Caring for Children Dying from Cancer at Home: a Qualitative Study of the Experience of Primary Care Practitioners

Background. The rarity of childhood cancers makes providing palliative care in the community an unusual event for primary care practitioners. Providing this care requires effective interprofessional collaboration with the team that forms to provide the care often working together for the first and only time. Objective. To explore the experiences of primary care practitioners following their involvement in the palliative care of a child with cancer at home. Methods. The study design was a community-based qualitative study. The study location was the West Midlands region. Purposeful sample of GPs and community nurses involved in providing palliative care to 12 children. One-to-one in-depth interviews with 47 primary care professionals (10 GPs and 37 community nurses) and 5 facilitated case discussions were undertaken. Field notes were documented and grounded theory data analysis undertaken: chronological comparative data analysis identifying generated themes. Results. GPs had minimal input into the preceding care of children undergoing treatment for cancer but sought to re-establish their role at the child’s transition to palliative care. GPs felt they had a role to play and could add value to this phase of care, highlighted their continuing role with the child’s family and acknowledged that they had gained from the experience of contributing. However, lack of specialist knowledge and uncertainty about their role within the team made this more challenging. In contrast, community nurses were routinely involved in both active treatment and palliation care phases. There was little evidence of collaboration between the specialist and primary care professionals involved. There was considerable variation in out of hours provision across cases. Conclusions. Engaging primary care practitioners needs to be more actively anticipated and negotiated at the transition to palliation. Variation in out of hours care is another cause for concern. Enhancing inter-professional collaboration and planning during both active and palliative care phases may help. Keywords. Cancer, family medicine, palliative care, paediatric.

Exploring the Success of Student Experiential Learning through Entrepreneurial Opportunities

Academic literature has increasingly recognized the value of non-traditional higher education learning environments that emphasize action-orientated experiential learning for the study of entrepreneurship (Gibb, 2002; Jones & English, 2004). Many entrepreneurship educators have accordingly adopted approaches based on Kolb’s (1984) experiential learning cycle to develop a dynamic, holistic model of an experience-based learning process. Jones and Iredale (2010) suggested that entrepreneurship education requires experiential learning styles and creative problem solving to effectively engage students. Support has also been expressed for learning-by-doing activities in group or network contexts (Rasmussen and Sorheim, 2006), and for student-led approaches (Fiet, 2001). This study will build on previous works by exploring the use of experiential learning in an applied setting to develop entrepreneurial attitudes and traits in students. Based on the above literature, a British higher education institution (HEI) implemented a new, entrepreneurially-focused curriculum during the 2013/14 academic year designed to support and develop students’ entrepreneurial attitudes and intentions. The approach actively involved students in small scale entrepreneurship activities by providing scaffolded opportunities for students to design and enact their own entrepreneurial concepts. Students were provided with the necessary resources and training to run small entrepreneurial ventures in three different working environments. During the course of the year, three applied entrepreneurial opportunities were provided for students, increasing in complexity, length, and profitability as the year progressed. For the first undertaking, the class was divided into small groups, and each group was given a time slot and venue to run a pop-up shop in a busy commercial shopping centre. Each group of students was supported by lectures and dedicated class time for group work, while receiving a set of objectives and recommended resources. For the second venture, groups of students were given the opportunity to utilize an on-campus bar/club for an evening and were asked to organize and run a profitable event, acting as an outside promoter. Students were supported with lectures and seminars, and groups were given a £250 budget to develop, plan, and market their unique event. The final event was optional and required initiative on the part of the students. Students were given the opportunity to develop and put forward business plans to be judged by the HEI and the supporting organizations, which selected the winning plan. The authors of the winning business plan received a £2000 budget and a six-week lease to a commercial retail unit within a shopping centre to run their business. Students received additional academic support upon request from the instructor, and one of the supporting organizations provided a training course offering advice on creating a budget and a business plan. Data from students taking part in each of the events was collected, in order to ascertain the learning benefits of the experiential learning, along with the successes and difficulties they faced. These responses have been collected and analyzed and will be presented at the conference along with the instructor’s conclusions and recommendations for the use of such programs in higher educations.