Heathcote’s practice-led teaching: Pioneering research as well as pioneering pedagogy

It is widely recognized that Dorothy Heathcote was a dynamic and radical teacher who transformed and continually reinvented drama teaching. She did this by allowing her emerging thinking and understandings to flow from, and be tested by, regular and intensive ‘practicing’ in the classroom. In this way theoretical claims were grounded and evidenced in authentic classroom practice. And yet, for all her impact, it is rare to hear the claim that Heathcote’s pedagogic breakthroughs resulted from a legitimate research methodology. Clever and charismatic teaching yes; research no. One of the world’s best teachers certainly, but not a researcher; even though every lesson was experimental and every classroom was a site for discovery. This paper investigates that conundrum firstly by acknowledging that Heathcote’s practice-led teaching approach to discovery did not map comfortably on to the established educational research traditions of the day. It argues that traditional research methodologies, with their well-established protocols and methods, could not understand or embrace a research process which does its work by creating ‘fictional realities’ of openness, allegory and uncertainty. In recent years however it can be seen that Heathcote’s practice led-teaching, so essential for advancing the field, closely aligns with what many contemporary researchers are now calling practice-led research or practice as research or, in many Nordic countries, artistic research. A form of performative research, practice-led research has not emerged from the field of education but rather from the creative arts. Seeking to develop ways of researching creative practice which is deeply sympathetic and respectful of that practice, artist-researchers have developed practice-led research “which is initiated in practice, where questions, problems, challenges are identified and formed by the needs of practice and practitioners” (Grey, 1996). This sits comfortably with Heathcote’s classroom priority of “discovering by trial, error and testing; using available materials with respect for their nature, and being guided by this appreciation of their potential” (Heathcote, 1967). The paper will conclude by testing the dynamics of Heathcote’s practice-led teaching against the six conditions of practice-led research (Haseman&Mafe, 2011), a testing which will allow for a re-interpretation and re-housing of Dorothy Heathcote’s classroom-based teaching methodology as a form of performative research in its own right.

Embodying a future for the future: Creative Robotics and Ecosophical Practice

In recent years I have begun to integrate Creative Robotics into my Ecosophically-led art practices – which I have long deployed to investigate, materialise and engage thorny, ecological questions of the Anthropocene, seeking to understand how such forms of practice may promote the cultural conditions required to assure, rather than degrade, our collective futures. Many of us would instinctively conceive of robotics as an industrially driven endeavor, shaped by the pursuit of relentless efficiencies. Instead I ask through my practices, might the nascent field of Creative Robotics still be able to emerge with radically different frames of intention? Might creative practitioners still be able to shape experiences using robotic media that retain a healthy criticality towards such productivist lineages? Could this nascent form even bring forward fresh new techniques and assemblages that better encourage conversations around sustaining a future for the future, and, if so, which of its characteristics presents the greatest opportunities? I therefore ask, when Creative Robotics and Ecosophical Practice combine forces in strategic intervention, what qualities of this hybrid might best further the central aims of Ecosophical Practice – encouraging cultural conditions required to assure a future for the future?

Palliative care and other physicians’ knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: Survey results

Background: To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning (ACP) in their jurisdiction of practice. This includes the use of advance directives/living wills (ADs) and substitute decision-makers (SDMs) who can legally consent to or refuse treatment if there is no valid AD. Aim: The study aimed to investigate the knowledge, attitudes and practices of medical specialists most often involved in end-of-life care in relation to the law on withholding/ withdrawing life-sustaining treatment (WWLST) from adults without decision-making capacity. Design/participants: A pre-piloted survey was posted to specialists in palliative, emergency, geriatric, renal and respiratory medicine, intensive care and medical oncology in three Australian States. Surveys were analysed using SPSS20 and SAS 9.3. Results: The overall response rate was 32% (867/2702); 52% from palliative care specialists. Palliative Care specialists and Geriatricians had significantly more positive attitudes towards the law (χ242 = 94.352; p < 0.001) and higher levels of knowledge about the WWLST law (χ27 = 30.033; p < 0.001), than did the other specialists, while still having critical gaps in their knowledge. Conclusions: A high level of knowledge of the law is essential to ensure that patients’ wishes and decisions, expressed through ACP, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or removal of treatment.

Paediatric death and dying: Exploring coping strategies of health professionals and perceptions of support provision

Without question a child’s death is a devastating event for parents and their families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents, and families on this painful journey. A delicate and sensitive area of practice, it has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of well-being. Aim To explore health professionals’ perceptions of bereavement support surrounding the loss of a child. Methods The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz’s (2006) approach. Results For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs . Analysis of the narratives also revealed health professionals’ perceptions of their support provision. Conclusion Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

Practice uncertainty: Changing perceptions

Practice uncertainty occurs when health care providers feel uncomfortable in response to unfamiliar or challenging patient care situations. Practice uncertainty is inevitable in health care, and there are many contextual factors that can lead to either good or bad outcomes for patients and health care providers. Practice uncertainty is not a well-established concept in the literature, perhaps because of the predominant empirical paradigm and the high value placed on certainty within current health care culture. This study was conducted to explore practice uncertainty and bring this topic into the foreground as a first step toward practice evolution. A shift in the perception of practice uncertainty may change the way in which practitioners experience this phenomenon. This process must start with nursing educators recognizing and acknowledging this phenomenon when it occurs.

Travelling bones: The repatriation of Indigenous ancestral remains

In the album Journey, Archie Roach -- the Australian Indigenous singer-songwriter hailing from Mooroopna in Victoria - has a melancholy song called ‘Travell’n Bones.' It is about the repatriation of Indigenous ancestral remains to their rightful home. This Chapter considers the legal, ethical, and cultural conflicts over Australian indigenous remains being held in museums, in Australia, the United Kingdom, the European Union, and the United States. James Nason comments: ‘The explosion of legal and extra legal attention on issues of cultural property and heritage was born of the frustration and anger of indigenous peoples whose rights and perspectives about cultural property and heritage issues had been largely absent and essentially unwanted by the museum of community.' Part I focuses upon disputes in Australia involving the repatriation of Indigenous Australian remains. In Bropho v HREOC, there was controversy over a cartoon, mocking the repatriation of the remains of Yagan, an Indigenous warrior, to Western Australia. There was a discussion about the operation of the Racial Discrimination Act 1975 (Cth), and the exemptions available from the operation of the regime. Part II considers the efforts by The Te Papa Tongarewa - the Museum of New Zealand - to repatriate Maori and Moriori ancestral remains to New Zealand, and to iwi communities of origin. The conclusion considers the relevance of the United Nations Declaration on the Rights of Indigenous Persons 2007, and issues raised by ventures such as the Genographic Project.

Pivotal people, pivotal journeys: Interim report on the impact of a fundraising study tour on CEOs and their organisations

A longitudinal qualitative study was conducted with CEOs of 12 fundraising organisations across Australia to answer the question - how mights a change in the CEO's fundraising knowledge improve fundraising activity and outcomes for their organisation? The CEOs along with the inaugural Australian Grantmaker of the Year, Caitriona Fay from Perpetual and lead researcher Dr Wendy Scaife travelled to San Antonio, Texas, USA to attend the annual Association of Fundraising Professionals (AFP) conference in March 2014. Participants identified five main success factors for such group learning initiatives about fundraising: - Getting away from the day to day business of running the organisation - Informal, social time to debrief and get to know others - Diversity of organisations whereby no one was in direct competition to others - Commitment, openness and willingness of individuals to participate - Group facilitation This research has been supported by the Perpetual Foundation – Trustees Endowment, The Edward Corbould Charitable Trust, and the Samuel and Eileen Gluyas Charitable Trust under the management of Perpetual Trustee Company Ltd.

Climbing skill and complexity of climbing wall design: Assessment of jerk as a novel indicator of performance fluency

This study investigated a new performance indicator to assess climbing fluency (smoothness of the hip trajectory and orientation of a climber using normalized jerk coefficients) to explore effects of practice and hold design on performance. Eight experienced climbers completed four repetitions of two, 10-m high routes with similar difficulty levels, but varying in hold graspability (holds with one edge vs holds with two edges). An inertial measurement unit was attached to the hips of each climber to collect 3D acceleration and 3D orientation data to compute jerk coefficients. Results showed high correlations (r = .99, P < .05) between the normalized jerk coefficient of hip trajectory and orientation. Results showed higher normalized jerk coefficients for the route with two graspable edges, perhaps due to more complex route finding and action regulation behaviors. This effect decreased with practice. Jerk coefficient of hip trajectory and orientation could be a useful indicator of climbing fluency for coaches as its computation takes into account both spatial and temporal parameters (ie, changes in both climbing trajectory and time to travel this trajectory)

The positioning of palliative care in acute care: A multiperspective qualitative study in the context of metastatic melanoma

Objective: The positioning and meaning of palliative care within the healthcare system lacks clarity which adds a level of complexity to the process of transition to palliative care. This study explores the transition to the palliative care process in the acute care context of metastatic melanoma. Method: A theoretical framework drawing on interpretive and critical traditions informs this research. The pragmatism of symbolic interactionism and the critical theory of Habermas brought a broad orientation to the research. Integration of the theoretical framework and grounded-theory methods facilitated data generation and analysis of 29 interviews with patients, family carers, and healthcare professionals. Results: The key analytical findings depict a scope of palliative care that was uncertain for users of the system and for those working within the system. Becoming “palliative” is not a defined event; nor is there unanimity around referral to a palliative care service. As such, ambiguity and tension contribute to the difficulties involved in negotiating the transition to palliative care. Significance of Results: Our findings point to uncertainty around the scopes of practice in the transition to palliative care. The challenge in the transition process lies in achieving greater coherency of care within an increasingly specialized healthcare system. The findings may not only inform those within a metastatic melanoma context but may contribute more broadly to palliative practices within the acute care setting.

Narrative as a tool for critical reflective practice in the creative industries

This paper explores the efficacy of narrative in reflective practice across a range of creative disciplines. As practitioners within the creative industries the authors internalise experience and re-contextualise it as stories, designs, music videos, fiction and non-fiction films and dance. They are uniquely placed to examine narrative in critical reflection through the prism of their creative practice and in so doing offer insights into reconceptualising professional practice. The authors demonstrate how engagement with and reflection on and in their stories enables wider reflection. Their purpose in reflection is not just to learn from mistakes but to develop an epistemology of practice that enables them to apply rigorous academic inquiry to articulate their tacit professional knowledge and establish new methods for dealing with uncertainty in creative practice research.

A comparison of final year undergraduate nursing students’ readiness for registration

The International Council of Nurses (2009) acknowledges that the perception : New Graduates are not prepared for the realities of practice nor do they have the competencies needed by current health care services...

“What are they really doing?” An exploration of student learning activities in field placement

Social work students consistently identify their field placement as having the most impact on their learning. Despite this, research on learning activities used during placement and the impact on practice competency and social work identity is limited. This is the second paper from a research study exploring student experiences of learning on placement. Data were gathered from 263 social work students about 14 key learning activities they experienced during placement. The more regularly students engaged in learning activities with their social work supervisor, the more likely they were to report a sense of social work identity and feelings of practice competence. However, the regular use of learning activities varied widely between placements. Surprisingly, approximately half the students did not regularly have the opportunity to observe social work practice, have their practice observed, or to link social work theory and the Code of Ethics to their practice with their social work supervisor.

Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children

Background Guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) around the world vary greatly. Most institutions recommend the use of heparin to prevent occlusion, however there is debate regarding the need for heparin and evidence to suggest 0.9% sodium chloride (normal saline) may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased cost. Objectives To assess the clinical effects (benefits and harms) of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Search Methods The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (last searched April 2015) and the Cochrane Register of Studies (Issue 3, 2015). We also searched the reference lists of retrieved trials. Selection criteria Randomised controlled trials that compared the efficacy of normal saline with heparin to prevent occlusion of long term CVCs in infants and children aged up to 18 years of age were included. We excluded temporary CVCs and peripherally inserted central catheters (PICC). Data Collection and Analysis Two review authors independently assessed trial inclusion criteria, trial quality and extracted data. Rate ratios were calculated for two outcome measures - occlusion of the CVC and central line-associated blood stream infection. Other outcome measures included duration of catheter placement, inability to withdraw blood from the catheter, use of urokinase or recombinant tissue plasminogen, incidence of removal or re-insertion of the catheter, or both, and other CVC-related complications such as dislocation of CVCs, other CVC site infections and thrombosis. Main Results Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin, however, between studies, all used different protocols for the standard and experimental arms with different concentrations of heparin and different frequency of flushes reported. In addition, not all studies reported on all outcomes. The quality of the evidence ranged from low to very low because there was no blinding, heterogeneity and inconsistency between studies was high and the confidence intervals were wide. CVC occlusion was assessed in all three trials (243 participants). We were able to pool the results of two trials for the outcomes of CVC occlusion and CVC-associated blood stream infection. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). The duration of catheter placement was reported to be similar between the two study arms, in one study (203 participants). Authors' Conclusions The review found that there was not enough evidence to determine the effects of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.

Assessing performance in critical care nursing practice using the Benner Novice to expert model: A pilot study

Background It is often believed that by ensuring the ongoing completion of competency documents and life-long learning in nursing practice guarantees quality patient care. This is probably true in most cases where it provides reassurances that the nursing team is maintaining a safe “generalised” level of practice. However, competency does not always promise quality performance. There are a number of studies that have reported differences in what practitioners know and what they actually do despite being deemed competent. Aim The aim of this study was to assess whether our current competency documentation is fit for purpose and to ascertain whether performance assessment needs to be a key component in determining competence. Method 15 nurses within a General ICU who had been on the unit <4 years agreed to participate in this project. Using participant observation and assessing performance against key indicators of the Benner Novice to Expert5 model the participants were supported and assessed over the course of a ‘normal’ nursing shift. Results The results were surprising both positively and negatively. First, the nurses felt more empowered in their clinical decision making skills; second, it identified individual learning needs and milestones in educational development. There were some key challenges identified which included 5 nurses over estimating their level of competence, practice was still very much focused on task acquisition and skill and surprisingly some nurses still felt dominated by the other health professionals within the unit. Conclusion We found that the capacity and capabilities of our nursing workforce needs continual ongoing support especially if we want to move our staff from capable task-doer to competent performers. Using the key novice to expert indicators identified the way forward for us in how we assess performance and competence in practice particularly where promotion to higher grades is based on existing documentation.

Studies of working memory in interrupted human-computer interaction

Distraction in the workplace is increasingly more common in the information age. Several tasks and sources of information compete for a worker's limited cognitive capacities in human-computer interaction (HCI). In some situations even very brief interruptions can have detrimental effects on memory. Nevertheless, in other situations where persons are continuously interrupted, virtually no interruption costs emerge. This dissertation attempts to reveal the mental conditions and causalities differentiating the two outcomes. The explanation, building on the theory of long-term working memory (LTWM; Ericsson and Kintsch, 1995), focuses on the active, skillful aspects of human cognition that enable the storage of task information beyond the temporary and unstable storage provided by short-term working memory (STWM). Its key postulate is called a retrieval structure an abstract, hierarchical knowledge representation built into long-term memory that can be utilized to encode, update, and retrieve products of cognitive processes carried out during skilled task performance. If certain criteria of practice and task processing are met, LTWM allows for the storage of large representations for long time periods, yet these representations can be accessed with the accuracy, reliability, and speed typical of STWM. The main thesis of the dissertation is that the ability to endure interruptions depends on the efficiency in which LTWM can be recruited for maintaing information. An observational study and a field experiment provide ecological evidence for this thesis. Mobile users were found to be able to carry out heavy interleaving and sequencing of tasks while interacting, and they exhibited several intricate time-sharing strategies to orchestrate interruptions in a way sensitive to both external and internal demands. Interruptions are inevitable, because they arise as natural consequences of the top-down and bottom-up control of multitasking. In this process the function of LTWM is to keep some representations ready for reactivation and others in a more passive state to prevent interference. The psychological reality of the main thesis received confirmatory evidence in a series of laboratory experiments. They indicate that after encoding into LTWM, task representations are safeguarded from interruptions, regardless of their intensity, complexity, or pacing. However, when LTWM cannot be deployed, the problems posed by interference in long-term memory and the limited capacity of the STWM surface. A major contribution of the dissertation is the analysis of when users must resort to poorer maintenance strategies, like temporal cues and STWM-based rehearsal. First, one experiment showed that task orientations can be associated with radically different patterns of retrieval cue encodings. Thus the nature of the processing of the interface determines which features will be available as retrieval cues and which must be maintained by other means. In another study it was demonstrated that if the speed of encoding into LTWM, a skill-dependent parameter, is slower than the processing speed allowed for by the task, interruption costs emerge. Contrary to the predictions of competing theories, these costs turned out to involve intrusions in addition to omissions. Finally, it was learned that in rapid visually oriented interaction, perceptual-procedural expectations guide task resumption, and neither STWM nor LTWM are utilized due to the fact that access is too slow. These findings imply a change in thinking about the design of interfaces. Several novel principles of design are presented, basing on the idea of supporting the deployment of LTWM in the main task.