Collaborative model

Abstract: This paper argues that the discretion-constraining impulses of most regulatory reinvention efforts fail to respond to the most serious weaknesses of rulemaking, implementation and enforcement. This is partly because reformers are encumbered by the theory and practice of interest representation and partly because administrative law lacks an alternative model of administrative decision making. The paper's purposes are threefold: (1) to offer a normative vision of collaborative governance against which to evaluate proposals for reform. Collaboration requires problem-solving, provisional solutions, broad participation, public-private sharing of responsibility and a flexible, engaged agency. (2) to illustrate how some innovative administrative processes, such as regulatory negotiation and negotiated permitting, embody elements of the collaborative model and to explain why, despite their promise, they fall short of the collaborative ideal. As examples, the paper relies on four case studies, two each of regulatory negotiation and EPA's Project XL. (3) to argue that the pursuit of collaboration requires a willingness to experiment with non-traditional source of accountability in order to address the problem of legitimacy.

Abstract: The unique character of medical education in the outpatient setting has created challenges in teaching and learning that cannot be solved by the adaptation of traditional inpatient approaches. Previous work and the authors’ own observational study describe a relatively passive learner focused on reporting history and physical examination data to the preceptor. Based on the work of Bordage in cognitive learning, and that of Osterman and Kottkamp on reflective practice for educators, the authors have developed a collaborative model for case presentations in the outpatient setting that links learner initiation and preceptor facilitation in an active learning conversation. This learner-centered model for case presentations to the preceptor follows a mnemonic called SNAPPS consisting of six steps: (1) Summarize briefly the history and findings; (2) Narrow the differential to two or three relevant possibilities; (3) Analyze the differential by comparing and contrasting the possibilities; (4) Probe the preceptor by asking questions about uncertainties, difficulties, or alternative approaches; (5) Plan management for the patient’s medical issues; and (6) Select a case-related issue for self-directed learning. The authors conducted a pilot study of SNAPPS, introducing the model to both thirdyear medical students and their preceptors. Feedback was enthusiastic and underscored the importance of the paired approach. SNAPPS represents a paradigm shift in ambulatory education that engages the learner and creates a collaborative learning conversation in the context of patient care. Acad Med. 2003;78:893– 898.

Abstract: There is an emerging discourse of knowledge translation that advocates a shift away from unidirectional research utilization and evidence-based practice models toward more interactive models of knowledge transfer. In this paper, we describe how our participatory approach to knowledge translation developed during an ongoing program of research concerning equitable care for diverse populations. At the core of our approach is a collaborative relationship between researchers and practitioners, which underpins the knowledge translation cycle, and occurs simultaneously with data collection/analysis/synthesis. We discuss lessons learned including: the complexities of translating knowledge within the political landscape of healthcare delivery, the need to negotiate the agendas of researchers and practitioners in a collaborative approach, and the kinds of resources needed to support this process.

Abstract: Collaborative planning processes have become increasingly popular for addressing environmental planning issues, resulting in a number of conceptual models for collaboration. A model proposed by Selin and Chavez suggests that collaboration emerges from a series of antecedents and then proceeds sequentially through problem-setting, direction-setting, implementation, and monitoring and evaluation phases. This paper summarizes an empirical study to evaluate if the Selin and Chavez model encompasses the range of factors important for the establishment and operation of collaboration in watershed planning from the perspective of the planning coordinator. Analysis of three case studies of watershed based planning efforts in the Intermountain West suggests the model realistically describes some of the fundamental collaborative elements in watershed planning. Particularly important factors include the involvement of stakeholders in data collection and analysis and the establishment of measurable objectives. Informal face-to-face dialog and watershed field tours were considered critical for identifying issues and establishing trust among stakeholders. Group organizational structure also seems to play a key role in facilitating collaboration. From this analysis, suggestions for refining the model are proposed.