Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

Developing Innovative TEL Practice in Teacher Education

This interactive symposium will focus on the use of different technologies in developing innovative practice in teacher education at one university in England. Technology Enhanced Learning (TEL) is a field of educational policy and practice that has the power to ignite diametrically opposing views and reactions amongst teachers and teacher educators, ranging across a spectrum from immense enthusiasm to untold terror. In a field where the skills and experience of individuals vary from those of digital natives (Prensky 2001) to lags and lurkers in digital spaces, the challenges of harnessing the potential of TEL are complex. The challenges include developing the IT skills of trainees and educators and the creative application of these skills to pedagogy in all areas of the curriculum. The symposium draws on examples from primary, secondary and post-compulsory teacher education to discuss issues and approaches to developing research capacity and innovative practice using different etools, many of which are freely available. The first paper offers theoretical and policy perspectives on finding spaces in busy professional lives to engage in research and develop research-informed practice. It draws on notions of teachers as researchers, practitioner research and evidenc-ebased practice to argue that engagement in research is integral to teacher education and an empowering source of creative professional learning for teachers and teacher educators. Whilst acknowledging the challenges of this stance, examples from our own research practice illustrate how e-tools can assist us in building the capacity and confidence of staff and students in researching and enhancing teaching, learning and assessment practice. The second paper discusses IT skills development through the TEL pathway for trainee teachers in secondary education across different curriculum subjects. The lead tutor for the TEL pathway will use examples of activities developed with trainee teachers and university subject tutors to enhance their skills in using e-tools, such as QR codes, Kahoot, Padlet, Pinterest and cloud based learning. The paper will also focus on how these skills and tools can be used for action Discussant - the wider use of technologies in a university centre for teacher education; course management, recruitment and mentor training. research, evaluation and feedback and for marking and administrative tasks. The discussion will finish with thoughts on widening trainee teachers’ horizons into the future direction of educational technology. The third paper considers institutional policies and strategies for promoting and embedding TEL, including an initiative called ‘The Learning Conversation’, which aims ‘to share, highlight, celebrate, discuss, problematise, find things out...’ about TEL through an online space. The lead for ‘The Learning Conversation’ will offer reflections on this and other initiatives across the institution involving trainee teachers, university subject tutors, librarians and staff in student support services who are using TEL to engage, enthuse and support students on campus and during placements in schools. The fourth paper reflects on the use of TEL to engage with trainee teachers in post-compulsory education. This sector of education and training is more fragmented than primary and secondary schools sectors and so the challenges of building a community of practice that can support the development of innovative practice are greater.

GPs Experience of Caring for Children with Cancer Receiving Palliative Care at Home

Background The study being undertaken builds on earlier work that found general practitioners (GPs) were at times uncertain of their role in paediatric palliative care and questioned whether their involvement had been beneficial to the child and family. The rarity of childhood cancer makes it difficult for GPs to develop or maintain palliative care knowledge and skills yet the GP is perceived by the family as the gatekeeper of care within the community. Aim The study is examining GPs perception of their role in caring for an individual child with cancer receiving palliative care and comparing this with families' perceptions of their GP's roles. Methodology The methodology incorporates tape-recorded semi-structured interviews, thematic framework analysis and Q methodology (QM) to capture the experiences of GPs who have cared for a child with cancer receiving palliative care as well as the perspectives of care experienced by the families. The semi-structured interview sample comprises 10 families (parents/guardians) whose child has been treated at a regional childhood cancer centre and their GPs. A further 40–60 GPs will be involved in the QM. Findings Findings detailing GP experiences from the initial study along with the preliminary findings of the semi-structured interviews with parents and GPs will be presented. Papers' contribution The results will identify and clarify GPs perceptions of their roles, and what families perceive their GPs role to be, enabling development of strategies to support GPs roles. It is anticipated that findings will inform the wider field of palliative care generally and the practice of both hospital and community paediatricians.