The UK MPharm (2) - Do we over assess?

Introduction-The pace of structural change in the UK health economies, the new focus on regulation and the breaking down of professional boundaries means that the Royal Pharmaceutical Society of Great Britain (RPSGB) has to continually review the scope, range and outputs of education provided by schools of pharmacy (SOPs). In SOPs, the focus is on equipping students with the knowledge, skills and attitudes necessary to successfully engage with the pre-registration year. The aim of this study [1] was to map current programmes and undergraduate experiences to inform the RPSGB debate. The specific objectives of this paper are to describe elements of the survey of final year undergraduates, to explore student opinions and experiences of their workload, teaching, learning and assessment. Material and methods-The three main research techniques were: (1) quantitative course document review, (2) qualitative staff interview and (3) quantitative student self completion survey. The questions in the survey were based on findings from exploratory focus group work with BPSA (British Pharmaceutical Students’ Association) members and were designed to ascertain if views expressed in the focus groups on the volume and format of assessments were held by the general student cohort. The student self completion questionnaire consisting of 31 questions, was administered in 2005 to all (n=1847) final year undergraduates, using a pragmatic mixture of methods. The sample was 15 SOPs within the UK (1 SOP opted out). The total response rate was 50.62% (n=935): it varied by SOP from 14.42% to 84.62%. The survey data were analysed (n=741) using SPSS, excluding non-UK students who may have undertaken part of their studies within a non-UK university. Results and discussion • 76% (n=562) respondents considered that the amount of formal assessment was about right, 21% (n=158) thought it was too much. • There was agreement that the MPharm seems to have more assessment than other courses, with 63% (n=463) strongly agreeing or agreeing. • The majority considered the balance between examinations and coursework was about right (67%, n=498), with 27% (n=198) agreeing that the balance was too far weighted towards examinations. • 57% (n=421) agreed that the focus of MPharm assessment was too much towards memorised knowledge, 40% (n=290) that it was about right. • 78% (n= 575) agreed with the statement “Assessments don’t measure the skills for being a pharmacist they just measure your knowledge base”. Only 10% (n=77) disagreed. • Similarly 49% (n=358) disagreed with, and 35% (n=256) were not sure about the statement “I consider that the assessments used in the MPharm course adequately measure the skills necessary to be a pharmacist”. Only 17% (n=124) agreed. Experience from this study shows the difficulty of administering survey instruments through UK Schools of Pharmacy. It is heavily dependent on timing, goodwill and finding the right person. The variability of the response rate between SOPs precluded any detailed analysis by School. Nevertheless, there are some interesting results. Issues raised in the exploratory focus group work about amount of assessment and over reliance on knowledge have been confirmed. There is a real debate to be had about the extent to which the undergraduate course, which must instil scientific knowledge, can provide students with the requisite qualities, skills, attitudes and behaviour that are more easily acquired in the pre-registration year. References [1] Wilson K, Jesson J, Langley C, Clarke L, Hatfield K. MPharm Programmes: Where are we now? Report commissioned by the Pharmacy Practice Research Trust., 2005.

Mapping teaching, learning and assessment in the MPharm in UK schools of pharmacy

Aim To undertake a national study of teaching, learning and assessment in UK schools of pharmacy. Design Triangulation of course documentation, 24 semi-structured interviews undertaken with 29 representatives from the schools and a survey of all final year students (n=1,847) in the 15 schools within the UK during 2003–04. Subjects and setting All established UK pharmacy schools and final year MPharm students. Outcome measures Data were combined and analysed under the topics of curriculum, teaching and learning, assessment, multi-professional teaching and learning, placement education and research projects. Results Professional accreditation was the main driver for curriculum design but links to preregistration training were poor. Curricula were consistent but offered little student choice. On average half the curriculum was science-based. Staff supported the science content but students less so. Courses were didactic but schools were experimenting with new methods of learning. Examinations were the principal form of assessment but the contribution of practice to the final degree ranged considerably (21–63%). Most students considered the assessment load to be about right but with too much emphasis upon knowledge. Assessment of professional competence was focused upon dispensing and pharmacy law. All schools undertook placement teaching in hospitals but there was little in community/primary care. There was little inter-professional education. Resources and logistics were the major limiters. Conclusions There is a need for an integrated review of the accreditation process for the MPharm and preregistration training and redefinition of professional competence at an undergraduate level.

"Marketing is all about T-shirts and posters - right?"

Five questions for conducting marketing as a profession that ushers in strategic change

How earlobes can signify leadership potential

Evolutionary biologists have learned that people with greater “genetic fitness,” as manifested by a high degree of left-right body symmetry, are not just considered better looking but also tend to be healthier, more intelligent, and more dominant than others. They’re the classic alphas who rise to the top of rigidly hierarchical organizations such as the military. But our research shows that people with subtle asymmetries—for example, imbalances in ear or finger length—are often better “transformational” leaders, able to inspire followers to put self-interest aside for the good of the group. Furthermore, teams they lead outperform teams whose leaders have more-symmetrical bodies. These findings add a new twist to the debate about whether effective leaders are born or made. We believe it’s not asymmetry per se that positions people to be good transformational leaders. Instead, we argue, these individuals’ childhood responses to others’ perceptions shape them for success.

Who are you sleeping with? The construction of heteronormativity in stories about sleep in British newspapers

In popular British understanding the terms 'sleeping' or 'slept' are often used to mean sex, and (hetero)sex is seen as crucial to sustaining intimate relationships. This study of UK newspapers coverage shows that stories about sieep and sleeping arrangements can be seen to (re)produce heteronormativity through focusing on the (heterosexual) 'marital bed'. The 'marital bed' is constructed as both the physical and symbolic centre of successful heterosexual relationships. Moreover, the maintenance of this symbolic space is gendered with women given primary responsibility. The focus on the 'marital bed' helps to exclude non-heterosexuals from the idea of intimate relationships, by effectively silencing their experiences of sleep and sleeping arrangements. Normative ideas about male and female (hetero)sexualities are drawn on to undermine women's right to refuse sex within the martial bed. In addition, the term 'sleep-sex' is used to reconceptualise stories of rape, minimising the victim's experiences and absolve the perpetrator from full responsibility for the assault. By exploring these articles we can see both how the representation of the organisation of sleep is produced through heteronormativity, as well as how heteronormativity determines whose accounts of sleeping are prioritised. © Sociological Research Online.

Grammar in the curriculum for English: what next?

It is clear from several government reports and research papers published recently, that the curriculum for English in primary and secondary schools is about to change, yet again. After years of a bureaucratic stranglehold that has left even Ofsted report writers criticising the teaching of English, it seems as if the conditions are right for further revisions. One of the questions that inevitably arises when a curriculum for English is reviewed, relates to the place and purpose of the teaching of grammar. This paper outlines a possible curriculum for grammar across both primary and secondary phases, arguing that for the teaching of grammar to have any salience or purpose at all, it has to be integrated into the curriculum as a whole, and not just that of writing. A recontextualised curriculum for grammar of the kind proposed here, would teach pupils to become critically literate in ways which recognise diversity as well as unity, and with the aim of providing them with the means to critically analyse and appraise the culture in which they live.

Flow patterns, performance and scale-up of distillation trays

This work is concerned with the nature of liquid flow across industrial sieve trays operating in the spray, mixed, and the emulsified flow regimes. In order to overcome the practical difficulties of removing many samples from a commercial tray, the mass transfer process was investigated in an air water simulator column by heat transfer analogy. The temperature of the warm water was measured by many thermocouples as the water flowed across the single pass 1.2 m diameter sieve tray. The thermocouples were linked to a mini computer for the storage of the data. The temperature data were then transferred to a main frame computer to generate temperature profiles - analogous to concentration profiles. A comprehensive study of the existing tray efficiency models was carried out using computerised numerical solutions. The calculated results were compared with experimental results published by the Fractionation Research Incorporation (FRl) and the existing models did not show any agreement with the experimental results. Only the Porter and Lockett model showed a reasonable agreement with the experimental results for cenain tray efficiency values. A rectangular active section tray was constructed and tested to establish the channelling effect and the result of its effect on circular tray designs. The developed flow patterns showed predominantly flat profiles and some indication of significant liquid flow through the central region of the tray. This comfirms that the rectangular tray configuration might not be a satisfactory solution for liquid maldistribution on sieve trays. For a typical industrial tray the flow of liquid as it crosses the tray from the inlet to the outlet weir could be affected by the mixing of liquid by the eddy, momentum and the weir shape in the axial or the transverse direction or both. Conventional U-shape profiles were developed when the operating conditions were such that the froth dispersion was in the mixed regime, with good liquid temperature distribution while in the spray regime. For the 12.5 mm hole diameter tray the constant temperature profiles were found to be in the axial direction while in the spray regime and in the transverse direction for the 4.5 mm hole tray. It was observed that the extent of the liquid stagnant zones at the sides of the tray depended on the tray hole diameter and was larger for the 4.5 mm hole tray. The liquid hold-up results show a high liquid hold-up at the areas of the tray with low liquid temperatures, this supports the doubts about the assumptions of constant point efficiency across an operating tray. Liquid flow over the outlet weir showed more liquid flow at the centre of the tray at high liquid loading with low liquid flow at both ends of the weir. The calculated results of the point and tray efficiency model showed a general increase in the calculated point and tray efficiencies with an increase in the weir loading, as the flow regime changed from the spray to the mixed regime the point and the tray efficiencies increased from approximately 30 to 80%.Through the mixed flow regime the efficiencies were found to remain fairly constant, and as the operating conditions were changed to maintain an emulsified flow regime there was a decrease in the resulting efficiencies. The results of the estimated coefficient of mixing for the small and large hole diameter trays show that the extent of liquid mixing on an operating tray generally increased with increasing capacity factor, but decreased with increasing weir loads. This demonstrates that above certain weir loads, the effect of eddy diffusion mechanism on the process of liquid mixing on an operating tray to be negligible.

Approximating differentiable relationships between delay embedded dynamical systems with radical basis functions

This thesis is about the study of relationships between experimental dynamical systems. The basic approach is to fit radial basis function maps between time delay embeddings of manifolds. We have shown that under certain conditions these maps are generically diffeomorphisms, and can be analysed to determine whether or not the manifolds in question are diffeomorphically related to each other. If not, a study of the distribution of errors may provide information about the lack of equivalence between the two. The method has applications wherever two or more sensors are used to measure a single system, or where a single sensor can respond on more than one time scale: their respective time series can be tested to determine whether or not they are coupled, and to what degree. One application which we have explored is the determination of a minimum embedding dimension for dynamical system reconstruction. In this special case the diffeomorphism in question is closely related to the predictor for the time series itself. Linear transformations of delay embedded manifolds can also be shown to have nonlinear inverses under the right conditions, and we have used radial basis functions to approximate these inverse maps in a variety of contexts. This method is particularly useful when the linear transformation corresponds to the delay embedding of a finite impulse response filtered time series. One application of fitting an inverse to this linear map is the detection of periodic orbits in chaotic attractors, using suitably tuned filters. This method has also been used to separate signals with known bandwidths from deterministic noise, by tuning a filter to stop the signal and then recovering the chaos with the nonlinear inverse. The method may have applications to the cancellation of noise generated by mechanical or electrical systems. In the course of this research a sophisticated piece of software has been developed. The program allows the construction of a hierarchy of delay embeddings from scalar and multi-valued time series. The embedded objects can be analysed graphically, and radial basis function maps can be fitted between them asynchronously, in parallel, on a multi-processor machine. In addition to a graphical user interface, the program can be driven by a batch mode command language, incorporating the concept of parallel and sequential instruction groups and enabling complex sequences of experiments to be performed in parallel in a resource-efficient manner.

British racial discourse: a study of political discourse about race and race-related matters at parliamentary and borough council levels

'British Racial Discourse' is a study of political discourse about race and race-related matters. The explanatory theory is adapted from current sociological studies of ideology with a heavy emphasis on the tradition developed from Marx and Engels's Feuerbach. The empirical data is drawn from the parliamentary debates on immigration and the Race Relations Bills, Conservative and Labour Party Conference Reports, and a set of interviews with Wolverhampton Borough councillors. Although the thesis has broader significance for British political discourse about race, it is particularly concerned with the responses of members of the two main political parties, rather than with the more overt and sensational racism of certain extreme Right-wing groups. Indeed, as the study progresses, it focuses more and more narrowly on the phenomenon of 'deracialised' discourse, and the details of the predominantly class-based justificatory systems of the Conservative and Labour Parties. Of particular interest are the argument forms (used in the debates on immigration and race relations) which manage to obscure the white electorate's responsibility for prejudice and discrimination. Such discoursive forms are of major significance for understanding British race relations, and their detailed examination provides an insight into the way in which 'ideological facades' are created and maintained.

The right time and place:strategic positioning for competitive manufacture

Increasingly in the UK, companies that have traditionally considered themselves as manufacturers are being advised to now see themselves as service providers and to reconsider whether to have any production capability. A key challenge is to translate this strategy into a selection of product and service-centred activities within the company's supply chain networks. Strategic positioning is concerned with the choice of business activities a company carries out itself, compared to those provided by suppliers, partners, distributors and even customers. In practice, strategic positioning is directly impacted by such decisions as outsourcing, off-shoring, partnering, technology innovation, acquisition and exploitation. If companies can better understand their strategic positioning, they can make more informed decisions about the adoption of alternative manufacturing and supply chain activities. Similarly, they are more likely to reject those that, like off-shoring, are currently en vogue but are highly likely to erode competitive edge and business success. Our research has developed a new concept we call 'competitive space' as a means of appreciating the strategic positioning of companies, along with a structured decision process for managing competitive space. Our ideas about competitive space, along with the decision process itself, have been developed and tested on a range of manufacturers. As more and more manufacturers are encouraged to move towards system integration and a serviceable business model, the challenge is to identify the appropriate strategic position for their organisations, or in other words, to identify their optimum competitive space for manufacture.

Right orbitofrontal corticolimbic and left corticocortical white matter connectivity differentiate bipolar and unipolar depression

Objectives - The absence of pathophysiologically relevant diagnostic markers of bipolar disorder (BD) leads to its frequent misdiagnosis as unipolar depression (UD). We aimed to determine whether whole brain white matter connectivity differentiated BD from UD depression. Methods - We employed a three-way analysis of covariance, covarying for age, to examine whole brain fractional anisotropy (FA), and corresponding longitudinal and radial diffusivity, in currently depressed adults: 15 with BD-type I (mean age 36.3 years, SD 12.0 years), 16 with recurrent UD (mean age 32.3 years, SD 10.0 years), and 24 healthy control adults (HC) (mean age 29.5 years, SD 9.43 years). Depressed groups did not differ in depression severity, age of illness onset, and illness duration. Results - There was a main effect of group in left superior and inferior longitudinal fasciculi (SLF and ILF) (all F = 9.8; p = .05, corrected). Whole brain post hoc analyses (all t = 4.2; p = .05, corrected) revealed decreased FA in left SLF in BD, versus UD adults in inferior temporal cortex and, versus HC, in primary sensory cortex (associated with increased radial and decreased longitudinal diffusivity, respectively); and decreased FA in left ILF in UD adults versus HC. A main effect of group in right uncinate fasciculus (in orbitofrontal cortex) just failed to meet significance in all participants but was present in women. Post hoc analyses revealed decreased right uncinate fasciculus FA in all and in women, BD versus HC. Conclusions - White matter FA in left occipitotemporal and primary sensory regions supporting visuospatial and sensory processing differentiates BD from UD depression. Abnormally reduced FA in right fronto-temporal regions supporting mood regulation, might underlie predisposition to depression in BD. These measures might help differentiate pathophysiologic processes of BD versus UD depression.

Much ado about not-very-much? Assessing ten years of German citizenship reform

This article examines the development and impact of German citizenship policy over the past decade. As its point of departure, it takes the 2000 Citizenship Law, which sought to undertake a full-scale reform and liberalisation of access to German membership. The article discusses this law’s content and subsequent amendments, focusing particularly on its quantitative impact, asking why the number of naturalisations has been lower than originally expected. The article outlines current challenges to the law’s structure operation and identifies potential trajectories for its future development.

Right hemisphere contributions to imitation tasks

Humans imitate biological movements faster than non-biological movements. The faster response has been attributed to an activation of the human mirror neuron system, which is thought to match observation and execution of actions. However, it is unclear which cortical areas are responsible for this behavioural advantage. Also, little is known about the timing of activations. Using whole-head magnetoencephalography we recorded neuronal responses to single biological finger movements and non-biological dot movements while the subjects were required to perform an imitation task or an observation task, respectively. Previous imaging studies on the human mirror neurone system suggested that activation in response to biological movements would be stronger in ventral premotor, parietal and superior temporal regions. In accordance with previous studies, reaction times to biological movements were faster than those to dot movements in all subjects. The analysis of evoked magnetic fields revealed that the reaction time benefit was paralleled by stronger and earlier activation of the left temporo-occipital cortex, right superior temporal area and right ventral motor/premotor area. The activity patterns suggest that the latter areas mediate the observed behavioural advantage of biological movements and indicate a predominant contribution of the right temporo-frontal hemisphere to action observation–execution matching processes in intransitive movements, which has not been reported previously.

Large scale organisational intervention to improve patient safety in four UK hospitals:mixed method evaluation

Objectives: To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design: Mixed method evaluation involving five substudies, before and after design. Setting: NHS hospitals in United Kingdom. Participants: Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention: The SPI1 was a compound (multicomponent) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results: Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration - monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items) - there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from17%(63) to13%(49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening.

Mixed methods research:don't "just do it"

Purpose The purpose of this paper is to identify some of the dilemmas involved in the debate on the how, when and why of mixed methods research. Design/methodology/approach The authors' starting point is formed by developments in the philosophy of science literature, and recent publications on mixed methods research outside of the management accounting domain. Findings Contrary to recent claims made in the management accounting literature, the authors assert that uncovering points of disagreement between methods may be as far as researchers can go by combining them. Being reflexive can help to provide a deeper understanding of the research process and the researcher's role in this process. Research limitations/implications The paper should extend the debate among management accounting researchers about mixed methods research. One of the lessons drawn is that researchers are actively immersed in the research process and cannot purge their own interests and views. Accepting this lesson casts doubt on what the act of research may imply and achieve. Practical implications The paper shows that combinations of research methods should not be made based on a "whatever works" attitude, since this approach ultimately is still infused with ontological and epistemological considerations that researchers have, and should try to explicate. Originality/value The value of this paper lies in the provision of philosophical underpinnings that have not been widely considered in the management accounting literature on mixed methods to date. © 2011 Emerald Group Publishing Limited. All rights reserved.