Moral distress: challenges for an autonomous nursing professional practice

Constantly experiencing limiting situations that hinder a professional practice coherent with its principles - of autonomy and advocacy of users' interests -, and often conditioned to experience moral distress, the nursing profession plays a prominent role in the current health model because it has the characteristic of managing the care rendered to users in a perspective of social inclusion, both in the basic health network and in hospitals. Aiming at carrying out a reflection on the nursing practice and the difficulties present in its work routine, and considering its characteristics as a profession, this article sought to make a reflection between the practice of nursing and the numerous moral challenges imposed by the routine, resulting, in many cases, in a value crisis that can reverberate directly on the quality of the service rendered, and in abandonment of the ideals of advocacy for users.

Diabète. Quels repères pour la prise en charge du diabète en 2010 [Diabetes. Perspectives on the management of diabetes in 2010.].

In the absence of works which would significantly change the perspective on the management of diabetes in the elapsed year, this article proposes a reflection on the integration of the evolving knowledge over the past decade into clinical practice. The major preventive impact of an approach targeting all the cardiovascular risk factors in diabetic patients will remain as the main lesson of this decade. The therapeutic goals need to be tailored to the individual patient's situation based on the evaluation of the benefit: inconvenience-ratio of the treatments. The process of their choice has to include the quest for a shared vision with the patient who is in charge of diabetes management in daily life.

A qualitative analysis of reflection in undergraduate and graduate programs

The purpose ofthis study was to explore various types ofreflection and to explore reflection on action, reflection as a practice, and reflection as a process. In doing this, the intent was to discover the perceived benefits of reflection in the classroom and to provide guidelines for future use at the undergraduate and graduate level. The qualitative components in this study included the data collection strategy of semistructured interviews with 2 undergraduate students, 2 graduate students, 1 undergraduate studies professor, and 1 graduate studies professor. The data analysis strategies included a within-case analysis and a cross-case analysis. Through the interviews participants discussed their experiences with the use ofreflection in the classroom. Through the completion ofthis analysis the researcher expected to discover the benefits ofreflection at this level of education, as well as provide suggestions for future use. Both undergraduate and graduate students and professors were found to benefit from the use of reflection in the classroom. The use ofreflection in the undergraduate and graduate classroom was found to improve student/teacher and student/peer relationships, foster critical thinking, allow for connections between learned theory and life experience, and improve students' writing abilities. Based on the results ofthe study the implications ofreflection for the undergraduate and graduate classroom and for further research are provided.

Valuing and encouraging critical reflection in pre-service teacher education

This qualitative study was designed to investigate aspects related to valuing and encouraging critical reflection in pre-service teacher education. An examination of the place and function of practicum logbooks as used at Covenant Canadian Reformed Teachers' College, a small private college which offers pre-service teacher education formed the core of the research. An analysis of the practicum logbooks written by five student teachers during three different practicum placements was performed at two levels. First, a content analysis served to identify general and specific categories within the practice teaching contextas a learning experience. Secondly, in-depth intuitive and thematic analyses of the entries which related specifically to reflection as a learning experience gave rise to critical questions. Throughout the process, the five participants formed an active and involved group of co-researchers, adding their voices to the narrative of the learning experience. Variables such as personality type, learning style and self-directedness added a dimension which deepened and emiched the study. The result of the study suggests that practicum logbooks form a valuable base for valuing and encouraging critical reflection in pre-service teacher education. The results also suggest that not all students appear to be equally capable of critical reflection. Recognizing that teacher education exists as a continuum appears to support the findings that in their journey along this continuum, student teachers not only move from reflection-on-action to reflection-in-action, but also from content to process to premise reflection. An awareness of contributing factors such as personality type, degree of risk-taking, preferred learning style and self-directedness on the part of teacher-educators will serve to create a climate of trust in which student teachers can safely develop critical reflection, using practicum logbooks as one possible medium.

What is reflection? A conceptual analysis of major definitions and a proposal of a five-component definition and model

La réflexion est considérée comme un élément significatif de la pédagogie et de la pratique médicales sans qu’il n’existe de consensus sur sa définition ou sur sa modélisation. Comme la réflexion prend concurremment plusieurs sens, elle est difficile à opérationnaliser. Une définition et un modèle standard sont requis afin d’améliorer le développement d’applications pratiques de la réflexion. Dans ce mémoire, nous identifions, explorons et analysons thématiquement les conceptualisations les plus influentes de la réflexion, et développons de nouveaux modèle et définition. La réflexion est définie comme le processus de s’engager (le « soi » (S)) dans des interactions attentives, critiques, exploratoires et itératives (ACEI) avec ses pensées et ses actions (PA), leurs cadres conceptuels sous-jacents (CC), en visant à les changer et en examinant le changement lui-même (VC). Notre modèle conceptuel comprend les cinq composantes internes de la réflexion et les éléments extrinsèques qui l’influencent.

The effect of BREEAM on clients and construction professionals

The effects and influence of the Building Research Establishment’s Environmental Assessment Methods (BREEAM) on construction professionals are examined. Most discussions of building assessment methods focus on either the formal tool or the finished product. In contrast, BREEAM is analysed here as a social technology using Michel Foucault’s theory of governmentality. Interview data are used to explore the effect of BREEAM on visibilities, knowledge, techniques and professional identities. The analysis highlights a number of features of the BREEAM assessment process which generally go unremarked: professional and public understandings of the method, the deployment of different types of knowledge and their implication for the authority and legitimacy of the tool, and the effect of BREEAM on standard practice. The analysis finds that BREEAM’s primary effect is through its impact on standard practices. Other effects include the use of assessment methods to defend design decisions, its role in both operationalizing and obscuring the concept of green buildings, and the effect of tensions between project and method requirements for the authority of the tool. A reflection on assessment methods as neo-liberal tools and their adequacy for the promotion of sustainable construction suggests several limitations of lock-in that hinder variation and wider systemic change.

Security devices based on liquid crystals doped with a colour dye

Liquid crystal properties make them useful for the development of security devices in applications of authentication and detection of fakes. Induced orientation of liquid crystal molecules and birefringence are the two main properties used in security devices. Employing liquid crystal and dichroic colorants, we have developed devices that show, with the aid of a polarizer, multiple images on each side of the device. Rubbed polyimide is used as alignment layer on each substrate of the LC cell. By rubbing the polyimide in different directions in each substrate it is possible to create any kind of symbols, drawings or motifs with a greyscale; the more complex the created device is, the more difficult is to fake it. To identify the motifs it is necessary to use polarized light. Depending on whether the polarizer is located in front of the LC cell or behind it, different motifs from one or the other substrate are shown. The effect arises from the dopant colour dye added to the liquid crystal, the induced orientation and the twist structure. In practice, a grazing reflection on a dielectric surface is polarized enough to see the effect. Any LC flat panel display can obviously be used as backlight as well.

Reflective analysis: Techniques for facilitating reflection

This paper describes a number of techniques for facilitating reflective critical analysis as a means of eliciting in-depth reflections on practice. The authors have previously used similar techniques in the research context, to assist practitioners to identify and analyse the basis of their work with clients. The techniques presented in this paper have been adapted for use in social work education, including in class-based and field education contexts, and to professional supervision.

Encouraging student to reflect on their employment experience

The purpose behind this case study is to share with a wider audience of placement officers, tutors and those who are involved in the management of placement students or employment of graduates, the approach taken to encourage reflective learning in undergraduate placement students at Aston Business School. Reflective learning forms an important foundation of the placement year at Aston Business School, where a professional placement is a mandatory element of the four year degree, for all Home/EU students (optional for International students) who are taking a Single Honours degree (i.e. a fully business programme). The placement year is not compulsory for those students taking a Combined Honours degree (i.e. a degree where two unrelated subjects are studied), although approximately 50% of those students taking an Aston Business School subject opt to take a placement year. Students spend their year out undertaking a ‘proper’ job within a company or public sector organisation. They are normally paid a reasonable salary for their work (in 2004/5 the average advertised salary was £13,700 per annum). The placement year is assessed, carrying credits which amount to a contribution of 10% towards the students’ final degree. The assessment methods used require the students to submit an academic essay relating theory to practice, a factual report about the company which can be of use to future students, and a log book, the latter being the reflective piece of work. Encouragement to reflect on the placement year has always been an important feature of Aston Business School’s approach to learning. More recently, however, feedback from employers indicated that, although our students have excellent employability skills, “they do not think about them” (Aston Business School Advisory Panel, 2001). We, therefore, began some activities which would encourage students to go beyond the mere acquisition of skills and knowledge. This work became the basis of a programme of introductions to reflective learning, mentoring and awareness of different learning styles written up in Higson and Jones (2002). The idea was to get students used to the idea of reflection on their experiences well before they entered the placement year.

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 have again changed our approach for this 2006/07 edition (our fourth) of the Aston Business School Good Practice Guide. As before, some contributions were selected from those identifying interesting best practice on their Annual Module reflection forms in 2005/2006. Other contributors received HELM (Research Centre in Higher Education Learning and Management) small research grants in 2005/2006. Part of the conditions were for them to write an article for this publication. We have also been less tight on the length of the articles this year. Some contributions are, therefore, on the way to being journal articles. HELM will be working with these authors to help develop these for publication. The themes covered in this year?s articles are all central to the issues faced by those providing HE teaching and learning opportunities in the 21st Century. Specifically this is providing support and feedback to students in large classes, embracing new uses of technology to encourage active learning and addressing cultural issues in a diverse student population. Michael Grojean and Yves Guillaume used Blackboard™ to give a more interactive learning experience and improve feedback to students. It would be easy for other staff to adopt this approach. Patrick Tissington and Qin Zhou (HELM small research grant holders) were keen to improve the efficiency of student support, as does Roger McDermott. Celine Chew shares her action learning project, completed as part of the Aston University PG Certificate in Teaching and Learning. Her use of Blackboard™ puts emphasis on the learner having to do something to help them meet the learning outcomes. This is what learning should be like, but many of our students seem used to a more passive learning experience, so much needs to be done on changing expectations and cultures about learning. Regina Herzfeldt also looks at cultures. She was awarded a HELM small research grant and carried out some significant new research on cultural diversity in ABS and what it means for developing teaching methods. Her results fit in with what many of us are experiencing in practice. Gina leaves us with some challenges for the future. Her paper certainly needs to be published. This volume finishes with Stuart Cooper and Matt Davies reflecting on how to keep students busy in lectures and Pavel Albores working with students on podcasting. Pavel?s work, which was the result of another HELM small research grant, will also be prepared for publication as a journal article. The students learnt more from this work that any formal lecture and Pavel will be using the approach again this year. Some staff have been awarded HELM small research grants in 2006/07 and these will be published in the next Good Practice Guide. In the second 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 for 2006/2007 is listed as Appendix 1 of this publication. Further details can be obtained from Catherine Foster (c.s.foster@aston.ac.uk), who coordinates the HELM seminars. For 2006 and 2005 HELM listed, 20 refereed journal articles, 7 book chapters, 1 published conference papers, 20 conference presentations, two official reports, nine working papers and £71,535 of grant money produced in this research area across the School. I hope that this shows that reflection on learning is alive and well in ABS. We have also been working on a list of target journals to guide ABS staff who wish to publish in this area. These are included as Appendix 2 of this publication. 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 the varying diverse approaches into a coherent and publishable form and for agreeing to fund the printing of this volume.

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.

Inspiring lecturers: sharing e-learning practice through european case studies

What motivates a university lecturer to consider introducing a new e-learning approach to their educational practice? Accounts of e-learning practice can invite discussion and reflection on the approaches taken, reinforcement of a particular model, connection with the experience of others, vicarious learning opportunities and glimpses into tacit knowledge. If these examples provoke thinking, could they have the ‘sticky qualities’, the memorable inspiration and ideas that move us to action, when we observe the practice of others? (Szulanski, 2003) “Case studies have the capacity to inspire but also to provoke and to challenge.” (JISC, 2004) This paper will discuss a process followed for sharing best practices of e-learning. It will explain how good practices were identified and gathered by the EUNIS E-Learning Task Force collaboration, using a database and a weblog (EUNIC, 2008). It will examine the methods used for the developing and compiling of the practices and the communication of these. Actual examples of some of the case studies gathered will be included in an appendix. Suggestions of ways to develop this process further and the tangible benefits identified will be examined to ask if effective practice can also become embedded practice.

Counting on use of technology to enhance learning

In global policy documents, the language of Technology-Enhanced Learning (TEL) now firmly structures a perception of educational technology which ‘subsumes’ terms like Networked Learning and e-Learning. Embedded in these three words though is a deterministic, economic assumption that technology has now enhanced learning, and will continue to do so. In a market-driven, capitalist society this is a ‘trouble free’, economically focused discourse which suggests there is no need for further debate about what the use of technology achieves in learning. Yet this raises a problem too: if technology achieves goals for human beings, then in education we are now simply counting on ‘use of technology’ to enhance learning. This closes the door on a necessary and ongoing critical pedagogical conversation that reminds us it is people that design learning, not technology. Furthermore, such discourse provides a vehicle for those with either strong hierarchical, or neoliberal agendas to make simplified claims politically, in the name of technology. This chapter is a reflection on our use of language in the educational technology community through a corpus-based Critical Discourse Analysis (CDA). In analytical examples that are ‘loaded’ with economic expectation, we can notice how the policy discourse of TEL narrows conversational space for learning so that people may struggle to recognise their own subjective being in this language. Through the lens of Lieras’s externality, desubjectivisation and closure (Lieras, 1996) we might examine possible effects of this discourse and seek a more emancipatory approach. A return to discussing Networked Learning is suggested, as a first step towards a more multi-directional conversation than TEL, that acknowledges the interrelatedness of technology, language and learning in people’s practice. Secondly, a reconsideration of how we write policy for educational technology is recommended, with a critical focus on how people learn, rather than on what technology is assumed to enhance.

Assessing the impacts of community participation policy and practice in Scotland and England

Background: Community participation has become an integral part of many areas of public policy over the last two decades. For a variety of reasons, ranging from concerns about social cohesion and unrest to perceived failings in public services, governments in the UK and elsewhere have turned to communities as both a site of intervention and a potential solution. In contemporary policy, the shift to community is exemplified by the UK Government’s Big Society/Localism agenda and the Scottish Government’s emphasis on Community Empowerment. Through such policies, communities have been increasingly encouraged to help themselves in various ways, to work with public agencies in reshaping services, and to become more engaged in the democratic process. These developments have led some theorists to argue that responsibilities are being shifted from the state onto communities, representing a new form of 'government through community' (Rose, 1996; Imrie and Raco, 2003). Despite this policy development, there is surprisingly little evidence which demonstrates the outcomes of the different forms of community participation. This study attempts to address this gap in two ways. Firstly, it explores the ways in which community participation policy in Scotland and England are playing out in practice. And secondly, it assesses the outcomes of different forms of community participation taking place within these broad policy contexts. Methodology: The study employs an innovative combination of the two main theory-based evaluation methodologies, Theories of Change (ToC) and Realist Evaluation (RE), building on ideas generated by earlier applications of each approach (Blamey and Mackenzie, 2007). ToC methodology is used to analyse the national policy frameworks and the general approach of community organisations in six case studies, three in Scotland and three in England. The local evidence from the community organisations’ theories of change is then used to analyse and critique the assumptions which underlie the Localism and Community Empowerment policies. Alongside this, across the six case studies, a RE approach is utilised to examine the specific mechanisms which operate to deliver outcomes from community participation processes, and to explore the contextual factors which influence their operation. Given the innovative methodological approach, the study also engages in some focused reflection on the practicality and usefulness of combining ToC and RE approaches. Findings: The case studies provide significant evidence of the outcomes that community organisations can deliver through directly providing services or facilities, and through influencing public services. Important contextual factors in both countries include particular strengths within communities and positive relationships with at least part of the local state, although this often exists in parallel with elements of conflict. Notably this evidence suggests that the idea of responsibilisation needs to be examined in a more nuanced fashion, incorporating issues of risk and power, as well the active agency of communities and the local state. Thus communities may sometimes willingly take on responsibility in return for power, although this may also engender significant risk, with the balance between these three elements being significantly mediated by local government. The evidence also highlights the impacts of austerity on community participation, with cuts to local government budgets in particular increasing the degree of risk and responsibility for communities and reducing opportunities for power. Furthermore, the case studies demonstrate the importance of inequalities within and between communities, operating through a socio-economic gradient in community capacity. This has the potential to make community participation policy regressive as more affluent communities are more able to take advantage of additional powers and local authorities have less resource to support the capacity of more disadvantaged communities. For Localism in particular, the findings suggest that some of the ‘new community rights’ may provide opportunities for communities to gain power and generate positive social outcomes. However, the English case studies also highlight the substantial risks involved and the extent to which such opportunities are being undermined by austerity. The case studies suggest that cuts to local government budgets have the potential to undermine some aspects of Localism almost entirely, and that the very limited interest in inequalities means that Localism may be both ‘empowering the powerful’ (Hastings and Matthews, 2014) and further disempowering the powerless. For Community Empowerment, the study demonstrates the ways in which community organisations can gain power and deliver positive social outcomes within the broad policy framework. However, whilst Community Empowerment is ostensibly less regressive, there are still significant challenges to be addressed. In particular, the case studies highlight significant constraints on the notion that communities can ‘choose their own level of empowerment’, and the assumption of partnership working between communities and the local state needs to take into account the evidence of very mixed relationships in practice. Most importantly, whilst austerity has had more limited impacts on local government in Scotland so far, the projected cuts in this area may leave Community Empowerment vulnerable to the dangers of regressive impact highlighted for Localism. Methodologically, the study shows that ToC and RE can be practically applied together and that there may be significant benefits of the combination. ToC offers a productive framework for policy analysis and combining this with data derived from local ToCs provides a powerful lens through which to examine and critique the aims and assumptions of national policy. ToC models also provide a useful framework within which to identify specific causal mechanisms, using RE methodology and, again, the data from local ToC work can enable significant learning about ‘what works for whom in what circumstances’ (Pawson and Tilley, 1997).

Student’s Perception on the Personal Impact of a Social Education Degree Internship

The functional profile of the social educator is based on the development of theoretical, technical and personal/relational skills, which should guide training courses organization. Assuming the shortcomings of a merely theoretical approach, besides a consistent preparation in theoretical and essential technical contents for socio-educational intervention, practice in context should be favoured as an opportunity to develop professional skills, together with a critical reflection on the functional profile. This study emerges from the need to reflect and rethink the internship, as well as how the respective supervision is developed, of the degree in social education at the School of Education of the Polytechnic Institute of Viseu, and it is based on the students’ perceptions about the impact of the internship on personal development. This is a qualitative and exploratory study, using the documentary analysis of 50 final internship reports. From the content analysis, four categories emerged referring to gains in terms of acquiring and managing knowledge, development of technical skills, personal and relational development and reinforcement of professional identity. The importance given to personal and relational development should be noted (41.4% of mentions) taking into account its relevance in constructing a professional identity. Findings on the technical skills and on the increase of profession knowledge, also by mobilising theoretical training, positively reinforce the internship model that is based on a proximity supervision approach and on a dialogical perspective of the professional learning.