESSIONAL COMPETENCE

2020 ◽  
Vol 11 (4.2) ◽  
pp. 115-139
Author(s):  
Laura Formenti ◽  
Allessandra Rigamonti
Keyword(s):  
Child Care ◽  
Transformative Learning ◽  
Child Protection ◽  
Professional Competence ◽  
Active Listening ◽  
Self Awareness ◽  
Professional Work ◽  
Self Directed Learning ◽  
Cultural Backgrounds ◽  
Residential Child Care

This position paper offers a pedagogical frame to empower professional work in residential child care. Jobs in this demanding field are characterized by daily relationships with children of different ages, needs, and cultural backgrounds. There is a need for effective communication and interaction with them, their families, co-workers, other professionals, and care agencies, as well as with the larger community. This complexity brings uncertainty and the necessity of thinking and acting in a sensitive way in order to open possibilities for systemic transformation at the micro, meso, and macro levels. In this framework, we focus on reflexivity as a meta-competence — a set of specific postures, competences, and attitudes that characterize expert professional action. A thorough literature review on reflexivity in social work and child protection is aimed at clarifying the meanings, uses, and features of this concept. We claim that systemic reflexivity can be used as a framework, a methodology, and a set of tools to empower professional work by enhancing emotional, cognitive, and epistemic self-awareness, systemic wisdom, abduction, and active listening. To help workers and teams develop these five competences, a self-directed learning module is currently being designed, based on systemic and narrative perspectives, and transformative learning theory.

scholarly journals THE POETICS OF ADULTERY IN THE ARTISTIC WORLD OF I. A. BUNIN

2020 ◽  
pp. 61-68
Author(s):  
Shestakova E.G.
Keyword(s):  
Coordinate System ◽  
Everyday Life ◽  
Comparative Method ◽  
Point Of View ◽  
The Self ◽  
Self Awareness ◽  
Aesthetic Perception ◽  
Ethical Choice ◽  
The Everyday

The article substantiates the relevance of isolating adultery as one of the independent, powerful phenomena of the artistic world of I. Bunin. It is proved that adultery in the Bunin world is inappropriate to interpret as trivial adultery, considered in an unambiguous ethical coordinate system. The main approaches and directions of research into the poetics of adultery are determined: historical-typological, comparative, method of motive's analysis. The main purposes of the article are: to trace the main variants and variations of adultery, to understand how and in what main directions its development took place in the Bunin world; to clarify the moral, aesthetic and existential foundations of adultery as something that binds together such contradictory and necessary for comprehending the mystery of authenticity (F. Stepun), personality and truthfulness of feelings, as liberty and duty, love and responsibility, loyalty and betrayal, devotion, decency and possibility of change for self, choice and chance. Results. The fact of adultery in I. Bunin in no way implies immorality, depravity of a person, even in those cases when it is unambiguous from the traditional point of view. This is typical both for works focused on the poetics of realism and for stories for which the discoveries of existentialism are significant. The banality, predictability of the situation and types of heroes of adultery, inevitable when describing betrayal, are the equivalent of the Kantian situation of moral and ethical choice in I. Bunin. Aesthetic perception and the experience of betrayal are one of the opportunities for the heroes to know who they are. Conclusions. I. Bunin's deliberate attention to the everyday life of adultery, but also his non-admission in the practice of life, is the hero's choice of their usual everyday life as a choice of themselves, an almost Heidegger's opportunity to be oneself, and not a representative of the vulgarity of everyday situations. Adultery is a space of inner freedom and honesty of the self, existential infinity and unlimited possibilities of immersion and self-awareness, as well as his rights, duties (not)choosing oneself.Key words: motive, the paradox of adultery, moral and ethical choice, existential attitude. У статті обґрунтовується актуальність виокремлення адюльтеру як одного із самостійних, сильних феноменів художнього світу І. Буніна. Доводиться, що адюльтер у бунінському світі неправомірно трактувати як тривіальну подружню невірність, розглянуту в однозначній етичній системі координат. Визначаються основні підходи та напрями дослідження поетики адюль-теру: історико-типологічний, порівняльний, метод мотивного аналізу. Мета. Простежити основні варіанти й варіації адюльтеру, зрозуміти, як і в яких основних напрямах відбувався його розви-ток у бунінському світі; прояснити моральну, естетичну та екзистенційну основи адюльтеру як того, що пов’язує воєдино такі суперечливі й необхідні для осягнення таємниці автентичності (Ф. Степун) особистості та істинності почуття, як свобода та обов’язок, любов і відповідальність, вірність і зрада, відданість, порядність і можливість змін для я, вибір і випадковість. Результат. Факт адюльтеру в І. Буніна в жодному разі не передбачає аморальність, порочність людини навіть у тих випад-ках, коли це з традиційної позиції виявляється однозначним. Це характерно і для творів, орієнтованих на поетику реалізму, і для оповідань, для яких значимі відкриття екзистенціалізму. Неминучі під час опису зради банальність, передбачуваність ситуації й типів героїв адюльтеру є в І. Буніна еквівалентом кантівської ситуації морально-етичного вибору. Естетичне сприй-няття та переживання зради – це одна з можливостей для героїв пізнати себе справжніх. Висновки. Навмисна увага І. Буніна до буденності адюльтеру, проте водночас його недопущення на практиці життя – це зроблений героями вибір своєї звичної буденності як вибір себе, майже хайдеггерівська можливість бути самим собою, а не репрезентантом вульгарності загальножиттєвих ситуацій. Адюльтер – це простір внутрішньої свободи й чесності я, екзистен-ціальної безмежності та безмежної можливості занурення й усвідомлення себе, а також його права, обов’язки (не)вибору себе.Ключові слова: мотив, парадокси адюльтеру, морально-етичний вибір, екзистенційне світовідчуття.

scholarly journals Decisions to Enter and Leave Skilled Nursing Facilities for Post-Acute Rehabilitation: A Qualitative Study

2020 ◽  
Vol 3 ◽  
Author(s):  
Daniel Chimitt ◽  
Jennifer Carnahan
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Comparative Method ◽  
Skilled Nursing Facilities ◽  
Phone Call ◽  
Healthcare Team ◽  
Discharge Process ◽  
Nursing Facilities ◽  
Skilled Nursing

Background and Hypothesis:   Approximately 40% of patients aged 80+ enter a Skilled Nursing Facility (SNF) following a hospitalization. SNFs can be used as “safety nets” to expedite the discharge process of older adults and it can be difficult to pinpoint how and who made the decision for a hospitalized older adult to discharge to a SNF.   This project examines the factors that drive older adults to enter and leave a SNF for their rehabilitation care.    Project Methods:   Interview transcripts from a qualitative study with patients and their caregivers were used to examine factors influencing admission to and discharge from SNFs. Baseline interviews were conducted within two to seven days after returning home from a SNF stay followed by a follow up phone call one to two weeks after the initial interview. Transcripts and audio files were coded (using NVivo version 12+) for major themes. Interviews were analyzed using a constant comparative method to elicit themes of interest to interviewees.    Results:   There were 24 baseline interviews and X follow up interviews performed with a total of 24 patients and 15 caregivers. The primary theme identified was that patients perceived a loss of autonomy when considering the decision-making process. 75% (18/24) patients or their caregivers felt the healthcare team told them they must go to a SNF for their rehabilitation. 38% (9/24) patients or caregivers felt they had no choice but to leave due to insurance coverage and 50% (12/24) stated that they needed more time.    Potential Impact:   To achieve better patient outcomes, one must understand both the purpose of skilled nursing facilities and also how patients and their families are feeling as they transition through this uncertain period of their lives. Restoring a patient’s sense of autonomy will foster better patient-healthcare relationships and improve trust in the system. 

scholarly journals Doctoral Students Living, Leading, and Learning During a Pandemic

2021 ◽  
Vol 6 (2) ◽  
pp. 25-33
Author(s):  
Debra Bukko ◽  
Jaskaran Dhesi
Keyword(s):  
Transformative Learning ◽  
Doctoral Students ◽  
Future Research ◽  
Self Awareness ◽  
State University ◽  
Structured Interviews ◽  
Group Data ◽  
Focus Group Data ◽  
Uncertain Time ◽  
The Impact

Purpose: The purpose of this study was to understand the impact of COVID-19 on doctoral students’ personal, professional, and academic roles and factors contributing to their persistence during the pandemic.Research Methods: The researchers engaged in qualitative research at a California State University CPED-inspired Ed.D. program, using semi-structured interviews, document analysis and a focus group. Data were analyzed through the CPED mentoring and advising framework, transformative learning theory, and self-authorship theory.Results: Three themes emerged: a convergence of roles within home and virtual spaces, leading in a complex and uncertain time, and caring relationships encourage persistence.Implications: Participants experienced increased self-awareness and development of cognitive, interpersonal, and intrapersonal dimensions of self. Relationships between cohort members and with faculty were integral to student persistence during a time of significant change and uncertainty. Recommendations for practice within Ed.D. programs and for future research are offered.

Understanding the building of professional identities with the LEGO® SERIOUS PLAY® method using situational mapping and analysis

2019 ◽  
Vol 10 (1) ◽  
pp. 99-112
Author(s):  
Catherine Hayes ◽  
Yitka Graham
Keyword(s):  
Nursing Students ◽  
Transformative Learning ◽  
Methodological Approach ◽  
Approaches To Learning ◽  
Social Constructionist ◽  
Academic Learning ◽  
Situational Analysis ◽  
Self Awareness ◽  
Content Type ◽  
Postgraduate Level

Purpose The purpose of this paper is to explore the notion that social constructionist approaches to learning, which a building with the hands provides, is a “technique that leverages the potential of the hand-mind dynamic” as historically reported in the extant published literature. Design/methodology/approach The use of the LEGO® SERIOUS PLAY® (LSP) method in the context of transformative learning in Higher Education was used to drive a Situational analysis with sixteen postgraduate nursing students, from African learning contexts. This methodological approach was used to specifically explore their identity as learners and then to facilitate processes of critical introspection on social constructivist learning opportunities. Findings Students’ perceived LSP permitted a deeper level of critical introspection on their transformative learning journeys than alternative approaches, such as written discourse or extended narratives, could have provided. They also perceived that a major benefit of using the LSP method was that it enabled them to understand and articulate their stories more easily than if they verbally reported them first. Research limitations/implications The sampling the authors used was purposive and reflective of the Nigerian background of our research participants, who study at the University of Sunderland. Practical implications LSP was perceived as an effective vehicle for the facilitation of reflection and self-awareness, which consequently contribute to students’ capacities to function at a metacognitive level. This has the potential to contribute to authentic transformative learning. Academic learning at postgraduate level hinged on the capacity of students to develop a pragmatic and working knowledge of what acknowledging their epistemic cognition entailed. Originality/value The methodological approach implemented in this paper provides a unique means of harnessing a now common gamification technique in pedagogic practice.

scholarly journals Building trust and facilitating goals of care conversations: A qualitative study in people with heart failure receiving home hospice care

2020 ◽  
Vol 34 (7) ◽  
pp. 925-933
Author(s):  
Dawon Baik ◽  
David Russell ◽  
Lizeyka Jordan ◽  
Daniel D Matlock ◽  
Frances Dooley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Family Support ◽  
Family Caregivers ◽  
Hospice Care ◽  
Qualitative Interviews ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Goals Of Care ◽  
Team Members ◽  
Interprofessional Healthcare

Background: Despite a majority of persons receiving hospice care in their homes, there are gaps in understanding how to facilitate goals of care conversations between persons with heart failure and healthcare providers. Aim: To identify barriers and facilitators which shape goals of care conversations for persons with heart failure in the context of home hospice. Design: A qualitative descriptive study design was used with semi-structured interviews. Setting/participants: We conducted qualitative interviews with persons with heart failure, family caregivers, and interprofessional healthcare team members at a large not-for-profit hospice agency in New York City between March 2018 and February 2019. Results: A total of 39 qualitative interviews were conducted, including with healthcare team members (e.g. nurses, physicians, social workers, spiritual counselors), persons with heart failure, and family caregivers. Three themes emerged from the qualitative interviews regarding facilitators and barriers in goals of care conversations for better decision-making: (1) trust is key to building and maintaining goals of care conversations; (2) lack of understanding and acceptance of hospice inhibits goals of care conversations; and (3) family support and engagement promote goals of care conversations. Conclusion: Findings from this study suggest that interventions designed to improve goals of care conversations in the home hospice setting should focus on promoting understanding and acceptance of hospice, family support and engagement, and building trusting relationships with interprofessional healthcare teams.

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