Leadership for inclusion: Conceptualising and enacting inclusion in integrated schools in a troubled society

Inclusion is increasingly understood as an educational reform that responds to the diversity of all learners, challenging the marginalization, exclusion and underachievement which may result from all forms of ‘difference’. Leadership for inclusion is conceptualized here as driving a constant struggle to create shared meanings of inclusion and to build collaborative practice, an effort that needs to be rooted in critical practice lest it risk replicating existing patterns of disadvantage. In response to calls for further research that challenge how school leaders conceptualize inclusion and for research that investigates how leaders enact their understandings of inclusion, this paper aims to increase our understanding of the extent to which leadership vision can map onto a school’s culture and of the organizational conditions in schools that drive responses to diversity. We investigate the enactment of leadership for inclusion in the troubled context of Northern Ireland by looking at two schools that primarily aim to integrate Catholic and Protestant children but which are also sites for a range of other dimensions of student ‘difference’ to come together. Whilst the two schools express differing visions of the integration of Catholics and Protestants, leadership vision of inclusion is enacted by members of the school community with a consensus around this vision brought about by formal and informal aspects of school culture. Multiple and intersecting spheres of difference stimulate a concerted educational response in both schools but integration remains the primary focus. In this divided society, religious diversity poses a significant challenge to inclusion and further support is required from leaders to enable teachers to break through cultural restraints.

A leadership framework to support the use of e-learning resources

Aim
This inquiry aims to apply the NHS leadership framework to nurse education for the implementation of e-learning.
Background
Recognition needs to be given to the emerging postgraduate nursing students new status of consumer and the challenge now for nurse education is how to remain relevant and competitive in this consumer led market. The move towards an e-learning paradigm has been suggested as a competitive and contemporary way forward for the student consumer. The successful introduction of e-learning in nurse education will require leadership and a strong organisational management system.
Discussion
Each element of the NHS leadership framework is described and interpreted for application in a higher education setting for the implementation of e-learning.
Conclusions
Change in the delivery of post graduate nurse education is necessary to ensure it remains current and reflective of consumer need in a competitive marketplace. By applying a leadership framework that acknowledges the skills and abilities of staff and encourages the formation of collaborative partnerships from within the wider university community, educators can begin to develop skills and confidence in teaching using e-learning resources.

Establishing a nurse practitioner collaborative: evolution, development, and outcomes

The first Australian palliative care nurse practitioner (NP) was endorsed in 2003. In 2009 the Victoria Department of Health funded the development of the Victorian Palliative Care Nurse Practitioner Collaborative (VPCNPC). Its aim was to promote the NP role, develop resources, and provide education and mentorship to NPs, nurse practitioner candidates (NPCs), and health service managers. Four key objectives were developed: identify the demographic profile of palliative care NPCs in Victoria; develop an education curriculum and practical resources to support the training and education of palliative care NPCs and NPs; provide mentorship to NPs, NPCs, and service managers; and ensure effective communication with all key stakeholders. An NPC survey was also conducted to explore NPC demographics, models of care, the hours of study required for the role, the mentoring process, and education needs. This paper reports on the establishment of the VPCNPC, the steps taken to achieve its objectives, and the results of the survey. The NP role in palliative care in Australia continues to evolve, and the VPCNPC provides a structure and resources to clearly articulate the benefits of the role to nursing and clinical services. The advanced clinical practice role of the nurse practitioner (NP) has been well established in North America for several decades and across a range of specialties (Ryan-Woolley et al, 2007; Poghosyan et al, 2012). The NP role in Australia and the UK is a relatively new initiative that commenced in the early 2000s (Gardner et al, 2009). There are over 1000 NPs across all states and territories of Australia, of whom approximately 130 work in the state of Victoria (Victorian Government Health Information, 2012). Australian NPs work across a range of specialties, including palliative, emergency, older person, renal, cardiac, respiratory, and mental health care. There has been increasing focus nationally and internationally on developing academic programmes specifically for nurses working toward NP status (Gardner et al, 2006). There has been less emphasis on identifying the comprehensive clinical support requirements for NPs and NP candidates (NPCs) to ensure they meet all registration requirements to achieve and/or maintain endorsement, or on articulating the ongoing requirements for NPs once endorsed. Historically in Australia there has been a lack of clarity and limited published evidence on the benefits of the NP role for patients, carers, and health services (Quaglietti et al, 2004; Gardner and Gardner, 2005; Bookbinder et al, 2011; Dyar et al, 2012). An NP is considered to be at the apex of clinical nursing practice. The NP role typically entails comprehensively assessing and managing patients, prescribing medicines, making direct referrals to other specialists and services, and ordering diagnostic investigations (Australian Nursing and Midwifery Council, 2009). All NPs in Australia are required to meet the following generic criteria: be a registered nurse, have completed a Nursing and Midwifery Board of Australia approved postgraduate university Master's (nurse practitioner) degree programme, and be able to demonstrate a minimum of 3 years' experience in an advanced practice role (Nursing and Midwifery Board of Australia, 2011). An NPC in Victoria is a registered nurse employed by a service or organisation to work toward meeting the academic and clinical requirements for national endorsement as an NP. During the period of candidacy, which is of variable duration, NPCs consolidate their competence to work at the advanced practice level of an NP. The candidacy period is a process of learning the new role while engaging with mentors (medical and nursing) and accessing other learning opportunities both within and outside one's organisation to meet the educational requirements. Integral to the NP role is the development of a model of care that is responsive to identified service delivery gaps that can be addressed by the skills, knowledge, and expertise of an NP. These are unique to each individual service. The practice of an Australian NP is guided by national standards (Nursing and Midwifery Board of Australia 2014). It is defined by four overarching standards: clinical, education, research, and leadership. Following the initial endorsement of four Victorian palliative care NPs in 2005, there was a lull in recruitment. The Victoria Department of Health (DH) recognised the potential benefits of NPs for health services, and in 2008 it provided funding for Victorian public health services to scope palliative care NP models of care that could enhance service delivery and patient outcomes. The scoping strategy was effective and led to the appointment of 16 palliative care nurses to NPC positions over the ensuing 3 years. The NPCs work across a broad range of care settings, including inpatient, community, and outpatient in metropolitan, regional, and rural areas of Victoria. At the same time, the DH also funded the Centre for Palliative Care to establish the Victorian Palliative Care Nurse Practitioner Collaborative (VPCNPC) to support the NPs and NPCs. The Centre is a state-wide service that is part of St Vincent's Hospital Melbourne and a collaborative Centre of the University of Melbourne. Its primary function is to provide training and conduct research in palliative care. The purpose of the VPCNPC was to provide support and mentorship and develop resources targeted at palliative care NPs, NPCs, and health service managers. Membership of the VPCNPC is open to all NPs, NPCs, health service managers, and nurses interested in the NP role. The aim of this paper is to describe the development of the VPCNPC, its actions, and the outcomes of these actions.