In service design projects, collaboration between design consultant and service provider can be problematic. The nature of these projects requires a high level of shared understanding and commitment, which providers may not be used to. We studied designer-provider collaboration in multiple real-life cases, in order to uncover determinants for successful collaboration. The case studies involved six service innovation projects, performed by Dutch design agencies. Independent researchers closely monitored the projects. Additional interviews with designers and providers gave insights in how both parties experienced their collaboration in the innovation projects. During data analysis, a coding scheme was created inductively. The scheme supported us in formulating 12 themes for designer-provider collaboration, amongst them four contextual determinants of shared understanding and stakeholder commitment in SD-projects. The insights from this study were then grounded in literature. Knowledge gaps were identified on themes about agreements of responsibilities, the open-endedness of an SD-process, an opportunitysearching approach, and organizational change that is required for the successful implementation of innovative service concepts.
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Objective: To construct the underlying value structure of shared decision making (SDM) models. Method: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz’s value theory to define values in SDM and to investigate value relations. Results: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals’ (HCPs) and patients’ skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients’ autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism]. Conclusion: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients’ Self-Direction. Practice implications: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients’ values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.
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In the pursuit of the communicative, collaborative and participatory planning processes advocated by academic planning literature, a practice has evolved that translates abstract objectives into practical workforms. Planning literature proposes many objectives that can be met by less top-down methods of generating ideas and making decisions. Little is known about how such objectives are translated into practical methods applied. This paper presents an inventory of practices that is meant to validate and supplement available theories on communicative planning. It concentrates on a specific part of the planning process: the moment where optional solutions to a problem are being generated, not by each stakeholder in isolation, but specifically by groups of stakeholders in constructive designerly interaction with each other. We interviewed 11 experienced professionals from the Netherlands who use interactive design sessions on a regular basis. This paper reports on their responses to questions about skills needed by session leaders, what types of venues are best to use, how to behave during sessions, requirements for participants to contribute, roles of governments and what explains the eventual effects of session outcomes. Although every session still needs to be tailor-made, based on practical wisdom and sensitivity to context, this study reveals recurring hands-on principles for organizing an effective dialogue for exploring solution space.
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In this paper we explore the influence of the physical and social environment (the design space) son the formation of shared understanding in multidisciplinary design teams. We concentrate on the creative design meeting as a microenvironment for studying processes of design communication. Our applied research context entails the design of mixed physical–digital interactive systems supporting design meetings. Informed by theories of embodiment that have recently gained interest in cognitive science, we focus on the role of interactive “traces,” representational artifacts both created and used by participants as scaffolds for creating shared understanding. Our research through design approach resulted in two prototypes that form two concrete proposals of how the environment may scaffold shared understanding in design meetings. In several user studies we observed users working with our systems in natural contexts. Our analysis reveals how an ensemble of ongoing social as well as physical interactions, scaffolded by the interactive environment, grounds the formation of shared understanding in teams. We discuss implications for designing collaborative tools and for design communication theory in general.
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University teacher teams can work toward educational change through the process of team learning behavior, which involves sharing and discussing practices to create new knowledge. However, teachers do not routinely engage in learning behavior when working in such teams and it is unclear how leadership support can overcome this problem. Therefore, this study examines when team leadership behavior supports teacher teams in engaging in learning behavior. We studied 52 university teacher teams (281 respondents) involved in educational change, resulting in two key findings. First, analyses of multiple leadership types showed that team learning behavior was best supported by a shared transformational leadership style that challenges the status quo and stimulates team members’ intellect. Mutual transformational encouragement supported team learning more than the vertical leadership source or empowering and initiating structure styles of leadership. Second, moderator analyses revealed that task complexity influenced the relationship between vertical empowering team leadership behavior and team learning behavior. Specifically, this finding suggests that formal team leaders who empower teamwork only affected team learning behavior when their teams perceived that their task was not complex. These findings indicate how team learning behavior can be supported in university teacher teams responsible for working toward educational change. Moreover, these findings are unique because they originate from relating multiple team leadership types to team learning behavior, examining the influence of task complexity, and studying this in an educational setting.
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In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient’s values. The shared decision-making model seems to be helpful in the integration of the individual patient’s values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient’s willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making – integrated with evidence-based practice – can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence- based practice to deliver patient-centred care.
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Introduction: Shared decision-making is considered to be a key aspect of woman-centered care and a strategy to improve communication, respect, and satisfaction. This scoping review identified studies that used a shared decision-making support strategy as the primary intervention in the context of perinatal care. Methods: A literature search of PubMed, CINAHL, Cochrane Library, PsycINFO, and SCOPUS databases was completed for English-language studies conducted from January 2000 through November 2019 that examined the impact of a shared decision-making support strategy on a perinatal decision (such as choice of mode of birth after prior cesarean birth). Studies that only examined the use of a decision aid were excluded. Nine studies met inclusion criteria and were examined for the nature of the shared decision-making intervention as well as outcome measures such as decisional evaluation, including decisional conflict, decisional regret, and certainty. Results: The 9 included studies were heterogeneous with regard to shared decision-making interventions and measured outcomes and were performed in different countries and in a variety of perinatal situations, such as women facing the choice of mode of birth after prior cesarean birth. The impact of a shared decision-making intervention on women’s perception of shared decision-making and on their experiences of the decision-making process were mixed. There may be a decrease in decisional conflict and regret related to feeling informed, but no change in decisional certainty. Discussion: Despite the call to increase the use of shared decision-making in perinatal care, there are few studies that have examined the effects of a shared decision-making support strategy. Further studies that include antepartum and intrapartum settings, which include common perinatal decisions such as induction of labor, are needed. In addition, clear guidance and strategies for successfully integrating shared decision-making and practice recommendations would help women and health care providers navigate these complex decisions.
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PurposeThe purpose of this paper is to investigate coaches' views on developing leadership and shared leadership capacity in particular in competitive youth football.Design/methodology/approachThis qualitative examination focusses on the leadership philosophy of ten male coaches at the sub-elite competitive level in youth football in The Netherlands and applies the theory of shared leadership to examine coaches' views on developing leadership capacity.FindingsOnly few coaches have a clear philosophy on the development of leadership in general and/or shared leadership in particular. Most coaches do not have a distinct view on how to involve players in the team processes. Shared leadership development in youth teams occurs occasionally but can be implemented more intentionally.Research limitations/implicationsAlthough this study lacks generalizability, coaches' views are required in understanding how shared leadership is to be developed in youth sport.Practical implicationsFor implementing shared leadership in football purposefully, a clear view on the development of youth is required, whereas coaches need to be taught, how to involve the individual players in team processes such as decision-making. In addition, leadership development in sport may have the potential of transfer of skills to other domains.Social implicationsLearning shared leadership at a young age by athletes can have a positive influence on relationships in teams on micro-level and might have an impact on meso-level within a football club because of its social constructionist approach.Originality/valueThis study is one of the first to apply shared leadership at the micro-level of competitive youth football making use of football coaches' view.
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University teacher teams can work toward educational change through the process of team learning behavior, which involves sharing and discussing practices to create new knowledge. However, teachers do not routinely engage in learning behavior when working in such teams and it is unclear how leadership support can overcome this problem. Therefore, this study examines when team leadership behavior supports teacher teams in engaging in learning behavior. We studied 52 university teacher teams (281 respondents) involved in educational change, resulting in two key findings. First, analyses of multiple leadership types showed that team learning behavior was best supported by a shared transformational leadership style that challenges the status quo and stimulates team members’ intellect. Mutual transformational encouragement supported team learning more than the vertical leadership source or empowering and initiating structure styles of leadership. Second, moderator analyses revealed that task complexity influenced the relationship between vertical empowering team leadership behavior and team learning behavior. Specifically, this finding suggests that formal team leaders who empower teamwork only affected team learning behavior when their teams perceived that their task was not complex. These findings indicate how team learning behavior can be supported in university teacher teams responsible for working toward educational change. Moreover, these findings are unique because they originate from relating multiple team leadership types to team learning behavior, examining the influence of task complexity, and studying this in an educational setting. https://www.scienceguide.nl/2021/06/leren-van-docentteams-vraagt-om-gezamenlijk-leiderschap/
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Purpose: This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. Methods: We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. Results: The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. Evaluation. The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. Conclusion: The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.
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