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Chapter 6 presents an educational perspective on TBLT. The chapter begins by summarizing general educational theories that support an approach to learning that emphasizes experience and ‘doing’ over knowing and ‘telling’ - such as that of Dewey (1938) - and recent work on complex skill acquisition and training. It then considers research that draws on educational accounts of the role of ‘engagement’ in task performance and learning and the importance of investigating learners’ perceptions of the tasks they perform as well as their actual performance.
Research participants want to receive results from studies in which they participate. However, health researchers rarely share the results of their studies beyond scientific publication. Little is known about the barriers researchers face in returning study results to participants.
Using a mixed-methods design, health researchers (N = 414) from more than 40 US universities were asked about barriers to providing results to participants. Respondents were recruited from universities with Clinical and Translational Science Award programs and Prevention Research Centers.
Respondents reported the percent of their research where they experienced each of the four barriers to disseminating results to participants: logistical/methodological, financial, systems, and regulatory. A fifth barrier, investigator capacity, emerged from data analysis. Training for research faculty and staff, promotion and tenure incentives, and funding agencies supporting dissemination of results to participants were solutions offered to overcoming barriers.
Study findings add to literature on research dissemination by documenting health researchers’ perceived barriers to sharing study results with participants. Implications for policy and practice suggest that additional resources and training could help reduce dissemination barriers and increase the return of results to participants.
Drawing on data collected in interviews with investors and corporates in the United States and Europe, this paper sheds light on the motives behind shareholder engagement. It explains why index funds engage in corporate governance, despite their apparent lack of financial incentive to do so. Applying Hirschman's concepts of exit and loyalty to the investment management industry, this paper suggests that for many institutional shareholders today, voice is more feasible than exit. For the largest index investors, the cost of engagement has fallen to a level where it is today negligible. The immense concentration amongst index funds, with the three largest fund managers controlling over 90 percent of assets, ensures sufficient return on their governance investments. Furthermore, interviews with activist investors suggest that they have learned to work with index investors and that index funds do not present barriers to successful campaigns. This paper therefore advocates against restricting index funds’ voting rights. Doing so would muzzle those shareholders with the deepest pockets and the greatest potential for corporate oversight. Instead what is needed is regulation to ensure greater disclosure of engagement efforts by the largest fund companies enabling greater academic and public oversight of asset managers’ engagement activities.
Introduction: Royal College Emergency Medicine (EM) trainees at the University of Ottawa participate in weekly Academic Full Days (AFD) that consist of didactic activities, simulation-based learning, and core content sessions referred to as Core Rounds (CR). Despite CR being intentioned for all EM trainees, an attendance attrition has been noted as trainees progress towards their senior (SR) years (PGY3-5). The objectives of this study were to (1) identify barriers to SR trainee CR attendance and (2) identify areas for CR improvement. Methods: An on-line survey was administered to SR EM trainees (PGY3-5, n = 28) and recent graduates from our program (practice year 1-2, n = 20) to explore perceptions of the value of AFDs, CR attendance barriers, and areas for CR improvement. The survey consisted of 5-point Likert scales and free-text responses. Quantitative responses were analyzed using Microsoft Excel. Free-text responses were analyzed qualitatively using thematic analysis. Each free-text response was reviewed independently by two investigators (JML, MCL) and underwent line-by-line coding. Through joint discussions, the codes from each response were synthesized and themes were identified. Results: Of the 48 trainees and attendings surveyed, 32 responded (response rate 67%). Most respondents (90%) stated they benefited from SR trainee attendance when they were at a junior (JR) level. The majority perceived they benefited less from CR as a SR trainee compared to when they were a JR trainee (85%). Further, 87% responded that CR were not tailored to a SR level, and that they would attend more frequently if sessions were geared to their level (81%). From our thematic analysis, three themes emerged relating to SR trainee absenteeism: 1) CR quality, 2) External Factors (eg. trainee fatigue) and 3) Malalignment with trainees’ own education plan. We also identified three themes relating to areas for CR improvement: 1) CR content, 2) CR format and 3) SR trainee involvement. Conclusion: Respondents indicated a benefit to having SR trainee presence at CR. This study identified barriers to SR resident attendance at CR and areas for improvement. With the transition to competency based medical education it is critical that trainees engage in effective educational experiences, especially as the RCPSC does not mandate AFDs for EM training in this new curriculum. A culture-change initiative and CR reformat is now underway at our institution with planned post-implementation analysis.
Engagement of people with dementia who are living in the community, their family or carers, and healthcare professionals in decision-making related to their future care is an area yet to be explored in the literature. In particular, little is known about the factors most likely to underpin their engagement.
To identify key factors for the engagement of the person with dementia living in the community, as well as their family or carer and their healthcare professionals in decision-making processes related to future care.
This is an integrative review guided by the PRISMA guidelines; the Mixed Methods Appraisal Tool was used to assess study quality. MEDLINE, PubMed, CINAHL, PsycINFO and Embase databases were searched for articles published from 2012 to 2018 that focused on people with dementia who live in the community, their family or carers, and community-based healthcare professionals.
Twenty articles were included in the review, and six key factors were identified through thematic analysis: knowledge and understanding of dementia and decision-making for the future, valuing decision-making for the future, healthcare professionals’ communication skills, timing of initiating conversations, relationship quality, and orientation to the future.
This review identifies the six key factors required for the engagement of the three primary key stakeholders in decision-making about the future care of people with dementia. It also situates the factors within the complex context in which people with dementia, their family or carers, and healthcare professionals typically find themselves.
This paper examines the effect of institutional contact on political participation among non-White communities. While both formal and informal institutions help shape community citizen participation, their effects vary on the historical inclusion (or exclusion) of certain racial groups. Formal institutions, like political parties, have historically excluded or neglected non-White and immigrant voters. We argue that for the excluded or neglected, non-traditional political institutions, like community based organizations, serve as supplements to facilitate political incorporation and engagement. These informal institutions help develop skills and resources among their constituents, and offer routine opportunities to participate. We use the 2008 Collaborative Multi-racial Post-Election Survey (CMPS) to test the differential effects of self-reported voter mobilization through nonpartisan and partisan institutional contact to explain variations among racial groups by the intensity of contact, occurrence of co-ethnic outreach, and type of institutional mobilization. We find that while contact by a partisan/political institution, like a political party or campaign, has an overall positive effect on political participation for all voters, contact by a nonpartisan/civic or community group is substantively more important for Latino and Asian American voter mobilization. Our analysis therefore offers cohesive evidence of how voters interact with and are affected by mobilization efforts that attends to differences across racial and ethnic boundaries, and variations in institutional contact.
This paper seeks to understand the engagement of people with dementia in creative and arts-based activities by applying a relational model of citizenship and incorporating concepts of contextual and embodied learning from adult learning theory. A theoretically driven secondary analysis of observational and interview data focuses on the engagement of staff, volunteers and people with dementia during an arts-based intervention in a day centre and care home. The processes through which learning is co-constructed between the person with dementia, staff/volunteer facilitators and peers in the group to co-produce a creative engaged experience involves: increasing confidence for learning, facilitating social and physical connections, and affirming creative self-expression. The role of facilitator is central to the process of creative engagement to reinforce a sense of agency amongst participants and recognise people's prior experiences of learning and engagement in creative activities. People with dementia continue to learn and grow through engagement in creative activities to produce positive outcomes for the individual participants and for the care staff who observe and participate in this creativity. Facilitating creativity requires attention to lifelong experiences of learning in addition to the immediate interactional context to integrate arts-based interventions in dementia care successfully.
Engagement represents how much a user is interested in and willing to continue the current dialogue. Engagement recognition will provide an important clue for dialogue systems to generate adaptive behaviors for the user. This paper addresses engagement recognition based on multimodal listener behaviors of backchannels, laughing, head nodding, and eye gaze. In the annotation of engagement, the ground-truth data often differs from one annotator to another due to the subjectivity of the perception of engagement. To deal with this, we assume that each annotator has a latent character that affects his/her perception of engagement. We propose a hierarchical Bayesian model that estimates both engagement and the character of each annotator as latent variables. Furthermore, we integrate the engagement recognition model with automatic detection of the listener behaviors to realize online engagement recognition. Experimental results show that the proposed model improves recognition accuracy compared with other methods which do not consider the character such as majority voting. We also achieve online engagement recognition without degrading accuracy.
The Association of Polar Early Career Scientists (APECS) is an important legacy of the International Polar Year (IPY). APECS continues to foster engagement in education, outreach and communication (EOC) activities relating to the polar regions and provide training for early career researchers (ECRs). We highlight opportunities for training, leadership and skills development, such as the annual Polar Weeks and Antarctica Day celebrations. Participation and engagement in EOC activities actively contributes to career development by enabling ECRs to develop valuable soft skills such as networking, communication and interdisciplinary knowledge. A pilot survey on EOC engagement highlighted that those who organise events also gain leadership skills such as team management. We discuss several factors contributing to the success of APECS in training the next generation of polar leaders. These include the geographical rather than discipline-specific focus of the organisation, utilisation of online resources, including social media, and the strong links with partner organisations. These examples demonstrate how the EOC legacy of IPY has continued due to APECS’ targeted efforts to create EOC opportunities and provide skills and leadership training for ECRs.
This article, presented as part of a panel on “Community-based preventive and remedial
measures” at a conference on Responses to Female Migration to ISIS, is on ways in which
local communities are able to strengthen social cohesion and prevent growing polarization,
especially in areas where radicalization to violent extremism takes place. The analysis is
based on the Human Security Collective (HSC)’s work in Palestine, Libya, Tunisia and the
Netherlands where we support local communities and the professionals who work with them on
addressing systemic causes that lead to exclusion, alienation and possibly radicalization
leading to violent extremism. We have learnt that approaches to prevent the attraction to
violent extremism networks require methods and processes akin to those developed for
conflict transformation. Some of the characteristics of this approach include the inclusion
of different stakeholders, local ownership in defining problems and seeking solutions, the
building of trusted relationships, the mentoring of young women and men who take on a
peer-model role, and the development of innovative small-scale community activities that can
then be taken up by the wider community. HSC and its partners connect these local community
initiatives to policymakers at municipal, national and international levels. Through the
process of facilitated dialogue we aim to create “safe spaces” where persons from different
backgrounds and with different interests are able to meet and exchange practices and
policies. In this way, policies are validated by lived realities and citizens become aware
of the way that policies that influence local security are developed and executed. This
dialogue leads to a mutual understanding of and improvement in security-related
Engagement systems encode the relative accessibility of an entity or state of affairs to the speaker and addressee, and are thus underpinned by our social cognitive capacities. In our first foray into engagement (Part 1), we focused on specialised semantic contrasts as found in entity-level deictic systems, tailored to the primal scenario for establishing joint attention. This second paper broadens out to an exploration of engagement at the level of events and even metapropositions, and comments on how such systems may evolve. The languages Andoke and Kogi demonstrate what a canonical system of engagement with clausal scope looks like, symmetrically assigning ‘knowing’ and ‘unknowing’ values to speaker and addressee. Engagement is also found cross-cutting other epistemic categories such as evidentiality, for example where a complex assessment of relative speaker and addressee awareness concerns the source of information rather than the proposition itself. Data from the language Abui reveal that one way in which engagement systems can develop is by upscoping demonstratives, which normally denote entities, to apply at the level of events. We conclude by stressing the need for studies that focus on what difference it makes, in terms of communicative behaviour, for intersubjective coordination to be managed by engagement systems as opposed to other, non-grammaticalised means.
Human language offers rich ways to track, compare, and engage the attentional and epistemic states of interlocutors. While this task is central to everyday communication, our knowledge of the cross-linguistic grammatical means that target such intersubjective coordination has remained basic. In two serialised papers, we introduce the term ‘engagement’ to refer to grammaticalised means for encoding the relative mental directedness of speaker and addressee towards an entity or state of affairs, and describe examples of engagement systems from around the world. Engagement systems express the speaker’s assumptions about the degree to which their attention or knowledge is shared (or not shared) by the addressee. Engagement categories can operate at the level of entities in the here-and-now (deixis), in the unfolding discourse (definiteness vs indefiniteness), entire event-depicting propositions (through markers with clausal scope), and even metapropositions (potentially scoping over evidential values). In this first paper, we introduce engagement and situate it with respect to existing work on intersubjectivity in language. We then explore the key role of deixis in coordinating attention and expressing engagement, moving through increasingly intercognitive deictic systems from those that focus on the the location of the speaker, to those that encode the attentional state of the addressee.
To explore the aspects of daily life that give people with young-onset dementia (YOD) a sense of usefulness.
Eighteen people with YOD and 21 informal caregivers participated in this qualitative study. Participants were recruited from specialized day-care centers for people with YOD in the Netherlands. Four focus groups were conducted with people with YOD, and four with informal caregivers. Focus groups were audio-recorded, transcribed, and analyzed using inductive content analysis.
Four themes emerged from the analysis: (1) staying engaged, (2) loss in daily life, (3) coping and adaptation, and (4) external support. Staying engaged in activities that provide a sense of usefulness or participating in leisure and recreational activities as much as possible in daily life emerged as the key theme. Retaining a sense of usefulness was considered both important and possible by having social roles or participating in functional activities. The importance of activities providing a sense of usefulness seemed to decrease over time, while the need for pleasant activities seemed to increase. Experienced loss, coping, adaptation, and available external support are important parts of the context in which the person with YOD tries to engage in daily life as much as possible. Active coping styles and external support appear to play a facilitating role in staying engaged.
It is important for people with YOD to have the opportunity to feel useful; especially in the early stages of the condition. Caregivers should be educated in ways to enhance a sense of usefulness and engagement in daily life for people with YOD.
Exposure to the death and dying of others is an anxiety-provoking condition that can contribute to psychological stress. However, the results of empirical studies that evaluated work-related outcomes among physicians and nurses with repeated exposure to dying patients are not consistent.
Our aim was to evaluate whether a high level of exposure to death and dying (LED) can increase the risk for poor professional quality of life (ProQoL) in most healthcare workers, but it can also improve ProQoL in a subset of healthcare workers with specific characteristics.
We employed a cross-sectional survey designed to better understand the role of LED as a predictor of ProQoL among healthcare workers.
Setting and Participants:
Comparison of physicians and nurses with high LED (home-based palliative care units) with a matched group of physicians and nurses with low LED (primary care units) and evaluation of possible interaction effects among LED, death anxiety (DA), and engagement as predictors of ProQoL.
The final sample included 110 questionnaires from the high-LED group (response rate = 39%) and 131 from the low-LED (response rate = 24%) group. Workers with high LED reported an increased level of compassion satisfaction (CS) and low to moderate levels of burnout (BU) and secondary traumatic stress (STS), with no significant differences with respect to other healthcare providers. Although levels of CS, STS, and BU did not differ between groups, a univariate MANOVA revealed that the interaction effect of LED × Engagement reduced levels of CS and that the interaction effect of LED × DA increased STS among workers with high LED.
Significance of results:
LED was significantly correlated with ProQoL among healthcare workers with high LED due to the reported interaction effect. These findings imply, for the first time, that there is a possible correlation between engagement and the risk for poor ProQoL among workers with high LED. Further research is essential to gain a better understanding of this issue.
Space matters. We read space like we read people’s faces. Space is an instrument of collaboration and innovation. At the University of Michigan’s Institute for Clinical and Health Research (MICHR), a team was created to creatively and economically enhance our operating space into a flexible workspace that supports privacy, innovation, creativity, and most important, a culture of collaboration.
The team used a human-centered design process to creatively engage the staff at large into analyzing our existing space, identifying latent needs, proposing solutions, generating feedback, and economically building the rethought process.
The redesigned workspace embraces the differences among MICHR’s teams while encouraging collaboration and teamwork and keeping costs at a minimum. It has resulted in a flexible space that includes co-located teams, spaces dedicated to different work goals, an open area for collaboration, quiet zones for focused work, and better wayfinding.
Through our Rethink Space project, we hope to have demonstrated that, by initiating the project internally and by engaging the users of the space themselves in an empathetic, visual, and human-centered way, a space redesign can be undertaken economically while also leading to improved levels of employee and team satisfaction.
Client engagement is an important part of contemporary aged care. However, the extent to which decisions are delegated to the older person, and the scope of issues about which decision making occurs, vary. The types of engagement that are offered to, and taken up by, aged-care clients have implications for the extent of power and influence older people hold. This paper reports on a qualitative study conducted in a large Australian service provider. It identifies the forms that client engagement takes in the aged-care context, the roles for staff and older people that are enacted through these activities, and the implications these have for power relationships and older people's influence. An inverse relationship was seen between the depth and scope of client influence, but a desire to address this suggested potential spaces for greater empowerment. A relationship was evident between the retention of control by staff and the perceived effectiveness of existing engagement strategies, highlighting the limitations of traditional power dynamics in engagement practice. An expanded model of engagement in aged care is proposed that recognises the foundational role of connection building as a facilitator of greater empowerment for older people. Implications for theory regarding engagement in aged care, and the practice of engagement in aged-care organisations, are discussed.