New organizational structures: skill implications for professionals

Many writers predict that emerging new organizational structures will displace the traditional hierarchical structures. This paper looks at the skill implications for ‘professionals’ as these changes take place. It presents data gathered from a series of structured group discussions conducted with managers and professionals in the UK retail financial services sector (banking, insurance and mortgage lending) to illustrate how changing structures are impacting on ‘professional’ skills and roles. Six key trends, identified in the group discussions, are examined in the light of models which predict the way ‘professionals’ will be managed over the next few years. These trends are illustrated by short case examples or vignettes.     

The new health care civilization: integration of physician land and manageria

Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care. Our research findings and conclusions strongly suggest that economic, management, and leadership competencies need to be incorporated into the professional development of physicians, especially in postgraduate and continuing education curricula.     

Operationalising lean in healthcare: the impact of professionalism

Abstract

Lean is endorsed as policy in practice in the UK but the challenges and complexities affecting Lean in healthcare are still to be adequately assessed. Through a qualitative single case study of an NHS organisation implementing Lean, 43 interviews with multi-disciplinary team members involved in Lean were conducted. The progress of Lean is found to be inhibited as medical professionals have failed to engage or provide clinical leadership in supporting the trajectory of Lean. This resulted in limited outcomes, sustainability implications, and failed projects. Lean is challenged by complexity and this is evident in conflicts between professional identity, corresponding status and clinical/managerial relationships. Medical professionals as a group have received a limited focus in papers assessing the progress of Lean in Healthcare from an operational perspective. Going forward, strategies for mitigating the negative impact of this can be developed to support operational managers in the healthcare domain.     

Using Conditioned Reinforcers to Improve Behavior-Change Skills: Clicker Training for Practitioners

We evaluated the use of a clicker sound as a conditioned reinforcer to teach behavior interventionists appropriate clinical skills during in-situ training. A multiple-baseline-across-behaviors design indicated that the intervention was effective in increasing all target behaviors for all participants. For two of the participants, we conducted maintenance probes one to five weeks after the final training session and performance continued to occur at a high level. Although the participants ranked the contingent clicker presentation as less disruptive and more fair than typical feedback methods, they ranked it as slightly less helpful, less worthwhile, and less pleasant than typical feedback methods. These findings suggest that clicker training can play a valuable role in training mental health professionals.     

What Happens in the Field Stays in the Field: Exploring Whether Professionals Play Minimax in Laboratory Experiments

The minimax argument represents game theory in its most elegant form: simple but with stark predictions. Although some of these predictions have been met with reasonable success in the field, experimental data have generally not provided results close to the theoretical predictions. In a striking study, Palacios‐Huerta and Volij ( 2008 ) presented evidence that potentially resolves this puzzle: both amateur and professional soccer players play nearly exact minimax strategies in laboratory experiments. In this paper, we establish important bounds on these results by examining the behavior of four distinct subject pools: college students, bridge professionals, world‐class poker players, who have vast experience with high‐stakes randomization in card games, and American professional soccer players. In contrast to Palacios‐Huerta and Volij's results, we find little evidence that real‐world experience transfers to the lab in these games—indeed, similar to previous experimental results, all four subject pools provide choices that are generally not close to minimax predictions. We use two additional pieces of evidence to explore why professionals do not perform well in the lab: (i) complementary experimental treatments that pit professionals against preprogrammed computers and (ii) post‐experiment questionnaires. The most likely explanation is that these professionals are unable to transfer their skills at randomization from the familiar context of the field to the unfamiliar context of the lab.     

Is the professional self-managing or is there really a need for professional management?

Is the professional self-managing or is there really a need for professional management? The answer to that question is in both cases: “Yes”. The professional is largely responsible for directing his own activities. Managers must take due account of this by applying rules and procedures on a modest scale and aiming to achieve maximum harmonisation of the objectives of the organisation and the personal objectives of the people working there. If they can do that then there can be said to be professional management.The difficulty in managing professionals is the difficulty in steering the force and the direction of the thinking of others who are — by nature - often differently-minded: professionals have generally followed a specialised, usually scientific education, enjoy a high social standing, like to “perform solo”, have a dislike of management both in the active and the passive sense and the output of their work is difficult for others to evaluate because there is generally no clear consensus on the definition of performance indicators.Managing professionals could be considered as managing brain capacity and that calls for more than just good sense. A manager of a group of professionals can even sometimes experience a great deal of professional pleasure in his work if he is capable of acting as a specialised generalist, pacemaker and coach for his or her team.     

欧洲各国人力资源经理的培养与教育及对我国的启示

人力资源管理的重要作用在很大程度上依赖于从业人员的素质、所受的教育和培训以及他们的专业技能和水平。本文运用文献研究法,简要回顾了欧洲人力资源管理职业化过程,通过大量的调查数据,对欧洲各国人力资源管理专业人员的教育和培训情况进行了介绍和分析,对从业人员的学历水平、所学专业、在职培训及各种不同组织雇用人力资源管理专业人员的情况作了详细分析。最后,对我国人力资源管理专业人员的培养提出了建议。     

Against the Antagonist View of Professional – Manager Relationships: The Case of the Culture Industry

In the emerging knowledge society, a major challenge for human resource management theory and practice is how to lead professionals and experts in day-to-day work. The literature on professionals suggests that the relationship between professionals and managers is complicated, as professional ideologies, practices and interests tend to clash with organizational and managerial objectives. This paper questions such an antagonist view and suggests that the relationship between the two groups is a rather intricate one and that there is no such clear disjunction between the two groups. In addition, there is a strong reliance on cases from the health care sector, especially in an Anglo-American context. The paper reports a study of the relationship between professionals, officers and politicians in the Swedish culture sector in the largest Swedish region. The findings suggest that professionals and managers are capable of taking the role of the other and see a broader perspective than merely individual interests.     

Behavior Skills Training with Voice-Over Video Modeling

The present study used behavior skills training (BST) to teach three adult participants to implement a video modeling intervention aimed at teaching social skills to adults with autism spectrum disorder (ASD). During baseline trials, participants were given access to written instructions before role-play with two actors (who simulated a quiet conversation) and one confederate (who played the role of an adult with ASD). During treatment, participants were given a video model with voice-over instruction depicting how to implement the video modeling intervention to teach social skills, repeated roleplay trials, and feedback following their performance. All participant scores (percentage of steps correctly implemented in each session) increased from baseline to treatment, and generalization was demonstrated with an actual consumer diagnosed with ASD. Additionally, after training participants to use a video model to teach one social skill, there was generalization to teaching as many as three additional novel social skills. Participants showed maintenance of skills during a treatment study that involved training adult clients with ASD to engage in the social skills.     

Engaging Professionals in Sustainable Workplace Innovation: Medical Doctors and Institutional Work

This paper investigates the role of medical professionals in the success and longevity of the implementation of workplace innovation and organizational change in the Accident and Emergency (A&E) Departments of two large public hospitals, in Australia and Canada, during the introduction of process improvement using Lean Management (LM) methodologies. We ask why and how doctors resist, influence or enable LM initiatives in healthcare. Using a qualitative methodology, we contribute to institutional work theory by unpacking the complex forms of boundary and practice work undertaken by key actors who effectively use their professional status and power to enable practice changes to be embedded. Our findings lend support to the importance of the involvement and ownership of senior doctors in the design, introduction and implementation of successful workplace innovation and organizational change. Senior doctors use their professional expertise, positional and political power at the industry, organization and workplace levels to influence strategically the use of resources designated for workplace innovation to improve efficiencies, quality of patient care and maintain their dominance. The significant organizational change achieved reflected the ownership and leadership of the workplace innovation by senior doctors in ‘hybrid roles’ who captured the rhetoric and minimized adversarialism among key stakeholders.     

Information Technology Acceptance by Individual Professionals: A Model Comparison Approach*

The proliferation of innovative and exciting information technology applications that target individual “professionals” has made the examination or re‐examination of existing technology acceptance theories and models in a “professional” setting increasingly important. The current research represents a conceptual replication of several previous model comparison studies. The particular models under investigation are the Technology Acceptance Model (TAM), the Theory of Planned Behavior (TPB), and a decomposed TPB model, potentially adequate in the targeted healthcare professional setting. These models are empirically examined and compared, using the responses to a survey on telemedicine technology acceptance collected from more than 400 physicians practicing in public tertiary hospitals in Hong Kong. Results of the study highlight several plausible limitations of TAM and TPB in explaining or predicting technology acceptance by individual professionals. In addition, findings from the study also suggest that instruments that have been developed and repeatedly tested in previous studies involving end users and business managers in ordinary business settings may not be equally valid in a professional setting. Several implications for technology acceptance/adoption research and technology management practices are discussed.     

Spirituality and the care of patients at the end-of-life: an essential component of care

Spirituality is an essential component of the care of patients with serious illness and those that are dying. Dame Cicely Saunders developed the hospice movement based on the biopsychosocialspiritual model of care, in which all four dimensions are important in the care of patients. Of all the models of care, hospice and palliative care recognize the importance of spiritual issues in the care of patients and their families. The National Consensus Project Guidelines for Quality Palliative Care, in the United States, provides specific recommendations about all domains of care including the spiritual domain, which is recognized as a critical component of care (The National Consensus Project for Quality Palliative Care www.nationalconsensusproject.org). Studies indicate that the majority of patients would like their spiritual issues addressed, yet find that their spiritual needs are not being met by the current system of care. Interestingly, spirituality is the one dimension that seems to get slightly less emphasis than the biopsychosocial dimensions of care. Some reasons may include the difficulty with definitions of spirituality for clinical and research purposes, the time constraints and financial burdens in the current healthcare system in the United States, and the lack of uniform training for all healthcare professionals. Yet, there are theoretical and ethical frameworks that support spiritual care as well as some educational models in spirituality and health that have been successful in medical education in the United States. Spirituality can be seen as the essential part of the humanity of all people. It is at its root, relational and thus forms the basis of the altruistic care healthcare professionals are committed to. Spirituality has to do with respecting the inherent value and dignity of all persons, regardless of their health status. It is the part of humans that seeks healing, particularly in the midst of suffering. Spiritual care models are based on an intrinsic aspect that calls for compassionate presence to patients as well as an extrinsic component where healthcare professionals address spiritual issues with patients and their loved ones. Currently in the healthcare system, evidence-base models are the criteria for practice recommendations. Yet, spirituality may not be amenable entirely to strict evidence-base criteria. As hospice and palliative care continues to develop as a field, healthcare professionals are challenged to think of ways to advocate for and include the spiritual dimension of care.     

‘Clock-watching and box-ticking’: British local authority planners,professionalism and performance targets

The speed of the statutory planning system has concerned UK Governments for decades. The Labour Government of 1997–2010 placed particular emphasis on increasing the efficiency of public services through performance targets. Whilst the subsequent Coalition Government of 2010–2015 removed many targets, those measuring the speed of planning application processing were kept. These performance targets have important potential implications in terms of the autonomy and space for discretionary judgement traditionally seen as intrinsic to the professional nature of planning. Empirical material exploring how British local authority planners responded to these targets suggests they have both restricted and empowered professionals and, whilst changes to practice have occurred, professional identities have remained more resilient. This contradictory picture highlights the importance of considering the role of frontline professionals in implementing reforms.     

The Most Important Skills an Urban Planner Needs In a Developing Country; The Case of Iran*

Differences in the context of developed vs. developing countries require different kinds of urban planning skills in each group. This paper intends to figure out the most important skills an urban planner should have in a developing country. A total of 341 questionnaires were filled by professionals, instructors, students, and graduates. The result shows that team work, research method and data collection, and technical skills are the most important skills at the undergraduate level, in Iran, while problem definition, analytical skills, and oral presentation are the most important ones at the graduate level. Managerial skills, at neither level, show any significance.     

Introducing the 3-A grief intervention model for dementia caregivers: acknowledge, assess and assist

With our aging population, it is estimated that in the near future there will be an overwhelming increase in the number of individuals dealing with Alzheimer's disease or a related dementia (ADRD). From the time that symptoms begin to insidiously emerge, it can take well over ten years for the disease to run its course. In addition to the crippling effect for those inflicted, this lengthy duration can have an ongoing debilitating effect on the family members who are grieving while providing care. Researchers have claimed that the manner in which family members experience and manage their grief reactions to the pre-death losses can influence both caregiving outcomes and adjustment to bereavement once those with the disease have died. Given the relevance of grief management, this article provides answers to such questions as: How do family caregivers of individuals with ADRD manifest their grief? How can healthcare professionals intervene in assisting with grief management? The answers are provided introducing the 3-A grief intervention model for family caregivers of individuals with ADRD. The 3-A model enfranchises the caregiver grief experience through Acknowledging, Assessing, and Assisting in grief management. In doing so, different grieving styles are identified and the role that denial and respite plays in adapting to the family caregiver's grief experience is recognized. Clinical strategies to assist in grief management are also provided.     

Exploring the use of virtues to facilitate identity construction among management students

This paper explores the challenges and opportunities facing educators who wish to facilitate management students’ identity construction as a means to foster their students’ emergent professional identities and post-graduate career attainments. We look to medical and law schools’ recent advancements, alongside their traditional dissemination of knowledge and technical skills, in better aligning students’ developing identities and related behaviors with respective professional ideals. Drawing on insights from these professional schools, we examine whether the concept of “professional virtues” that’s proven valuable in these contexts might also be used to facilitate students’ professional identity construction within management education.     

Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief

Following perinatal loss, a type of ambiguous loss, bereaved couples struggle with and experience distress due to various forms of ambiguity. Moreover, the juxtaposition of their grief with society's minimization often disenfranchises them from traditional grieving processes. The purpose of this study was to explore sources of ambiguity and disenfranchised grief related to perinatal loss. Audio-taped interviews with 13 bereaved couples at 2, 6, and 13 months following the death of their fetus or infant were analyzed. Several categories of ambiguity and disenfranchised grief emerged, pertaining to: (a) the viability of the pregnancy; (b) the physical process of pregnancy loss; (c) making arrangements for the remains; and (d) sharing the news. This study uncovers the many sources of ambiguity and disenfranchised grief that bereaved couples face in interactions with family, friends, society, and healthcare professionals. These insights may inform healthcare professionals in their attempts to ease distress related to perinatal loss.     

Resolving conflicts: principles and practice

Physicians and other medical professionals undergo extensive professional training for the privilege of obtaining their professional licenses. For most physicians, clinical training is conducted in extremely competitive circumstances. Many physicians endorse competition as an appropriate method for producing greater individual and collective competence within the profession. Competition, however, is a very limited way to resolve conflicts. And, in the current environment of greater resource restrictions and reform, the competitive model, at best, seems short-sighted. Many of the current relationships involving physicians and others are transitional, involving various partners in numerous practice and professional relationships. For example, medical practices are merging; hospitals are engaging physicians in numerous business structures, even employment. However, longer term relationships are enhanced by mutual respect and collaboration, rather than chronic competition to "win" one's rights over another. Thus, the need among physicians to enhance their conflict resolution skills is expanded in today's environment.