Process-oriented Training Research Articles

A Need for Targeted Teaching of Shared Decision-Making as Identified from an Assessment of Client-Centered Communication Skills Training with Companion Animal Veterinarians.

Shared decision-making has been increasingly discussed as a communication practice within veterinary medicine, and it is gaining more traction for diagnostic and treatment planning conversations and specifically offering a spectrum of care. This teaching tip describes the data from an investigation of veterinarians' shared decision-making in a pre-test/post-test communication skills training intervention that used a client-centered, skills-based communication approach. Practice teams from a purposive sample of four companion animal veterinary clinics in Texas participated in a 15-month communication skills intervention, including interactive group workshops and one-on-one communication coaching. To assess the outcome of the intervention, for nine participating veterinarians, appointments recorded pre- (n=85) and post-intervention (n= 85) were analyzed using the Observer OPTION 5 instrument to assess shared decision-making. The intervention effect was evaluated using mixed logistic regression, adjusting for appointment type. The communication intervention did not significantly impact participating veterinarians' demonstration of shared decision-making (pre=25.42, n=55; post=28.03, n=56; p=0.36). Appointment type was significantly associated with veterinarians' OPTION 5 scores (p=.0004) and health problem appointments (OPTION 5=30.07) demonstrated greater shared decision-making than preventive care appointments (OPTION 5=22.81). Findings suggest that client-centered, skills-based training traditionally used in veterinary curricula and continuing education may not foster the use of shared decision-making, which is a higher-order communication approach that may require a dedicated process-oriented training. This teaching tip highlights the need for a targeted stepwise approach to teach shared decision-making.

The use of the interactive DA-42T aircraft cockpit mockup in the process-oriented training

When conducting training sessions at an aviation university, it is advisable to demonstrate samples of aeronautical equipment, individual elements of systems and accessories, or use specialized stands and posters. However, when studying modern types of training aircraft, the cockpits of which contain multifunction displays, complications arise when absorbing training resources. When studying multi-function display cockpits, it is necessary to use interactive training devices in which displays must operate under power and possess the required capabilities. Training on hardware is impracticable in some cases, and unadvisable in others. The use of the integrated simulator for training in various disciplines is limited as the simulator is primarily designed to impart primary aircraft control skills rather than for classroom training. The article deals with the issue of upgrading pilot-trainees training skills during the familiarization with the cockpit equipment using an interactive DA-42T aircraft cockpit mockup with all the controls and indications (except for the control stick and pedals), including two primary multi-function displays and one backup, during the process-oriented training of the university. The operation of multi-function indicators is implemented in the form of special devices with a display and a push-button frame connected to a specially developed program on a PC that simulates the aircraft data system operation. For this purpose, to be based on information from the Aircraft Flight Manual, the information frames, shown on multi-function displays in the DA-42T aircraft, are reproduced. The content of the developed frames duplicates completely the DA-42T aircraft indication, contributing to improving academic study and acquiring practical skills to work on the integrated simulator as well as in a real aircraft. The physical cockpit mockup controls also correspond, in terms of the appearance and location, to the controls in the real DA-42T aircraft cockpit. The procedure to develop simulators of multi-function displays and the DA-42T aircraft cockpit mockup is described. The capabilities to use simulators of multi-function displays and the DA-42T cockpit mockup in the process-oriented training to upgrade skills are described. The conducted research results are described; the advantages of using the interactive cockpit mockup in the process-oriented training are presented.

Beliefs on translation speed among students. A case study

AbstractNovice translation graduates are often found to be slow translators. The fact that this deficiency is usually rectified through professional experience implies that initial performance issues are the outcome of a complex interplay of factors, which do not involve intrinsic abilities. Based on insights from cognitively oriented research on students’ beliefs about language learning and the impact these beliefs have on students’ performance, the present study posits that the beliefs students have towards the question of translation speed represent one of the factors that fashion their productivity. Targeting graduates from the English Language and Translation programme at a private university in an Arab Gulf State, a mixed method approach, including a survey and a semi-structured interview, was adopted to explore the beliefs students have towards the question of speed and to identify the sources of these beliefs in their training programme. Analysis reveals that productivity awareness among the investigated population is almost non-existent and points at the predominantly product-oriented approach that characterises their learning experience as the main source of this condition. This article argues that improving students’ awareness of productivity requirements is not just a case of integrating timed activities, but calls for the adoption of multi-layered process-oriented training principles and practices at the level of delivery, feedback, and assessment criteria.

A process-oriented approach for documenting and gauging intercultural competence in translation

ABSTRACTThis article describes and contextualises how intercultural competence in translation can be empirically documented and assessed using a process-oriented dual methodology consisting of juxtaposed screen recording and think-aloud data. A discussion of how Byram’s (1997) triadic intercultural communicative competence model of knowledge, skills and attitudes maps onto directly observable translator behaviours is followed by the results of a small-scale pilot study, which exemplify how various facets of intercultural competence are manifest in contexts involving MA-level student translation of German culturemes into US English. Continuing in the spirit of previous behaviour-oriented approaches to empirically document intercultural competence in translation, this article foregrounds process-oriented training as a means by which to glean insight into learner strengths and weaknesses with the objective of fostering growth in this domain, thereby optimising a still largely elusive area within translation pedagogy.

Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention

BackgroundBecoming parents for the first time is challenging. Mothers need both social and professional support to handle these challenges. Professionals’ attitudes affect quality of care and support. So to improve professional support, an intervention consisting of a process-oriented training was performed. Due to the positive results of the intervention there is a need to illuminate the methodological approach further. The overall aim was therefore to describe a methodological approach to improve and evaluate health care professionals’ attitudes toward breastfeeding and parental support in order to improve quality of care in childbearing.MethodsThis study was a longitudinal randomized control intervention study, in which groups of mothers received care in childbearing from midwives and child health nurses. These health professionals had gone through a process-oriented training, or not. In order to improve attitudes of health professionals the training was based on evidence, practical skills and reflective processes (both private and professional experiences) in relation to breastfeeding and parental support. Included in the longitudinal study were health professionals from five intervention municipalities n = 36 and health professionals from five control municipalities n = 45. All mothers who fulfilled the inclusion criteria were consecutively identified from the hospital register and asked to participate in the study. Mothers who accepted to participate were included in the interventions group (n = 206) or control groups (n = 162, n = 172 respectively) based on which municipality they belonged to.ResultsThe results of the process-oriented training improved the professionals’ attitudes toward breastfeeding and parental support. These improved attitudes in health professionals increased intervention-group mother’s satisfaction with professional and social support. Intervention-group mother’s relation to and feelings for their baby as well as breastfeeding was also improved.ConclusionThese results stress the importance of professionals’ attitude in quality of care during childbearing, as well as pointing to the possibility to improve professionals’ attitudes with a process-oriented training.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), trial registration: ACTRN12611000354987.

Women's use of nipple shields-Their influence on breastfeeding duration after a process-oriented education for health professionals.

This study investigated if a process-oriented training for health professionals will influence women's use and reasons for using a nipple shield, the baby's weight, and the duration of breastfeeding. An intervention was performed for health professionals that included a process-oriented training program on breastfeeding support. Primiparas living in either the intervention municipality or in a control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with those for the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, at 3 months, and at 9 months postpartum. The mothers' use of nipple shields related to the finding that if the women had a higher body mass index in the beginning of the pregnancy, the babies had difficulty in grasping over the nipple, and the mothers had pain or wound on the nipple. For the mothers in the IG group, there was no significant difference if they had used nipple shields or not in relation to breastfeeding duration. In contrast, the mothers in the control groups had a significant shorter breastfeeding duration if they had used nipple shields. In the IG, there were no significant difference between the use of nipple shields and the babies' weights at 3 or 9 months. The babies of women in the CGB who used nipple shields had a significantly lower weight at 3 months than the babies of those who did not use nipple shields (p=0.02). A process-oriented training in breastfeeding counseling prolongs the duration of breastfeeding for women with breastfeeding problems, where the problems are remedied by the use of nipple shields.

Process-oriented training in breastfeeding for health professionals decreases women's experiences of breastfeeding challenges.

BackgroundThe World Health Organization recommends promoting exclusive breastfeeding for six months. Women often end breastfeeding earlier than planned, however women who continue to breastfeed despite problems often experience good support and counselling from health professionals. The aim of this study was to evaluate the effects of a process-oriented training in breastfeeding support counselling for midwives and child health nurses, on women’s satisfaction with breastfeeding counselling, problems with insufficient breast milk and nipple pain in relation to exclusive breastfeeding shorter or longer than 3 months.MethodsAn intervention through process-oriented training for health professionals regarding support in childbearing and breastfeeding took part in the south west of Sweden. This study was conducted in Sweden, in 2000 - 2003. Ten municipalities were paired, and within each pair, one was randomly assigned to the group of five intervention (IG) municipalities and one to the group of five control municipalities. Primiparas (n = 540) were invited to participate in a longitudinal study to evaluate the care they received. A survey was distributed at 3 days, 3 months and 9 months postpartum. Data collection for control group A (n = 162) started before the intervention was initiated. Data for control group B (n = 172) were collected simultaneously with the intervention group (IG) (n = 206). Women were also divided into two groups depending on whether they exclusive breastfed < 3 months or ≥ 3 months.ResultsWomen in IG were more satisfied with the breastfeeding counselling (p = 0.008) and felt the breastfeeding counselling was more coherent (p = 0.002) compared to control groups, when exclusive breastfeeding was < 3 months. In addition fewer women in the IG, among the group exclusively breastfeeding < 3 months, had problems with insufficient breast milk compared to the control groups (p = 0.01).ConclusionA process-oriented training for health professionals in support influenced women’s ability to solve breastfeeding problems such as the experience of insufficient breast milk production. Women with exclusive breastfeeding lasting ≥ 3 months more often had breastfeeding duration in line with their planned breastfeeding duration, compared to women who had breastfeeding duration < 3 months.Trial registrationACTRN12611000354987

Retrospection as a Pedagogical Tool for Process-oriented Training in Consecutive Interpreting

Retrospection as a Pedagogical Tool for Process-oriented Training in Consecutive Interpreting

Promoting professional development in new school principals

Purpose – The purpose of this paper is to examine the use of coaching for newly appointed school principals and head teachers as they establish themselves in their new role. Design/methodology/approach – To examine the use of coaching for newly appointed school principals and head teachers as they establish themselves in their new role. Findings – Teachers in a number of countries receive coaching to improve their effectiveness. It is also now being offered to newly appointed school administrators – the school principal in the USA, the head teacher elsewhere – to help them settle into their new role. Surprisingly, there has been little research assessing the effectiveness of executive coaches or find out what benefits – if any – result from coaching. It seems, then, to be a good time to look at new principal coaching and ask what does or doesn't work. And who better to ask than the coaches themselves. Practical implications – Distinguishes between the coaching needs of newly appointed teachers and those of school administrators. Suggests a requirement for more process-oriented training for new principal coaches. Social implications – Highlights the emphasis that these coaches place on process rather than content and discusses their use of real-life, real-time issues to promote reflective enquiry and professional development. Originality/value – Considers coaching from the perspective of the coach. Demonstrates how coaching can support recently appointed school principals as they adapt to their new work environment and develop the skills needed to take on complex tasks.

Professional Support in Pregnancy Influence Maternal Relation to and Feelings for the Baby after Cesarean Birth: An Intervention Study

Background: Cesarean birth may negatively affect mother-infant interactions, while professional support may positively affect these interactions. The aim of this study was to evaluate the effects of a process-oriented training program for antenatal midwives and postnatal nurses on first time mothers’ perceptions of professional support and on their relation to and feelings for their baby after a cesarean or a normal birth. Methods: An intervention through process-oriented training for health professionals regarding professional support in childbearing was conducted between 1999 and 2003. Ten municipalities were paired and within each pair, randomly assigned to intervention (five) or control (five) municipality. Mothers having caesarean (n=94) or normal birth (n=301) were included. Mothers received routine care (Control Group=CG) or care from health professionals having received training (Intervention Group=IG). The mothers answered questionnaires three days, three and nine months after birth. Factor analysis identified three factors: “Taking in baby,” “Confidence in relation to baby,” and “Feelings for baby.” Results: Mothers in the IG with cesarean birth reported more positive for the “Taking in baby” factor (p=0.002) three days after birth, more positive for the “Confidence in relation to baby” factor (p=0.004) and for the “Feelings for baby” factor (p=0.004) nine months after birth compared to Mothers in the CG. Mothers in the IG reported stronger professional support from health professionals compared to CG. Conclusion: Our result suggests that improved professional support during pregnancy may buffer negative effects of caesarean birth for first-time mothers in relation to and feelings for the baby.

A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding: An Intervention Study

The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) living in either an intervention or control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03). A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.

Becoming baby‐friendly in Spain: a quality‐improvement process

To describe the implementation process and effect of a quality-improvement intervention aimed at achieving compliance with the Baby-friendly Hospital Initiative (BFHI). We conducted a prospective study of the development and evaluation of a quality-improvement intervention at the Yecla Hospital, Spain. A random sample of 1273 infants born in the hospital was followed up in primary care centres between 1997 and 2005. The study interventions were process-oriented training, audit and feedback, quality-improvement cycles and provision of breastfeeding support resources. The main outcome measures were changes in compliance with the Global Criteria for the BFHI and breastfeeding rates before, during and after the intervention. Compliance with the Global Criteria increased progressively, and in 2004 all criteria were met. The median duration of breastfeeding went up gradually from the start of the intervention. The likelihood of being breastfed at different ages among infants born in 2005 was between 45% [odds ratio (OR) 0.55; 95% confidence interval (CI) 0.38-0.79] and 86% (OR 0.14; 95% CI 0.09-0.20) higher than among infants born in 1997. Quality-improvement interventions based on participation, training, audit and feedback of information, and provision of resources are useful for the implementation of the BFHI, which is associated with a significant increase in breastfeeding rates.

A Mother's Feelings for Her Infant Are Strengthened by Excellent Breastfeeding Counseling and Continuity of Care

Continuous support during the childbirth process ultimately may strengthen the mother's self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement in general. In the present study, we investigated whether mothers, who were attended by midwives and nurses who had had a process-oriented training program in breastfeeding counseling, perceived stronger maternal feelings for their infant than mothers who had received only routine care. In a previous study, an intervention that included a process-oriented program on breastfeeding counseling for health professionals and continuity in family classes through childbirth was conducted. The 10 largest municipalities were classified in pairs that were similar in size and had similar figures of breastfeeding duration. The municipalities were randomized pairwise to either an intervention or a control group. The present study is a follow-up study on women's feelings for their infants in relation to the kind of care that they had had and was undertaken between April 2000 and January 2003. The sampling frame was based on women who were cared for at either the intervention clinic or control clinics. The mothers at the control clinics had received standard routine care and had attended family classes through the point of birth. Data collection for control group A started before effects of the intervention could be studied. Data for control group B were collected simultaneously with data collection for the intervention group (n = 540). The mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. Background data of the mothers were collected. The perception of support that was provided by the health professionals and the perception of mother-infant relationship and feelings for the infant were rated on Likert scales. At 3 days postpartum, both the intervention group and control group B versus the control group A thought that their understanding of the infant was better, they perceived more strongly that the infant as their own, and they enjoyed more breastfeeding and resting with the infant. Although there was no significant difference between the intervention group and control group B at 3 days and 3 months observation, mothers in the intervention group talked more to their infant, perceived their infant to be more beautiful than other infants, and perceived more strongly that the infant was their own than did the mothers in control group B at 9 months observation. In addition, the mothers in the intervention group felt significantly more confident with the infant and felt the infant to be closer than did the mothers in control group B. A process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention that guaranteed continuity of care strengthened the maternal relationship with the infant and the feelings for the infant.

402-O. An Experiment in Process-oriented Training: Learning to Think Like an ED Nurse

402-O. An Experiment in Process-oriented Training: Learning to Think Like an ED Nurse

Does Continuity of Care by Well‐Trained Breastfeeding Counselors Improve a Mother's Perception of Support?

Social support has been shown to be greatly important for breastfeeding success. The objective of this study was to investigate if mothers who were attended by midwives and nurses specially trained in breastfeeding counseling perceived better continuity of care and emotional and informative breastfeeding support than mothers who received only routine care. Ten municipalities, each with an antenatal center and child health center, in southwest Sweden were randomized either to intervention or control municipalities. The intervention included a process-oriented training in breastfeeding counseling and continuity of care at the antenatal and child health centers. Primiparas were asked to evaluate the care given, and those living in the control municipalities were divided into control groups A and B. Data collection took place at different points in time for the two control groups. The 540 mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. The perception of support provided by the health professionals and from the family classes was rated on Likert scales. Intervention group mothers rated the breastfeeding information given during the family class as significantly better during pregnancy than both control groups, and better than control group B mothers at 3 months postpartum; compared with both control groups, intervention group mothers perceived that they received significantly better overall support and that postnatal nurses provided better information about breastfeeding and the baby's needs. At 9 months, intervention group mothers were more satisfied with knowledge about social rights, information about the baby's needs, and their social network than control group B mothers. Both intervention group and control group B mothers perceived better overall support than control group A during pregnancy. At 3 and 9 months, intervention group mothers perceived that postnatal nurses were more sensitive and understanding compared with both control groups. After implementation of a process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention guaranteeing continuity of care, the mothers were more satisfied with emotional and informative support during the first 9 months postpartum. The results lend support to family classes incorporating continuity of care.

The Personal is Professional: Professionalism and the Birth to Threes Practitioner

This article puts forward the idea that in order to sufficiently meet the needs of very young children and thereby develop quality provision, early years practitioners must develop a professional approach that combines personal awareness with theoretical knowledge. It argues that the development of such abilities is enabled in process-oriented training over an extended period of time and describes the ‘Key Times' Project (London Metropolitan University with the London Borough of Camden, 2000–2005) as illustration of a process that impacted positively on practitioners' professional self-worth through valuing self-awareness in relation to the physical and emotional dimensions of practice.

Process-oriented training in breastfeeding alters attitudes to breastfeeding in health professionals

The purpose of the study was to measure the attitudes of antenatal midwives and postnatal nurses to breastfeeding before and after common, process-oriented breastfeeding training. Antenatal centres and child-health centres in 10 municipalities were randomized to either an intervention or a control group. The antenatal midwives and postnatal nurses in the intervention group were together given process-oriented breastfeeding training and were, in addition, asked to develop a common breastfeeding policy. A previously developed instrument was used to measure the effects of a training programme on breastfeeding attitudes among midwives and postnatal nurses. It consisted of four scales measuring a person's attitudes toward breastfeeding in four dimensions: regulating, facilitating, disempowering, and breastfeeding-antipathy attitudes. A mean score was calculated for each individual on these four dimensional scales. The higher the score, the stronger the attitude. After one year, the intervention group reduced their scores on the regulating scale when compared with the control group (p<0.001). The intervention group decreased their scores on the regulating scale and increased their scores on the facilitating scale over the first year after training. The control group also significantly increased their scores on the facilitating scale. When the results were analysed profession-wise, the postnatal nurses in the intervention group decreased their scores on the regulating and disempowering scales and increased their scores on the facilitating scale. In contrast, the midwives in the intervention group decreased their scores only on the breastfeeding antipathy scale. The control group midwives decreased their scores on the disempowering scale. No differences were found among the postnatal nurses in the control group. Process-oriented breastfeeding training made both antenatal midwives and postnatal nurses better disposed to breastfeeding; postnatal nurses in particular improved their attitudes. Attitudes to breastfeeding tended to be stable over time, but process-oriented training lowered the scores a little on the regulating scale, suggesting that after this kind of training counsellors would find it less necessary to schedule and control the mothers' breastfeeding behaviour.

An ED Orientation/Fellowship: An Experiment in Process-Oriented Training and Learning to Think Like an Emergency Nurse

For the past few years, the emergency department at South Nassau Communities Hospital (SNCH), like many other area hospitals, has been spending large amounts of money on agency nurses and in-house overtime because of chronic shortages of qualified nursing staff. Nurses and orientees believed the standard ED orientation program was inadequate.

The influence of management training upon organizational climate: An exploratory study

AbstractThe influence of three management training programs (MT) for first line supervisors (foremen) upon organizational climate were evaluated using a questionnaire design with repeated testing and statistical controls. The main objective for two of the three MT programs under study was to change the organizational climate in a direction that would facilitate learning at work. Results indicate that the most process‐oriented training program did change the organizational climate, as perceived by the supervisors, but paradoxically in an apparently negative direction, especially as far as interpersonal conflicts and supervisorial skills were concerned. This finding is interpreted as reflecting changes in supervisors' perception of organizational climate without any necessary ‘real’ change in the climate itself. The supervisors' increased awareness of organizational climate factors was, on a theoretical basis, considered to facilitate learning at work, thus explaining the apparent paradox.

Teaching internalization to middle-level mental health workers in training.

13 trainees enrolled in a process-oriented training program for middle-level mental health workers completed the I-E scale 1 mo. prior to enrollment and again 11 mo. later. Ss participated in 41 90-min. intensive group-counseling sessions which emphasized internalization and actuation of responsible behavior. The results show that, as a group, I-E scores of Ss shifted significantly ( p &lt; .02) in the direction of internality, as did their daily behavior.