Background: Communities of practice and social-professional networks are generally considered to enhance workplace experience and enable organizational success. However, despite the remarkable growth in interest in the role of collaborating structures in a range of industries, there is a paucity of empirical research to support this view. Nor is there a convincing model for their systematic evaluation, despite the significant potential benefits in answering the core question: how well do groups of professionals work together and how could they be organised to work together more effectively? This research project will produce a rigorous evaluation methodology and deliver supporting tools for the benefit of researchers, policymakers, practitioners and consumers within the health system and other sectors. Given the prevalence and importance of communities of practice and social networks, and the extent of investments in them, this project represents a scientific innovation of national and international significance.
Background: Leadership behaviour in complex networks is under-researched, and little has been written concerning leadership of translational research networks (TRNs) that take discoveries made 'at the bench' and translate them into practices used 'at the bedside.' Understanding leaders' opportunities and behaviours within TRNs working to solve this key problem in implementing evidence into clinical practice is therefore important. This study explored the network position of governing body members and perceptions of their role in a new TRN in Sydney, Australia. The paper asks three questions: Firstly, do the formal, mandated leaders of this TRN hold key positions of centrality or brokerage in the informal social network of collaborative ties? Secondly, if so, do they recognise the leadership opportunities that their network positions afford them? Thirdly, what activities associated with these key roles do they believe will maximise the TRN's success? Methods: Semi-structured interviews of all 14 governing body members conducted in early 2012 explored perceptions of their roles and sought comments on a list of activities drawn from review of successful transdisciplinary collaboratives combined with central and brokerage roles. An on-line, whole network survey of all 68 TRN members sought to understand and map existing collaborative connections. Leaders' positions in the network were assessed using UCInet, and graphs were generated in NetDraw. Results: Social network analysis identified that governing body members had high centrality and high brokerage potential in the informal network of work-related ties. Interviews showed perceived challenges including 'silos' and the mismatch between academic and clinical goals of research. Governing body members recognised their central positions, which would facilitate the leadership roles of leading, making decisions, and providing expert advice necessary for the co-ordination of effort and relevant input across domains. Brokerage potential was recognised in their clearly understood role of representing a specialty, campus or research group on the governing body to provide strategic linkages. Facilitation, mentoring and resolving conflicts within more localised project teams were spoken of as something 'we do all the time anyway,' as well as something they would do if called upon. These leadership roles are all linked with successful collaborative endeavours in other fields. Conclusions: This paper links the empirical findings of the social network analysis with the qualitative findings of the interviews to show that the leaders' perceptions of their roles accord with both the potential inherent in their network positions as well as actual activities known to increase the success of transdisciplinary teams. Understanding this is key to successful TRNs.
IntroductionClinician-led diabetes education is a fundamental component of care to assist people with Type 1 diabetes (T1D) self-manage their disease. Recent initiatives to incorporate a more patient-centered approach to diabetes education have included recommendations to make such education more individualized. Yet there is a dearth of research that identifies patients’ perceptions of clinician-led diabetes education. We aimed to describe the experience of diabetes education from the perspective of young adults with T1D.MethodsWe designed a self-reported survey for Australian adults, aged 18–35 years, with T1D. Participants (n = 150) were recruited by advertisements through diabetes consumer-organizations. Respondents were asked to rate aspects of clinician-led diabetes education and identify sources of self-education. To expand on the results of the survey we interviewed 33 respondents in focus groups.ResultsSurvey: The majority of respondents (56.0%) were satisfied with the amount of continuing clinician-led diabetes education; 96.7% sought further self-education; 73.3% sourced more diabetes education themselves than that provided by their clinicians; 80.7% referred to diabetes organization websites for further education; and 30.0% used online chat-rooms and blogs for education. Focus groups: The three key themes that emerged from the interview data were deficiencies related to the pedagogy of diabetes education; knowledge deficiencies arising from the gap between theoretical diabetes education and practical reality; and the need for and problems associated with autonomous and peer-led diabetes education.ConclusionOur findings indicate that there are opportunities to improve clinician led-diabetes education to improve patient outcomes by enhancing autonomous health-literacy skills and to incorporate peer-led diabetes education and support with clinician-led education. The results provide evidence for the potential value of patient engagement in quality improvement and health-service redesign.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-014-0056-0) contains supplementary material, which is available to authorized users.
BackgroundAlthough patient safety is becoming widely taught in medical schools, its effect has been less rigorously evaluated. We describe a multicentre study to evaluate student changes in patient safety attitudes using a standardised instrument, the Attitudes to Patient Safety Questionnaire3 (APSQ3).MethodsA patient safety training package designed for medical students was delivered in the first year and second year in four Australian medical schools. It comprises eight face-to-face modules, each of two hours. Seminars start with an interactive introduction using questions, video and role play, followed by small group break-outs to discuss a relevant case study. Groups are led by medical school tutors with no prior training in patient safety. Students and tutors then reassemble to give feedback and reinforce key concepts. Knowledge and attitudes to patient safety were measured using the APSQ3, delivered prior to safety teaching, at the end of the first and second years and 12 months after teaching ceased.ResultsA significant improvement in attitude over time was demonstrated for four of nine key items measured by the APSQ3: value of patient safety teaching; danger of long working hours, value of team work and the contribution patients can make in reducing error. Informal feedback from students was very positive.ConclusionWe showed persistent, positive learning from a patient safety education intervention 12 months after teaching finished. Building on the introduction of patient safety teaching into medical schools, pathways for motivated students such as appropriate electives, option terms and team-based research projects would be of value.
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