Understanding the Patient Experience Through the Power of Film: a Mixed Method Qualitative Research Project

Film is a highly attractive teaching instrument for the study of different terminal diseases, exploring bioethics (Beauchamp and Childress, 2009) and is a preferred medium over traditional lectures (Edmunds, 2013) to provide realistic examples for adult learners. It can tap into ethical issues; facilitate decision-making; and examine underlying issues such as euthanasia; assisted suicide; and professional responsibility. Contrast this with standard means of teaching, such as scenarios- although a useful pedagogic tool, these are limited because students must imagine the clinical scenario. Film can fill that imaginative gap (Volandes, 2007). It can be utilised as an active teaching strategy for a variety of topics in nursing (Edmunds, 2013) providing a unique way to promote active learning in nursing education (Herrman, 2006). The objectives of the study, aim to help pre registration student nurses from each year of study to engage with their role as health care professionals; provide open discussion and debate on how they view the personal experience of illness/disease/disability/death and to reflect on their role and provision of patient care. It is delivered in 3 tiers to provide a range of data for thematic analysis; 1) Film screening followed by a ‘5 minute reaction’ discussion and post screening questionnaire; 2) Pre screening guided activities for reflection and discussion; 3) Focus groups. This project meets identified aims from the UK Professional Standards Framework (UKPSF) by fostering creative and innovative approaches to teaching and learning; facilitating and supporting the design and delivery of continuing education development programmes and activities; and demonstrates professionalism that staff and institutions bring to teaching. Preliminary feedback and themes will be presented.

Reform, Standards and Teacher Identity: Challenges of Sustaining Commitment

Teacher commitment has been found to be a critical predictor of teachers’ work performance, absenteeism, retention, burnout and turnover, as well as having an important influence on students’ motivation, achievement, attitudes towards learning and being at school (Firestone (1996). Educational Administration Quarterly, 32(2), 209–235; Graham (1996). Journal of Physical Education, Recreation and Dance, 67(1), 45–47; Louis (1998). School Effectiveness and School Improvement, 9(1), 1–27; Tsui & Cheng (1999). Educational Research and Evaluation, 5(3), 249–268). It is also a necessary ingredient to the successful implementation, adaptation or resistance reform agendas. Surprisingly, however, the relationship between teachers’ motivation, efficacy, job satisfaction and commitment, and between commitment and the quality of their work has not been the subject of extensive research. Some literature presents commitment as a feature of being and behaving as a professional (Helsby, Knight, McCulloch, Saunders, & Warburton (1997). A report to participants on the professional cultures of Teachers Research Project, Lancaster University, January). Others suggest that it fluctuates according to personal, institutional and policy contexts (Louis (1998). School Effectiveness and School Improvement, 9(1), 1–27) and identify different dimensions of commitment which interact and fluctuate (Tyree (1996). Journal of Educational Research, 89(5), 295–304). Others claim that teachers’ commitment tends to decrease progressively over the course of the teaching career (Fraser, Draper, & Taylor (1998). Evaluation and Research in Education, 12 (2), 61–71; Huberman (1993). The lives of teachers. London: Cassell). In this research, experienced teachers in England and Australia were interviewed about their understandings of commitment. The data suggest that commitment may be better understood as a nested phenomena at the centre of which is a set of core, relatively permanent values based upon personal beliefs, images of self, role and identity which are subject to challenge by change which is socio-politically constructed.

The Personal and Professional Selves of Teachers: Stable and Unstable Identities

In much educational literature it is recognised that the broader social conditions in which teachers live and work, and the personal and professional elements of teachers' lives, experiences, beliefs and practices are integral to one another, and that there are often tensions between these which impact to a greater or lesser extent upon teachers' sense of self or identity. If identity is a key influencing factor on teachers' sense of purpose, self‐efficacy, motivation, commitment, job satisfaction and effectiveness, then investigation of those factors which influence positively and negatively, the contexts in which these occur and the consequences for practice, is essential. Surprisingly, although notions of ‘self’ and personal identity are much used in educational research and theory, critical engagement with individual teachers' cognitive and emotional ‘selves’ has been relatively rare. Yet such engagement is important to all with an interest in raising and sustaining standards of teaching, particularly in centralist reform contexts which threaten to destabilise long‐held beliefs and practices. This article addresses the issue of teacher identities by drawing together research which examines the nature of the relationships between social structures and individual agency; between notions of a socially constructed, and therefore contingent and ever‐remade, ‘self’, and a ‘self’ with dispositions, attitudes and behavioural responses which are durable and relatively stable; and between cognitive and emotional identities. Drawing upon existing research literature and findings from a four‐year Department for Education and Skills funded project with 300 teachers in 100 schools which investigated variations in teachers' work and lives and their effects on pupils (VITAE), it finds that identities are neither intrinsically stable nor intrinsically fragmented, as earlier literature suggests. Rather, teacher identities may be more, or less, stable and more or less fragmented at different times and in different ways according to a number of life, career and situational factors.

Variations in the Work and Lives of Teachers: Relative and Relational Effectiveness

The VITAE project is a four‐year (2001–2005) research study, commissioned by the Department for Education and Skills, conducted with 300 teachers in 100 schools in seven local education authorities in England. The project aimed to identify factors that may affect their work and lives over time and how these factors may, in turn, impact on their teaching and subsequent pupil progress and outcomes. It combined quantitative and qualitative methods of data collection and analysis in order to define and examine notions of teachers' relational and relative effectiveness. The first part of the paper addresses the nature of effectiveness and three key themes relating to the changing contexts of teachers' work, lives and effectiveness: the challenge of reform to notions of professionalism; professional identities; changes in teachers' work and lives. The research design and early findings and their effects upon the development of the research form the second part. The final part of the paper discusses three sets of understandings which are fundamental to any consideration of teachers' work, lives and effectiveness: relative and relational effectiveness; teacher identities; teachers' life and work contexts. The research suggests that policy‐makers, school leaders and teachers themselves need to attend to these if teacher recruitment, retention and standards are to improve.

Supporting Completion of an Online Continuing Professional Development Programme For Newly Qualified Practitioners: a Qualitative Evaluation

Background: Development programmes to support newly qualified practitioners gain confidence in their first professional role often show varied levels of engagement, due to competing priorities and demands. In Scotland, the Flying Start NHS® programme uses a structured programme of online and work-based learning with associated mentoring, to support individuals through an often difficult transition to become capable, confident practitioners. . Whilst the programme was generally well received, the factors leading to widely varying completion rates between professions and organisations were not well understood. Aim: to identify the factors leading to successful completion of Flying Start, a transition programme for newly qualified practitioners. Method: A qualitative approach was adopted to gather data from two groups of participants. Semi-structured telephone interviews were conducted with strategic and management level participants (n=23), from five health boards in Scotland. Semi-structured interviews (n=22) and focus groups (n=11) were conducted with practitioners within 6 months either side of completing the programme. The interviews were transcribed and analysed using framework analysis. Results: Four key themes related to successful completion emerged from the analysis: organisational support; the format of the programme; understanding completion; motivation and incentives to complete. Factors leading to successful completion were identified at programme, organisational and individual level. These included clear communication and signposting, up-to-date and relevant content, links with continuing professional development frameworks, effective leadership, mentor and peer support, setting clear standards for assessment, and facilitating appropriate IT access. Conclusions: A strong strategic commitment to embedding a development programme for newly qualified practitioners can ensure the necessary support is available to encourage timely completion. The mentor’s role - to provide face-to-face support - is identified as a key factor in completion and is achieved through setting attainable targets, monitoring progress, and providing motivation. However organisational structures that facilitate the mentoring relationship are also necessary.

A Video Analysis of Intra- and Inter-professional Leadership Behaviours Within “The Burns Suite”: Identifying Key Leadership Models

Objective Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of “The Burns Suite” (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. Methods A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen’s κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. Results All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence “maintaining standards”), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that “distributed leadership” was predominant, whereby leadership was “distributed” or “shared” among team members. The leadership behaviors within TBS also seemed to fall in line with the “direction, alignment, and commitment” ontology. Conclusions Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education.

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.