The concept of internationalization has been seen as a buzz word and container concept. The meaning of internationalization includes everything that relates to international, meanwhile internationalization is losing its meaning. This study takes a practical approach to searching for some clarification of this concept. During the period 2009-2011, 73 key actors in the field of internationalization at 16 Dutch higher education institutions (HEIs) were interviewed. Among the 14 elements identified by this study as constituting the concept of internationalization, many may be commonly know. However, the value of this study is that it ranks their significance and provides a sound base for further comparative studies in other countries. Moreover, this study compares and contrasts the differing interpretations of what the pursuit of internationalization means in research universities and universities of applied sciences and concludes that internationalization is pursued differently in the two sectors and clarifies the cause of these differences. These sectoral differences are important but have so far been rarely acknowledged in the internationalization literature. Finally, knowledge about practitioners’ perceptions of internationalization is not widely available in the education literature on internationalization. This study provides this knowledge based on the Dutch situation and argues that the current trend of theoretical development and general conceptualization in this field needs to recognize the actual practices, if our aim is to produce meaningful and feasible models/guidelines/frameworks that are recognizable by the practitioners.
Aim. To report the expectations and experiences of general practitioners and practice nurses regarding the U-CARE programme, to gain a better understanding of the barriers and facilitators in providing proactive, structured care to frail older people and to determine whether implementation is feasible. Background. Care for older patients with complex care needs in primary care is fragmented, reactive and time consuming. A structured, proactive care programme was developed to improve physical functioning and quality of life in frail older patients. Design. An explanatory mixed-methods study nested in a cluster-randomized trial. Methods. The barriers to and needs for the provision of structured, proactive care, and expectations regarding the U-CARE programme were assessed with prequestionnaires sent to all participating general practitioners (n = 32) and practice nurses (n = 21) in October 2010. Postquestionnaires measured experiences with the programme after 5 months. Twelve months later, focus group meetings were conducted. Results. Practice nurses and general practitioners reported that it was difficult to provide proactive and structured care to older patients with multi-morbidity, different cultural backgrounds and low socioeconomic status. Barriers were a lack of time and financial compensation. Most general practitioners and practice nurses indicated that the programme added value for the coordination of care and allowed them to provide structured care. Conclusion. This explanatory mixed-methods study showed that general practitioners and practice nurses perceived the U-CARE programme as feasible in general practice. A transition was made from reactive, ad hoc care towards a proactive and preventive care approach
The purpose of this study was to explore the experiences and impact of peer-to-peer shadowing as a technique to develop nurse middle managers’ clinical leadership practices. A qualitative descriptive study was conducted to gain insight into the experiences of nurse middle managers using semi-structured interviews. Data were analysed into codes using constant comparison and similar codes were grouped under sub-themes and then into four broader themes. Peer-to-peer shadowing facilitates collective reflection-in-action and enhances an “investigate stance” while acting. Nurse middle managers begin to curb the caring disposition that unreflectively urges them to act, to answer the call for help in the here and now, focus on ad hoc “doings”, and make quick judgements. Seeing a shadowee act produces, via a process of social comparison, a behavioural repertoire of postponing reactions and refraining from judging. Balancing the act of stepping in and doing something or just observing as well as giving or withholding feedback are important practices that are difficult to develop.
