Identifying criteria for the assessment of pharmacy students' communication skills with patients

Objectives To identify criteria by which patients can assess the communication skills of pharmacy students. Method Potential assessment criteria were generated from 2 main sources: a literature review and a focus group discussion. A modified two-round Delphi survey was subsequently conducted with 35 professionals who were actively involved in teaching and assessing communication skills of pharmacy students to determine the importance and reliability of each criterion. Results Consensus ratings identified 7 criteria that were important measures of pharmacy students' communication skills and could be reliably assessed by patients. Conclusions A modified two-round Delphi consultation survey successfully identified criteria that can be used by patients to assess the communication skills of pharmacy undergraduates. Future work will examine the feasibility of using patients as assessors of communication skills of pharmacy students, preregistration pharmacists, and qualified pharmacists.

Lecturers' experiences of assessing generic skills in an active learning environment for engineering education in Malaysia - Emergent findings

The aim of this paper is to explore the engineering lecturers' experiences of generic skills assessment within an active learning context in Malaysia. Using a case-study methodology, lecturers' assessment approaches were investigated regarding three generic skills; verbal communication, problem solving and team work. Because of the importance to learning of the assessment of such skills it is this assessment that is discussed. The findings show the lecturers' initial feedback to have been generally lacking in substance, since they have limited knowledge and experience of assessing generic skills. Typical barriers identified during the study included; generic skills not being well defined, inadequate alignment across the engineering curricula and teaching approaches, assessment practices that were too flexible, particular those to do with implementation; and a failure to keep up to date with industrial requirements. The emerging findings of the interviews reinforce the arguments that there is clearly much room for improvement in the present state of generic skills assessment.

Engaging employers as partners in work-based learning assessment:proposal for a quality enhancement framework

This paper seeks to advance research and practice related to the role of employers in all stages of the assessment process of work-based learning (WBL) within a tripartite relationship of higher education institution (HEI), student and employer. It proposes a research-informed quality enhancement framework to develop good practice in engaging employers as partners in assessment. The Enhancement Framework comprises three dimensions, each of which includes elements and questions generated by the experiences of WBL students, HEI staff and employers. The three dimensions of the Enhancement Framework are: 1. ‘premises of assessment’ encompassing issues of learning, inclusion, standards and value; 2. ‘practice’, encompassing stages of assessment made up of course design, assessment task, responsibilities, support, grading and feedback; 3. ‘communication of assessment’ with the emphasis on role clarity, language and pathways. With its prompt questions, the Enhancement Framework may be used as a capacity-building tool for promoting, sustaining, benchmarking and evaluating productive dialogue and critical reflection about assessment between WBL partners. The paper concludes by emphasising the need for professional development as well as policy and research development, so that assessment in WBL can more closely correspond to the potentially transformative nature of the learning experience.

Gender and feminine Identities - women as managers in a UK academic institution

The paper considers gender identities in higher education. It examines how people involved in university life engage in (re)creating gender identities and in (re)producing gender-related expectations (and stereotypes) of managerial behaviour. The process of construction of feminine identities is explored through the discourses of academics from a UK university (mainly women who hold managerial positions). The paper reports findings from a series of in-depth interviews with women managers (dean, associate deans and heads of departments) and with university academics (men and women) from a Business School, part of a large British new university. The school was of special interest because women held the majority of senior managerial posts. It appears that the process of construction of femininities is mainly developed around four (stereo-)typical aspects generally associated with feminine management practices (multi-tasking, supporting and nurturing, people and communication skills, and team-work).

Municipal benchmarking:organisational learning and network performance in the public sector

The main purpose of this dissertation is to assess the relation between municipal benchmarking and organisational learning with a specific emphasis on benchlearning and performance within municipalities and between groups of municipalities in the building and housing sector in the Netherlands. The first and main conclusion is that this relation exists, but that the relative success of different approaches to dimensions of change and organisational learning are a key explanatory factor for differences in the success of benchlearning. Seven other important conclusions could be derived from the empirical research. First, a combination of interpretative approaches at the group level with a mixture of hierarchical and network strategies, positively influences benchlearning. Second, interaction among professionals at the inter-organisational level strengthens benchlearning. Third, stimulating supporting factors can be seen as a more important strategy to strengthen benchlearning than pulling down barriers. Fourth, in order to facilitate benchlearning, intrinsic motivation and communication skills matter, and are supported by a high level of cooperation (i.e., team work), a flat organisational structure and interactions between individuals. Fifth, benchlearning is facilitated by a strategy that is based on a balanced use of episodic (emergent) and systemic (deliberate) forms of power. Sixth, high levels of benchlearning will be facilitated by an analyser or prospector strategic stance. Prospectors and analysers reach a different learning outcome than defenders and reactors. Whereas analysers and prospectors are willing to change policies when it is perceived as necessary, the strategic stances of defenders and reactors result in narrow process improvements (i.e., single-loop learning). Seventh, performance improvement is influenced by functional perceptions towards performance, and these perceptions ultimately influence the elements adopted. This research shows that efforts aimed at benchlearning and ultimately improved service delivery, should be directed to a multi-level and multi-dimensional approach addressing the context, content and process of dimensions of change and organisational learning.

Medical error:a discussion of the medical construction of error and suggestions for reforms of medical education to decrease error

Introduction: There is a growing public perception that serious medical error is commonplace and largely tolerated by the medical profession. The Government and medical establishment's response to this perceived epidemic of error has included tighter controls over practising doctors and individual stick-and-carrot reforms of medical practice. Discussion: This paper critically reviews the literature on medical error, professional socialization and medical student education, and suggests that common themes such as uncertainty, necessary fallibility, exclusivity of professional judgement and extensive use of medical networks find their genesis, in part, in aspects of medical education and socialization into medicine. The nature and comparative failure of recent reforms of medical practice and the tension between the individualistic nature of the reforms and the collegiate nature of the medical profession are discussed. Conclusion: A more theoretically informed and longitudinal approach to decreasing medical error might be to address the genesis of medical thinking about error through reforms to the aspects of medical education and professional socialization that help to create and perpetuate the existence of avoidable error, and reinforce medical collusion concerning error. Further changes in the curriculum to emphasize team working, communication skills, evidence-based practice and strategies for managing uncertainty are therefore potentially key components in helping tomorrow's doctors to discuss, cope with and commit fewer medical errors.

Leadership discourse

Leadership discourse is both a type of discourse and an emerging field of study. The field examines the ways in which senior people construct their identities through interaction in business and professional settings such as meetings, interviews, and conference calls. The study of leadership discourse has moved away from psychological approaches based on charisma and communication skills, and toward social constructionist and discursive perspectives of how leadership is enacted and performed. Focusing principally on spoken interactions, this article explores definitions of leadership and discourse, the relationship between the two concepts, and the theoretical antecedents of the field of study. It also identifies the major methodological approaches used to analyze leadership discourse with examples from the work of scholars deploying each approach. The article concludes with some reflections on future directions for this field.

Oral anticoagulation in atrial fibrillation, the patients and physicians experiences of the consultation:a qualitative study

Background: Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF), however it is still underutilized and sometimes refused by patients. This project was divided in two inter-related studies. Study 1 explored the experiences that influence prescription of OAC by physicians. Study 2 explored the experiences which influence patients' decisions to accept, decline or discontinue OAC. Methods: Semi-structured individual interviews were conducted in both studies. In Study 1four sub-groups of physicians (n = 16) experienced with OAC in AF were interviewed: consultant cardiologists, consultant general physicians, general practitioners and cardiology registrars. In Study 2 three sub-groups of patients (n = 11) diagnosed with AF were interviewed; those who accepted, refused, and who discontinued warfarin. Results: Study 1: Two over-arching themes emerged from doctors' experiences: (1) communicating information and (2) challenges with OAC prescription for AF. Physicians still adopt a paternalistic approach to decision-making. They should instead motivate patients to take part in treatment discussions and choices should reflect the patient's needs and concerns. Physician education should focus more on communication skills, individualised care and time-management as these are critical for patient adherence. Continuous OAC education for AF should adopt a multi-disciplinary approach. Further, interpreters should also be educated on medical communication skills. Study 2: Three over-arching themes comprised patients' experiences: (1) the initial consultation, (2) life after the consultation, and (3) patients' reflections. Patient education during the initial consultation was critical in increasing patient's knowledge of OAC. On-going patient education is imperative to maintain adherence. Patients valued physicians' concern for their needs during decision-making. Patients who had experience of stroke were more receptive to education aimed towards stroke risk reduction rather than bleeding risk. Patients' perceptions of warfarin are also influenced by the media. Comment: Qualitative research is crucial in exploring barriers to treatment as it provides an excellent insight into patients' experiences of healthcare. A patient-centred approach should be adopted and incorporated into physicians' education. Education and patient involvement in the decision-making process is essential to promote treatment acceptance and long-term adherence

The development and operation of the effective interpersonal relationship skills relevant to career development problems from staff assessment at an industrial research laboratory

This study concerns the application of a model of effective interpersonal relationships to problems arising from staff assessment at I.C.I. Ltd. Corporate Laboratory between 1972 and 1974. In collaboration with academic and industrial supervision, the study commenced with a survey of management and supervisor opinions about the effectiveness of current staff (work) relationships, with particular reference to the problem of recognising and developing creative potential. This survey emphasised a need to improve the relationships between staff in the staff assessment context. A survey of research into creativity emphasised the importance of the interpersonal environment for obtaining creative behaviour in an organisation context. A further survey of theories of how inter­personal behaviour related to personal creativity (therapeutic psychology) provided a model of effective interpersonal behaviour (Carkhuff, 1969) that could be applied to the organisation context of staff assessment. The objective of the project was redefined as a need to improve the conditions of interpersonal behaviour in relation to certain (career development) problems arising from staff assessment practices. In order to demonstrate the application of the model of effective interpersonal behaviour, the research student recorded interviews between himself and members of staff designed to develop and operate the dimensions of the model. Different samples of staff were used to develop the 'facilitative' and the 'action oriented' dimensions of bahaviour, and then for the operation of a helping programme (based on vocational guidance tests). These interactions have been analysed, according to the scales of measurement in the model ana the results are presented in case study form in this thesis. At each stage of the project, results and conclusions were presented to the sponsoring organisation (e.g. industrial supervisor) in order to assess their (subjective) opinion of relevance to the organ­ isation. Finally, recommendations on further actions towards general improvement of the work relationships in the laboratory were presented in a brief report to the sponsor.

Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST

Aim: To explore current risk assessment processes in general practice and Improving Access to Psychological Therapies (IAPT) services, and to consider whether the Galatean Risk and Safety Tool (GRiST) can help support improved patient care. Background: Much has been written about risk assessment practice in secondary mental health care, but little is known about how it is undertaken at the beginning of patients' care pathways, within general practice and IAPT services. Methods: Interviews with eight general practice and eight IAPT clinicians from two primary care trusts in the West Midlands, UK, and eight service users from the same region. Interviews explored current practice and participants' views and experiences of mental health risk assessment. Two focus groups were also carried out, one with general practice and one with IAPT clinicians, to review interview findings and to elicit views about GRiST from a demonstration of its functionality. Data were analysed using thematic analysis. Findings Variable approaches to mental health risk assessment were observed. Clinicians were anxious that important risk information was being missed, and risk communication was undermined. Patients felt uninvolved in the process, and both clinicians and patients expressed anxiety about risk assessment skills. Clinicians were positive about the potential for GRiST to provide solutions to these problems. Conclusions: A more structured and systematic approach to risk assessment in general practice and IAPT services is needed, to ensure important risk information is captured and communicated across the care pathway. GRiST has the functionality to support this aspect of practice.

Complex skills and academic writing:a review of evidence about the types of learning required to meet core assessment criteria

Assessment criteria are increasingly incorporated into teaching, making it important to clarify the pedagogic status of the qualities to which they refer. We reviewed theory and evidence about the extent to which four core criteria for student writing-critical thinking, use of language, structuring, and argument-refer to the outcomes of three types of learning: generic skills learning, a deep approach to learning, and complex learning. The analysis showed that all four of the core criteria describe to some extent properties of text resulting from using skills, but none qualify fully as descriptions of the outcomes of applying generic skills. Most also describe certain aspects of the outcomes of taking a deep approach to learning. Critical thinking and argument correspond most closely to the outcomes of complex learning. At lower levels of performance, use of language and structuring describe the outcomes of applying transferable skills. At higher levels of performance, they describe the outcomes of taking a deep approach to learning. We propose that the type of learning required to meet the core criteria is most usefully and accurately conceptualized as the learning of complex skills, and that this provides a conceptual framework for maximizing the benefits of using assessment criteria as part of teaching. © 2006 Taylor & Francis.

Postural control is not systematically related to reading skills:implications for the assessment of balance as a risk factor for developmental dyslexia

Impaired postural control has been associated with poor reading skills, as well as with lower performance on measures of attention and motor control variables that frequently co-occur with reading difficulties. Measures of balance and motor control have been incorporated into several screening batteries for developmental dyslexia, but it is unclear whether the relationship between such skills and reading manifests as a behavioural continuum across the range of abilities or is restricted to groups of individuals with specific disorder phenotypes. Here were obtained measures of postural control alongside measures of reading, attention and general cognitive skills in a large sample of young adults (n = 100). Postural control was assessed using centre of pressure (CoP) measurements, obtained over 5 different task conditions. Our results indicate an absence of strong statistical relationships between balance measures with either reading, cognitive or attention measures across the sample as a whole. © 2014 Loras et al.