Group problem-solving skills training for self-harm: randomised controlled trial

Background: Rates of self-harm are high and have recently increased. This trend and the repetitive nature of self-harm pose a significant challenge to mental health services. Aims: To determine the efficacy of a structured group problem-solving skills training (PST) programme as an intervention approach for self-harm in addition to treatment as usual (TAU) as offered by mental health services. Method: A total of 433 participants (aged 18-64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6-week and 6-month follow-up and repeated hospital-treated self-harm was ascertained at 12-month follow-up. Results: The treatment groups did not differ in rates of repeated self-harm at 6-week, 6-month and 12-month follow-up. Both treatment groups showed significant improvements in psychological and social functioning at follow-up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6-week (P = 0.004) and 6-month (P = 0.01) follow-up. Repetition was not associated with waiting time in the PST group. Conclusions: This brief intervention for self-harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective.

Investigating practitioner self-efficacy in an era of mathematical reform

The purpose of this study is to explore teacher self-efficacy at a time of radical mathematical reform. Project Maths – the new initiative which was rolled out nationwide in 2010 differs from previous attempts at innovation in that it targets a much closer connection between curriculum and pedagogy. Gone are the days of well-rehearsed routines where the role of the mathematician was essentially that of demonstrator. Teaching for understanding is now the main ‘official’ pedagogical focus, with emphasis on the practitioner playing the part of mediator between subject-matter and student. Mathematical instruction is not merely concerned with the transmission of knowledge and skills which is a particular pedagogical position to take. It is also an emotional practice (Hargreaves, 1998) that colours and expresses the feelings and actions of practitioners. While emotion plays a key role in teachers’ commitment to curricular reform, it is also shaped by the social and cultural contexts of mathematical change, alongside with the attitudes and beliefs of the mathematical teaching community. Inspired by Bandura’s theory of learning (1986), this investigation aims to shed light on the complex interplay between so-called mastery and vicarious experiences, social persuasion and physiological states. Vygotsky’s view of learning (1978) as a socio-cultural process is also drawn upon, as it provides a useful structure against which teacher self-efficacy and professional development can be examined. Finally, Hiebert’s theory (1986) is used to examine mathematics teaching self-efficacy and mathematics self-efficacy.

Nurses', midwives' and key stakeholders' experiences and perceptions on requirements to demonstrate the maintenance of professional competence.

Aim: To present the qualitative findings from a study on the development of scheme(s) to give evidence of maintenance of professional competence for nurses and midwives. Background: Key issues in maintenance of professional competence include notions of self- assessment, verification of engagement and practice hours, provision of an evidential record, the role of the employer and articulation of possible consequences for non-adherence with the requirements. Schemes to demonstrate the maintenance of professional competence have application to nurses, midwives and regulatory bodies and healthcare employers worldwide. Design: A mixed methods approach was used. This included an online survey of nurses and midwives and focus groups with nurses and midwives and other key stakeholders. The qualitative data are reported in this study. Methods: Focus groups were conducted among a purposive sample of nurses, midwives and key stakeholders from January–May 2015. A total of 13 focus groups with 91 participants contributed to the study. Findings: Four major themes were identified: Definitions and Characteristics of Competence; Continuing Professional Development and Demonstrating Competence; Assessment of Competence; The Nursing and Midwifery Board of Ireland and employers as regulators and enablers of maintaining professional competence. Conclusion: Competence incorporates knowledge, skills, attitudes, professionalism, application of evidence and translating learning into practice. It is specific to the nurse's/midwife's role, organizational needs, patient's needs and the individual nurse's/midwife's learning needs. Competencies develop over time and change as nurses and midwives work in different practice areas. Thus, role-specific competence is linked to recent engagement in practice.