Facilitated Focus Groups Research Articles

Attitude toward physical activity among Asian American family caregivers of persons living with dementia

This qualitative study aimed to explore attitudes toward physical activity behaviors in the context of dementia caregiving among Asian Indian, Chinese, Korean, and Vietnamese American family caregivers of persons living with dementia. We used qualitative data from verbatim transcripts of current caregivers (N = 21) from focus groups and individual interviews. Ethnically or linguistically matched moderators facilitated focus groups and interviews in four languages. Finalized themes included: (1) Physical activity and exercise are different.; (2) Exercise has many benefits.; (3) Health issues and stress from caregiving demotivate engaging in regular exercise.; (4) Prioritizing and planning exercises are necessary; and (5) Social support is essential to engage in physical activity. Caregiving limits the type of exercise some can do, depending on care recipients’ conditions. Efforts to help caregivers prioritize exercise and seek social support from others, including healthcare professionals, would be greatly needed to promote physical activity among this population.

Motivators of and barriers to in-person health care and video telehealth utilization among older Black adults: a qualitative study

ABSTRACT Objective Older Black adults continue to experience heightened rates of chronic illness and poor health outcomes. Further, older Black adults must navigate interlocking systems of oppression (e.g. racism, ageism, ableism, and classism etc.) that impact their healthcare utilization. Telehealth has emerged as a common health care modality, which presents unique concerns for aging populations. Design The present study explored the motivators of and barriers to in-person healthcare and video telehealth use among a sample of predominantly lower-income, older Black adults. The researchers collaborated with community scientists to recruit, facilitate focus groups and provide technological support for participants. Sixteen virtual focus groups were conducted (n = 147) with older Black adults aged 55–84 years. The researchers utilized a thematic analysis approach to identify twelve distinct themes. Results Participants identified the following as motivators to using in-person health care: improved patient-provider relationships, increased community support, and more culturally sensitive resources. Limited accessibility, discrimination and resulting distrust, and poor patient-provider communication were identified as barriers to in-person health care use. E-health literacy and accessibility both emerged as motivators of and barriers to using telehealth, while disinterest in telehealth and impersonal patient-provider relationships were noted as additional barriers. Conclusion These findings provide key implications for reducing the burden of health care inequity for older Black adults. Future implementation research should use equity-focused frameworks such as the patient-centered culturally sensitive health care (PC-CSHC) model. Additionally, collaboration with the community is necessary to create and implement the necessary culturally sensitive health interventions.

Large Language Model Use in Radiology Residency Applications: Unwelcomed but Inevitable

ObjectiveThis study explores radiology program directors’ perspectives on the impact of large language model (LLM) use among residency applicants to craft personal statements. MethodsEight program directors from the Radiology Residency Education Research Alliance participated in a mixed-methods study, which included a survey regarding impressions of artificial intelligence (AI)-generated personal statements and focus group discussions (July 2023). Each director reviewed four personal statement variations for five applicants, blinded to author type: the original and three Chat Generative Pre-trained Transformer-4.0 (GPT) versions generated with varying prompts, aggregated for analysis. A 5-point Likert scale surveyed the writing quality, including voice, clarity, engagement, organization, and perceived origin of each statement. An experienced qualitative researcher facilitated focus group discussions. Data analysis was performed using a rapid analytic approach with a coding template capturing key areas related to residency applications. ResultsGPT-generated statement ratings were more often average or worse in quality (56%, 268 of 475) than ratings of human-authored statements(29% [45 of 160]). Although reviewers were not confident in their ability to distinguish the origin of personal statements, they did so reliably and consistently, identifying the human-authored personal statements at 95% (38 of 40) as probably or definitely original. Focus group discussions highlighted the inevitable use of AI in crafting personal statements and concerns about its impact on the authenticity and the value of the personal statement in residency selections. Program directors were divided on the appropriate use and regulation of AI. DiscussionRadiology residency program directors rated LLM-generated personal statements as lower in quality and expressed concern about the loss of the applicant’s voice but acknowledged the inevitability of increased AI use in the generation of application statements.

Patient Perspectives on Utilizing a Mobile Medical Clinic in Rural Philippine Communities

The purpose of the ABC’s for Global Health Medical Mobile Clinic (ABC-MMC) is to (1) provide primary health care services and (2) prevent and manage hypertension and type 2 diabetes in underserved rural villages (barangays) in Pampanga Province, Philippines. The aims of this study were: (1) to evaluate patient perceptions regarding ABC-MMC’s health care services; and (2) understand the barriers to and facilitators for patient engagement in ABC-MMC. This was an exploratory qualitative study conducted in November 2021 using open-ended, semi-structured focus group interviews. Participants enrolled in ABC-MMC were recruited from six of the 18 barangays served by ABC-MMC. Community health workers (CHWs) recruited from each barangay were instructed on how to facilitate focus groups. Focus group interviews were digitally recorded and open coding methods were used to analyze the resulting data. Six focus groups were conducted with N=57 adult Filipino participants (28.1% male, 71.9% female). Overall, mean age was 61 years. A majority had hypertension (84.2%), while 42.1% had type 2 diabetes. Mean duration for patient-enrollment in ABC-MMC was 2.3 years. Four major focus group themes emerged: (1) barriers for access to healthcare, (2) facilitators for accessing healthcare, (3) positive perceptions towards ABC-MMC, and (4) limited health literacy. As far as authors know, ABC-MMC is the first mobile primary healthcare program emphasizing continuity of care in low-income rural Philippine barangays that (1) addresses the lack of healthcare services, and (2) focuses on chronic disease prevention and management. This study found that the ABC-MMC was well-received by rural Filipino communities. Moreover, barriers and facilitators were identified to inform how best to promote engagement in ABC-MMC services and improve health outcomes in low-income underserved rural Philippine barangays.

Leveraging qualitative approaches to guide sustainable international research collaborations.

Qualitative research approaches were used to launch an international research collaboration between the U. S. and Cambodia. Cambodian officials requested assistance in learning qualitative approaches to complement the research skills of Cambodian mental health providers. This article provides a description of how U. S. researchers responded to that request and engaged with Cambodian psychiatrists to explore mental health needs and interventions in both countries and initiate a sustainable relationship. The early focus on qualitative research methodologies may be an avenue that mitigates some of the challenges that can characterize international research. In this study, early communications involved developing a plan to teach qualitative methods while also collecting and analyzing data in both countries that would address the mental health concerns experienced by respective care providers. A case study exemplar was embedded with a scripted focus group guide to collect data from U. S. focus groups, then share with Cambodian psychiatrists. Components of hermeneutic phenomenological interviewing and descriptive content analysis were used to simultaneously teach and enact the research methods, gather data in both countries to analyze, and inspire participants to replicate the methods in their ongoing work. Cambodian psychiatrists were able to demonstrate competence in facilitating focus groups after being participant-observers. Researcher/practitioners from both U. S. and Cambodian teams gained new understandings about the mental health needs of their patients. The mutual engagement of a research focus is an effective way to establish cross-cultural relationships. The challenges of staying with stable teams over times remain, but the content shared and learned in a participatory structure yields understandings that cross cultural boundaries. Anticipated and unexpected challenges may be offset by an intention of reciprocity and mutual engagement. The use of qualitative methodologies, early and repeatedly, can facilitate relational understanding.

Medical Associate Professionals in the UK

Anyone who has any connection with the world of social media will be aware of the ‘storm in a teacup’ that has been brewing in the last few months with Medical Associate / Assistant Professionals (MAPs) in the UK as Parliament debated and swiftly passed legislation1 related to their regulation by the UK General Medical Council. In its supporting statement, the UK Minister for Health2 specified,
 
 ‘Physician associates work under the supervision of doctors taking medical histories, carrying out physical examinations, performing some medical procedures and analysing test results. Anaesthesia associates review patients before surgery, initiate and manage medications, administer fluids and blood therapy during surgery, and ensure there is a plan for patients following their operation. Both roles can work autonomously, but always under the supervision of a fully trained and experienced doctor.’
 The legislation was passed in the UK Parliament in Feb24 and will be in force from Dec’24.
 The British Association of Physicians of Indian Origin (BAPIO) is leading a survey 17and workshop designed to have a 360-degree review of the impact of MAPs on training and career progression for all doctors, including the missing voice of several thousands of doctors who are not in formal training, are locally employed on shorter-term contracts, are considered as speciality doctors by the GMC. A vast proportion of these doctors are international medical graduates, and a significant proportion belong to cohorts who are under-represented in leadership positions (including those that were previously considered from Black or minority ethnic groups). The workshops and focus groups will include representation from all under-represented groups of doctors across the spectrum, patient representatives, nursing, and allied healthcare professionals who form an integral part of the MDT, medical leaders, higher education institutions, NHS workforce Training and Education and NHS employers. The results of the independently facilitated focus groups and survey results will be published with recommendations for all stakeholders in May 2024, and aim to provide a framework for action, reflecting consultation and views of the whole healthcare profession.

Adaptive business model development for community-based peatland restoration in Riau

Livelihood on peatland often involves unsustainable practices such as drainage and extraction, causing peatland degradation. Indonesia’s peatland restoration approach therefore includes interventions for livelihood revitalization and transformation. This paper describes lessons learned in facilitating sustainable livelihood transitions for restoring peatland using the Sustainable Business Model for Communities (SBMC) canvas as a tool. We utilized Participatory Action Research (PAR) methods, where we engaged in intensive focus group discussions, surveys and facilitation of the action or implementation of the business model. SBMC is a useful tool that facilitates the community mapping their ideas and exercising collective action for restoring peatland while generating green business for the community groups in Siak Regency, Riau Province. Our finding suggests that to successfully transform peatland practices and restore ecosystems, a business model should balance economic motives with restoration objectives, enhance community collective action, improve transparency, and increase adaptability. Embracing uncertainty and complexity in community-based peatland restoration can provide an opportunity for learning and improving the community’s business model. Viewing business model development as an iterative process enables the community group to revisit and refine their model in response to landscape adaptation.

Using interview excerpts to facilitate focus group discussion

The use of interviews and focus groups is well-established in the social science methods literature. However, discussion on how research can combine these two methods in creative ways is less common. While researchers are generally aware of the potential of focus groups for further probing issues that emerge in one-on-one interviews, few studies detail how this might be achieved in practice. In this article, we describe and reflect on a focus group elicitation strategy that uses individual interview excerpts to facilitate discussion in group settings. In our reflection, we draw on a study that investigated the sharing of embryo images in fertility treatment. The article contributes to the methods literature firstly, by reflecting on the novel use of individual interview material in focus groups and secondly, by discussing the re-enactment of interview excerpts as an effective audio elicitation tool to be used in the later stages of research.

Visualising Findings in the Co-Design of Telepractice for the Disability Community.

The methods and strategies utilised to facilitate focus group discussion within a co-design context have a fundamental impact on the opportunity for participants to actively engage with the content. This is a description of the strategies our project utilized including visual prompts and preparation guide to assist both service users and staff participants facilitate access to concepts discussed within our focus group sessions.

Uncovering Teachers’ Challenges in Teaching Qualitative Research: Basis for Innovation and Training

The purpose of this study is to uncover the challenges of teachers teaching qualitative research in North District, Tanjay City Division, for the school year 2023-2024. This study employed a phenomenological design to characterize and comprehend teachers' circumstances. The researcher used a qualified teacher to facilitate focus group discussion with the six participants following an interview guide to gather data and for reflexivity purposes. The FGD was conducted four times for data saturation purposes at one of the restaurants in Tanjay City since it was the participants’ choice and convenience. Moreover, purposive sampling was utilized by the researcher based on the selection criteria. Additionally, a consented audio recording proved to be helpful in accurately transcribing the participants' comments, which were subsequently subjected to thematic analysis. To do this, the researcher had to become familiar with the transcripts, create codes, group codes into themes, examine and clarify themes, and present results. The study revealed five themes: missed opportunities, diversity amidst challenges, management constraints, students’ attitudes towards research and resilience, and resourcefulness amidst challenges. This revealed that teachers’ lack of knowledge, training, irrelevant skills in the subject, students’ low comprehension skills, and lack of interest are the underlying challenges that teachers face in teaching qualitative research. However, despite these challenges, teachers demonstrated resilience and resourcefulness by finding ways to gain knowledge and practice that could help them deliver the subject. Consulting experienced teachers, sourcing out other references, localizing materials, and translating English to Cebuano, their mother tongue teachers helped them sustain the goal of their profession to teach. Thus, the results of this study will form the basis for innovation, training, and workshops for research teachers. This study recommends that Tanjay City Division strengthen any enhancement program that aims to capacitate the teachers in research. Moreover, future researchers can do instrumentation on thematic analysis to gauge the knowledge and skills of research teachers in analyzing qualitative data which will be the basis for innovation and future enhancement programs in research.

Lessons Learnt From Conducting an Instrumental Ethno-Case Study in a Mainstream Secondary School

The aim of this paper is to provide an insight into the lessons learnt as the primary researcher during an instrumental ethno-case study research project that took place in a mainstream secondary academy that set out to examine the physical education (PE) experiences of adolescent, white, pupils in a ‘typical’ working-class secondary school (Ayrefield Community School – ACS). With the term instrumental ethno-case study used to reflect the non-continuous nature of the 34 days spent in the school over a 16-month period, the structure and content of the paper aims to provide a greater theoretical and practical understanding of this relatively nuanced and contemporary approach to qualitative research in education. Determined that the study design remained based in ethnography, consideration is also given to the impact of professional and personal time constraints on an ability to engage in a truly immersive ethnographical study. In this regard, the paper also aims to provide additional guidance on the design and implementation of the study and the recording and interpretation of the data for any researcher with similar aims and/or time constraints. In addition, the paper also utilises Norbert Elias’ sociological concept of involvement and detachment as the lens through which the juxtaposition between objective researcher and experienced mainstream secondary school teacher was explored and managed throughout the duration of the study. Overall, therefore, the paper aims to provide a theoretical justification for the use of the term instrumental ethno-case study design, additional guidance and lessons learnt on the design and implementation of this approach, and further detail on the extent to which the potential conflict between objective researcher and former school teacher was acknowledged and managed. The project itself primarily set out to examine the physical education (PE) experiences of adolescent, white, pupils in a ‘typical’ mainstream working-class secondary school (Ayrefield Community School – ACS) and in doing so also sought to explore the attitudes of the pupils in relation to their views on qualifications and education generally, how they spent their leisure time, and more specifically, how their own actions and relationships with their male PE staff came to influence the content and delivery of their PE provision. Therefore, reflecting on the use of the traditional case study methodologies of covert and overt observations, informal guided conversations, and focus group interviews with male pupils and school staff, the paper highlights and examines the practicalities and considerations associated with the selection of, and access to, a ‘typical’ white, working-class school, how care was taken to encourage ‘natural’ behaviour during covert and overt observations, the specific nature of informal guided conversations with pupils and staff, and the techniques utilised in order to facilitate focus group interviews with these male adolescent pupils.

Abstract A059: The role of conversational chatbots in enhancing shared decision making for African American men with early stage prostate cancer

Abstract Introduction : Enhancing shared decision making (SDM) for African American (AA) men with early stage prostate cancer using conversational chatbots (CCs) aims to improve communication, provide information, and empower them in their treatment decision making process. SDM is a collaborative approach that involves patients and healthcare providers working together based on medical evidence and patient preferences. However, AA men face significant disparities in prostate cancer (PCa) outcomes, including higher incidence and mortality rates compared to other racial/ethnic groups in the United States. Limited access to recommended PCa information and inadequate information during SDM conversations contribute to the challenges AA men face when making treatment decisions. The purpose of this study was to develop a conversational chatbot (CC) to provide PCa information in real time thus, enhancing SDM for AA men with PCa. Methods: The Ottawa Decision Support Framework and the International Patient Decision Aids Standards provided guidance and framework for the development of the CC. Our participatory research approach involved a diverse Community-Based Participatory Research Advisory Board (CBPRAB) consisting of twelve members. The CBPRAB included AA PCa survivors, AA men, caregivers, advocates, community leaders, and cancer care providers. Through training in research methods and focus group facilitation, CBPRAB members actively contributed their valuable insights, ensuring a collaborative and inclusive research process. Results: Five stakeholder focus groups (n = 44) comprising AA men, PCa survivors, spouses, healthcare professionals, and advocates provided valuable input for the development of the CC. In total, 819 questions were generated through interviews conducted during the focus groups. These questions were either inferred from the discussions or explicitly provided by the participants. The answers to these questions were developed from evidence based sources, such as the American Cancer Society and National Comprehensive Cancer Network Guidelines. An Android-based smartphone application that allows users to submit questions via speech was created. The application matches the user's question within the data set of 819 questions and provides answers in both voice and text formats. Conclusion : The Android-based smartphone application was alpha tested on four stakeholder focus groups (n=35). The CC developed in the smartphone application demonstrated the capacity to provide real time responses to user questions sourced from an 819-question database derived from our stakeholder focus groups. By offering evidence based information and directing users to additional resources if the question is not in the database, the CC can improve accessibility to medical information, thus enhancing the SDM process regarding early stage prostate cancer. Citation Format: Angela D. Adams. The role of conversational chatbots in enhancing shared decision making for African American men with early stage prostate cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A059.

Threat and adaptation: The maternal lived experience of continuing pregnancy after receiving a prenatal diagnosis of agenesis of the corpus callosum

One stated objective of prenatal screening and diagnosis is the preparation for delivering a baby with medical needs or disability, however, psychosocial outcomes of parents who received a prenatal diagnosis suggest that this objective is not yet realised. Preparation may be complicated by diagnostic and prognostic uncertainty. A prenatal diagnosis that includes significant uncertainty due to the heterogeneous presentations, classifications, causes and outcomes is agenesis of the corpus callosum. As a neuroanatomical anomaly identified in the second or third trimesters, the diagnosis is likely to cause distress for expectant mothers, yet there is limited guidance for holistic support. To begin to address the paucity of research, this hermeneutic phenomenological study sought to explore, and provide a telling of the maternal experience of continuing pregnancy after a prenatal diagnosis of agenesis of the corpus callosum. Through interviews and a series of online, asynchronous and facilitated focus groups, lived experiences during pregnancy from the time of diagnosis to birth were explored with 26 mothers who participated in this international study. Themes were constructed through reflexive thematic analysis to describe the experience of the lived phenomenon. The first theme, Under Threat, included subthemes of The Threat to the Life of the Baby and Threatened Image of the Expected Family. The second theme, Day to Day Toward Adaptation, included subthemes of Holding it Together and Falling Apart, and More Than Information, Searching for Meaning, Hope and Control. To realise the commonly stated objective of prenatal diagnosis, to support maternal preparation, healthcare professionals require awareness of the profound, yet individual experience of prenatal diagnosis to adequately respond and support mothers through their continued pregnancies. Healthcare services should be designed to flexibly respond in a woman- and family-centred manner to reduce the threat and support maternal adaptation after a prenatal diagnosis.

Experiences and Priorities in Youth and Family Mental Health: Protocol for an Arts-Based Priority-Setting Focus Group Study.

During the COVID-19 pandemic, eHealth services enabled providers to reach families despite widespread social distancing restrictions. However, their rapid adoption often occurred without community partners' involvement and without an understanding of how they prioritize aspects of their mental health and associated service provision, both of which promote family and community-centered health care delivery. Establishing priorities in health care is essential for developing meaningful and reliable health services. As such, there is an urgent need to understand how eHealth service users, especially families who may have historically faced oppression and systemic barriers to service access, can best benefit from them. Arts-based approaches can elicit an understanding of priorities by providing an engaging and expressive means of moving beyond readily expressible discursive language and stimulating meaningful dialogue reflective of participants' lived experiences. The purpose of this research is to determine the priorities and preferences of youth; parents or caregivers; newcomers and immigrants; and Indigenous community members regarding the use of eHealth in supporting their mental health using an innovative arts-based priority-setting method. This study uses a mixed-methods approach combining qualitative, quantitative, and arts-based research. It follows a survey used to identify key knowledge partners who are interested in improving eHealth services for mental health support in Manitoba, Canada. Knowledge partners interested in group-based priority setting will be contacted to participate. We will facilitate approximately two focus groups across each subgroup of youth, parents or caregivers, newcomers or immigrants, and Indigenous community members using an integrative, quantitatively anchored arts-based method termed the "Circle of Importance" to understand participants' mental health priorities and how eHealth or technology may support their mental well-being. The Circle of Importance involves placing small objects, whose meaning is determined by participants, on a visual board with concentric circles that correspond to a 5-point Likert scale of importance. Following each focus group, we will evaluate participants' and focus group facilitators' experiences of the Circle of Importance using a survey and follow-up structured in-person interviews to garner how we can improve the arts-based approach used in the focus groups. The PRIME (Partnering for Research Innovation in Mental Health through eHealth Excellence) theme received institutional ethics approval on August 23, 2023. Data collection is projected for August 2023, with follow-up focus groups occurring in early 2024 as required. Data analysis will occur immediately following data collection. Findings will directly inform a multiyear applied research agenda for PRIME aimed at improving mental health services through engaging key knowledge partners. The results may inform how arts-based methods in a priority setting can reflect aspects of experience beyond the capacities of qualitative or quantitative methods alone, and whether this approach aligns well with a positive experience of research participation. PRR1-10.2196/50208.

July 2021 civil unrest: South African diagnostic radiography students' experiences.

South Africa (SA), in 2021, experienced a wave of civil unrest following political events that led to mass looting and the destruction of property. Civil unrests, among other disruptions, have been seen to cause ripple effects on healthcare education, particularly for radiography students who undergo work integrated learning within hospitals and universities, even during these times of unrest. This study aimed to explore and describe the undergraduate diagnostic radiography students' experience of the civil unrest that occurred in SA in 2021. The study was conducted across five universities in South Africa, offering the diagnostic radiography programme. A qualitative, interpretive phenomenological design was employed as it enabled the researchers to facilitate focus group interviews to gain insight into the lived experiences of the students during this time. Four themes emerged from the study data, namely: (1) Negative effects on students' emotional and psychological well-being, (2) Academic and clinical support mechanisms during disruptions, (3) The influence of disruptions on clinical training, (4) Recommendations to support students for future disruptions. The participants from this study described the negative effects that the civil unrest had on their emotional and mental well-being. There is a need for increased support mechanisms during times of disruptions from universities across South Africa. The findings highlight the ripple effects that disruptions, such as civil unrests, have on radiography students. This can assist universities to relook at their institutional support structures, in order to enhance the current support given to students across universities in times of disruptions.

Co-design and content validity of the movement measurement in the early years (MoveMEY) tool for assessing movement behaviour of pre-school aged children

BackgroundMovement behaviours (physical activity, sedentary behaviour, and sleep) are important for pre-school children’s health and development. Currently, no tools with appropriate content validity exist that concurrently capture these movement behaviours in young children. The aim of this study was to co-design and assess the content validity of a novel tool to concurrently measure movement behaviours in pre-school aged children (aged 3–4 years).MethodsWe followed four distinct steps to develop and assess the content validity of Movement Measurement in the Early Years (MoveMEY): (1) We conducted an extensive literature search, to identify pre-existing proxy measurement tools (questionnaires and diaries) to inform the design of a novel tool, which aimed to effectively capture movement behaviour guidelines of pre-school aged children. (2) We facilitated focus group discussions with parents and carers of pre-school aged children (n = 11) and (3) a qualitative survey with free text responses was completed by topic relevant researchers (n = 6), to co-design the measurement tool. (4) We assessed the content validity of the developed tool, MoveMEY, through interviews with parents of pre-school aged children (n = 12) following piloting of the tool.ResultsWe developed an initial version of MoveMEY based on the format of an existing questionnaire and by mapping the content of questions to the guidelines. Co-design of MoveMEY resulted in changes to the format (e.g. short questionnaire to a seven-day diary) and content (e.g. inclusion of ‘general information’ questions on illness, disabilities and sleep disturbances; question on screen time before bed). Content validity assessment demonstrated that the items of MoveMEY were relevant and comprehensive for the assessment of children’s movement behaviours. MoveMEY was felt to be comprehensible, however, parental suggestions were implemented to finalise and improve MoveMEY (e.g. adding examples to questions aiming to detect moderate to vigorous physical activity).ConclusionMoveMEY is the first co-designed measurement tool that has relevance for assessing the movement behaviour guidelines of pre-school aged children. Parent/carer and topic relevant researcher involvement throughout the development process resulted in a seven-day daily reported activity diary that is comprehensive of children’s movement behaviours and comprehensible to parents and carers.

‘Your CV looks amazing but I am sorry, you didn’t get the job’: analysing experiences of global majority physiotherapists aspiring to and working at consultant level practice in the UK

IntroductionEffective leadership shapes organisational culture to deliver world class healthcare. Racially minoritised individuals rarely access opportunities leading to leadership positions. This paper expands on themes from qualitative research which explored...

Creating experiential learning opportunities in enterprise education: an example of a facilitator-led business simulation game in a taught setting

PurposeSimulation in education has been well documented. Business simulation games (BSGs) are often digital and run by a third-party provider. This can create barriers to engagement from educator and student perspectives. This paper explores a facilitator-led BSG, posing the question: can facilitator-led BSGs provide practical experiential learning experiences within a taught setting.Design/methodology/approachExploratory inductive research recruited a sample of 45 student participants, an external examiner and a module leader. Qualitative data were collected using focus group discussion, participant obsession and facilitator reflection. Mixed-method feedback forms were also used.FindingsThe facilitator-led BSG offered a flexible approach to challenge or problem-based learning, experiential learning, collaborative learning and critical reflection. Student feedback was positive, and there was an increase in engagement within all elements of the module.Originality/valueThis paper presents a case study example of the implementation of a facilitator-led BSG, providing an alternative solution for teaching practitioners to structured simulations run by third-party hosts. This paper highlights a flexible approach to student-centric experiential and challenging learning through enterprise education within small-group settings. There are opportunities for further evaluation and exploration of the notion, which can be developed from this paper in future works.

In-Depth Co-Design of Mental Health Monitoring Technologies by People with Lived Experience

Advancements in digital monitoring solutions collaborate closely with electronic medical records. These fine-grained monitoring capacities can generate and process extensive electronic record data. Such capacities promise to enhance mental health care but also risk contributing to further stigmatization, prejudicial decision-making, and fears of disempowerment. This article discusses the problems and solutions identified by nine people with lived experience of being mental health care consumers or informal carers. Over the course of ten facilitated focus group format sessions (two hours) between October 2019 and April 2021, the participants shared their lived experience of mental health challenges, care, and recovery within the Australian context. To support the development, design, and implementation of monitoring technologies, problems, and solutions were outlined in the following areas—access, agency, interactions with medical practitioners, medication management, and self-monitoring. Emergent design insights include recommendations for strengthened consent procedures, flexible service access options, and humanized consumer interactions. While consumers and carers saw value in digital monitoring technologies that could enable them to take on a more proactive involvement in their personal wellness, they had questions about their level of access to such services and expressed concerns about the changes to interactions with health professionals that might emerge from these digitally enabled processes.

Co‐designing conservation interventions through participatory action research in the Indian Trans‐Himalaya

Abstract Community‐based conservation, despite being more inclusive than fortress conservation, has been criticized for being a top‐down implementation of external ideas brought to local communities for conservation's benefit. This is particularly true for Changpas, the pastoral people of Changthang in trans‐Himalayan India who live alongside unique wildlife. Our main aim was to co‐design conservation interventions through participatory action research. We worked with two Changpa communities, to understand the issues faced by them. Subsequently, we co‐designed context‐sensitive interventions to facilitate positive human–nature interactions. We did so by integrating the PARTNERS (Presence, Aptness, Respect, Transparency, Empathy, Responsiveness, Strategic Support) principles with the Trinity of Voice (Access, Standing and Influence). In Rupsho, we facilitated focus group discussions (FGDs) led by the community. We found livestock depredation by wildlife was primarily facilitated by the weather. This led to co‐designing of a new corral design, which was piloted with seven households, safeguarding 2385 pashmina goats and sheep. Approximating the value of each sheep/goat to be USD125, this intervention amounts to a significant economic protection of USD c. 42,500 for each household. This is along with intangible gains of trust, ownership and improved self‐esteem. In Tegazong, a restricted area adjoining the Indo‐China border with no previous research records, we worked with 43 Changpa people to co‐create research questions of mutual interest. Wildlife presence and reasons for livestock loss were identified as areas of mutual interest. The herders suggested they would record data in a form of their choice, for 6 months, while they live in their winter pastures. This participatory community monitoring revealed nutrition and hypothermia to be a key cause of livestock death. Subsequently, we delimited two previously untested interventions: lamb cribs and provisioning of locally sourced barley as a feed supplement. The wildlife monitoring recorded the first record of Tibetan Gazelle Procapra picticuadata, outside of their known distribution, in Tegazong. We aim to highlight the benefits of co‐designing projects with local communities that link research and conservation, while also discussing the challenges faced. Ultimately, such projects are needed to ensure ethical knowledge generation and conservation, which aims to be decolonial and inclusive.