Professional decision making with digitalisation of patient contacts in a medical advice setting: a qualitative study of a pilot project with a chat programme in Sweden

ObjectivesPatient e-services are increasingly launched globally to make healthcare more efficient and digitalised. One area that is digitalised is medical advice, where patients asynchronously chat with nurses and physicians, with patients having filled in a form with predefined questions before the chat. This study aimed to explore how occupational professionalism and the possibility of professional judgement are affected when clinical patient contact is digitalised. The study’s overall question concerns whether and how the scope of the healthcare staff’s professional judgement and occupational professionalism are affected by digitalisation.Design and settingA qualitative study of healthcare professionals working in a pilot project with a chat programme for patients in a medical advice setting in Sweden.Participants and analysisContextual inquiries and 17 interviews with nurses (n=9) and physicians (n=8). The interviews were thematically analysed. The analysis was inductive and based on theories of decision making.ResultsThree themes emerged: (1) Predefined questions to patients not tailored for healthcare professionals’ work, (2) reduced trust in written communication and (3) reduced opportunity to obtain information through chat communication.ConclusionsThe results indicate that asynchronous chat with patients might reduce the opportunity for nurses and physicians to obtain and use professional knowledge and discretionary decision making. Furthermore, the system’s design increases uncertainty in assessments and decision making, which reduces the range of occupational professionalism.

PEMANSUHAN UJIAN PENILAIAN SEKOLAH RENDAH DAN PELAKSANAAN PENTAKSIRAN BILIK DARJAH: SATU TINJAUAN DALAM KALANGAN GURU BESAR

The abolition of Primary School Achievement Test (UPSR) has triggered various reactions among educators. Although this agenda has been informed since the introduction of the new curriculum in 2011, educators and parents did not fully accept this. This research was conducted to explore and understand in-depth the views of school headmasters on the abolition of the UPSR and obtain their views on the implementation of Classroom Assessment (PBD). At the early stage the researchers conducted a survey to get an initial picture of their reactions to the issues and subsequently, the issue was explored in depth using qualitative methods. Focus group interviews conducted online to explore their perspectives on the abolition of UPSR and the implementation of PBD, which is now taking over the place of UPSR completely. However, with semi-structured interviews that were conducted, the data were distributed based on the themes that had been identified. Most school headmasters disagree with the abolition of the USPR as they do not fully understand the implementation of PBD. Among the aspects that they still lack understanding are the curriculum changes, professional judgement, quality assurance, and formative and summative assessment methods. Policymakers must ensure that a deep understanding can be formed among school headmasters to ensure that the implementation of PBD can be strengthened and fully understood. It is also suggested that further research be conducted to measure the acceptance among teachers on this issue. Keywords: UPSR abolition, Classroom assessment, Understanding towards PBD Abstrak: Pemansuhan Ujian Penilaian Sekolah Rendah (UPSR) telah mencetuskan pelbagai reaksi dalam kalangan warga pendidik. Walaupun perkara ini merupakan suatu agenda yang telah dimaklumkan sejak pengenalan kurikulum baharu pada tahun 2011, namun warga pendidik dan ibu bapa masih belum boleh menerima perkara ini sepenuhnya. Penyelidikan ini dijalankan untuk meneroka dan memahami secara mendalam tentang pandangan guru besar tentang pemansuhan UPSR ini serta mendapatkan pandangan mereka tentang pelaksanaan Pentaksiran Bilik Darjah (PBD). Pada peringkat awal para penyelidik telah menjalankan satu tinjauan untuk mendapatkan gambaran awal reaksi mereka terhadap isu ini dan seterusnya isu mengupas secara mendalam dengan menggunakan kaedah kualitatif. Temu bual kumpulan berfokus telah dijalankan secara atas talian untuk meneroka perspektif mereka terhadap isu pemansuhan UPSR dan pelaksanaan PBD yang kini mengambil alih tempat UPSR sepenuhnya. Melalui temu bual separa struktur yang telah dijalankan, data-data telah diagihkan berdasarkan tema-tema yang telah dikenal pasti. Sebahagian besar guru besar sekolah kurang bersetuju dengan pemansuhan UPSR ini memandangkan mereka kurang memahami sepenuhnya tentang pelaksanaan PBD. Antara aspek yang mereka masih kurang faham adalah dari segi perubahan kurikulum, pertimbangan profesional, penjaminan kualiti dan kaedah pentaksiran formatif dan sumatif. Pihak penggubal dasar haruslah memastikan pemahaman yang mendalam dapat dibentuk dalam kalangan guru besar sekolah untuk memastikan pelaksanaan PBD dapat dimantapkan dan difahami sepenuhnya. Dicadangkan juga agar kajian lanjut dijalankan untuk mengukur penerimaan dalam kalangan guru-guru terhadap isu tersebut. Kata kunci: Pemansuhan UPSR, Pentaksiran bilik darjah, Pemahaman tentang PBD

Using Data as a Source of Reflection in a Feedback Loop

This chapter considers recent policy trends toward evidence-based practices in Arizona, the U.S., and across the globe. The rise in the use of “scientific” evidence for educational policymaking rests on two common beliefs about knowledge: (1) the belief that school knowledge is universal, and (2) the belief that empirical evidence or data is the primary indicator of knowledge and learning. Recent U.S. policies have reflected the importance of data or numeric evidence from externalized evaluations to guide school decisions. Internationally, multinational organizations, such as the World Bank, have also made evidence-based policymaking a priority both in their own work as influential research and policy organizations as well as their members. Yet there are cautions against this particular use of evidence to replace professional judgement and the wider democratic deliberation about the aims, ends and content of education. Our school development project considers evidence-based values and humanistic, democratic values at tension. School development participants applied a balanced perspective on data with numerical evidence subordinated to educational values, using all as a source of reflection and growth. The chapter, thus, defines data as information that educators, school teams, and other agency members use to inform professional judgement and influence.

Applying light for human health: What lighting designers need to know

As lighting designers, our work impacts people and the environment. Putting human-centric thinking and approaches at the heart of design is the first principle. This paper reflects a personal view on what lighting designers need to know before they can apply professional judgement and claim that their lighting design will improve human health.

Judgement in geotechnical engineering practice

Professional judgement is the basis for many of the decisions taken by geotechnical engineers to make progress in the design, execution and works supervision. Judgment is a mandatory component of any engineering achievement, essential to assess the various uncertainties that inevitably affect engineering practice. Confidence in such judgements can result in small to big consequences, not only for the engineer itself, but also for others, sometimes with the risk of human loss and significant damage. The definition and the development of judgment in geotechnical engineering is discussed. The bases of the judgement are analysed in detail and the heuristics and bias, responsible for failures in the judgment, are identified. The importance of experts’ judgement and codification are highlighted and ways to improve judgment are also described. The lessons learned in a case study of one accident and two incidents that have occurred during the execution of the Lisbon Terreiro do Paço metro station construction works are presented to highlight the importance of an informed decision making informed through the engineering judgement.

Understanding the “Conflict of Interest

According to Wikipedia, ‘Çonflict of interest’ is a set of circumstances that creates a risk that professional judgement or actions regarding a primary interest will be unduly influenced by a secondary interest' [1]. It may be broadly described as conditions which may influence one’s judgement in a situation (primary interest) for some other gain (secondary interest), this may be financial or non-financial . It is of importance to understand that having a secondary gain is not wrong but these gains should not be illegal. This pertains to delivery of patient care, teaching and research in the medical profession.

Dissecting leadership education and assessment in surgery

The importance of leadership is well recognised within surgery owing to the heavily teamwork dependent nature and uniquely dynamic working environment of the operating room. Teaching and assessment methods of leadership within UK surgical training has arguably lacked credence in comparison to the more tangible technical clinical competencies due to the fact that the daily tasks of surgeons are multifaceted and cannot be simplified into a tick-box exercise. As such, some surgical trainees perceive themselves to be minimally competent in their leadership ability. The new surgical curricula planned to be implemented by the Intercollegiate Surgical Curriculum Programme in August 2021 aims to address this by shifting leadership training and assessment towards an outcome-based approach, rather than a competency-based approach, with an emphasis on the role of the professional judgement of trainers as well as trainee self-reflection. This article explores these proposed changes by framing them within the context of the wider literature pertaining to surgical leadership education.