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

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

Medication use review in Qatar: Are community pharmacists prepared for the extended professional role?

Background
The incidence of chronic illnesses is increasing globally. Non-adherence to medications and other medication-related problems are common among patients receiving long-term medications. Medication use review (MUR) is a service provision with an accredited pharmacist undertaking structured, adherence-centered reviews with patients receiving multiple medications. MUR services are not yet available in community pharmacies in Qatar.

Objective
The current study aims to evaluate community pharmacists' knowledge, attitudes, and perception towards establishing MUR as an extended role in patient care.

Setting
Private community pharmacies in Qatar including chains and independent pharmacies.

Methodology
A cross-sectional survey using a self-administered questionnaire was conducted among licensed community pharmacists from December 2012 to January 2013. Data analysis was conducted using descriptive and inferential statistics.

Main outcome measures
Knowledge, attitudes, and practices related to MUR concept and services.

Results A total of 123 participants responded to the survey (response rate 56 %). The mean total knowledge score was 71.4 ± 14.7 %. An overwhelming proportion of the participants (97 %) were able to identify the scope of MUR in relation to chronic illnesses and at enhancing the quality of pharmaceutical care. Furthermore, 80 % of the respondents were able to identify patients of priority for inclusion in an MUR program. However, only 43 % of the participants knew that acute medical conditions were not the principal focus of an MUR service, while at least 97 % acknowledged that the provision of MUR services is a great opportunity for an extended role of community pharmacists and that MUR makes excellent use of the pharmacist's professional skills in the community. The participants generally reported concerns about time, dedicated consultation area, and support staff as significant barriers towards MUR implementation.

Conclusion
This study suggests that community pharmacists in Qatar had sufficient knowledge about the concept of MUR and its scope, but there were still important deficiencies that warrant further education. The findings have important implications on policy and practice pertaining to the implementation of MUR as an extended role of pharmacists and as part of Qatar's National Health Strategy to move primary health care forward.

Investigation project: Representations about the professional role of recently graduated from the psychology career, state University of La Plata : Its relation with job insertion and performance

In this paper we present a research that took place between 2010 and 2012 included in an investigation scholarship awarded by the State University of la Plata. It is about the problem with the transition between college and professional work. It is a part of the produced studies on the importance of social representations as factors that impact on the performance of specific activities. In this case it's about finding out the relations given among the representations about graduated professional role of the Psychology career and its job insertion and performance. The theoretical framework corresponds to Social Psychology and Guidance theories. Methodologically this is an exploratory and descriptive study, based on the 'triangulation' conception, of multiple type, that allows combining in the same investigation, different strategies, theoretical perspectives and sources; however qualitative techniques were prioritized to analyze data. Finally there are some considerations about the social representations concerning to the professional performance, mainly in the clinical field associated to education, and also to the problems of both situations over other fields

Investigation project: Representations about the professional role of recently graduated from the psychology career, state University of La Plata : Its relation with job insertion and performance

In this paper we present a research that took place between 2010 and 2012 included in an investigation scholarship awarded by the State University of la Plata. It is about the problem with the transition between college and professional work. It is a part of the produced studies on the importance of social representations as factors that impact on the performance of specific activities. In this case it's about finding out the relations given among the representations about graduated professional role of the Psychology career and its job insertion and performance. The theoretical framework corresponds to Social Psychology and Guidance theories. Methodologically this is an exploratory and descriptive study, based on the 'triangulation' conception, of multiple type, that allows combining in the same investigation, different strategies, theoretical perspectives and sources; however qualitative techniques were prioritized to analyze data. Finally there are some considerations about the social representations concerning to the professional performance, mainly in the clinical field associated to education, and also to the problems of both situations over other fields

Investigation project: Representations about the professional role of recently graduated from the psychology career, state University of La Plata : Its relation with job insertion and performance

In this paper we present a research that took place between 2010 and 2012 included in an investigation scholarship awarded by the State University of la Plata. It is about the problem with the transition between college and professional work. It is a part of the produced studies on the importance of social representations as factors that impact on the performance of specific activities. In this case it's about finding out the relations given among the representations about graduated professional role of the Psychology career and its job insertion and performance. The theoretical framework corresponds to Social Psychology and Guidance theories. Methodologically this is an exploratory and descriptive study, based on the 'triangulation' conception, of multiple type, that allows combining in the same investigation, different strategies, theoretical perspectives and sources; however qualitative techniques were prioritized to analyze data. Finally there are some considerations about the social representations concerning to the professional performance, mainly in the clinical field associated to education, and also to the problems of both situations over other fields

Analyse de l’implantation d’un plan d’action pour le renforcement du rôle professionnel de la sage-femme dans le Royaume du Maroc

Dans le cadre d’une stratégie nationale visant les objectifs du Millénaire pour le développement 4 et 5 au Maroc - réduire la mortalité maternelle et infantile -, un plan d’action a été développé au sein des trois systèmes (socioculturel, éducationnel, disciplinaire) dans lesquels évolue un rôle professionnel de la santé et ce, pour renforcer le rôle professionnel de la sage-femme. La présente thèse vise à évaluer le niveau d’implantation du plan d’action et à comprendre les facteurs contextuels ayant affecté son implantation et susceptibles d’empêcher l’atteinte de ses effets. Le cadre conceptuel adopté dérive du modèle de Hatem-Asmar (1997) concernant l’interaction entre les systèmes éducationnel, disciplinaire et socioculturel pour changer un rôle professionnel de la santé; et le cadre de Damschroder et al. (2009) pour l’analyse de l’implantation d’une intervention en santé. Le devis est une étude de cas unique à trois niveaux d’analyse. Les données sont recueillies à partir de multiples sources de données : 11 entrevues individuelles semi-structurées, 20 groupes de discussion, observations d’activités de formation, analyse de documents. Les résultats ont montré des déficits notables au niveau de l’implantation. Seize barrières et sept facilitateurs ont été catégorisés sous les construits du cadre de Damschroder et al. (2009) et sous les dimensions des trois systèmes. Un alignement inadéquat entre les dimensions (valeurs, méthodes, acteurs et finalités) du système socioculturel et celles (valeurs, méthodes, acteurs) des systèmes éducationnel et disciplinaire d’une part, avec le plan d’action d’autre part empêche son implantation globale. La structure bureaucratique et le manque de préparation du système socioculturel ont constitué les barrières les plus influentes sur: la diffusion de l’information; l’implication des acteurs du terrain dans le processus; et l’état de préparation du système éducationnel. Les principaux facilitateurs étaient : les valeurs promues à l’égard des droits humains et le mouvement politique pour renforcer le rôle professionnel de la sage-femme et réduire la mortalité maternelle. Quant au plan, il a été perçu comme étant bénéfique mais complexe et émanant d’une source externe. Les résultats mettent l’accent sur la nécessité de contourner les barrières identifiées dans les trois systèmes afin d’obtenir des contextes propices à la production des effets. Par ailleurs, les résultats ont soulevé aussi sept barrières qui risquent de compromettre l’atteinte des effets désirés. Elles concernent: le cadre légal, les représentations sociales et le support médiatique au niveau du système socioculturel; le réseautage et les mécanismes de communication, les caractéristiques liées au rôle, à l’environnement de pratique, et le niveau de préparation du système disciplinaire. Notre recherche confirme qu’un changement visant le système éducationnel isolément représente une vision réductrice pour le renforcement du rôle des sages-femmes. Une combinaison des conditions contextuelles favorables au niveau des dimensions des trois systèmes est requise pour atteindre le but de la stratégie gouvernementale, soit fournir des sages-femmes qualifiées selon les normes globales de la Confédération Internationale des sages-femmes, capables d’offrir des soins de qualité en santé de la reproduction qui permettront de contribuer à réduire la mortalité maternelle et néonatale.

A model of teacher professional development based on the principles of lesson study

The researcher’s professional role as an Education Officer was the impetus for this study. Designing and implementing professional development activities is a significant component of the researcher’s position description and as a result of reflection and feedback from participants and colleagues, the creation of a more effective model of professional development became the focus for this study. Few studies have examined all three links between the purposes of professional development that is, increasing teacher knowledge, improving teacher practice, and improving student outcomes. This study is significant in that it investigates the nature of the growth of teachers who participated in a model of professional development which was based upon the principles of Lesson Study. The research provides qualitative and empirical data to establish some links between teacher knowledge, teacher practice, and student learning outcomes. Teacher knowledge in this study refers to mathematics content knowledge as well as pedagogical-content knowledge. The outcomes for students include achievement outcomes, attitudinal outcomes, and behavioural outcomes. As the study was conducted at one school-site, existence proof research was the focus of the methodology and data collection. Developing over the 2007 school year, with five teacher-participants and approximately 160 students from Year Levels 6 to 9, the Lesson Study-principled model of professional development provided the teacher-participants with on-site, on-going, and reflective learning based on their classroom environment. The focus area for the professional development was strategising the engagement with and solution of worded mathematics problems. A design experiment was used to develop the professional development as an intervention of prevailing teacher practice for which data were collected prior to and after the period of intervention. A model of teacher change was developed as an underpinning framework for the development of the study, and was useful in making decisions about data collection and analyses. Data sources consisted of questionnaires, pre-tests and post-tests, interviews, and researcher observations and field notes. The data clearly showed that: content knowledge and pedagogical-content knowledge were increased among the teacher-participants; teacher practice changed in a positive manner; and that a majority of students demonstrated improved learning outcomes. The positive changes to teacher practice are described in this study as the demonstrated use of mixed pedagogical practices rather than a polarisation to either traditional pedagogical practices or contemporary pedagogical practices. The improvement in student learning outcomes was most significant as improved achievement outcomes as indicated by the comparison of pre-test and post-test scores. The effectiveness of the Lesson Study-principled model of professional development used in this study was evaluated using Guskey’s (2005) Five Levels of Professional Development Evaluation.

Setting the agenda, influencing public opinion, and advocating for social change

This study seeks to contribute to the systematic explanation of journalists’ professional role orientations. Focusing on three aspects of journalistic interventionism – the importance of setting the political agenda, influencing public opinion and advocating for social change – multilevel analyses found substantive variation in interventionism at the individual level of the journalist, the level of the media organizations, and the societal level. Based on interviews with 2100 journalists from 21 countries, findings affirm theories regarding a hierarchy of influences in news work. We found journalists to be more willing to intervene in society when they work in public media organizations and in countries with restricted political freedom. An important conclusion of our analysis is that journalists’ professional role orientations are also rooted within perceptions of cultural and social values. Journalists were more likely to embrace an interventionist role when they were more strongly motivated by the value types of power, achievement and tradition.

The changing nature and role of the head of department

There is little doubt that devolution of responsibility to schools and the growth of school-based management have impacted upon the role and workload of school leaders. Not only Principals have been affected by these changes as Welch (1996) argues that Principals of public secondary schools have passed responsibility down to Deputy-principals and to Heads of Department. As such, the Head of Department role, like other school administration positions, has undergone significant change. Of interest to this paper is the changing role of Heads of Department in secondary schools. This study reports on the findings of semi-structured interviews with eight Heads of Department from four public secondary schools and Principals from each of these schools in South East Queensland. Four years after the first set of interviews, two heads of department were reinterviewed. Both sets of interviews focused upon the role, change, and the importance of leadership. The research generated eight specific themes each of which was considered consistent with the nature of the role in a period of significant cultural change. These were the difference in perceptions regarding the Head of Department role, held by Principals and Heads of Department; Head of Department leadership in terms of a curriculum framed department or whole school leadership; how individuals perceived leadership, and how they learned of leadership; the impact of the changing culture upon the individual Head of Department; the growing influence of situational factors upon the role; the impact of managerialism; the changing nature of a secondary school department; and a growing and more complex workload, and the need for different skills. Furthermore, the findings pointed towards the need for effective change processes and a reconceptualized head of department role. The paper concludes with some implications for the ongoing professional development needs of Heads of Department.

Lehrende als ‘agents of change’ - Konzeptionelle Überlegungen zu einer kinderrechtlichen Annotation und Ausdeutung der Standards für die Lehrerbildung

Die Dissertation geht von der Überlegung aus, dass ein Wandel im deutschen Bildungssystem aufgrund kinderrechtlicher und demokratischer Überlegungen eine essenzielle Zukunftsaufgabe ist. Dies geschieht im Besonderen vor dem Hintergrund kinderrechtlicher Forderungen, wie sie beispielsweise aus dem Status Deutschlands als Mitgliedsland der UN-Kinderrechtskonvention und des UN-Übereinkommens über die Rechte von Menschen mit Behinderung entstehen: Die Korrelation zwischen Herkunft und Bildungserfolg sowie die noch konzeptionell ungenügend entwickelten Ansätze zur Inklusion werden als bestimmend für die Diskussion erkannt. Die Arbeit vertritt die These, dass Lehrende eine zentrale Rolle in einem notwendigen Prozess der Umwandlung des deutschen Bildungssystems spielen können und nimmt in emanzipatorischer Absicht die Lehrenden als Zielgruppe in den Blick. Aufgrund der Struktur der Lehrendenausbildung wird zudem dafür argumentiert, entsprechende Veränderungen im Sinne ihrer Nachhaltigkeit und flächendeckenden Relevanz in der Lehrendenausbildung des ersten universitären Ausbildungsabschnittes zu verankern. Als Instrument, welches die Kriterien von Nachhaltigkeit und umfassender Relevanz erfüllt, werden die Standards für die Lehrerbildung im Bereich Bildungswissenschaften benannt und theoretisch unterfüttert. Grundsätzlich spannt sich der Blickwinkel der Arbeit zwischen der Betrachtung der Struktur des Bildungssystems, des Wissens und Könnens von Lehrenden und Lernenden im Sinne der Kompetenzorientierung sowie der Haltung auf, welche Lehrende einnehmen. Dabei wird aufgezeigt, dass sich diese Faktoren wechselseitig auf vielfache Art und Weise beeinflussen. Auf der Basis dieser Überlegungen wird zunächst das deutsche Bildungssystem in seinen Strukturen beschrieben und die Lehrenden und Lernenden als Teilnehmende am Bildungsgeschehen skizziert. Ein exkursiver Vergleich dreier aufgrund kinderrechtlicher Parameter ausgewählter europäischer Bildungssysteme eruiert zudem, inwiefern die aufgezeigten Bestimmungsgrößen Struktur, Wissen/Können und Haltung Einfluss auf kinderrechtliche Verfasstheit des Bildungssystems nehmen, wobei die Grundprinzipien der UN-Kinderrechtskonvention hier als Messinstrument dienen. Davon ausgehend, erscheint pädagogische Haltung als eine wesentliche Einflussgröße, die im weiteren Verlauf der Arbeit im Sinne der kritischen Pädagogik zu einer Konzeption Pädagogischer Verantwortung verdichtet wird. Vor diesem Hintergrund erfolgt eine Betrachtung aktueller Problematiken im deutschen Bildungssystem, die sich an den in den Standards für die Lehrerbildung identifizierten Ausbildungsschwerpunkten orientiert und erneut die Prinzipien und rechtlichen Vorgaben der UN-Kinderrechtskonvention als Maßstab wählt. Auf der Grundlage dieser umfassenden Diskussion werden in einem sich anschließenden Analyseschritt Annotationen vorgenommen, die die Formulierungen der 11 Standards für die Lehrerbildung inhaltlich erweitern und ergänzen. In Verbindung mit einer Pädagogischen Verantwortung, die sich der Ausbildung kritischer Mündigkeit verpflichtet, werden die annotierten Standards als eine Möglichkeit der kinderrechtlichen (Selbst-)Evaluation von Lehrenden sowie als Instrument einer kinderrechtliche Gesichtspunkte fokussierenden Lehrendenbildung verstanden und dargestellt.

Teacher leadership : interns crossing to the domain of higher professional learning with mentors?

Over the last two decades, the notion of teacher leadership has emerged as a key concept in both the teaching and leadership literature. While researchers have not reached consensus regarding a definition, there has been some agreement that teacher leadership can operate at both a formal and informal level in schools and that it includes leadership of an instructional, organisational and professional development nature (York-Barr & Duke, 2004). Teacher leadership is a construct that tends not to be applied to pre-service teachers as interns, but is more often connected with the professional role of mentors who collaborate with them as they make the transition to being a beginning teacher. We argue that teacher leadership should be recognised as a professional and career goal during this formative learning phase and that interns should be expected to overtly demonstrate signs, albeit early ones, of leadership in instruction and other professional areas of development. The aim of this paper is to explore the extent to which teacher education interns at one university in Queensland reported on activities that may be deemed to be ‘teacher leadership.’ The research approach used in this study was an examination of 145 reflective reports written in 2008 by final Bachelor of Education (primary) pre-service teachers. These reports recorded the pre-service teachers’ perceptions of their professional learning with a school-based mentor in response to four outcomes of internship that were scaffolded by their mentor or initiated by them. These outcomes formed the bases of our research questions into the professional learning of the interns and included, ‘increased knowledge and capacity to teach within the total world of work as a teacher;’ ‘to work autonomously and interdependently’; to make ‘growth in critical reflectivity’, and the ‘ability to initiate professional development with the mentoring process’. Using the approaches of the constant comparative method of Strauss and Corbin (1998) key categories of experiences emerged. These categories were then identified as belonging to main meta-category labelled as ‘teacher leadership.’ Our research findings revealed that five dimensions of teacher leadership – effective practice in schools; school curriculum work; professional development of colleagues; parent and community involvement; and contributions to the profession – were evident in the written reports by interns. Not surprisingly, the mentor/intern relationship was the main vehicle for enabling the intern to learn about teaching and leadership. The paper concludes with some key implications for developers of preservice education programmes regarding the need for teacher leadership to be part of the discourse of these programmes.

Revealing common attributes of organizational identities using performance measurement systems

Identity is unique, multiple and dynamic. This paper explores common attributes of organisational identities, and examines the role of performance management systems (PMSs) on revealing identity attributes. One of the influential PMSs, the balanced scorecard, is used to illustrate the arguments. A case study of a public-sector organisation suggests that PMSs now place a value on the intangible aspects of organisational life as well as the financial, periodically revealing distinctiveness, relativity, visibility, fluidity and manageability of public-sector identities that sustain their viability. This paper contributes to a multi-disciplinary approach and its practical application, demonstrating an alternative pathway to identity-making using PMSs.

Kertomuksia kirkon työntekijäksi kasvamisesta : Kirkon nuorisotyötä opiskelevien spiritualiteetin ja ammatillisen identiteetin muotoutuminen

The aim of the study was to analyse Church Youth Work Leader students different processes of developing their spirituality and professional identity. The study was carried out in connection with the church-orientated education at the Diaconia University of Applied Sciences (Diak). The method of the study was narrative analysis. The data consisted of stories written (N=46) and told (N=10) by students, that were collected over three years in two units of Diak. The data was analysed in two ways: first with categorical-content analysis, and then with holistic-content analysis and holistic-form reading in order to establish the comprehensive views of complete narratives. The theoretical starting-point was to regard spirituality widely, including religion and faith. In the first data analysis, this theory was focused so that spirituality was namely Christian spirituality including personal faith and worship, membership in the Christian community and persons values and ideas about the meaning of life. The results of the investigation were presented in five model narratives. The story of a social care worker represents the process of a student orientating to social work. In this story spirituality manifested as a part of social and personal identity but not as a part of professional identity. The vocation for helping people led the student to social care work. In the story of a counselor, students good connection to their home parish took a central role. They had good experiences working as young Christian volunteers, and during their studies this volunteer role became professional role. Spirituality was strongly joined to professional identity. The story of an educator represents a vocation for spiritual work and youth work in the church. In this story students also had good connections to their home parishes. Spirituality manifested as a part of personal, social and professional identity. In the story of a spiritual worker or preacher, each person s spiritual vocation was remarkable. Spirituality was extremely individual and it defined the personal, social and professional identity. Spiritual devotion caused a change in students orientation from the church to social services. The story of a searcher tells about a student who is still looking for her or his own profession. The focus of the story was on personal growth and considering one s values and the meaning of life. Spirituality was manifested in personal identity. The results indicate that the practical placements in the second academic year have an important effect on students professional orientation and professional identity. The connection to the local parish has also significant meaning for students spiritual formation and development into church professions.

Professional non-neutrality: criticising the third party in psychotherapy

Using audio-recorded data from cognitive-constructivist psychotherapy, the article shows a particular institutional context in which successful professional action does not adhere to the pattern of affective neutrality which Parsons saw as an inherent component of medicine and psychotherapy. In our data, the professional’s non-neutrality functions as a tool for achieving institutional goals. The analysis focuses on the psychotherapist’s actions that convey a critical stance towards a third party with whom the patient has experienced problems. The data analysis revealed two practices of this kind of critique: (1) the therapist can confirm the critique that the patient has expressed or (2) return to the critique from which the patient has focused away. These actions are shown to build grounds for the therapist’s further actions that challenge the patient’s dysfunctional beliefs. The article suggests that in the case of psychotherapy, actions that as such might be seen as apparent lapses from the neutral professional role can in their specific context perform the task of the institution at hand.