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.

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.

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.

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.

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.

A Multinational Health Professional Perspective of the Prevalence of Mood Disorders in Patients with Acute and Chronic Wounds.

Recent research has started to identify mood disorders and problems associated with acute and chronic wounds, which have been shown to contribute to delayed healing, poor patient well-being and a reduced quality of life. Furthermore, mood disorders have been shown to have a negative impact on financial costs for service providers and the wider society in terms of treatment and sickness absence. This study aimed to survey a multinational sample of health professionals to explore their perspective and awareness of mood disorders amongst acute and chronic wound patients. Responses were received from n = 908 health professionals working in Asia, Africa, Australia, Europe, North America and South America. A strong awareness of the prevalence of mood disorders appeared to be widespread among the health professionals across the world, in addition to a view on the potential factors contributing to these problems with mood. Despite this, it was thought that few patients were actually receiving treatment for their mood disorders. Implications for clinical practice include the need for health professionals to actively engage with their patients to enable them to learn from their experiences. Studies that explore the benefits of treatments and techniques appropriate for minimising mood disorders in patients with wounds would provide empirical evidence for health professionals to make recommendations for patients with acute and chronic wounds.

Best Practice for Providing Social Care and Support to People Living with Concurrent Sight Loss and Dementia: Professional Perspectives

Purpose-Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions. Design/methodology/approach-The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors. Findings-Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences. Research limitations/implications-Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area. Practical implications-There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working. Social implications-People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact. Originality/value-This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care

Legal, Ethical and Professional Issues

The chapter addresses the professional, legal and ethical issues associated with medicines management and the role of the nurse. To ensure safe practice it is imperative safeguards are recognised and applied; therefore pertinent legislative frameworks, policy and professional regulation are discussed. Safeguarding patients when administering prescribed medicines means the nurse must have up-to-date knowledge and skill and a key aspect of this is to ensure consent to treatment from the service user is secured; for this reason drawing on relevant legislation, the consensual process is reviewed. Not infrequently medicine management provokes ethical and legal challenges for the health care professional; these demand reflection and careful consideration; consequently in this chapter legal and ethical parameters and professional boundaries are appraised.

Bridging the Divide in Work and Occupational Psychology: Evidence From Practice

This study explores the extent to which work and organizational (W&O) psychology practitioners use evidence, how they apply it to the everyday contexts in which they work and the types of barriers they encounter in so doing. It adopts a mixed methods approach involving the administration of a survey to a UK sample (N=163) of W&O psychologists and a series of semi-structured interviews (N=25) exploring in greater depth how evidence is applied in practice. Findings reveal that practitioners consult a wide range of different types of evidence which they employ at various stages of engagement with client organisations and that this evidence is pressed into service in the pursuit of solutions which are both acceptable from the client perspective and consistent with the scientific standards underpinning professional knowledge and expertise in W&O psychology. Barriers to evidence-use were mainly practical in nature, concerning issues around managing the client-consultant relationship and the particularities of implementation context, both of which were shown to influence evidence utilisation. The study contributes to current debate on the extent to which W&O psychologists adopt an evidence-based approach and provides a valuable and much called-for empirical insight into the enactment of the scientist-practitioner model in W&O psychology

Changing Professional Identity in the Transition from Practitioner to Lecturer in Higher Education: an Interpretive Phenomenological Analysis

This research explores the experiences of five professional practitioners from disciplines including teaching, youth work, sport and health who had become lecturers in Higher Education. Their experiences are considered using Interpretative Phenomenological Analysis and tentative conclusions are reached on the meaning of such experiences for the individuals. The work extends previous studies (Shreeve 2010, 2011; Gourlay 2011a, 2011b; Boyd & Harris 2010) to consider the relationship between knowledge and influence and how institutional preference for knowledge gained from research impacts on the validity of knowledge derived from professional experience. The research finds shared feelings associated with inauthenticity and loss arising from concerns that the contribution of the professional in Higher Education is undervalued. The research challenges the assumption that professional practitioners adopt the professional identity of a lecturer in Higher Education instead finding that they create their own professional identities in the liminal space between the professional and academic domains, but points to difficulties associated with constructed nature of such professional identities within the institutional structure of a Higher Education institution.

Unpacking the Link Between Entrepreneurialism and Employability: an Assessment of the Relationship Between Entrepreneurial Attitudes and Likelihood of Graduate Employment in a Professional Field

Purpose This research investigates the relationship between students’ entrepreneurial attitudes and traits and their classification of employment six months after university graduation. It aims to identify what specific attitudes and traits of entrepreneurial graduates are linked to employability in a professional or managerial field. Design/Methodology The research adopts a quantitative approach to measure the entrepreneurial drive of final-year undergraduate business school students and regresses this measurement against the employment level of the same students six months after their graduation. The employment classification of each respondent was classified as ‘professional/managerial’ or ‘non-professional/non-managerial’, in line with the Standard Occupational Classification (SOC) 2010. Findings The research found that both proactive disposition and achievement motivation were statistically linked to the likelihood of graduates being employed in a professional or managerial position six months after graduation. Originality/Value This research goes beyond existing literature linking entrepreneurship to employability to quantitatively examine what specific attitudes and traits can be linked to employability in recent graduates. By identifying the aspects of entrepreneurialism that have a relationship with employability, more information is available for educators who are designing entrepreneurial education programs and allows for greater focus on aspects that may be of greatest benefit to all students.

A Global Portrait of Counselling Psychologists’ Characteristics, Perspectives, and Professional Behaviors

Counselling psychologists in eight countries (Australia, Canada, New Zealand, South Africa, South Korea, Taiwan, the United Kingdom, and the United States) responded to survey questions that focused on their demographics as well as their professional identities, roles, settings and activities. As well, they were asked about satisfaction with the specialty and the extent to which they endorsed 10 core counselling psychology values. This article reports those results, focusing both on areas in which there were between-country similarities as well as on those for which there were differences. These data provide is a snapshot of counselling psychology globally and establish a foundation for the other articles in this special issue of the journal.