Exploring business models to provide a foundation for enhanced eye care services in high street optometric practice

High street optometric practices are for-profit businesses. They mostly provide sight testing and eye examination services and sell optical products, such as spectacles and contact lenses. The sight testing services are often sold at a vastly reduced price and profits are generated primarily through high margin spectacle sales, in a loss leading strategy. Published literature highlights weaknesses in this strategy as it forms a barrier to widening the scope of services provided within optometric practices. This includes specialist non-refraction based services, such as shared care. In addition this business strategy discourages investment in advanced diagnostic equipment and higher professional qualifications. The aim of this thesis was to develop a greater understanding of the traditional loss-leading strategy. The thesis also aimed to assess the plausibility of alternative business models to support the development of specialist non-refraction services within high street optometric practice. This research was based on a single independent optometric practice that specialises in advanced retinal imaging and offers a broad range of shared care services. Specialist non-refraction based services were found to be poor generators of spectacle sales likely due to patient needs and presenting concerns. Alternative business strategies to support these services included charging more realistic professional fees via cost-based pricing and monthly payment plans. These strategies enabled specialist services to be more self-sustainable with less reliance on cross-subsidy from spectacle sales. Furthermore, improving operational efficiency can increase stand-alone profits for specialist services.Practice managers may be reluctant to increase professional fees due to market pressures and confidence. However, this thesis found that patients were accepting of increased professional fees. Practice managers can implement alternative business models to enhance eye care provision in high street optometric practices. These alternative business models also improve revenues and profits generated via clinical services and improve patient loyalty.

A framework of best practice of continuing professional development for the accounting profession

The International Accounting Education Standards Board (IAESB) places a strong emphasis on individual professionals taking responsibility for their Continuing Professional Development (CPD). On the other hand, the roles performed by professional accountants have evolved out of practical necessity to 'best' suit the diverse needs of business in a global economy. This diversity has meant that professional accountants are seen in highly specialised roles requiring diverse skill sets. In order to enhance the contribution of the accountant as a knowledge professional for business, it follows that CPD that leverages off an individual's experience should be designed to meet the needs of professionals across the different specialised roles within the profession. In doing so the project identifies how CPD should differ across roles and levels of organisational responsibility for accounting professionals. The study also makes a number of policy recommendations to IAESB and IFAC. © 2013 © 2013 Taylor & Francis.

Good practice guide in learning and teaching

Once again this publication is produced to celebrate and promote good teaching and learning support and to offer encouragement to those imaginative and innovative staff who continue to wish to challenge students to learn to maximum effect. It is hoped that others will pick up some good ideas from the articles contained in this volume. We had changed our editorial approach in drawing together the articles for this 2005/6 edition (our third) of the ABS Good Practice Guide. Firstly we have expanded our contributors beyond ABS academics. This year?s articles have also been written by staff from other areas of the University, a PhD student, a post-doctoral researcher and staff working in learning support. We see this as an acknowledgement that the learning environment involves a range of people in the process of student support. We have also expanded the maximum length of the articles from two to five pages, in order to allow greater reflection on the issues. The themes of the papers cluster around issues relating to diversity (widening participation and internationalisation of the student body), imaginative use of new technology (electronic reading on BlackboardTM ) and reflective practitioners, (reflection on rigour and relevance; on how best to train students in research ethics, relevance in the curriculum and the creativity of the teaching process) Discussion of efforts to train the HE teachers of the future looks forward to the next academic year when the Higher Education Academy?s professional standards will be introduced across the sector. In the last volume we mentioned the launch of the School?s Research Centre in Higher Education Learning and Management (HELM). Since then HELM has stimulated a lot of activity across the School (and University) particularly linking research and teaching. A list of the HELM seminars is listed as an appendix to this publication. Further details can be obtained from Catherine Foster (c.s.foster@aston.ac.uk) who coordinates the HELM seminars. HELM has also won its first independent grant from the EU Leonardo programme to look at the effect of business education on employment. In its annual report to the ABS Research Committee HELM listed for 2004 and 2005, 11 refereed journal articles, 4 book chapters, 3 published conference papers, 18 conference papers, one official reports and £72,500 of grant money produced in this research area across the School. I hope that this shows that reflection on learning is live and well in ABS. May I thank the contributors for taking time out of their busy schedules to write the articles and to Julie Green, the Quality Manager, for putting our diverse approaches into a coherent and publishable form.

Good practice guide in learning and teaching

This is the second edition of our Aston Business School (ABS) Good Practice Guide and the enthusiasm of the contributors appears undiminished. I am again reminded that I work with a group of very committed, dedicated and professional colleagues. Once again this publication is produced to celebrate and promote good teaching across the School and to offer encouragement to those imaginative and innovative staff who continue to wish to challenge students to learn to maximum effect. It is hoped that others will pick up some good ideas from the articles contained in this volume. Contributors to this Guide were not chosen because they are the best teachers in the School, although they are undoubtedly all amongst my colleagues who are exponents of enthusiastic and inspiring approaches to learning. The Quality Unit approached these individuals because they declared on their Annual Module Reflection Forms that they were doing something interesting and worthwhile which they thought others might find useful. Amongst those reading the Guide I am sure that there are many other individuals who are trying to operate similar examples of good practice in their teaching, learning and assessment methods. I hope that this publication will provoke these people into providing comments and articles of their own and that these will form the basis of next year’s Guide. It may also provoke some people to try these methods in their own teaching. The themes of the articles this year can be divided into two groups. The first theme is the quest to help students to help themselves to learn via student-run tutorials, surprise tests and mock examinations linked with individual tutorials. The second theme is making learning come to life in exciting practical ways by, for example, hands-on workshops and simulations, story telling, rhetorical questioning and discussion groups. A common theme is one of enthusiasm, reflection and commitment on behalf of the lecturers concerned. None of the approaches discussed in this publication are low effort activities on the part of the facilitator, but this effort is regarded as worthwhile as a means of creating greater student engagement. As Biggs (2003)[1] says, in his similarly inspiring way, students learn more the less passive they are in their learning. (Ref). The articles in this publication bear witness of this and much more. Since last year Aston Business School has launched its Research Centre in Higher Education Learning and Management (HELM) which is another initiative to promote excellent learning and teaching. Even before this institution has become fully operational, at least one of the articles in this publication has seen the light of day in the research arena and at least two others are ripe for dissemination to a wider audience via journal publication. More news of our successes in this activity will appear in next year’s edition. May I thank the contributors for taking time out of their busy schedules to write the articles this summer, and to Julie Green who runs the ABS Quality Unit, for putting our diverse approaches into a coherent and publishable form and for chasing us when we have needed it! I would also like to thank Ann Morton and her colleagues in the Centre for Staff Development who have supported this publication. During the last year the Centre has further stimulated the learning and teaching life of the School (and the wider University) via their Learning and Teaching Week and sponsorship of Teaching Quality Enhancement Fund (TQEF) projects. Pedagogic excellence is in better health at Aston than ever before – long may this be because this is what life in HE should be about.

Science or practice? UK undergraduate experiences and attitudes to the MPharm degree

Objective: The debate surrounding the science/practice balance in the teaching of undergraduate pharmacy has been played out in the professional literature for years. The objective of this work was to explore the attitudes of pharmacy undergraduates on the practice-science debate. Setting: The study was undertaken as part of a national study of teaching, learning and assessment methods in United Kingdom (UK) schools of pharmacy. Method: Six focus groups were carried out. The sample was 44 volunteer students from nine UK schools of pharmacy, representing all 4 years of the MPharm programme. Groups were tape recorded and transcribed. Analysis of the transcripts was theme based by topic. Main Outcome Measure: Qualitative data on student attitudes and experiences. Results: Most students thought that there was too strong an emphasis placed on the science components of the course in the early part of their studies. Later in the course they realised that the majority of the science was necessary; it just had not been apparent to them at the time. There were strongly held attitudes across all 4 years that it would be beneficial to include more practice-related material at the beginning of their studies. This would be beneficial for three reasons: to make the course more interesting, to aid in the contextualisation of the science component and to assist the students in any early placement or vacational work. Conclusion: Internationally, changes to the role of the pharmacist from a traditional supply function to a more clinical role has resulted in differing educational needs for the pharmacist of the future. Pharmacy will remain a degree built on a strong scientific background, but students advise that the contextualisation and sequencing of material within the degree could make a considerable improvement to their learning. Consulting students helps us to understand the teaching, learning and assessment experience better by giving insights into ways of improving the delivery. In the case of the UK, there are legislative changes impending which may provide an opportunity to review the balance of practice-and science in the curriculum. © 2006 Springer Science+Business Media B.V.

The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role. © 2004 Elsevier Ltd. All rights reserved.

Do pharmacy graduates possess the necessary professional skills?

Background - Expansion of the pharmacists' role within the United Kingdom has raised the question as to whether pharmacy graduates are equipped with the professional skills and attributes they will need to fulfil such roles. Aim - To describe the professional skills and attributes pre-registration recruiters perceive pharmacy graduates should exhibit and to establish whether final year students perceive they possess these skills and attributes. Method - Five individuals were interviewed from a variety of pre-registration employers; 90 final year students completed a questionnaire (response 69.2%). Results - The recruiters thought that whilst graduates possess sufficient knowledge, they show weaknesses such as inability to apply theoretical knowledge into practice and the lack of good communication and interpersonal skills. Conversely, a majority of students felt that they did possess the necessary skills to enter pre-registration training. Conclusion - Schools of pharmacy need to ensure that students have an opportunity to develop key professional skills to assist students in securing pre-registration positions. © 2010 FIP.

Hospital pharmacists' awareness of a new antibiotic guideline in the UK:implications for practice

Objectives: Pharmacists play an important role in the review of local hospital guidelines. British Thoracic Society (BTS) guidelines for the management of patients with community-acquired pneumonia (CAP) were updated in 2001, and it is important that individual hospital recommendations are based upon this national guidance. The aim of this study was to identify UK Chief Pharmacists' awareness of these updated guidelines one year after their publication. Secondary aims were to identify whether pharmacists had subsequently initiated revision of institutional CAP guidelines, and what roles different professional staff had performed in this process. Method: A self-completion postal questionnaire was sent to the Chief Pharmacist (or their nominated staff) in 253 UK NHS hospitals in November 2002. This aimed to identify issues relating to their awareness of the 2001 BTS guidelines and subsequent revision of their hospital's guidelines. Results:188 questionnaires were returned (a response rate of 74%), of which 164 hospitals had local antibiotic prescribing guidelines. Respondents in 29% of these hospitals were unaware of the 2001 BTS publication and institutional guidelines had been revised in only 51% of hospitals where the Chief Pharmacist was purportedly aware of the new BTS guidance. Generally, more staff types were involved in revising guidelines than initiating revision. Conclusions:Variability existed in both Chief Pharmacists' awareness of new national guidance and subsequent review processes operating in individual hospitals. A lack of proactive reaction to new national guidance was identified in some hospitals, and it is hoped that the establishment of specialist "infectious diseases pharmacists" will facilitate the review of institutional antibiotic prescribing guidelines in the future. © Springer 2005.

Quality improvement in professional local government services : a longitudinal study

This sustained longitudinal study, carried out in a single local authority, investigates the implementation of a Total Quality Management (TQM) philosophy in professional local government services. At the start of this research, a large majority of what was written about TQM was polemical and based on limited empirical evidence. This thesis seeks to provide a significant and important piece of work, making a considerable contribution to the current state of knowledge in this area. Teams from four professional services within a single local authority participated in this research, providing the main evidence on how the quality management agenda in a local authority can be successfully implemented. To supplement this rich source of data, various other sources and methods of data collection have been used: 1) Interviews were carried out with senior managers from within the authority; 2) Customer focus groups and questionnaires were used; 3) Interviews were carried out with other organisations, all of which were proponents of a TQM philosophy. A number of tools have been developed to assist in gathering data: 1) The CSFs (critical success factors) benchmarking tool; 2) Five Stages of Quality Improvement Model. A Best Practice Quality Improvement Model, arising from an analysis of the literature and the researcher's own experience is proposed and tested. From the results a number of significant conclusions have been drawn relating to: 1) Triggers for change; 2) Resistance of local government professionals to change 3) Critical success factors and barriers to quality improvement in professional local government services; 4) The problems associated with participant observation and other methodological issues used.

Gender and general practice: the single-handed woman General Practitioner

This research examines women GPs' careers, how they run their practices and how they reconcile professional and domestic lives. It looks at the particular experiences of women GPs who practise alone, and at the pressures in past practice experience which have led them to do so. It is argued that many of the problems of group practice which can be identified are attributable to gender. For example, one reason given for entering general practice is a desire to be able to provide the full range of medical care and not to specialise. Women GPs, however, may find themselves seeing more women patients for "women's problems" and children than they would freely choose. Women have not entered general practice in order to specialise in these areas of medicine. Indeed, if they had wanted to specialise in obstetrics, gynaecology or paediatrics they would have had difficulty advancing very far in these male-dominated areas of hospital hierarchy. Other gender related problems exist for women in general practice and practising single-handedly is one strategy that women GPs have used to counter the problems of working in male-dominated practices and partnerships. However, the twenty-four hour commitment of single-handed practice may bring further pressures in reconciling this with responsibility for home life. Out-of-hours cover, which can be viewed as the link between professional and domestic life, where the one intrudes into the other, is also examined in terms of the gender issues it raises. The interaction of gender and ethnicity is also considered for the 11 Asian women GPs in the study. Interviews were conducted with 29 single-handed women GPs in the Midlands. In addition, some cases were studied in greater depth by being observed in their surgeries and on home visits for a day each. A qualitative/feminist approach to analysis has been employed.

Current practice and opinion in special schools for the maladjusted in England and Wales

This study seeks to describe current practice and opinion in schools for the maladjusted in England and Wales and to exarnlne how far this coincides with earlier descriptions. A review of the literature provides an account of this earlier work, and data accrued from questionnaires completed by 114 schools describe current practice and opinion. The study represents the most extensive empirical enquiry into the work of these schools since 1955 and provides a wide data basis for future research and assessment of progress and change. The data suggest that there is much communality of practice and opinion within the schools, with most schools emphasising their therapeutic rather than their educational purpose. The work is characterised by the wide use and perceived efficacy of warm, caring adult to child relationships, improvement of pupil self-image through success, and individual counselling and discussion, which permeate a structure of routine, discipline and educational concern. Specialised treatments are not used widely and involve only a minority of pupils. Practice tends to be in reference to conduct disordered pupils who are now perceived as the largest single disorder group within the schools, whereas previously neurotic disorders formed the largest single group. The majority of pupils are perceived as underachieving on entry and requiring remedial help: consequently the educational programme has a remedial bias. For staff, qualities of personality are considered to be more valuable than professional skills. The schools differ in the emphasis they allocate to one or more of four identified areas of treatment described as concern for pupils' needs; degree of pupil participation; theoretical orientation: and the use of external controls. There is a diminished reference to psychoanalytical theory and an increased reference to behaviourist theory relative to previous practice. Similarly, the use and perceived importance and effectiveness of pupil participation and unconditional affection has diminished.

Inside ‘Inside View’: reflections on stimulating debate and engagement through a multimedia live theatre production on the dilemmas and issues of pre-natal screening policy and practice

Background The role of applied theatre in engaging both lay and professional publics with debate on health policy and practice is an emergent field. This paper discusses the development, production performance and discussion of ‘Inside View’.1 Objectives The objectives were to produce applied theatre from research findings of a completed study on genetic prenatal screening, exploring the dilemmas for women and health professionals of prenatal genetic screening, and to engage audiences in debate and reflection on the dilemmas of prenatal genetic screening. Methods ‘Inside View’ was developed from a multidisciplinary research study through identification of emergent themes from qualitative interviews, and development of these by the writer, theatre producer and media technologist with input from the researchers. Findings Inside View was performed in London and the Midlands to varied audiences with a panel discussion and evaluation post performance. The audiences were engaged in debate that was relevant to them professionally and personally. Knowledge translation through applied theatre is an effective tool for engaging the public but the impact subsequently is unclear. There are ethical issues of unexpected disclosure during discussion post performance and the process of transforming research findings into applied theatre requires time and trust within the multidisciplinary team as well as adequate resourcing.

Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma

BACKGROUND: Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. OBJECTIVE: To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. METHODS: Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. RESULTS: A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. CONCLUSIONS: A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.

Proof in the pedagogic pudding? The challenges of promoting evidence-based teaching practice in a research-focused institution

Drawing upon the findings of a mixed methodological study, this paper critically analyses the cultural, pedagogical, and organisational issues encountered by academics and support staff working within a newly established Centre for Learning Innovation and Professional Practice tasked with facilitating a new teaching-focused policy in a previously research-led institution. The aim of this policy is to assure that, across the institution, teaching is given the same priority and kudos as research. Focusing specifically staff perceptions of the impact of the new policy on various aspects of academic life including, pedagogic practice, student support, staff training, and organisational management, the paper critically addresses the cultural and attitudinal challenges of change management (Kotter, 1996) within a ‘grey-brick’ university. In doing so it makes a significant contribution to current academic theory and debate in the areas of pedagogic practice and organisational management.

New career models in UK professional service firms:from up-or-out to up-and-going-nowhere?

In this paper, we empirically examine how professional service firms are adapting their promotion and career models to new market and institutional pressures, without losing the benefits of the traditional up-or-out tournament. Based on an in-depth qualitative study of 10 large UK based law firms we find that most of these firms do not have a formal up-or-out policy but that the up-or-out rule operates in practice. We also find that most firms have introduced alternative roles and a novel career policy that offers a holistic learning and development deal to associates without any expectation that unsuccessful candidates for promotion to partner should quit the firm. While this policy and the new roles formally contradict the principle of up-or-out by creating permanent non-partner positions, in practice they coexist. We conclude that the motivational power of the up-or-out tournament remains intact, notwithstanding the changes to the internal labour market structure of these professional service firms.