Institut national de la jeunesse et de l’éducation populaire – Service à compétence nationale, DJEPVA – Ministère de la ville, de la jeunesse et des sports 95, avenue de France – 75650 Paris cedex 13 – Téléphone : 01 70 98 94 00 – Télécopie : 01 70 98 94 20 – www.injep.fr Jean-Pierre Halter, chercheur associé à l’INJEP, et Francine Labadie, coordinatrice de l’Observatoire à l’INJEP. Cadre d’un projet de territoire issu de la volonté des élus et de la société civile, fédérant une grande diversité d’acteurs, le « pays » pourrait constituer un territoire privilégié pour la mise en œuvre d’une politique de jeunesse intégrée. En s’appuyant sur deux vastes monographies portant sur le pays de Marennes-Oléron et le pays de la Vallée du Lot, cette étude s’intéresse à la pertinence du pays comme territoire de développement local pour une action publique en direction des jeunes ruraux. En coordonnant l’action des communautés de communes ou d’agglomération, et en ouvrant sa gouvernance aux acteurs associatifs ainsi qu’aux jeunes, le pays pourrait être un espace approprié permettant le dépassement de l’approche sectorielle, dominante dans l’action publique intercommunale.

Etudes et recherches

Health and safety issues in a vocational training center were explored in this study. Several sources and methods were used: group interviews with students in traditionally female [F] and male [M] trades, i.e. hairdressing (7 F) and automated systems electromechanics (8 M, 1 F); self-administered questionnaires on injuries sustained at the school; observations of activities in these programs; and analysis of ministerial documents. Findings indicate that the partially divergent ways that OHS is addressed in these programs cannot be explained only by the specific characteristics of the two trades. Some aspects put female students in hairdressing at a disadvantage: status accorded to OHS in the study programs, learning activities, and conditions for learning and managing prevention and injuries. The discussion focuses on a gender-differentiated analysis, the importance of improving the way OHS is addressed in the programs, in particular, those primarily involving female students, and the need to pursue research. In addition, the results from individual interviews with women (5 F) training for non-traditional trades lead to discussion on the interrelated effects of sex-based gender and professional gender.

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Health and safety of students in vocational training in Quebec: a gender issue?

Background Unprofessional behaviour is a challenge in academic medicine. Given that faculty are role models for trainees, it is critical to identify strategies to manage these behaviours. A scoping review was conducted to identify interventions to prevent and manage unprofessional behaviour in any workplace or professional setting. Methods A search of 14 electronic databases was conducted in March 2016, reference lists of relevant systematic reviews were scanned, and grey literature was searched to identify relevant studies. Experimental and quasi-experimental studies that reported on interventions to prevent or manage unprofessional behaviours were included. Studies that reported impact on any outcome were eligible. Two reviewers independently screened articles and completed data abstraction. Qualitative analysis of the definitions of unprofessional behaviour was conducted. Data were charted to describe the study, participant, intervention and outcome characteristics. Results 12,482 citations were retrieved; 23 studies with 11,025 participants were included. The studies were 12 uncontrolled before and after studies, 6 controlled before and after studies, 2 cluster-randomised controlled trials (RCTs), 1 RCT, 1 non-randomised controlled trial and 1 quasi-RCT. Four constructs were identified in the definitions of unprofessional behaviour: verbal and/or non-verbal acts, repeated acts, power imbalance, and unwelcome behaviour. Interventions most commonly targeted individuals (22 studies, 95.7%) rather than organisations (4 studies, 17.4%). Most studies (21 studies, 91.3%) focused on increasing awareness. The most frequently targeted behaviour change was sexual harassment (4 of 7 studies). Discussion Several interventions appear promising in addressing unprofessional behaviour. Most of the studies included single component, in-person education sessions targeting individuals and increasing awareness of unprofessional behaviour. Fewer studies targeted the institutional culture or addressed behaviour change.

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Prevention and management of unprofessional behaviour among adults in the workplace: A scoping review

Healthcare is a complex arena of multi-skilled interaction. In recent years, it has grown extensively out of the simple act of treating the sick by a noble healer to taking measures of preventing illness not only of the clients but also of the community. It is no more a deal between two persons: the sick and the healer (like a doctor). Community healthcare is regulated by several agencies including legislative agencies (like government, international health organisations), professional bodies, industrial regulators, consumer advocates and commercial entities (such as insurance companies and pharmaceuticals). Healthcare service providers or professionals are not the sole regulators rather their actions need to balance the legal obligations to the client (such as client satisfaction), to staff (such as workplace safety) and to business (to maintain competitive advantage in the industry).
Current healthcare service provision is challenged by many factors including diversification of the task, diversity of workforce characteristics due to globalisation and increased service demand by knowledgeable customers searching proactive healthcare and not just curative care. To overcome these challenges along with maintaining quality service, organisations need skilled staff. This, however, is threatened by occupational hazards like occupational violence against staff (OVAS) which is well documented globally and across Australia.
The impact of OVAS is not limited only to disruption of service but also to the quality of service and shortage of human resources in some cases. Regulatory agencies like the Department of Health, Comcare, Safe Work Australia and Worksafe Victoria (VAGO, 2013) are providing guidelines on OVAS management.
Most healthcare providers are considering some actions, but not with any universal consensus. According to the hierarchy of control in Work Health and Safety Management System (WHSMS) a hazard could best be controlled by eliminating it, but if not then training of staff is an option. Training will always be needed whether or not other measures of hazard and risk control are implemented. This encourages research to develop effective training in terms of trainers’ perspective (in delivery), learners’ perspective (of appreciating the sessions) and management’ perspective (of the outcome of hazard control).
Literature shows that the workforce training in hospitals to control OVAS lacks consistency and uniformity across Australian hospitals. ‘Management of Violence and Aggression International Training’ (MSVT) is one training programme run by the BN123 Health, Victoria, since 1990.
With that background the main aim of this qualitative case study research project was to “identify the effectiveness of the existing training programme (MSVT) in prevention of occupational violence against staff (OVAS) “. Occupational violence is a part of work health and safety issue. So, the research intended to enquire: ‘Is the existing MSVT in prevention of OVAS achieving its purpose, particularly in the current WHSMS setting of the hospital?’
The literature review assisted in identifying the causes of OVAS, types, prevalence and the factors associated with it. It also helped to analyse the published incidents. Among different training evaluation methods, the Kirkpatrick’s model was found most suitable to evaluate MSVT. Analysis attempted to correlate the outcome of the training against existing objectives. Limited access to information meant that I could not perform in-depth analyses, but the findings of this study are expected to guide future research on the effectiveness of MSVT at BN123 Health with more integration to the WHSMS and other safety programmes
This research used a qualitative case study with Actor-Network Theory (ANT) to fulfil the goal. The limited access to health facilities both due to obstacle in sensitive data collection and accessing busy participants of different sections of the hospital in a limited time frame.
This study explored actors related to OVAS and suggested adoption of an innovative approach to improve workplace safety through the formation of new networks. It did this by looking through the lens of Actor-Network Theory (ANT). The present vision of the government in digitalising the health sector in Australia is a prime opportunity to re-align the network in the WHSMS of the hospital for better impact of training on the OVAS situation.
Limited guidance from top management was an issue. MSVT was under the control of the Psychiatric Department at its inception but was then moved under Human Resources (HR), which seems to have reduced its importance and resource management ability. Hospitals are dominated by clinical priorities rather than HR issues.
Being a part of the general training programme administered by HR has limited the ability of MSVT as it struggled to receive funding to recruit enough full-time trainers to undertake research on OVAS incidents, promote the programme across the whole organisation, publish materials to create awareness to all staff and develop resources to help retain the knowledge of the participants in the post-training period.
Limited flow of information on OVAS was another issue. Even though BN123 Health invests in innovation like RSKSOFT, for reporting it did not purchase all the modules of that programme to improve the flow of information to the trainers of MSVT.
BN123 Health demonstrated a proactive attitude in managing OVAS by procuring and trademarking MSVT but is lacking continuity of efforts in it, maybe due to its commitment to clinical aspects of the service. This could be verified by further research.
The research identified scope for innovation. Firstly, the training programme could be strengthened by incorporating recent updates on organisational objectives and legislative changes and standardisation with industry practices. It could also be strengthened by incorporation of an improved audio-visual component, distance learning facilities for beginners and refreshers, updating resources including books and journals, inter-organisation exchange programmes and inclusion of regular research results in booklets and handouts. Targeted delivery would also assist, with constant vigilance on incidents and inclusion of vulnerable groups in training.
Another worthwhile innovation would be to change the focus from staff only programmes to involve customer or client interest. This could include arranging training for clients and carers as they are a party in the conflict. Management training would be useful to prepare resources for the population of the catchment area, bringing together all healthcare providers (including GPs) who refer clients to the hospital. Updating real-time information collection, storage and analysis by professionals as well as information access to trainers would also be a worthwhile innovation.
With the availability of mobile technology, BN123 Health has scope to improve its ability to get real-time information from the incident spot and to develop better management to control events. This could also provide arrangements for easy data entry by general staff.

Management of training to prevent occupational violence: a case study of the Work Health and Safety Management System (WHSMS) in a hospital in Victoria

Statistics indicate that even if young workers complete vocational training, as a group they are at risk of sustaining injury It appears that a lack of training in the area of injury prevention may explain some of this effect Teachers are considered to be key actors in injury-prevention training and in the process of developing students' preventive behaviour at work, but little is known about the reality The objective of this study was to understand how teachers experience their activities in support of students' development of injury-prevention behaviour at work Semi-structured interviews were conducted with eleven teachers from four different vocational training programs The content of the interviews was then examined using phenomenological analysis Results show representations participants form of occupational health and safety, of injury-prevention behaviour and of their roles as teachers in relation to prevention A closer look at these roles reveals the daily challenges teachers encounter Among other things, there seems to be a lack of continuity in the training process, insufficient pedagogical resources and resistance on the students' part Results offer an insight into teachers' experience with their part in the support of vocational students' development of injury-preventing behaviour  It appears they recognize having to play an active role in the development of injury-preventing behaviour at work among students, but have to face daily challenges affecting their teaching Results of this study can serve as a starting point to make improvements to the injury-prevention training offered in vocational training centres

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Supporting vocational students' development of preventive behaviour at work: a phenomenological analysis of teachers' experiences

Cette etude porte sur les evenements accidentels associes a une blessure sans egard a sa gravite, survenus en cours de formation professionnelle, et sur les symptomes typiques d’une exposition professionnelle ressentis par les eleves. La population etudiee compte 327 eleves du programme d’entretien d’equipement motorise. Tous les evenements accidentels survenus en atelier a l’automne 2003 ont ete documentes et un questionnaire sur des symptomes ressentis en lien avec l’exposition professionnelle en atelier de formation a ete rempli par 213 eleves. Pour la periode de septembre a decembre 2003, 72 evenements ont ete repertories (taux d’evenements accidentels = 22 %). De ces derniers, 83,4 % sont survenus dans les specialites mecanique automobile et carrosserie qui accueillaient 62,9 % des eleves inscrits, alors que les specialites mecanique de vehicules lourds et engins de chantiers cumulaient 16,7 % des evenements bien qu’elles comptaient 37 % des effectifs. Le questionnaire sur les symptomes a revele que 11,3 % des repondants eprouvaient des douleurs au bas du dos et 16,0 % declaraient avoir des problemes cutanes qu’ils attribuaient, notamment, a leur exposition en atelier professionnel. Enfin, 29,6 % des repondants ont declare ressentir de la fatigue, avoir des difficultes de concentration ou des maux de tete sur une base reguliere. Les resultats fournissent des indications importantes pour le Centre de formation professionnelle participant. La direction et les enseignants de ce CFP peuvent reperer des activites et des produits a risques et mettre de l’avant des mesures preventives appropriees. La nature exploratoire de l’etude ne permet pas de generaliser les resultats a l’ensemble des ateliers professionnels, mais temoigne de l’importance de documenter les questions de sante et de securite en milieu de formation professionnelle.

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Santé et sécurité du travail et formation professionnelle : Prochaine cible d’intérêt

No research has verified the effectiveness of measures for the prevention of workplace violence in the school setting. The present project includes several steps: administration of a pre- and post-intervention questionnaire, training of workers and implementation of an awareness program, distribution of prevention material and qualitative and quantitative evaluation. The aim is to verify if the awareness program had an effect on the level of prevention management undertaken by the school and if there was any effect of the intervention on the wokers’ perception of the safety level of the setting and if the number of victims of violent acts and behaviors was reduced. The results of the post-test show that less physical violence was reported by the experimental group and less psychological violence by the control group. These results are discussed in relation to the implementation of the intervention.

A qualitative and quantitative evaluation of an experiment for preventing violence in the workplace

Le present article a pour but de jeter un regard sur la prevention de la violence au travail au Quebec et au Canada. Tout d'abord, les definitions et les legislations canadienne et quebecoise au regard des differentes formes de violence au travail seront exposees. Puis, apres avoir etabli la pertinence des programmes de prevention contre la violence en milieu de travail, seront decrits les differents types de programmes, et seront presentees les mesures mises en place dans bon nombre d'organisations, ainsi que les ressources disponibles au Quebec et au Canada pour prevenir la violence en milieu de travail. Finalement, deux interventions visant a lutter contre la violence au travail seront presentees : l'une en milieu hospitalier et l'autre en milieu scolaire. Chacune de ces interventions fera l'objet d'un certain nombre de constats concernant l'implantation des structures et des procedures recommandees dans la documentation nord-americaine lors de la mise en place d'un programme de prevention de la violence au travail.

Denis Laliberte

Papers

Santé et sécurité du travail et formation professionnelle : Prochaine cible d’intérêt

A qualitative and quantitative evaluation of an experiment for preventing violence in the workplace

Prévention de la violence en milieu de travail: Perspective québécoise et canadienne