In the midst of continuous health professions curriculum reforms, critical questions arise about the extent to which conceptual ideas are actually put into practice. Curricula are often not implemented as intended. An under-explored aspect that might play a role is governance. In light of major curriculum changes, we explored educators' perspectives of the role of governance in the process of translating curriculum goals and concepts into institutionalized curriculum change at micro-level (teacher-student). In three Dutch medical schools, 19 educators with a dual role (teacher and coordinator) were interviewed between March and May 2018, using the rich pictures method. We employed qualitative content analysis with inductive coding. Data collection occurred concurrently with data analysis. Different governance processes were mentioned, each with its own effects on the curriculum and organizational responses. In Institute 1, participants described an unclear governance structure, resulting in implementation chaos in which an abstract educational concept could not be fully realized. In Institute 2, participants described a top-down and strict governance structure contributing to relatively successful implementation of the educational concept. However it also led to demotivation of educators, who started rebelling to recover their perceived loss of freedom. In Institute 3, participants described a relatively fragmentized process granting a lot of freedom, which contributed to contentment and motivation but did not fully produce the intended changes. Our paper empirically illustrates the importance of governance in curriculum change. To advance curriculum change processes and improve their desired outcomes it seems important to define and explicate both hard and soft governance processes.
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Introduction: Undergraduate healthcare students on placement abroad can experience challenges that affect their wellbeing, personal and professional development. These challenges may result in students taking a more peripheral role in workplace activities, which negatively impacts learning. We studied how personal and professional challenges affect students’ learning and wellbeing during a clinical placement abroad.Methods: We used the rich pictures drawing method to elicit semi-structured student interviews and capture personal and professional challenges within different contexts. Language, culture, education, and belonging were used as sensitizing concepts, underlying thematic analysis. We conducted a parallel and iterative analysis of the transcripts and rich pictures. Team discussions focused on developing patterns and further conceptualization of results.Results: Based on thirteen student accounts, we identified four main themes: ‘Learning to work in the international context’; ‘Cultural differences shape professional identity’; ‘Deliberate social connections’; and ‘Personal growth through international experiences’. Active participation in local practices was crucial to overcome barriers in language, culture or education, and increase belonging. Local healthcare teams and peers supported students’ wellbeing, personal and professional development by helping them establish their role as a learner, whilst exploring the scope and boundaries of their future profession.Conclusions: Language, cultural and educational challenges can be considered an inevitable part of student placement abroad. Local peers and staff may support this transition and help recognize learning opportunities and challenges in the workplace. Clinical educators can facilitate learning and wellbeing by providing social support and guidance on professional behavior, including communication.
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Het welbevinden van de Nederlandse jeugd staat onder druk. Jeugdprofessionals die dagelijks werken aan vorming, begeleiding, preventie en behandeling van jonge mensen, zien zich daarin geconfronteerd met de nodige uitdagingen. Aangezien kennis en protocollen ontoereikend zijn in het komen tot adequaat handelen, is het van belang te exploreren wat ‘praktische wijsheid’ van individuele professionals hierin kan betekenen. Data uit acht open interviews, met inzet van de rich pictures methode, zijn geanalyseerd om te onderzoeken wat praktische wijsheid in het jeugddomein behelst. Dit toonde aan dat professionals komen tot het juiste handelen in knellende situaties door het eigen morele kompas als belangrijke richting gever te gebruiken. Het handelingsrepertoire is rijk en loopt uiteen van het volgen van intuïtie en wendbaarheid tot het gebruikmaken van kennis en zelfkennis. Het is van belang dat organisaties ruimte maken voor wat professionals al doen hieromtrent, maar ook dat (gezamenlijke) reflectie wordt gefaciliteerd. Elementen uit onze onderzoeksmethode lijken hierbij behulpzaam te kunnen zijn.
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Post-earthquake structural damage shows that wall collapse is one of the most common failure mechanisms in unreinforced masonry buildings. It is expected to be a critical issue also in Groningen, located in the northern part of the Netherlands, where human-induced seismicity has become an uprising problem in recent years. The majority of the existing buildings in that area are composed of unreinforced masonry; they were not designed to withstand earthquakes since the area has never been affected by tectonic earthquakes. They are characterised by vulnerable structural elements such as slender walls, large openings and cavity walls. Hence, the assessment of unreinforced masonry buildings in the Groningen province has become of high relevance. The abovementioned issue motivates engineering companies in the region to research seismic assessments of the existing structures. One of the biggest challenges is to be able to monitor structures during events in order to provide a quick post-earthquake assessment hence to obtain progressive damage on structures. The research published in the literature shows that crack detection can be a very powerful tool as an assessment technique. In order to ensure an adequate measurement, state-of-art technologies can be used for crack detection, such as special sensors or deep learning techniques for pixel-level crack segmentation on masonry surfaces. In this project, a new experiment will be run on an in-plane test setup to systematically propagate cracks to be able to detect cracks by new crack detection tools, namely digital crack sensor and vision-based crack detection.
