Search

Background: We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also 'fresh eyes' on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention – a serious board game – to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff. Methods: A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan's Critical Incident Technique. A paper-based questionnaire on 'Safety Concerns' was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians. Results: The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention. Conclusion: In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns. [ABSTRACT FROM AUTHOR]

Introduction Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning. Methods and analysis We will use quantitative and qualitative methods to collect data. The sample size will be approximately 200 interns and SHOs across the two hospital sites. Two surveys will be included with one measuring leadership inclusiveness and psychological safety and a second capturing information on safety concerns that participants may have witnessed in their places of work. The PlayDecide embedded learning intervention will be developed with key stakeholders. This will be trialled in the middle stage of data collection for both interns and SHOs. A detailed content analysis will be conducted on the surveys to assess any changes in reporting following the PlayDecide intervention. This will be compared with the incident reporting levels and the results of the preintervention and postintervention leadership inclusiveness and psychological safety survey. Statistical analysis will be conducted using SPSS. Differences will be considered statistically significant at p<0.05. Semistructured interviews using a critical incident technique will be used for the ongoing analysis and evaluation of the project. These will be transcribed, deidentified and coded into themes. Ethics and dissemination The study has been granted ethics approval from University College Dublin (Ref. LS-15-19-Ward-McAuliffe: Imbuing Medical Professionalism in Relation to Safety). The study results will be disseminated through peer-reviewed publications. [ABSTRACT FROM AUTHOR]

The article discusses Ontario industrial workers' family finances, including in regard to gender and the economic vulnerabilities that family budgets face. An overview of the members of middle classes in Canada, including their ability to find employment and the class distinctions between middle and working classes, is provided. The role that women play in the social conditions of Ontario families, including women's role in heading single-parent families, acting as caregivers to laid-off spouses and managing family budgets, is discussed.

The aim of the paper is to assess open disclosure in Ireland following clinical adverse events in healthcare. A number of areas were examined from the patient's and healthcare team's perspectives. The barriers/constraints to open disclosure, the extent of policies, procedures or guidelines that are available for staff to consult with, inclusive of how they are implemented, harvested valuable insight. The supports available for healthcare staff following an adverse event and patients' expectations after such an event are also encompassed to include the relationship open disclosure has on concerns regarding litigious intent. The questionnaire was disseminated to a multidisciplinary healthcare group. The questions were numbered 1-9, with a mixture of open and closed questions. A five-point Likert format was used with three questions in attitudinal/ opinion statements, regarding supports available for staff following an adverse event. A Statistical Package for Social Sciences was used to assist with the interpretation of data. This study was directed at the multidisciplinary healthcare team and senior management within the Health Service Executive (HSE) and Voluntary sectors. The oldest hospitals in Ireland are voluntary public hospitals some of them originating from the 18th century, having been established by charities and religious orders. Voluntary hospitals are partly funded by the HSE, specifically having their own governance structure. There was a response rate of 67% (n ¼ 192). A total 56.5% of respondents stated their organization did not have an open disclosure policy, procedure or guideline in place however, 16% of the attendees stated there was one in place. A total of 54.4% (104) acknowledged barriers/concerns surrounding open disclosure, with fear of litigious intent noted by 24% of respondents. A total of 52.3% (101) identified support availability to staff following an adverse event, 38.9% (10) felt there was little/no follow-up support, with 11.1.% (2) stating they were made to feel guilty, and associated it with being "on trial". Findings demonstrate an unstructured approach to disclosure of adverse events in Ireland, with fear of litigation a major concern for healthcare professionals. Error awareness among the general public, the introduction of protective legislation and implementation of a national standard on open disclosure in conjunction with practical training and education will all positively and practically influence open disclosure of adverse events in Ireland. [ABSTRACT FROM AUTHOR]

The article examines the learning and perceptions of teacher researchers and facilitators in a literacy-focused, teacher-research course. The study shows that these educators learned about themselves as system members, learners, and change agents within varying spheres of influence. Some of purposes that the teacher-research course served includes the sharing aspects of literacy instruction and instruction in other subjects, venting frustrations, reflecting on problems and proposing solutions, and detailing difficulties with their research.

Throughout Western highly industrialised countries, there has been a marked shift toward more conservative social policies signalling a dismantling of the welfare state as part of the process of globalisation. This paper examines the aetiology of the (un)employment insurance programme in the Canadian context. Recently, legislators have tightened eligibility rules, lowered earnings replacement rates and altered coverage requirements. While these changes signal a shredding of the social safety net, they differentially impact on certain segments of the population. Despite official pronouncements of fairness, employment insurance changes intensify the subordination women experience in the paid labour force. [ABSTRACT FROM PUBLISHER]

Provides information on the analysis of teacher action research studies and the different methods in classroom management. Suggested themes and categories of teacher-research methodology; Management of group discussion and class inquiries; Details on student-teacher relationships in a teacher action research project.

This paper examines the general evolution of part-time work in the Canadian context and the related scholarship on insecure employment. We analyse the major factors implicated in the expansion of part-time employment and speculate on the further evolution of this form of peripheral employment and its likely implications in particular for women, youth, and older workers. Finally, we discuss the challenge to unions and the state in addressing the question of workers' insecurity and marginalized work. Cet article examine l'evolution generale du travail a temps partiel et ce, dans un contexte canadien, ainsi que les etudes et la recherche sous-jacentes sur l'incertitude marquant le travail. Nous analyserons les pricipaux facteurs accompagnant la croissance du travail a temps partiel et reflechirons sur l'evolution a long terme de cette forme de travail peripherique et ses ramifications aupres des femmes, de la jeunesse et des travailleurs du troisieme age. En dernier lieu, nous aborderons les defis que doivent relever les syndicats et determinerons ou nous en sommes concernant l'insecurite des travailleurs et la precarite du travail. [ABSTRACT FROM AUTHOR]

The article discusses about federal and state funding for social services, which has been drastically reduced in the past 10 years. Many definitions and forms of privatization exist. Privatization generally means the transfer of government services from the public sector to private resources. This process includes divesting state-owned enterprises, raising user fees, allowing the private sector to provide services either in place of or in competition with government, and contracting out service delivery to private firms through a competitive bidding process. The Massachusetts experience is relevant for people in other states, because privatization and reductions in funds for social services continue to be trends throughout the United States. The 1980s saw an increase in the centralization of departments and in the size of catchments areas for emergency services. An accompanying trend is the reduction of professional social work services in favor of managed care provisions. Utilization review procedures, both for Medicaid and private insurers, particularly health maintenance organizations, have resulted in treatment time limits replacing clinical judgment.

Copyright of Industrial Relations / Relations Industrielles is the property of Universite Laval, Department of Industrial Relations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Provides information on misconceptions and overgeneralization being made about reading instructions in the U.S. Notion that teachers do not teach phonics any more in elementary school; Effectiveness of research-based reading programs in promoting the reading achievement of all students; Actions that should be taken by teachers to address the misinformations.