The Changing Context for Planning Education in the UK and the Prospects for Research-Led, Practice-Engaged Teaching

The UK’s Royal Town Planning Institute (RTPI) celebrates its centenary in 2014, marking 100 years of close relationships between university-based Planning Schools and a professional body focussed on planning practice. During this period, the context for university education and the very idea of planning has changed dramatically contributing to a continual renegotiation of the relationships between the planning profession and the educational institutions it accredits. These changes have been particularly acute in the last ten years where a number of factors have forced a rapid change in the nature of planning education in the UK. This has included a boom and then slump in the number of planning students linked to the national economic situation, a reorganisation of many planning schools and their merger with cognate disciplines such as geography and an increased focus of research output, rather than professional engagement the key institutional indicator of success. This last factor adds a particularly new dimension to the profession-university relationship, which could potentially lead to either a straining of tensions or a synergy through research-led teaching that could significantly benefit both.

This paper will briefly review the evolution of UK planning schools and the co-evolution of the main ideas informing planning education. It will then describe the current profile of UK planning schools, based on an extensive national survey conducted on behalf of the Royal Town Planning Institute. The paper will then critically review the main challenges and opportunities facing UK Planning Schools in the context of changes in both planning practice and higher education. It will then move on to the concept of research-led teaching, drawing on current practice in the UK and review how well this concept serves students and the idea of developing reflective planning practitioners. Finally, the paper will seek to draw broad lessons from the experience of the UK and reflect on the type of planning education that can best serve planning professions in a variety of international contexts in the future.

The struggle for safe staffing levels in the USA: A political economy of evidence-based practice

This paper examines the debate over nursing staff to patient ratios through the lens of Marxist political economy, arguing that the owners and controllers of healthcare in the USA have a vested interest in opposing mandated minimum ratios, while those involved in carrying out nursing care have a vested interest in their implementation, which coincides with the interests of patients. We examine how evidence-based practice articulates with social power, and proceed to interrogate the research methods used to generate evidence for practice, noting that randomised controlled trials are not suitable for evaluating nurse/patient ratios, which means that observational studies are the primary source of evidence. Representatives of nursing managers have used the fact that observational studies, while demonstrating an association between high ratios and poor outcomes, have not established a causal relationship, to support their argument that there is not sufficient evidence for the imposition of mandatory ratios. We argue that the precautionary principle provides firm justification for mandatory ratios, unless and until a causal relationship has been disproved. We conclude that those involved in the generation of evidence have to choose between technical arguments about the inferiority of observational studies, or emphasising their sufficiency in triggering the precautionary principle.

Evidence-based practice: the relevance of systematic reviews.

Aim:
To demonstrate how systematic reviews provide robust evidence to inform clinical decision making in practice.

Background
Systematic reviews collate findings from a number of research studies in order to provide a comprehensive and reliable summary of the best available evidence. The use of systematic reviews to inform practice based decisions has increased as a result of the overwhelming amount of research literature available, poor quality of research evidence and the need to ensure practice is based upon the best available evidence. Systematic reviews are an efficient way of coping with large volumes of data to answer focused research questions. They differ from traditional literature reviews as they adhere to an explicit scientific process. The use of explicit and rigorous methods to identify, appraise and synthesise relevant studies minimises bias and provides a reliable basis for decision making. As a result systematic reviews provide clear evidence on the effectiveness of a healthcare intervention to inform policy and decision making across healthcare systems. An example of how the findings from systematic reviews can provide reliable evidence to inform healthcare decisions will be provided in this presentation1. This will demonstrate how focused clinical questions can be answered by systematic reviews and translated into practice.

Reference:
1. McGaughey J, Alderdice F, Fowler R, Kapila A, Moutray M. (2007) Outreach and Early Warning Systems (EWS) for the prevention of Intensive Care admission admission and death of critically ill adult patients on general hospital wards (REVIEW). The Cochrane Database of Systematic Reviews 3. art no CD005529

The Changing Context for Planning Education in the UK and the Prospects for Research-Led, Practice-Engaged Teaching

The UK’s Royal Town Planning Institute (RTPI) has celebrated its centenary in 2014, marking 100 years of close relationships between university-based planning schools and a professional body focused on planning practice. During this period, the context for university education and the very idea of planning have changed dramatically contributing to a continual renegotiation of the relationships between the planning profession and the educational institutions it accredits. These changes have been particularly pronounced in the last 10 years where a number of factors have forced a rapid change in the nature of planjavascript:void(0);ning education in the UK. This has included a boom and then slump in the number of planning students linked to the dynamics of national economic situation, a reorganization of many planning school curricula, and their merger with cognate disciplines such as geography and an increased focus on research output, rather than professional engagement as the key indicator of institutional success. This last factor adds a particularly new dimension to the profession-university relationship, which could potentially lead to either straining of tensions or a synergy through research-led teaching that could significantly benefit both. This chapter will briefly review the evolution of UK planning schools and of the main ideas informing planning education. It will then describe the current profile of UK planning schools, based on an extensive national survey conducted on behalf of the Royal Town Planning Institute. The paper will then critically review the main challenges and opportunities facing UK planning schools in the context of changes in both planning practice and higher education. It will then move on to the concept of research-led teaching, drawing on current practice in the UK and review how well this concept serves students and the idea of developing reflective planning practitioners. Finally, the paper will seek to draw broad lessons from the experience of the UK and reflect on the type of planning education that can best serve planning professions in a variety of international contexts in the future.

Deconstructing Evidence-Based Practice and Its Application in Children to with Mental Health Disorders

This is a mixed methodology study that uses an autoethnographic approach to combine both an autobiography and a survey of practitioners who work in children’s mental health. It is largely about the implementation of Evidence-Based Practice (EBP), and the questions, concerns, experiences that I have had, and compared them with those of my fellow practitioners. In addition, it is about my journey as a mental health professional, and how I have come to recognize that in order to achieve the goals I wanted to achieve, I needed to return to university to pursue a Master’s degree. Within the research, I identify and discuss different definitions of EBP and identify several themes. I deconstruct the implementation of EBPs through the lens of Foucault and his notions of governmentality. I offer policy and practice recommendations to improve the implementation of EBP and the services received by children facing mental health issues.

Development and evaluation of a research-based prosthodontic clinical record

Introduction: Bien que l'importance de transférer les données de la recherche à la pratique a été largement démontrée, ce processus est toujours lent et fait face à plusieurs défis tels que la conceptualisation des évidences, la validité interne et externe de la recherche scientifique et les coûts élevés de la collecte de grandes quantités de données axées sur le patient. Les dossiers dentaires des patients contiennent des renseignements valables qui donneraient aux chercheurs cliniques une opportunité d'utiliser un large éventail d'informations quantitatives ou qualitatives. La standardisation du dossier clinique permettrait d’échanger et de réutiliser des données dans différents domaines de recherche. Objectifs: Le but de cette étude était de concevoir un dossier patient axé sur la recherche dans le domaine de la prosthodontie amovible à la clinique de premier cycle de l’Université de Montréal. Méthodes: Cette étude a utilisé des méthodes de recherche-action avec 4 étapes séquentielles : l'identification des problèmes, la collecte et l'interprétation des données, la planification et l’évaluation de l'action. Les participants de l'étude (n=14) incluaient des professeurs, des chercheurs cliniques et des instructeurs cliniques dans le domaine de la prosthodontie amovible. La collecte des données a été menée à l’aide d’une revue de littérature ciblée et complète sur les résultats en prosthodontie ainsi que par le biais de discussions de groupes et d’entrevues. Les données qualitatives ont été analysées en utilisant QDA Miner 3.2.3. Résultats: Les participants de l'étude ont soulevé plusieurs points absents au formulaire actuel de prosthodontie à la clinique de premier cycle. Ils ont partagé leurs idées pour la conception d'un nouveau dossier-patient basé sur 3 objectifs principaux: les objectifs cliniques, éducatifs et de recherche. Les principaux sujets d’intérêt en prosthodontie amovibles, les instruments appropriés ainsi que les paramètres cliniques ont été sélectionnés par le groupe de recherche. Ces résultats ont été intégrés dans un nouveau formulaire basé sur cette consultation. La pertinence du nouveau formulaire a été évaluée par le même groupe d'experts et les modifications requises ont été effectuées. Les participants de l'étude ont convenu que le cycle de recherche-action doit être poursuivi afin d'évaluer la faisabilité d’implémentation de ce dossier modifié dans un cadre universitaire. Conclusion: Cette étude est une première étape pour développer une base de données dans le domaine de la prothodontie amovible. La recherche-action est une méthode de recherche utile dans ce processus, et les éducateurs académiques sont bien placés pour mener ce type de recherche.

Ethnographic methodologies for construction research: knowing, practice and interventions

Ethnographic methodologies developed in social anthropology and sociology hold considerable promise for addressing practical, problem-based research concerned with the construction site. The extended researcher-engagement characteristic of ethnography reveals rich insights, yet is infrequently used to understand how workplace realities are lived out on construction sites. Moreover, studies that do employ these methods are rarely reported within construction research journals. This paper argues that recent innovations in ethnographic methodologies offer new routes to: posing questions; understanding workplace socialities (i.e. the qualities of the social relationships that develop on construction sites); learning about forms, uses and communication of knowledge on construction sites; and turning these into meaningful recommendations. This argument is supported by examples from an interdisciplinary ethnography concerning migrant workers and communications on UK construction sites. The presented research seeks to understand how construction workers communicate with managers and each other and how they stay safe on site, with the objective of informing site health-and-safety strategies and the production and evaluation of training and other materials.

Mapping Educational Specialist knowHow (MESH): the building of a knowledge management system for research informed practice

In this invited article the authors present an evaluative report on the development of the MESHGuides project (http://www.meshguides.org/). MESHGuides’ objective is to provide education with an international knowledge management system. MESHGuides were conceived as research summaries for supporting teachers’ in developing evidence-based practice. Their aim is to enhance teachers’ capacity to engage actively with research in their own classrooms. The original thinking for MESH arose from the work of UK-based academics Professor Marilyn Leask and Dr Sarah Younie in response to a desire, which has recently gathered momentum in the UK, for the development of a more research-informed teaching profession and for the establishment of an on-line platform to support evidence-based practice (DfE, 2015; Leask and Younie 2001; OECD 2009). The focus of this article is on how the MESHGuides project was conceived and structured, the technical systems supporting it and the practical reality for academics and teachers of composing and using MESHGuides. The project and the guides are in the early stages of development, and discussion indicates future possibilities for more global engagement with this knowledge management system.

Factors associated with evidence-based practice among registered nurses in Sweden : a national cross-sectional study

Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation. Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models. Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0). Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

The challenge of managing continence care in residential aged care settings : recommendations for research and practice

Incontinence-related problems are a major reason for placement in residential aged care facilities. Data from the Residential Classification Scale indicates that 86% of people in residential aged care facilities in Australia are dependent on others for bladder management, 77% require some support with bowel management and 78% require some support with toileting. In this paper, we present an overview of the literature on the issues that need to be considered for the management of incontinence in residential aged care settings. Based on this literature, we make recommendations for research and practice. Although residential care facilities are mandated to provide continence care, there is little research evidence on which to base care or to evaluate the effectiveness of current practices. Further research is required to address this gap in information to ensure delivery of residential aged care that meets the requirements of the Aged Care Act 1997.

Evidence based practice: are critical care nurses ready for it?

In the emergence of the evidence based practice movement, critical care nurses have struggled to identify scientific evidence on which to base their clinical practice. While the lack of critical care nursing research is a major concern, other important issues have significantly stalled the implementation of evidence even when it is available. A descriptive study of 274 critical care nurses was undertaken to examine nursing research activity in Victorian critical care units. The study aimed to identify critical care nurses' research skills, the barriers encountered in participation and implementation and the current availability of resources.

Results revealed that 42 per cent of the nurses who participated in the study believed that they were not prepared adequately to evaluate research, and less than a third believed they were sufficiently skilled to conduct valid scientific studies. An association was found between nurses' ability to confidently perform research activities and higher academic qualifications. The study found that there is a lack of organisational support and management commitment for the development of evidence based nursing.

In order to facilitate the implementation of evidence based practice, clinicians must be made aware of the available resources, be educated and mentored when carrying out and using clinical research, and be supported in professional initiatives that promote evidence based practice. It is argued that this will have positive implications for patient outcomes in the critical care environment.

Selecting the right integration of research into practice strategy

Healthcare professionals need to be cognizant of integration of research into practice literature to advance clinical practice. This article describes the strengths and limitations associated with 10 currently used integration of research into practice strategies and the issues that need to be considered when selecting an appropriate strategy. Selecting the right strategy that ensures the uptake of best available evidence is an essential component of developing evidence-based practice and ultimately improving patient care.

Implementing a journal club in a palliative care setting : a link in the chain of evidence-based practice

This paper describes the implementation and evaluation of a journal club in a privately funded palliative care unit. Journal club meetings were initiated as part of a quality improvement process to foster the uptake of evidence-based practice. Nurses were presented with research articles each month and discussions were conducted focussing on methodological considerations of the research and implications of the research for patient care. The maximum number of attendees at any one meeting was nine and the minimum number was four. Overall, evaluations were positive about all aspects of the meetings. Attendees found that the selected articles were relevant, providing new information, stimulated discussion and reflection on clinical practice and encouraged further reading. One of the positive aspects of the meetings identified by participants was the facilitation style that enabled discussion in a safe and supportive environment. An important outcome of the meetings is the potential to explore evidence-based practices relevant to palliative care and to implement new practices or revise existing ones. As part of this process practice changes and clinical guidelines have been implemented. A dedicated facilitator with university links and a supportive organisational culture promoted club meetings as a practical way to provide clinical nurses with the opportunity to explore evidence-based research in the area of palliative care.