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AbstractThis article reports findings from a 13‐month ethnographic study of knowledge use and expertise among 78 workers in a U.S. residential treatment center for children. It investigates the question of how youth care workers developed expertise in an organization that did not require graduate professional education and provided little didactic training. It demonstrates how processes of informal apprenticeship allowed some workers to develop locally recognized expertise through working alongside more experienced peers. It analyzes the puzzling initial finding that workers simultaneously attributed expertise to innate "common sense" and reported that they developed this form of expertise through informal on‐the‐job apprenticeship. Taking a cultural perspective on learning, this article conceptualizes youth‐serving organizations as communities of practice in which informal apprenticeship contributes to the development of locally valued forms of expertise and addresses the question of why youth care workers appeared to differ in their ability to make use of opportunities for such learning. It explores implications of these findings for workforce development in youth residential treatment and for social work education in general, suggesting simple methods for maximizing opportunities for situated learning.

Although social work scholars have proposed and promoted various models for making effective and ethical clinical decisions, little empirical research has addressed processes of clinical decision-making as they occur naturally in 'real world' mental health practice. This article briefly reviews approaches to the study of decision-making, and presents findings from an ethnographic study of the collaborative decision-making activities of mental health workers in a residential treatment center for children and adolescents. This article describes and analyzes a local theory and practice of interactional clinical decision-making in which workers provide competing interpretations of the 'meaning' of clients' behaviors before committing to a particular course of clinical action. This process, which I term the 'behavior-has-meaning' hermeneutic, serves not only to guide clinical interventions, but as a forum for modeling, developing, and evaluating locally valued forms of clinical expertise. Implications of these findings for the implementation of prescriptive models of clinical decision-making – such as the evidence-based practice process – are discussed.

The paper illustrates how socioeconomic issues impact upon individuals at a micro level and contribute towards a process of social exclusion These issues are examined with reference to one specific group: women living in dual-adult households residing in an inner city council estate in Sheffield. It particularly explores the relationship between the household, women's labour market participation and social exclusion. The relationship between the household and labour market has tended to receive limited attention within traditional urban literature. This study attempts to examine housing issues within an extended framework, utilising a range of cross-disciplinary literature from social, economic and housing disciplines. The factors which impact upon a process of social exclusion are illustrated with reference to case studies of individual women. The data for each case study were ascertained by utilising life-history analysis which allows for a sequential examination of events.

AbstractEthnographic studies of people at the margins of society, struggling with complex and intertwined personal and social problems, have provided useful insights to social work students and practitioners. Similarly, ethnographic studies of social work practice have provided deeper understandings of how professionals work with individuals, groups and organizations. It has been argued that, given the similarities in the skills required to be an ethnographer and a professional social worker, ethnography should be included in social work curricula, both as an approach to research and as a way to enhance practice skills. The main contribution of this article is to extend this argument using the novel approach of exploring the similarities and divergences between the epistemological approaches of ethnography and social work, in terms of how knowledge is sought, constructed and critically questioned.

The nursing profession has long valued and emphasized the importance of leadership from the bedside to all levels of organizations. Involvement at the board level allows nurses to create institutional processes to improve the delivery of services, set policies, and establish benchmarks to address pressing issues. No research exists to identify which skills nurses find most helpful in executing board responsibilities and what experiences lead to the attainment of these skills. The purpose of this study was to develop a repository of clear and relevant items that could be used to establish an instrument that measures nurses' professional experiences and board member responsibilities. This article describes our study methods, and results, including five emerging themes that describe nurses' perception of board activities and their board participation. These themes encompassed the intertwining of experiences and skills, foundational experiences that support credibility, transferable skills, use of policy processes, and the importance of networking. Discussion of our findings, limitations, and implications for practice can inform professional development activities to support nurses as they pursue board service, and the development of an instrument to evaluate the impact of their experiences, effectiveness, and perceived contributions when serving on boards.

Original Medicare produced an increased index of suspicion regarding health costs in 1965. As services expanded, costs escalated. Policy makers moved to control upward spending trends in an attempt to leverage resources across the population. Changes in reimbursement accompanied by the expansion of levels of care during an episode of illness caused stakeholders to carefully analyze value based opportunities. The groundbreaking Patient Protection and Affordable Care Act (ACA) compels nurses to continue innovation, transformational leadership, and care coordination as major stakeholders in provision of the next generation of cost containment, quality advances, and patient access improvements. This article discusses the nurse impact on national health cost reduction, value based healthcare reimbursement, and opportunities for nurses to impact healthcare quality. In addition, we consider the nurse impact on healthcare quality and access to care, as well as continued opportunities for nurses to impact access and lead change.

Self-reported health (and the extent to which this was associated with partner abuse or psychosocial variables) was investigated in 132 women recruited from a domestic violence service. The survey instrument included abuse disability, life event and daily stress exposure, social support, anger expression style, and perceived health status. The prevalence estimates for this sample were significantly higher than standard estimates across a range of health problems. Regression models demonstrated that whilst the extent of partner abuse predicted the prevalence of three conditions, psychosocial factors were more substantial predictors of health and well-being in domestic violence victims. Of these, life event frequency and anger expression were the most significant. These findings provide important information about the health of domestic violence victims as they seek support from domestic violence agencies, with relevance for practitioners working with victims who have terminated a violent relationship and for those supporting victims who remain with a violent partner. Adapted from the source document.