Learning in Health and Social Care最新文献

The aim of this study is to investigate the emergent concept of cultural lag through analysis and evaluation of academic staff's engagement with an established pre-registration interprofessional learning (IPL) programme. By cultural lag is meant the apparent inability of some practitioners to commit wholeheartedly to the philosophy of IPL notwithstanding the current political and professional context.

The theoretical framework adopted for this study constructs the move from uniprofessional to interprofessional education as a psychosocial transition, a process of psychological adaptation to a different social world, which may be characterized or revealed by specific language and behaviours.

A qualitative survey of faculty academic staff was conducted electronically during the 2005/2006 academic year to determine the level of involvement with the programme and attitudes towards interprofessional learning. The sample comprised all 178 permanent members of academic staff and the final response was 63 (35%). Thematic, content analysis suggests that the whole meaning of the data is that academic staff see IPL as a means of promoting multi-professional working and improved professional relationships, which has the potential to promote more person-centred services and enhance care.

During the analysis, it was noted that there seemed to be some dissonance between the overall approval rating for IPL and the way in which respondents expressed themselves. Some of the language used and reported behaviours are analysed and interpreted as reaction to loss and indicative of the process of psychosocial transition.

It is concluded that there are signs of the phenomenon of cultural lag among the respondents. The study begins to articulate its characteristics and may be helpful in shedding some light on the attitudes and behaviours of staff who are either ambivalent or hostile to interprofessional education. It is suggested that developing and delivering interprofessional education could pose a considerable cultural challenge that cannot be ignored during curriculum development and must be taken account of when planning and managing educational change.

Relatively little is known about the specific attributes of health professional students which may influence their attitudes towards both interprofessional teamwork and interprofessional education. A survey was distributed to all pre-licensure health professional students from medicine, nursing, pharmacy and social work programmes at our institution. Respondents were asked to rate their attitudes towards interprofessional healthcare teams and interprofessional education using validated and reliable scales reported in the literature. Information on the respondents’ gender, profession, year of study and prior experience with interprofessional education was also collected. There was no significant difference between attitudes of medicine and nursing students towards interprofessional teamwork; however, both these student groups report significantly less positive attitudes towards interprofessional teams than pharmacy and social work students. Medicine students reported significantly less positive attitudes towards interprofessional education than nursing, pharmacy and social work students. Female students and senior undergraduate students reported significantly more positive attitudes towards interprofessional teamwork and interprofessional education, while students reporting prior experience with interprofessional education reported significantly more positive attitudes towards interprofessional teamwork. Profession, gender and year of study appear to be attributes which were related to more positive attitudes towards both interprofessional teamwork and education.

This paper explores the ways in which nurses in acute care settings can address the emotional needs of their patients and uses psychoanalytical concepts to provide a level of explanation. It is acknowledged that dealing with the emotional needs of patients is a key function of the nurse's role; however, there is much in the literature, particularly that from a psychoanalytical perspective, that would suggest that, in practice, defences are often used as a way of avoiding involvement with patient. This qualitative study used observational techniques as a means of collecting data from two settings in a large teaching hospital, one an acute surgical ward and the second setting was award specializing in haematological conditions. In the two settings, nurse–patient interactions differed. In the haematological ward, the emotional needs were acknowledged and addressed, whereas in the acute surgical ward institutional defences predominated, which prevented close patient involvement. The emotional needs were often passed onto the medical staff or nurse specialists, which could prevent nurses developing the requisite skills. Certain important conclusions were elicited from the data. As with any qualitative analysis, this was in keeping with a particular research framework and another framework, or indeed another researcher may have drawn different conclusions. The main conclusions drawn were the following: the nurses working in the haematological setting had developed many of the skills necessary to deal with patients’ emotional needs. In the surgical setting, the organizational system did not allow the nurses to engage sufficiently to build and develop these particular skills.

We are planning a special edition devoted to Ethics around professional learning in health and social care in Volume 8 of the journal. The guest editors will be Professor Paul Wainwright and Dr Ann Gallagher both from the University of Kingston.

We are looking for full research papers, for scholarship papers, practice accounts and insights, and for reviewers for this edition. Please do get in touch with me ([email protected]) as the journal editor for further information if you wish to submit a paper or contribute in some way. I will forward all queries to the guest editors.

Please note also that the cluster of work on Internationalization and learning in health and social care will now be completed in Volume 8.

This paper explores the potential of adopting an alternative approach to the facilitation of clinical supervision in a practice context by focusing on the experiences of academic staff of facilitating clinical supervision for clinical colleagues. The exploratory study, which forms the basis for ideas generated, was very small and hence it might be better conceptualized as an analysis of conversations about practice understandings rather than research per se, and certainly, we make no claims of any possibility of generalizability. Nonetheless, we anticipate that our findings will be of interest to a wide audience involved in clinical supervision given that the supervision by academic staff of colleagues in practice is an unusual and unconventional departure from the norm.

The experiences of six academic staff from one higher education institution who were brought together to form a focus group provide the basis for discussion. Analysis of the structured discussion led to emergence of four major themes which are presented in an order that moves from the individuals’ experiences and perceptions of themselves in the process, to explore the relational nature of clinical supervision. The first theme highlights issues of professional identity or academics’ sense of themselves as health professionals and/or academics. This leads to the second theme that explores the tangible benefits identified by participants of providing clinical supervision as academics. The third theme about the perceived contribution that academics make to supervision, links, finally, to the perceived reciprocity that springs from clinical supervision relationships between academics providing supervision in practice, and clinicians. Our findings, based on this modest inquiry, suggest that this model of clinical supervision has potential to prove highly fruitful for both academic staff and their clinical colleagues.

One way to offer students pursuing health and social care programmes realistic experiences of teamwork is interprofessional training wards where students from different educational programmes learn teamwork by working together. In the present study, a training ward in municipal care for older people was evaluated. Students from occupational therapy, nursing and social work programmes worked together on the ward for 3 weeks to learn with, from and about each other. The aim of the study was to compare students’ attitudes towards practice on a training ward before and after and to evaluate goal fulfilment after 3 weeks’ interprofessional education on a training ward. An attitude questionnaire was distributed to all students before and after their time on the ward, supplemented with a retrospective goal-fulfilment questionnaire afterwards. The results show that the collaborative, social experience the training ward offers was appreciated by the students and in most respects, met the learning goals set up for the course. The most important learning experience was working together in a real-life setting. However, there are some issues to take into consideration when planning and developing training wards. The setting needs to be realistic and relevant in relation to future roles for all of the student groups involved. The value and purpose of engaging together in basic patient care needs to be the subject of further investigation. When it comes to fostering competent team-workers, training wards seem to be one way forward. But to fully understand the challenges and difficulties involved in planning these wards, the learning achieved must be understood in the context of the setting as a whole, in all its aspects.