Change is endemic in modern society, and the educational systems that operate in it. In Higher Education societal trends such as globalization and economic rationalism are impacting on teachers. Changes in the student population, new educational methods derived from shifting perspectives on the role of knowledge and re-structuring of the organizations within which teachers work have also led to transformation of the professional context. At European level policy initiatives such as the Bologna Declaration (1999) have necessitated an overhaul of educational provision. This research project attempts to focus on these wideranging changes through the lens of teacher autonomy in order to establish what is changing in the working lives of teachers in a Dutch university, how they are responding to these changes and how they can be helped to respond to change effectively and discriminatingly. This is an insider research project, using case study and semi-structured interviewing to yield data that is subjected to thematic linguistic analysis. It was piloted in 2006, and interviewing was resumed in February 2007. Findings indicate the contested nature of teacher autonomy, and suggest that professional autonomy can impede as well as facilitate teachers in processes of engaging with change. The team - operating as a community of practice - is identified as the location where change agency can operate most effectively. Distributed leadership - specifically perceived in the activities of team leaders and teacher change agents - is seen as crucial to processes of embedding change in educational practice.
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As anyone who has travelled the dissertation road knows the process dominatesuntil the end of that road is reached. After the fireworks, it is time, high time, toshare the outcomes outside of a small circle of experts. This monograph is part of the catalytic goals of a study undertaken between 2006 and 2012 in Groningen at the Hanze University of Applied Sciences (HG) where I am employed. The study was originally inspired by my efforts, not always successful, to help my colleagues as their teacher of English and as academic staff developer. Initially it was meant to be an applied, practitioner research to identify needs, in preparation of a pilot project, not a scientific investigation. I wanted very much to understand why Dutch teachers, who received no extra pay or status became involved in international teaching. What motivated them, what kept them going, and most of all what did they need in terms of support in the transition and changes they were experiencing?
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ObjectiveFirst, to make an inventory of activity limitations commonly reported by knee osteoarthritis (OA) patients undergoing multidisciplinary rehabilitation. Second, to evaluate treatment outcome using the Patient Specific Functional Scale (PSFS) and compare it to the Western Ontario and McMasters Universities Osteoarthritis Index physical function subscale (WOMAC-pf).DesignAn observational study with assessments before and immediately after multidisciplinary rehabilitation. Five hundred and thirteen patients used the PSFS, a patient-reported tool to identify activity limitations and score the patient's ability to perform the activity on an 11-point Numeric Rating Scale (NRS), to report three activities in which they were limited. Frequencies and percentages of their highest-prioritized activity were calculated and categorized according to the International Classification of Functioning, Disability, and Health (ICF). Paired-samples T-tests were used to analyze the change in ability to perform the activities. Effect sizes of PSFS and WOMAC-pf were compared.ResultsMost patients indicated limitations in walking, walking up/down stairs, prolonged standing, and standing up from a chair. Following these common activities, 26 different activities were identified. The majority of these highest-prioritized activities fell under the first-level ICF category of Mobility. The ability to perform all activities significantly improved after treatment. Effect sizes ranged between 0.60 and 0.97 and were greater than the effect size of the WOMAC-pf (0.41).ConclusionKnee OA patients who undergo multidisciplinary rehabilitation exhibit improvements in performing daily activities. The PSFS is a valuable tool to evaluate patient-specific activity limitations and seems to capture improvements in activity limitations beyond the WOMAC-pf.
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