Peer assisted learning in health education.

There are many forms of Peer Assisted Learning (PAL). There are well-established theoretical models as to why PAL is proven to be effective across educational sectors. To maximise gains from PAL careful consideration needs to be given to the roles of peers. Evidence suggests that PAL projects with clearly defined roles for interaction result in strongest outcomes. Effect Sizes (ES) from meta-analyses of peer assisted learning indicate ES of between 0.25-0.50. Outcomes can be social and emotional as well as academic. PAL generally requires adaptation of existing resources and can be cost-effective to implement compared to other educational developments.

Special Education Today in the United Kingdom

This chapter attempts to provide a critical analysis of special needs education within the United Kingdom today. Central to such an analysis is an understanding of the rapidly changing social and political milieu within which special needs education is embedded, including the rapidly changing demographics of schooling, and the devolution of political power into four separate but linked countries - England, Wales, Scotland and Northern Ireland. Following a discussion of such wider social, political and educational issues, the authors thoroughly explore the convergences and divergences in policy and practice across the four devolved administrations. They describe a plethora of contemporary texts within each of the four administrations that speak to the need for special needs education to change in response to 21st century concerns about the problems of access to, and equity in education for all children. Despite this, they explain why they remain circumspect about the potential of such developments to lead to successful inclusive practices and developments on the ground. Their analysis in the last section centres on the issue of teacher education for inclusion and some very innovative UK research and development projects that have been reported to successfully engage teachers with new paradigm thinking and practice in the field of inclusive special needs education.

Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities

Background and objectives
Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. Although professionals’ perceptions of their training needs in this area have been studied, the perceptions of people with learning disabilities and family carers are not known. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training.

Methods
A qualitative, exploratory design was used. A total of 17 people with learning disabilities were recruited to two focus groups which took place within an advocacy network. Additionally, three family carers of someone with a learning disability, requiring palliative care, and two family carers who had been bereaved recently were also interviewed.

Results
Combined data identified the perceived learning needs for healthcare professionals. Three subthemes emerged: ‘information and preparation’, ‘provision of care’ and ‘family-centred care’.

Conclusions
This study shows that people with learning disabilities can have conversations about death and dying, and their preferred end-of-life care, but require information that they can understand. They also need to have people around familiar to them and with them. Healthcare professionals require skills and knowledge to effectively provide palliative care for people with learning disabilities and should also work in partnership with their family carers who have expertise from their long-term caring role. These findings have implications for educators and clinicians.

Learning, development, and support needs of community palliative care clinical nurse specialists

Background: The palliative care clinical nurse specialist (PC-CNS) is a core member of the specialist palliative care team. According to professional policy, the role has four specific components: clinical practice, education, research, and leadership and management. Little is known about how to support staff in this role. Aim: The aim of this study was to explore what learning, development, and support PC-CNSs in one hospice need to enable them to fulfil all components of their role. Design: Using a descriptive exploratory approach, semi-structured interviews were undertaken with a purposive sample of community PC-CNSs from a hospice in Northern Ireland. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Findings: Seventeen interviews were analysed and three themes identified: influence of organisational culture, influence of the individual, and learning and development solutions. Conclusions: Participants reported that the PC-CNS role was stressful. They identified that the organisational culture and indeed individuals themselves influenced the learning and development support available to help them fulfil the four components of the role. Working relationships and stability within teams affected how supported individuals felt and had implications for managers in meeting the needs of staff while balancing the needs of the service.

Informing pre-registration nurse education: a proposal outline on the value, methods and ethical considerations of involving children in doctoral research

As pre-registration nurse education programmes evolve within the United Kingdom, it is imperative to involve patient/client groups within the research process, as the outcome may invoke a change in the care delivery of the registered nurse (RN). This paper focuses upon children and how children might hypothetically contribute to informing a generic nursing programme in their capacity as a rights holder and expert in their own lives. Even though their contribution and value has been debated around their capacity as research advisor, research participant and co researcher, this paper explores how the child's view of their experience of hospital and of the good nurse could be best captured. Research is a powerful vehicle that can enable their voice to equally inform UK nurse educators and policy makers so that the child's health care needs are effectively met in hospital by RN's who complete a generic programme.

Changing policy and legislation in special and inclusive education: a perspective from Northern Ireland

It is now 15 years since the signing of the 1998 Belfast (or ‘Good Friday’) Peace Agreement which committed all participants to exclusively democratic and peaceful means of resolving differences, and towards a shared and inclusive society defined by the principles of respect for diversity, equality and the interdependence of people. In particular, it committed participants to the protection and vindication of the human rights of all. This is, therefore, a precipitous time to undertake a probing analysis of educational reforms in Northern Ireland associated with provision in the areas of inclusion and special needs education. Consequently, by drawing upon analytical tools and perspectives derived from critical policy analysis, this article, by Ron Smith from the School of Education, Queen’s University Belfast, discusses the policy cycle associated with the proposed legislation entitled Every School a Good School: the way forward for special educational needs and inclusion. It examines how this policy text structures key concepts such as ‘inclusion’, ‘additional educational needs’ and ‘barriers to learning’, and how the proposals attempt to resolve the dilemma of commonality and difference. Conceived under direct rule from Westminster (April 2006), issued for consultation when devolved powers to a Northern Ireland Assembly had been restored, and with the final proposals yet to be made public, this targeted educational strategy tells a fascinating story of the past, present and likely future of special needs education in Northern Ireland. Before offering an account of this work, it is placed within some broader ecological frameworks.

Exploring the needs of socially excluded young men

In recent years, social exclusion has gained the attention of governments around the world. This paper reports on a qualitative study involving 27 young men aged 14-19 years experiencing particular forms of exclusion in the context of Northern Irish society. The study used a focus group methodology to elicit their views with the aim of exploring both emotional and psychological needs and the structural factors that may contribute to their experiences of social exclusion. The findings reveal a range of unmet social and psychological needs, the impact of sectarianism and segregation, and a paucity of support systems in place. The paper concludes by making recommendations about how policy-makers and practitioners could find more imaginative ways of engaging such vulnerable young men to reduce social exclusion. 

Meeting the Needs of Vulnerable Young Men: A Study of Service Provider Views

This article uses a qualitative approach to elicit the views of 31 professionals who provide services to vulnerable young men. The findings reveal six key themes following focus group interviews: (i) the importance of masculinity in explaining problematic behaviour; (ii) the misuse of alcohol and drugs; (iii) alienation and social isolation; (iv) concerns about suicide and self-harm; (v) the quality of existing services; and (vi) recommendations for changes to services. Service providers generally acknowledged the social context in explaining these behaviours and argued for enhanced services and a more developed skills base in working with vulnerable young men. 

Does antenatal education prepare fathers for their role as birth partners and for parenthood?

A systematic review of the literature was undertaken to explore fathers' opinions and views on antenatal education and its effectiveness in preparing them for their role as birth partners and for parenthood. The findings are categorised under four key themes: outnumbered, excluded, anxious and uncertain, and preparedness. While research suggests that most fathers want to support their partners and be involved in the pregnancy, labour and birth of their baby, they are less likely to attend antenatal classes than women. While fathers who attend antenatal education classes value them, their experiences are not always as positive or helpful in preparing them for their role as birth partners or in parenthood. It was highlighted that men are more likely to feel unprepared when complications at birth arise. A common finding was that men would welcome the opportunity to focus on their individual needs.

Combining and integrating life /social sciences and citizen trainers in Nurse Education - a N. Ireland initiative

Before commencement of the academic year 2012/2013 the social sciences, public health and the biomedical sciences were taught to separate modules. This reinforced the idea off separate disciplines certainly for some of the younger students and a failure to appreciate the interconnectedness (whole person) perspective on health; separately modules taught and assessed in separate silos. There was limited understanding by the lecturers of the other areas that they were not teaching to -reflecting perhaps a dis-coordinated approach to health sciences (Mason and Whitehead 2003). As a result of significant discussion and interdisciplinary negotiation the life, social sciences public health/ health education were drawn together in the one module for the academic year 2012/13. The module provides the undergraduate students with an introduction to an understanding of Life Sciences, psychology, sociology and public health and their contribution within the context of nursing and midwifery. Each week’s teaching seeks to reflect against the other module delivered in first year - addressing clinical skills. The teaching is developing innovative e-learning approaches, including the use of a virtual community. The intention is to provide the student with a more integrated understanding and teaching to the individual’s health and to health within a social context (Lin 2001; Iles- Shih 2011). The focus is on health promotion rather than disease management. The module runs in three phases across the student’s first-year and teachers to the field of adult mental health, learning disability, children’s nursing and the midwifery students -progressively building on the student’s clinical experience. The predominant focus of the module remains on health and reflecting aspects of life and social life within N. Ireland. One of the particular areas of interest and an area of particular sensitivity is engaging the students to the context of the Northern Ireland civil unrest (the Troubles); this involves a co-educational initiative with service users, only previously attempted with social work students (Duffy 2012). The service users are represented by WAVE an organisation offering care and support to bereaved, traumatised or injured as a result of the violent civil conflict `the Troubles’. The `Troubles’ had ranged over an extended period and apart from the more evident and visual impact of death and injury, the community is marked by a disproportionate level of civil unrest, the extremes of bereavement, imprisonment, displacement antisocial behaviour and family dysfunction (Coulter et al. 2012). As co-educators with the School of Nursing and Midwifery, WAVE deliver a core lecture (augmented by online material), then followed by tutorials. The tutorials are substantially led by those who had been involved with and experienced loss and trauma as a result of the conflict (Health Service users) as `citizen trainers’ and provide an opportunity for them to share their experience and their recollection of personal interaction with nursing and midwifery students; in improving their understanding of the impact of `The Troubles’ on patients and clients affected by the events (Coulter et al. 2012) and to help better provide a quality of care cognisant of the particular needs of those affected by `the Troubles’ in N.Ireland. This approach is relatively unique to nursing in N. Ireland in that it involves many of those directly involved with and injured by the `Troubles’ as `citizen trainers’ and clearly reflects the School’s policy of progressively engaging with users and carers of nursing and midwifery services as co-educators to students (Repper & Breeze 2006). Only now could perhaps such a sensitive level of training to student nurses and midwives be delivered across communities with potential educative lessons for other communities experiencing significant civil unrest and sectarian conflict.

Does ageism still exist in nurse education?

Worldwide demographic changes mean that older people represent a significant group of patients for nurses everywhere. Ageism is increasingly recognised as an issue among healthcare professionals and evidence suggests that problems with quality of care remain. Nursing curricula have to address the needs of an ageing population in a variety of settings, reflect the importance of therapeutic care and explore nursing students’ attitudes, in order to provide them with the appropriate skills to meet the needs of older people. This article debates the main factors influencing gerontological content in nursing curricula and suggests that ageism is still evident in nurse education. A variety of strategies are identified to assist in developing appropriate curriculum content.

Caught in a 'spiral': barriers to healthy eating and dietary health promotion needs from the perspective of unemployed young people and their service providers

The number of young people in Europe who are not in education, employment or training (NEET) is increasing. Given that young people from disadvantaged backgrounds tend to have diets of poor nutritional quality, this exploratory study sought to understand barriers and facilitators to healthy eating and dietary health promotion needs of unemployed young people aged 16-20 years. Three focus group discussions were held with young people (n=14). Six individual interviews and one paired interview with service providers (n=7). Data were recorded, transcribed verbatim and thematically content analysed. Themes were then fitted to social cognitive theory (SCT). Despite understanding of the principles of healthy eating, a ‘spiral’ of interrelated social, economic and associated psychological problems was perceived to render food and health of little value and low priority for the young people. The story related by the young people and corroborated by the service providers was of a lack of personal and vicarious experience with food. External, environmental factors such as the proliferation and proximity of fast food outlets and the high perceived cost of ‘healthy’ compared to ‘junk’ food rendered the young people low in self-efficacy and perceived control to make healthier food choices. Agency was instead expressed through consumption of junk food and substance abuse. Both the young people and service providers agreed that for dietary health promotion efforts to succeed, social problems needed addressed and agency encouraged through (individual and collective) active engagement of the young people themselves.

Developing an information booklet to meet the needs of intensive care patients and relatives

Changes in the economic climate and the delivery of health care require that pre-operative information programmes are effective and efficiently implemented. In order to be effective the pre-operative programme must meet the information needs of intensive care unit (ICU) patients and their relatives. Efficiency can be achieved through a structured pre-operative programme which provides a framework for teaching. The need to develop an ICU information booklet in a large teaching hospital in Northern Ireland has become essential to provide relevant information and improve the quality of service for patients and relatives, as set out in the White Paper, ‘Working for Patients’, (DoH, 1989). The first step in establishing a patient education programme was to ascertain patients' and relatives' informational needs. A ‘needs assessment’ identified the pre-operative information needs of ICU patients and their relatives (McGaughey, 1994) and the findings were used to plan and publish an information booklet. The ICU booklet provides a structure for pre-operative visits to ensure that patients and relatives information needs are met.

Growing Up On an Interface: Findings and Implications for the Social Needs, Mental Health and Lifetime Opportunities of Belfast Youth

In this research we aimed to find out what types of risk (if any) affected young people and children growing up in places of high religious segregation or what we normally call interface communities. This is important as we know that risk and experiences of harm and violence can have negative impacts upon development, emotional well-being and future prospects. It is important to understand what types of risk affect young people and children so as we can respond to these in terms of aiding better personal and community development with regard to health, work, education and wider opportunities.