'Murder or Mercy?' an innovative module helping UK medical students to articulate their own ethical standpoints regarding end-of-life decisions

Objectives This student selected component (SSC) was designed to equip United Kingdom (UK) medical students to respond ethically and with sensitivity to requests they might receive as qualified doctors in regard to euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and to provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment. Method The module is delivered by specialists from a number of disciplines including law, theology, medicine and nursing, each providing students with a working knowledge allowing them to actively discuss cases, articulate their own views and practise ethical reasoning through group and individual study. Visits to local intensive care units, palliative care wards and hospices are integrated effectively with theory. Student assessment comprises a dissertation, student-led debate and reflective commentary. Module impact was evaluated by analysis of student coursework and a questionnaire. Results Students found the content stimulating and relevant to their future career and agreed that the module was well-structured and that learning outcomes were achieved. They greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to real cases and to debate ethical issues with peers. Students reported an increased discernment of the ethical and legal position and practical considerations and a greater awareness of the range of professional and lay viewpoints held. Student perceptions were confirmed on analysis of their submitted coursework. Many participants were less strongly in favour of euthanasia and assisted dying on module completion than at the outset but all felt better equipped to justify their own viewpoint and to respond appropriately to patient requests. Conclusions The multi-disciplinary nature of this course is helpful in preparing students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position.

Special Needs Education, eLearning and the Reflective ePortfolio: Implications for Developing and Assessing Competence in Pre-Service Education.

This paper reports on the use of an eportfolio for assessing aspects of a Post-Graduate pre-service teacher education programme specifically in the context of special needs education in Northern Ireland. Participants were challenged to develop their individual eportfolios by selecting and presenting evidence for assessment drawn from diverse sources. The rationale for using eportfolios for assessment purposes was to offer students the opportunity to demonstrate competencies by documenting and reflecting upon academic and pedagogical learning during a one year Post Graduate Certificate of Education (PGCE) programme.

Evidencing reflective practice in social work education: Theoretical uncertainties and practical challenges

Reflective practice has become an increasingly influential idea in social work education and, in the UK context, it has recently been acknowledged as key to ensuring that social workers are better equipped to engage in complex decision making and effective practice. However, there remains a lack of clarity about how this concept is defined and operationalised in teaching and learning and there has been little systematic empirical examination of its utility in facilitating professional development. Drawing on research with undergraduates at Queen's University Belfast, this paper aims to develop understanding of students' experience of reflective practice. The results suggest that agency systems that have become over-reliant on rules and procedures present formidable obstacles to learning both at an individual and at an organisational level. The paper argues that the relationship between how reflective practice is taught and how it is enacted in practice needs to be better understood if such obstacles are to be overcome. The paper concludes by considering the implications of the findings for developing reflective practice in social work education and practice and highlights the challenges that need to be addressed if reflection and critical thinking are to become more firmly embedded within agency systems and practice cultures.

Moving to evidence-based practice in long-term care:the role of a Best Practise Resource Centre in two long-term care settings.

In this article, the authors provide an overview on the development of a Long-Term Care Best Practise Resource Centre. The results of both a feasibility study and the outcomes of a 1-year demonstration project are presented. The demonstration project involved a hospital as the information service provider and two demonstration sites, a home care service agency and a nursing home that used the services of the Centre. The goals of the Centre were threefold: provide access to literature for staff in long-term care (LTC) settings; improve the information management skills of health care providers; and support research and the integration of best practices in LTC organizations. The results of the pilot study contributed to the development of a collaborative information access system for LTC clinicians and managers that provides timely, up-to-date information contributing to improving the quality of care for adults receiving LTC. Based on this demonstration project, strategies for successful innovation in LTC are identified.

M level Inquiry Across Disciplinary Boundaries: Using Reflective Sketchbooks

Debates unfolding around the recent development of M Level programmes for teacher education are not unfamiliar to those being addressed in other professional disciplines such as business. A strong theme in our analysis is that reflective practitioners could be provided with a wider range of tools and methods to support them in their reflection. Considerable energies have been expended on e portfolios, but our experience of use of paper based reflective
sketchbooks suggests that they may have some distinct advantages over text-dominated electronic media. In fact such sketchbooks challenge typed text as the dominant route to learning and communication (Gilbert 1998), (New, 2005), (Hickman, 2007). Professionals in teacher education are currently exploring ways in which M level can be conceived in terms of professional learning. This is also important terrain in other professions. For example, best practice in business management involves constant innovation so that students do not experience a split between the research context of the business faculty and the experience of operating in the business situation. This is paralleled in education by the concern that trainees do not experience a split between the research or scholarly informed approach of university tutors, and the experience of practical teaching in school. Our research question is concerned with how a consciously developed reflective sketchbook method can generate levels of critical thought that are both postgraduate and professionally valued in the workplace. We are also interested in the contribution this form of enquiry at M Level can make in terms of life long learning.