Joan Versnel

Workplace learning and the metacognitive functions of routines

In the face of research that shows that workplace knowledge and learning are highly contextual, calls for the teaching of generalizable skills for the workplace have been widespread. While the authors reject the usefulness of teaching generalizable skills, they believe that there are commonalities in workplace knowledge that can be taught. These commonalities are related to metacognition rather than simple cognition, and the approach in this paper is to explore the potential of metacognitive instruction for workplace learning. Specifically, the concept of routines is used to develop an instructional theory derived from the inherent metacognitive functions of routines themselves. The paper draws upon contemporary cognitive theory and on recent research on workplace learning, and it builds on studies the authors have conducted on learning in the workplace and on the observation of routines at work.

A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors

Abstract Purpose: A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke self-management interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing specifically on function and participation outcomes. Methods: Twelve databases were searched for the years 1986–2012 to identify self-management programs for stroke survivors. Pre-post, quasi-experimental and randomized controlled trial study designs were included. Descriptive information about the intervention was scrutinized to identify what self-management support strategies were present in the intervention and comparisons were made between programs using a group versus a one-to-one format. All outcomes were included and categorized. Results: The most prominent strategies identified in our review were goal setting and follow-up, and an individualized approach using structured information and professional support. There are indications that self-management programs can significantly increase participation and functional ability. However, the high level of clinical heterogeneity in program delivery, outcomes and level of stroke severity made it impossible to conduct a meta-analysis. Further examination of individual self-management support strategies, such as linking rehabilitation goal setting to post-acute self-management programs, the inclusion of family members and the contribution of peer-support is warranted. Implications for Rehabilitation Self-management programs for stroke survivors: Linking post-acute self-management programs to rehabilitation goal setting could improve outcomes. Involving family members in self-management programs may benefit stroke survivors.

Learning in the workplace: Fostering resilience in disengaged youth

OBJECTIVE International reports on school-to-work transition make it clear that worldwide youth are at-risk for educational disengagement and are three times as likely to be unemployed as their adult counterparts. Work-based education (WBE) is one of the most frequently recommended solutions for youth disengagement which suggests that WBE serves as a protective factor and encourages resilience in at-risk youth. The objective of this study was to describe and compare the experiences of two at-risk youth enrolled in WBE. PARTICIPANTS Two 18-year old at-risk youth enrolled in WBE were chosen for study because they were learning in workplaces judged likely to promote resilience. Both had been disengaged from school prior to enrolling in WBE. METHOD Each multiple-perspective case study includes the perspective of the youth, the workplace employer, and the work-based educator. Data consisted of ethnographic observations and interviews conducted at the workplace, and with the teacher in the school. RESULTS Each case study highlights how supportive adults and an at-risk youth engage in interactions that facilitate the emergence of resilience in the workplace. CONCLUSIONS In these two cases, risk and resilience are context specific, suggesting that at-risk youth may require tailored workplace programs to meet their career development needs.

Development of a Chronic Care Model for Neurological Conditions (CCM-NC).

BackgroundPersons with neurological conditions and their families face a number of challenges with the provision of health and community-based services. The purpose of this study was to understand the existing health and community service needs and gaps in care and to use this information to develop a model to specify factors and processes that may improve the quality of care and health and well-being for persons with neurological conditions.MethodsWe conducted semi-structured interviews with health care professionals, community-based non-health care professionals working with individuals with neurological conditions, and policy makers –from the Ministries of Health, Community and Social Services, Transportation and Education– across Canada. We used a purposive sampling and snowballing approach to obtain maximum variation across professions, sector and geography (provinces and territories, rural and urban). Data analysis was an iterative, constant comparative process involving descriptive and interpretive analyses and was initially guided by the components of the Expanded Chronic Care Model.ResultsA total of 180 individuals completed the interviews: 39% (n = 70) health care professionals, 47% (n = 85) community-based non-health care professionals, and 14% (n = 25) policy makers. Based on the data we developed the Chronic Care Model for Neurological Conditions (CCM-NC). The major needs/gaps are represented by the following themes: acceptance and openness to neurological conditions, evidence informed policy, investments and funding, supported transitions, caregiver support, and life enhancing resources (education, employment, housing and transportation), knowledge and awareness of neurological conditions and availability and access to health services. The model maintains that intersectoral collaboration across the health system, community and policy components is needed. It recognizes that attitudes, policies, enhanced community integration and health system changes are needed to develop activated patients and families, proactive service delivery teams, a person-centred health system and healthy public policy for persons with neurological conditions.ConclusionThe CCM-NC will generate debate and discussion about the actions needed in each of the model components to enable people with neurological conditions to sustain healthier lives. Next steps include validating the model with persons with neurological conditions, in and outside of the Canadian context and developing and evaluating interventions to test the model.

Exemplary practice in work‐based education: a validation study

This paper validates the concept of exemplary practice in work‐based education (WBE) programs. The validation uses two theoretical frameworks: Social Cognitive Career Theory, and Billett’s research on workplace learning. The empirical component of the validation study consists of two widely differing case studies of high school students in work placements. Concepts found in previous research (communication, assessment and evaluation, linking school and workplace learning, and creating a pathway) are evident in the data of this study and are consistent with the theoretical frameworks, thus validating the concept of exemplary practice.

Identifying gaps in knowledge: A map of the qualitative literature concerning life with a neurological condition

Objectives To describe patterns in the qualitative literature regarding the everyday experience of living with a neurological condition; to identify areas of depth as well as gaps in the existing knowledge base. Methods An extensive search of the literature yielded 474 articles meeting the inclusion criteria. Data extraction, based on scrutiny of both abstract and full text article included country of origin, diagnosis, stated aim, methodological framework/design, participants, and data collection method(s). Studies were categorized into 27 topics within four broad foci. Results Four broad foci describe the field: impact and management, daily activities and occupations, impact on family, and the healthcare experience. Overall the research is unevenly distributed by diagnosis; some are well represented while others are the subject of little research. Even diagnoses well represented in quantity can be limited in breadth. Discussion Possible explanations for the patterns of emphasis include: a focus on issues and problems, highlighted points of contact between patients and healthcare providers, and ability of participants to voice their views. The literature is also characterized by limited across diagnoses research or that comparing the experience of people with different diagnoses. There is a need for more research in particular diagnoses; more varied data collection methods and acknowledgement of ethnicity, gender, discrimination, and social inequalities.

The Patient Activation Measure: a validation study in a neurological population

PurposeTo assess the validity of the Patient Activation Measure (PAM13) of patient activation in persons with neurological conditions.Methods“The Everyday Experience of Living with and Managing a Neurological Condition” (The LINC study) surveyed 948 adults with neurological conditions residing in Canada in 2011 and 2012. Using data for 722 respondents who met coding requirements for the PAM-13, we examined the properties of the measure using principle components analysis, inter-item correlations and Cronbach’s alpha to assess unidimensionality and internal consistency. Rasch modeling was used to assess item performance and scaling. Construct validity was assessed by calculating associations between the PAM and known correlates.ResultsPAM-13 provides a suitably reliable and valid instrument for research in patients with neurological conditions, but scaling problems may yield measurement error and biases for those with low levels of activation. This is of particular importance when used in clinical settings or for individual client care. Our study also suggests that measurement of activation may benefit from tailoring items and scaling to specific diagnostic groups such as people with neurological conditions, thus allowing the PAM-13 to recognize unique attributes and management challenges in those conditions.ConclusionsThe PAM-13 is an internally reliable and valid tool for research purposes. The use of categorical activation “level” in clinical settings should be done with caution.

Using Interactive Technology to Disseminate Research Findings to a Diverse Population

This paper demonstrates how case stories can be used to disseminate the findings of several case studies on negotiating accommodations in the workplace. It highlights the power of interactive technology and of the partnership between the researchers and the Canadian Council for Rehabilitation and Work (CCRW). The paper describes the process of designing an interactive web-based case story for the purpose of disseminating research findings. The interactive case story is an extension of both the case study and the narrative case story. As part of a larger research project, it is our goal to use interactive case stories to investigate the impact of essential skills training on workers with disabilities who negotiate with employers for workplace accommodations. Resume Le present article montre comment les histoires de cas peuvent etre utilisees pour diffuser les conclusions de plusieurs etudes de cas sur la negociation entourant l’amenagement du milieu de travail. Il met en evidence le pouvoir de la technologie interactive et du partenariat entre les chercheurs et le Conseil canadien de la readaptation et du travail (CCRT). L’article decrit le processus de conception d’une histoire de cas interactive en ligne visant a diffuser des resultats de recherche. L’histoire de cas interactive est un prolongement a la fois de l’etude de cas et du recit de l’histoire de cas. Dans le cadre d’un plus vaste projet de recherche, notre but est d’utiliser des histoires de cas interactives pour etudier l’impact de la formation sur les competences essentielles chez les travailleurs handicapes qui negocient avec leur employeur pour l’amenagement de leur milieu de travail.

Occupational Therapy Shared Decision Making in Adolescent Mental Health

Shared decision making (SDM) shares values of client-centered practice; however, a few studies exist that explore experiences of occupational therapists (OTs) working in adolescent mental health. This study aims to better understand SDM in adolescent mental health using the Canadian Model of Client-Centered Enablement. A qualitative study included interviews (n = 6) and analysis using an inductive approach. The role of the OT, client factors, therapeutic relationship, and nature of the decision were identified as influencing the process and outcome of SDM. The study helps better understand SDM in practice, the need for specialized education for OTs and has identified future research areas.

They want to come to school: Work-based education programs to prevent the social exclusion of vulnerable youth.

OBJECTIVE This paper describes and compares exemplary work-based education (WBE) programs in Ontario Canada designed to meet the needs of two groups of vulnerable youth - at-risk youth and youth with severe disabilities. PARTICIPANTS Two focus group interviews were held, one with professionals from exemplary programs designed to meet the needs of at-risk youth and one with professionals from exemplary programs for youth with severe disabilities. METHOD Standard qualitative analyses were conducted on each focus group transcript to generate themes which were subsequently grouped into larger patterns. Then cross-case analyses identified consistencies and unique features within the two types of WBE programs. RESULTS Two major patterns that characterize the WBE programs emerged from the analyses: the first pattern described the programmatic approaches to WBE appropriate for each type of type of student (which included themes such as the need for an alternative learning environment for at-risk youth), and the second pattern highlighted the rationale for each kind of program (which included themes like ensuring equity for youth with severe disabilities). CONCLUSIONS The findings suggest that schools should continue to provide distinct WBE programs for each of these groups of vulnerable youth - at-risk youth and youth with severe disabilities.