In competence-based vocational education, personal professional theories, in which students integrate different types of knowledge and beliefs, are seen as important. Exactly how these theories can be measured is the main focus of this study, which uses a multi-method triangulation approach, an interview and a self-report. The latter (less-structured) matter seems to provide less insight into personal professional theories then the structured methods. Both structure and adequate prompts are important when personal professional theories are explicated.
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Aim and objectives: To provide an in-depth insight into the barriers, facilitators and needs of district nurses and nurse assistants on using patient outcomes in district nursing care. Background: As healthcare demands grow, particularly in district nursing, there is a significant need to understand how to systematically measure and improve patient outcomes in this setting. Further investigation is needed to identify the barriers and facilitators for effective implementation. Design: A multi-method qualitative study. Methods: Open-ended questions of a survey study (N = 132) were supplemented with in-depth online focus group interviews involving district nurses and nurse assistants (N = 26) in the Netherlands. Data were analysed using thematic analysis. Results: Different barriers, facilitators and needs were identified and compiled into 16 preconditions for using outcomes in district nursing care. These preconditions were summarised into six overarching themes: follow the steps of a learning healthcare system; provide patient-centred care; promote the professional's autonomy, attitude, knowledge and skills; enhance shared responsibility and collaborations within and outside organisational boundaries; prioritise and invest in the use of outcomes; and boost the unity and appreciation for district nursing care. Conclusions: The preconditions identified in this study are crucial for nurses, care providers, policymakers and payers in implementing the use of patient outcomes in district nursing practice. Further exploration of appropriate strategies is necessary for a successful implementation. Relevance to clinical practice: This study represents a significant step towards implementing the use of patient outcomes in district nursing care. While most research has focused on hospitals and general practitioner settings, this study focuses on the needs for district nursing care. By identifying 16 key preconditions across themes such as patient-centred care, professional autonomy and unity, the findings offer valuable guidance for integrating a learning healthcare system that prioritises the measurement and continuous improvement of patient outcomes in district nursing.
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Background to the problem Dutch society demonstrates a development which is apparent in many societies in the 21st century; it is becoming ethnically heterogeneous. This means that children who are secondlanguage speakers of Dutch are learning English, a core curriculum subject, through the medium of the Dutch language. Research questions What are the consequences of this for the individual learner and the class situation?Is a bi-lingual background a help or a hindrance when acquiring further language competences. Does the home situation facilitate or impede the learner? Additionally, how should the TEFL professional respond to this situation in terms of methodology, use of the Dutch language, subject matter and assessment? Method of approach A group of ethnic minority students at Fontys University of Professional Education was interviewed. The interviews were subjected to qualitative analysis. To ensure triangulation lecturers involved in teaching English at F.U.P.E. were asked to fill in a questionnaire on their teaching approach to Dutch second language English learners. Thier response was quantitatively and qualitatively analysed. Findings and conclusions The students encountered surprisingly few problems. Their bi-lingualism and home situation were not a constraint in their English language development. TEFL professionals should bear the heterogeneous classroom in mind when developing courses and lesson material. The introduction to English at primary school level and the assessment of DL2 learners require further research.
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The purpose of the research we undertook for this Conference Paper was to investigate whether marketing campaigns for specific types of drinks could be directed towards age cohorts rather than towards intercultural differences between countries. We developed consumer profiles based on drinking motives and drinking behavior by age cohorts. We hypothesized that differences between countries in the youngest age groups are smaller than in the older age groups, where country specific tradition and culture still plays a more prominent role. We, therefore tested, from the data obtained by the COnsumer BEhaviouR Erasmus Network (COBEREN), the hypothesis that the extent to which the age specific profiles differ between countries increases with age. The results confirm our hypothesis that the extent to which drinking motives differ between countries increases with age. Our results suggest that marketing campaigns which are directed towards drinking motives, could best be tailored by age cohort, in particular when it concerns age group 18-37 and more particular for beer, spirits and especially premix drinks. Marketing campaigns for non-alcoholic beverages should be made specific for the British countries and the Western countries, but even more effectively be made specific for the age cohort 18-37.
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Horizontal collaborative purchasing (HCP) has often been cited as a way for hospitals to address the challenges of the rising healthcare costs. However, hospitals do not seem to utilize horizontal collaborative purchasing on any large scale, and recent initiatives have had mixed results. Focusing on Dutch hospitals, in this paper we present major impediments for collaborative purchasing, resulting in a first component of our proposed electronic horizontal collaborative purchasing model for hospitals; as a second component it contains a collaborative purchasing typology. A first validation round with hospital purchasing professionals, described separately in Kusters and Versendaal (2011), confirmed four applicable purchasing types and fourteen salient collaborative purchasing impediments. The model is operationalized by including possible information technology (IT) solutions that address the specific fourteen impediments. This model is validated through methodological triangulation of four different validation techniques. We conclude that IT has the potential to support, or overcome, the impediments of HCP. The validation also reveals the need to distinguish between more processrelated, as opposed to social-related, obstacles; the immediate potential for IT solutions is greater for the process-related impediments. Ultimately, we conclude that the collaborative epurchasing model (e-HCP) and implementation roadmap can be used by healthcare consortia, branche organizations, partnering healthcare institutes and multi-site healthcare institutes as a means to help identifying strategies to initiate, manage and evaluate collaborative purchasing practices
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Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. Results: A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of EBP were that nurses had little knowledge of EBP and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of EBP was adapted. Nurses worked according to the EBP discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Conclusions: Action research provides an opportunity to empower nurses and to tailor EBP to the practice context. Applying and implementing EBP is difficult for front-line nurses with limited EBP competencies. Relevance to clinical practice: Adaptation of the academic model of EBP to a more pragmatic approach seems necessary to introduce EBP into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses’ clinical decision making at the individual patient level.
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Introduction: There is a lack of effective interventions available for Pediatric Physical Therapists (PPTs) to promote a physically active lifestyle in children with physical disabilities. Participatory design methods (co-design) may be helpful in generating insights and developing intervention prototypes for facilitating a physically active lifestyle in children with physical disabilities (6–12 years). Materials and methods: A multidisciplinary development team of designers, developers, and researchers engaged in a co-design process–together with parents, PPTs, and other relevant stakeholders (such as the Dutch Association of PPTs and care sports connectors). In this design process, the team developed prototypes for interventions during three co-creation sessions, four one-week design sprint, living-lab testing and two triangulation sessions. All available co-design data was structured and analyzed by three researchers independently resulting in themes for facilitating physical activity. Results: The data rendered two specific outcomes, (1) knowledge cards containing the insights collected during the co-design process, and (2) eleven intervention prototypes. Based on the generated insights, the following factors seem important when facilitating a physically active lifestyle: a) stimulating self-efficacy; b) stimulating autonomy; c) focusing on possibilities; d) focusing on the needs of the individual child; e) collaborating with stakeholders; f) connecting with a child's environment; and g) meaningful goal setting. Conclusion: This study shows how a co-design process can be successfully applied to generate insights and develop interventions in pediatric rehabilitation. The designed prototypes facilitate the incorporation of behavioral change techniques into pediatric rehabilitation and offer new opportunities to facilitate a physically active lifestyle in children with physical disabilities by PPTs. While promising, further studies should examine the feasibility and effectivity of these prototypes.
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Higher education has the potential to act as ecosystem catalysts, connecting with the places our institutions which they are a part of, for learning-based changes with wicked (sustainability) challenges. This, however, calls for reorienting and rethinking of the higher educational narratives and subsequent practices towards more ecological and relational ones. In this study, a pilot aimed to connect a course at The Hague University of Applied Sciences (The Netherlands) to an industrial park next to the university which is undergoing transition towards a sustainable living space. The pilot, which ran from September 2020 to February 2021, included 17 students from 9 nationalities and 12 different bachelor programmes, and was designed according to the concepts of an ‘ecology of learning’. In this semester long course, called Mission Impact, students reflected every five-weeks, to capture their learning experiences using a combination of arts-based and narrative reflection methods. Two questions guided the analysis: (1) what are the key design characteristics of an ecological approach to higher education that connects to sustainability transformations (in times of COVID-19) and (2) what does this type of education asks from to learners. The reflective artefacts were analysed using Narratives of T-Mapping and juxtaposed with autoethnographic insights maintained by the first author for triangulation. Preliminary results of this pilot include the structure in chaos, space for transformation, openness for emerging futures & action confidence as components of such an ecological education that connects to and co-creates sustainability transformations.
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AIMS: The Canadian Occupational Performance Measure (COPM) can be used to support children to clarify their needs themselves. However, for pediatric occupational therapists it is not sufficiently clear how to effectively use the COPM with children from 8 years of age.This study aimed to formulate specific instructions for using the COPM with children themselves, based on the experience of children, parents, and occupational therapists. In addition, professional consensus on the instructions was reached.METHODS: A multi-stage approach was used to develop the instructions. Triangulation of methods was used to gather knowledge of how the COPM with children themselves is performed in daily practice: interviews with 23 children, questionnaires completed by 30 parents, interviews with 13 therapists, and 10 video recordings of COPM administration. Specific instructions were derived from this knowledge and consensus for these instructions was reached by Delphi method.RESULTS: The data were analyzed and resulted in 40 specific instructions. Consensus of at least 80% amongst 10 occupational therapists, who regularly use the COPM with children, was achieved on each instruction.CONCLUSION: There is consensus on 40 specific instructions for administering the COPM with children. Following these instructions might help children to formulate their own goals for intervention.
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This study analyses how the social construction of integrity takes place within the context of football in the Netherlands. Combining a contextual approach to sports integrity with the analytic lens of sensemaking, this qualitative multi-method case study analyses – in one extreme case in Dutch youth amateur football – why and when the ‘incident’ was perceived as an ‘integrity issue’, and how the meaning of (the) integrity (issue) was socially constructed by (interactions between) stakeholders involved in the case. Our findings show why, when, and how moral norms and values are (not) debated and at stake, and that the social construction of sports integrity is intertwined with the institutional context and the role of secondary stakeholders. It provides insights that can help sports organizations to identify risks in their moral sports culure and to develop measures or policies to safeguard integrity in sport.
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