The Acute Care Undergraduate TEaching (ACUTE) initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom

Background: The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation. Design: Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale. Results: A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation. Conclusions: We propose these competencies form a core set for undergraduate training in resuscitation and acute care.

Inspecting the teaching of singing in the teacher training colleges of England, Wales and Scotland 1883-1899

This paper investigates the links between the teaching of singing, training and inspection during the late Victorian era. It utilises as a primary source the annual inspection reports of the music inspector, Sir John Stainer. More specifically it focuses upon the musical background of the students in the training colleges of England, Wales and Scotland, the methods employed to teach sight singing and voice production, the vocal repertoire and preparation for the teaching of singing in schools. Finally, some comparison is made with the present day and the relationship between the teaching of singing, training and inspection.

The role of drama in the teaching of speaking and listening as the basis for social capital

This paper explores how the concept of 'social capital' relates to the teaching of speaking and listening. The argument draws on Bourdieu's notion that a common language is an illusion but posits that an understanding of the grammar of speech can be productive in the development of both an understanding of what constitutes effective speech and the development of competence in speaking. It is argued that applying structuralist notions of written grammar is an inadequate approach to understanding speech acts or enhancing the creative use of speech. An analysis is made of how typical features of speech relate to dramatic dialogue and how the meaning of what is said is contingent upon aural and visual signifiers. On this basis a competent speaker is seen as being one who produces expressions appropriate for a range of situations by intentionally employing such signifiers. The paper draws on research into the way drama teachers make explicit reference to and use of semiotics and dramatic effectiveness in order to improve students' performance and by so doing empower them to increase their social capital. Ultimately, it is concluded that helping students identify, analyse and employ the aural, visual and verbal grammar of spoken English is not an adjunct to the subject of drama, but an intrinsic part of understanding the art form. What is called for is a re-appraisal by drama teachers of their own understanding of concepts relating to speech acts in order to enhance this area of their work.

In-service training needs in an African context: a study of headteacher and teacher perspectives in the Gucha District of Kenya

Improving the quality of teaching is an educational priority in Kenya, as in many developing countries. The present paper considers various aspects of in-service education, including views on the effectiveness of in-service, teacher and headteacher priorities in determining in-service needs and the constraints on providing in-service courses. These issues are examined though an empirical study of 30 secondary headteachers and 109 teachers in a district of Kenya. The results show a strong felt need for in-service provision together with a firm belief in the efficacy of in-service in raising pupil achievement. Headteachers had a stronger belief in the need for in-service for their teachers than did the teachers themselves. The priorities of both headteachers and teachers were dominated by the external pressures of the schools, in particular the pressures for curriculum innovation and examination success. The resource constraints on supporting attendance at in-service courses were the major problems facing headteachers. The results reflect the difficulties that responding to an externally driven in-service agenda creates in a context of scarce resources.

The symbiotic roles of empirical experimentation and thought experimentation in the learning of physics

This study was an attempt to identify the epistemological roots of knowledge when students carry out hands-on experiments in physics. We found that, within the context of designing a solution to a stated problem, subjects constructed and ran thought experiments intertwined within the processes of conducting physical experiments. We show that the process of alternating between these two modes- empirically experimenting and experimenting in thought- leads towards a convergence on scientifically acceptable concepts. We call this process mutual projection. In the process of mutual projection, external representations were generated. Objects in the physical environment were represented in an imaginary world and these representations were associated with processes in the physical world. It is through this coupling that constituents of both the imaginary world and the physical world gain meaning. We further show that the external representations are rooted in sensory interaction and constitute a semi-symbolic pictorial communication system, a sort of primitive 'language', which is developed as the practical work continues. The constituents of this pictorial communication system are used in the thought experiments taking place in association with the empirical experimentation. The results of this study provide a model of physics learning during hands-on experimentation.