Program Redesign Research Articles

A collaborative process for a program redesign for education in evidence-based health care.

We outline the framework of a collaborative process to redesign an existing 5-year health education program, which may prove useful to other similar institutions. The aim was to strengthen evidence-based practice and curriculum alignment. A whole-of-program approach was used to restructure the existing courses into 3 "streams": professional practice, clinical research, and clinical science. The process incorporated a series of facilitated workshops organized by the department director of learning and teaching and the faculty facilitation team, and it was inclusive of all available members of the department, a clinic supervisor, a sessional (casual teaching) staff member, and a recent graduate of the program. Unit content and assessments were restructured to progress the program learning outcomes from year to year. The undergraduate program was redesigned to create a more logical learning pathway for students. Consolidation of subject topics in the postgraduate program allowed for the development of stand-alone research-only units. The mechanism of curriculum mapping allowed for discussion about the flow of information from year to year and how evidenced knowledge and understanding can be developed. It is necessary that everyone participates and understands the importance of program goals as developed by the process. Because drift in curriculum can occur incrementally over the years, to be effective, the program requires ongoing monitoring and regular collaboration to continue improvements.

Structured system analysis of determination of modern key competences in the world

There were analyzed Normative documents of the interstate structures (UNESCO, UNICEF, UNDP, the International Department of Standards) and non-profit international organizations and foundations (the Roman Club, the 21st Century Partnership, the Center for the Redesign of Educational Programs, the Institute for Business Ethics, the World Education Forum, the Students' Training School Oxford University and the British Nesta Foundation for the Development of Innovations), developed over the last decades, the world experience in identifying competencies was outlined. The content of the terms competence, in order to determine the categorical apparatus and the terminology of the research was specified. The results of long-term research of competencies in 100 countries of the world were presented in order to identify and select the key ones, and their comparative analysis of 2015 and 2020 was presented by analysts and experts of Worldwide Economic Forum. The data of the conducted research testify that the competence in the complex solution of problems remains as a priority in the modern world space. Critical thinking and creativity should ensure the selection of information, its correct rethinking; contribute to the fullest disclosure of talents and capacity building. The system-structural scheme of analysis of the definition of key competencies in the world by interstate structures and non-profit international organizations and foundations was created. Global problems of the educational crisis rise were characterized and requirements of society for specialists were defined. Foreign practice of solving modern problems and formulating the requirements for the 21st century education was characterized, essential characteristics of updated key competencies for further implementation of international norms into the educational process of domestic educational institutions were revealed. It was proved that for successful implementation of competences in educational programs and plans it is necessary to determine their general set within educational institutions depending on the branches of knowledge and specialization and provide educators and academic staff with necessary scientific, methodological and methodical tools, develop their ability to self-education and making a career and a new way of teaching others

Redesigning Residency Training: Summary Findings From the Preparing the Personal Physician for Practice (P4) Project.

The Preparing the Personal Physician for Practice (P4) project (2007 to 2014) involved a comparative case study of experiments conducted by 14 selected family medicine programs designed to evaluate new models of residency education that aligned with the patient-centered medical home (PCMH). Changes in length, structure, content, and location of training were studied. We conducted both a critical review of P4 published Evaluation Center and site-specific papers and a qualitative narrative analysis of process reports compiled throughout the project. We mapped key findings from P4 to results obtained from a survey of program directors on their top 10 "need to know" areas in family medicine education. Collectively, 830 unique residents took part in P4, which explored 80 hypotheses regarding 44 innovations. To date, 39 papers have resulted from P4 work, with the P4 Evaluation Center producing 17 manuscripts and faculty at individual sites producing 22 manuscripts. P4 investigators delivered 21 presentations and faculty from P4 participating programs delivered 133 presentations at national meetings. For brevity, we present findings derived from the analyses of project findings according to the following categories: (1) how residency training aligned with PCMH; (2) educational redesign and assessment; (3) methods of financing new residency experiences; (4) length of training; (5) scope of practice; and (6) setting standards for conducting multisite educational research. The P4 project was a successful model for multisite graduate medical education research. Insights gained from the P4 project could help family medicine educators with future residency program redesign.

Doctoral Program in Educational Leadership Redesign: Utilizing a Multicriteria Framework

The development of educational leaders, who have a profound influence in shaping a culture of organizational learning; ethical community engagement; advocacy for diversity, equity and inclusion; and theory to practice solutions, is the aim of redesign efforts in one educational leadership (EDLE) program in the United States. These ideas, grounded in a multicriteria framework, are reified in the Carnegie Project on the Education Doctorate’s (CPED) Principles and Design Concepts and reinforced by the University Council for Educational Administration (UCEA) criteria. Yet, right from the beginning, faculty struggled with ideological differences and logistical challenges. Without the dean and department chair’s collaborative, visionary leadership and support of key faculty, efforts to redesign the program would have been stifled. We argue that the multicriteria framework, underscoring the importance of collaborative leadership, is the cornerstone of the education doctorate program redesign. The article’s contributions are intended to inform the planning, implementation, and evaluation of this program redesign and its impact.

Redesigning the Education Doctorate for Community College Leaders: Generation, Transformation, and Use of Professional Knowledge and Practice

This paper describes the redesign of a community college executive leadership doctoral program that seeks to develop senior-level leaders. The paper provides how the redesign was intentionally aligned with the CPED principles and specifically the sixth principle. The paper sought data from students, faculty and other documents to gain an insight into the impact of aligning the program with principles and design concepts. The paper suggests that it is important for this program to integrate examples from practice and practitioners, include job shadowing experiences for students and faculty, and ensure there are active learning activities that are relevant to the students. The paper includes an overview of the program redesign as well as reflection on the first iteration of the new coursework through student's voice, faculty feedback, and a discussion of lessons learned.

Facilitating and Supporting EdD Students’ Scholar Practitioner Writing as an Epistemological Tool

Becoming adept at crafting scholarly writing is an important aspect of a doctoral student’s development. Presented in this article is an EdD course, embedded writing scaffold that engages students and faculty to develop students’ scholarly inquiry projects. That scaffold is the Applied Inquiry Plan (AIP). The AIP creates a programmatic pathway to guide a Dissertation in Practice. Working to improve the quality and value of scholar practitioner writing parallels and draws from efforts in the biomedical fields to develop writing guidelines that impact the quality and value of practice. Creating and using the AIP provides opportunities for broad discussion of how to engage EdD students to view their writing as an epistemological tool. Discussed is the AIP impact on EdD program redesign and improvement.

Sense Making and Professional Identity in the Implementation of edTPA

edTPA is designed to strengthen teacher professionalization and provide a framework for program redesign. However, using a national assessment to shift the content of local programs is challenging because of their inherent organizational complexity. In this article, we focus on this complexity, using a systems lens to analyze edTPA implementation at a large, public university. Employing a mixed-methods case study design, we survey 250 teacher educators and candidates to understand how they interpret the demands of edTPA and how their varied perspectives impact each other. We interview a stratified, purposive subset of participants to explore mechanisms underlying quantitative findings. We find substantial internal variation in edTPA implementation that translates into differential support for candidates. This variation could not be explained by duration of implementation of edTPA. Varied perspectives may stem from distinct perceptions of teacher educators’ professional roles and the role they see edTPA playing in teacher professionalization.

Saving Social Security Disability Insurance: Designing and Testing Reforms Through Demonstration Projects

The Bipartisan Budget Act of 2015 partially addressed the poor state of the Social Security Disability Insurance (SSDI) Trust Fund, over the short run and the medium run. At the time of the act, the fund was roughly one year from depletion. Over the short run, Congress reallocated some portion of the payroll tax funds from the Old-Age and Survivors Insurance (OASI) Trust Fund to the Disability Insurance (DI) Trust Fund to allow the continued payment of full benefits under the current system through fiscal year 2022. According to the most recent report (2017) of the Social Security Board of Trustees, the DI Trust Fund will be depleted in 2028. Looking toward the longer run, Congress took the opportunity to provide a mandate and resources for program redesign. Sections 821–23 of the Bipartisan Budget Act granted expanded authority for the Social Security Administration to engage in demonstration projects aimed at improving the opportunity for disability beneficiaries to remain attached to the labor force or return to work. In this working paper we build on our earlier writing, which proposes reforms to the SSDI program, and consider demonstration project designs that promote the testing of salient aspects of our proposals. We emphasize both a modular design for demonstration projects and the sequence of projects as important for designing effective demonstrations that speak to both administrative and congressional needs for information in the 2018–2028 time frame. We also consider other critical tenets that project designers should consider before fielding projects in the very near future.

Secondary Teacher Education Program Redesign as a Community of Practice

A recurring problem in university teacher education programs is the lack of connection between what teacher candidates do in coursework and what they practice in classroom field placements. This article describes the efforts of the secondary teacher education program (STEP) faculty in the College of Education and Human Sciences at South Dakota State University to redesign their coursework and field experiences into a residency program to better address the development of teacher candidates and needs of school districts. The authors reflect upon their efforts using a Communities of Practice framework. There are implications in the redesign process for teacher education programs hoping to address similar situations for the benefit of the teacher candidate, the universities, and the school districts.

Advancing A Community of Practice: Reflections from the Field One Year Later

A year after embarking on program redesign to align with CPED principles and practices, faculty from a small doctoral program at a private university assessed their work. Specific initiatives such as embedding social justice principles into program components and revising admissions strategies were largely successful. Conversely, attempts to re-conceptualize the Dissertation in Practice met with resistance from numerous stakeholders. The challenges and opportunities of substantively changing a long-standing program have affected the way this faculty work together and envision the future of their program. New approaches to collaboration, innovation, and conflict resolution, viewed from an organizational change perspective, and rooted in the program culture, resulted from their collective efforts to strengthen the education doctorate.

From silos to cells: Reducing repetitive jobs through sociotechnical redesign

Given the negative effects of repetitiveness on employees’ well-being, organisational performance and societal expenditure, it is desirable to reduce the number of repetitive jobs. So far, intervention strategies seeking to reduce the number of such jobs have mainly focused on individual jobs, without taking into consideration that these are embedded in organisational structures. Employee surveys and interviews were collected to measure changes in organisational structures and job repetitiveness in 18 different organisations, which had each participated in a sociotechnical redesign programme. The findings show that making work units responsible for a complete product or service (i.e. implementing cells), or installing semi-autonomous teams, results in a decreased number of repetitive jobs. This study underlines the impact of interventions in organisational structures on decreasing the number of repetitive jobs, and challenges current intervention strategies.

Continuity of Care in Resident Outpatient Clinics: A Scoping Review of the Literature.

Continuity between patients and physicians is a core principle of primary care and an accreditation requirement. Resident continuity clinics face challenges in nurturing continuity for their patients and trainees. We undertook a scoping review of the literature to better understand published benchmarks for resident continuity; the effectiveness of interventions to improve continuity; and the impact of continuity on resident and patient satisfaction, patient outcomes, and resident career choice. We developed a MEDLINE search strategy to identify articles that defined continuity in residency programs in internal medicine, family medicine, and pediatrics published prior to December 31, 2015, and used a quality evaluation tool to assess included studies. The review includes 34 articles describing 12 different measures of continuity. The usual provider of care and continuity for physician formulas were most commonly utilized, and mean baseline continuity was 56 and 55, respectively (out of a total possible score of 100). Clinic and residency program redesign innovations (eg, advanced access scheduling, team-based care, and block scheduling) were studied and had mixed impact on continuity. Continuity in resident clinics is lower than published continuity rates for independently practicing physicians. Interventions to enhance continuity in resident clinics have mixed effects. More research is needed to understand how changes in continuity affect resident and patient satisfaction, patient outcomes, and resident career choice. A major challenge to research in this area is the lack of empanelment of residents' patients, creating difficulties in scheduling and measuring continuity visits.

The Correlation between Self-Efficacy and Time to Degree Completion of Educational Leadership Doctoral Students

Aim/Purpose: This study examined an Ed.D. program redesign to address time to degree completion. The aim was to emphasize the need to improve students’ academic writing and embody a scholarly practitioner approach to research. Background: Doctoral programs have the highest attrition of graduate programs, with almost half of the students taking six to seven years to complete. Methodology: An ex-post-facto correlational research design examined self-efficacy and educational leadership doctoral students perceived versus actual program progression. This was statistically determined through Pearson’s correlation coefficients and a t-test analysis. Contribution: This study provides other doctoral programs who are struggling with time to degree completion a model to consider as they contemplate a program redesign. Findings: Ed.D. students in the 2014 and 2015 cohorts reported high self-efficacy (3.62 and 3.57 respectively, out of 4.00). There was a statistically significant difference in the number of defenses completed per semester based on the program redesign. Recommendations for Practitioners: Ed.D. programs should consider using a scholarly practitioner approach. This focus may lead to faster rates of degree completion and better prepare students to solve problems of practice in their practitioner setting. Recommendation for Researchers: While the results are promising as to expediting time to degree completion, like most doctoral programs it does not seem to impact overall completion rates of the program as a whole, thus, warranting further research. Impact on Society: Expediting time-to-completion enables students to graduate sooner. This will yield cost savings to the student, free up faculty resources, and most importantly prepare students to sooner serve as scholarly practitioners. Future Research: Future research should continue to examine time to degree completion, as well as students’ lived experiences and examine how those shape doctoral students’ efforts and abilities in their Ed.D. work from start to program completion.

Design matters in home visiting improvement

Maternal and child health home visiting services play a critical role in healthcare within the United States. Programs are widely varied and services offered depend on local and regional adopted designs. Observational and experimental research provides mixed conclusive results. Some literature reports statistically significant positive outcomes for home visitation services while other research fails to duplicate or provide secondary matched findings. Future research design opportunities include national, inclusive, cross collaborative home visiting research that seeks to minimize limitations. Future home visiting programs should utilize research opportunities in public and private program redesign, continuous quality improvement as well as in accreditation for optimal effect on target populations. Only with strong, supportive research can maternal and child home visiting services be tailored, replicated and consistent across the United States.

Advancing Care Within an Adult Mental Health Day Hospital: Program Re-Design and Evaluation.

Day hospital mental health programs provide alternate care to individuals of high acuity that do not require an inpatient psychiatric stay. Ensuring provision of best practice within these programs is essential for patient stabilization and recovery. However, there is scant literature to review when creating such a program. This paper provides an overview of the steps an acute care hospital took when designing and implementing new programming within a day hospital program. Qualitative data was collected following initial program rollout. This data helped to inform the ongoing modification of groups offered, group scheduling and content, as well as ensuring patient satisfaction and adequate skill delivery during the rollout period and beyond. The goal of this paper is to inform health service delivery for other programs when attempting to build or re-design a day hospital program.

Instructional Insights: Restructuring the Fieldwork Experience: One Clinic's Journey

ABSTRACTAlthough there are standards for occupational therapy education, there are no universal standards for the affiliated fieldwork settings, only guidelines from the educational institutions. As a result, a student learning experience often varies dramatically from facility to facility. Several factors that may affect the clinical experience include the preparedness of a student, the willingness of a clinic to work through potential student challenges, and the theoretical foundation a clinic has built for disseminating occupational therapy practice skills. This article highlights the journey of one clinic through a redesign of the occupational therapy fieldwork program and outlines the steps taken to transform student experiences and improve program success. Starting with a self-directed review of the fieldwork process, and through a combination of program redesign, application of a theoretical foundation, and refocus toward a competency-based program, the student success rate at this acute rehabilitation hospital drastically improved and achieved positive feedback from all involved.

Introducing Broad Skills in Higher Engineering Education: The Patents and Standards Courses at Eindhoven University of Technology

Over the years, the engineering profession has changed and evolved. e expectations that employers and society have of engineers nowadays are dierent from those of even a few decades ago, and universities have been trying to respond to these changing needs by rethinking and redesigning their courses. is paper describes the large-scale e orts by Eindhoven University of Technology to redesign its entire undergraduate program. More specifically, it elaborates on a series of three courses on patents and standards to illustrate how new academic innovations have been put into practice while also reporting a critical evaluation of these reforms. We conclude that the undergraduate program redesign has led to an almost 50% rise in intake. Additionally, despite conrming our belief that this is a better way to train engineers, the new approach has also been challenging and not always appreciated by students as much as we would like. In regards to the patents and standards courses in particular, the e orts to increase workload while maintaining student satisfaction levels eventually proved to be successful.

Curriculum Redesign in Veterinary Medicine: Part II.

Curricular review is considered a necessary component for growth and enhancement of academic programs and requires time, energy, creativity, and persistence from both faculty and administration. On a larger scale, a comprehensive redesign effort involves forming a dedicated faculty redesign team, developing program learning outcomes, mapping the existing curriculum, and reviewing the curriculum in light of collected stakeholder data. The faculty of the Texas A&M University College of Veterinary Medicine & Biomedical Sciences (TAMU) recently embarked on a comprehensive curriculum redesign effort through partnership with the university's Center for Teaching Excellence. Using a previously developed evidence-based model of program redesign, TAMU created a process for use in veterinary medical education, which is described in detail in the first part of this article series. An additional component of the redesign process that is understated, yet vital for success, is faculty buy-in and support. Without faculty engagement, implementation of data-driven curricular changes stemming from program evaluation may be challenging. This second part of the article series describes the methodology for encouraging faculty engagement through the final steps of the redesign initiative and the lessons learned by TAMU through the redesign process.

Learning to redesign teacher education: a conceptual framework to support program change

University-based teacher education faces intensifying pressure to prove its effectiveness. This has prompted renewed interest in program redesign. In this article, we argue that enacting meaningful redesign requires university-based teacher educators to learn new ways of thinking and acting not only with teacher candidates but also with their university and K-12 colleagues. Drawing on Engeström’s expansive learning theory and our own efforts to redesign our teacher education program along a practice-based teacher education model, we delineate a conceptual framework and illustrate how it supports the organizational learning necessary to enact change in university-based teacher education. The expansive learning redesign framework specifies conceptual tools and social practices to guide, enact, and sustain university-based teacher education redesign. It acknowledges the multi-organizational nature of university-based teacher education and provides tools for engaging K-12 educators in the redesign of teacher education.

Feasibility of a Lifestyle Redesign®-Inspired Intervention for Well Older Adults.

We examined the feasibility of Aging Well by Design, a Lifestyle Redesign®-inspired intervention for community-dwelling older adults. The original Lifestyle Redesign program was shortened to 3 mo and implemented as a community outreach program of a major health care system. Community-dwelling older adults participated in the 12-wk program, which emphasized an occupational approach to healthy aging. Outcomes evaluated were recruitment, attendance, resource use, participant satisfaction, and subjective benefit to participants. The 13 participants, ages 66-88 yr, attended an average of 10 of 12 sessions. The intervention was completed as planned, physical resources were suitable, and financial resources were adequate. Participants expressed satisfaction with the program's facilitator, group discussions, and materials. Perceived benefits were social relationships, awareness of community resources, and change in attitude toward aging. Implementation of a 3-mo Lifestyle Redesign-inspired program within a health care system was feasible.