Opportunities For Shared Learning Research Articles

The effectiveness of a shared conference experience in improving undergraduate medical and nursing students' attitudes towards inter-professional education in an Asian country: a before and after study.

BackgroundIn recent years, increasing emphasis has been placed on the importance of collaboration within multi-disciplinary healthcare teams, so as to facilitate holistic patient care and thus allow improved treatment outcomes. There is hence an urgent need to educate healthcare undergraduates early in their professional careers on the importance of and complexities involved in cooperating with counterparts from other allied healthcare professions. In conjunction with this, a milestone student-led conference for undergraduate students, the 9th Student Medical-Nursing Education Conference (SMEC), was organised in 2013 to provide a unique opportunity for shared learning among the entire cohort of undergraduate medical and nursing students in Singapore matriculating in that year.MethodsThis study evaluated the effectiveness of the 9th SMEC 2013 as a shared conference experience in improving the attitudes of undergraduate medical and nursing students in Singapore towards inter-professional education (IPE). A 19-point Readiness for Inter-Professional Learning Scale (RIPLS) questionnaire comprising three subscales was administered to participants both before and after the conference. 352 responses were collected, giving a response rate of 75.1 %. Results were analysed using paired-samples t-tests with statistical significance set at p = 0.05.ResultsImprovements in overall scores for both medical and nursing students were reported for all three RIPLS subscales. Examining the RIPLS items individually, significant improvement in scores for both medical and nursing students was obtained in all 19 items. Prior exposure to IPE activities was not a predictor of improvement in IPE attitudes.ConclusionThe authors propose that student-led jointly-organised conference experiences are effective in improving healthcare students’ attitudes towards IPE. This study provides valuable insights to facilitate the development of further IPE programs to allow for the rapid and effective promotion of cooperation and collaboration between students across various healthcare disciplines.

Interdisciplinary teamwork and the power of a quality improvement collaborative in tertiary neonatal intensive care units.

Significant gaps in healthcare quality and outcomes can be reduced via quality improvement collaboratives (QICs), which improve care by leveraging data and experience from multiple organizations.The Children's Hospital Neonatal Consortium Collaborative Initiatives for Quality Improvement team developed an infrastructure for neonatal QICs. We describe the structure and components of an effective multi-institutional neonatal QIC that implemented the "SLUG Bug" project designed to reduce central line-associated bloodstream infections (CLABSIs).The operational infrastructure of SLUG Bug involved 17 tertiary care neonatal intensive care units with a goal to reduce CLABSI in high-risk neonates. Clinical Practice Recommendations were produced, and the Institute of Healthcare Improvement Breakthrough Series provided the framework for the collaborative. Process measures studied the effectiveness of the collaborative structure.CLABSI rates decreased by 20% during a 12-month study period. Compliance bundle reporting exceeded 80%. A QIC score of 2.5 or more ("improvement") was achieved by 94% of centers and a score 4 or more ("significant improvement") was achieved by 35%.Frequent interactive project meetings, well-defined project metrics, continual shared learning opportunities, and individual team coaching were key QIC success components. Through a coordinated approach and committed leadership, QICs can effectively implement change and improve the care of neonates with complex diagnoses and rare diseases.

Linking Learners for Life Where They Live (L4): Developing a Global Health Initiative for Student Engagement.

This article describes a graduate student learning experience as part of an international nursing collaborative working together to develop an academic partnership for global health education in the circumpolar north. The experience provided an opportunity to conduct a pilot project in a rural, remote, northern community using an indigenous, global context. Building on the Canadian-Siberian collaboration, the graduate student attended an academic institution in Siberia, where she focused on the sharing of expertise, knowledge, and insights in order to address the challenges facing indigenous people in achieving optimal health and well-being in the circumpolar north. The goal was to create a foundation for "putting health into place" in a northern context, with the hope of creating shared learning opportunities for undergraduate students between the 2 countries.The intent is to share the approach used by the graduate student to use a conceptual model to assess the feasibility of creating a context-relevant global health experience for northern nursing education.

Nutrition guidelines for undergraduate medical curricula: a six-country comparison.

AimTo assess nutrition curriculum guidelines for undergraduate medical education in the United States, Canada, the United Kingdom, Republic of Ireland, Australia, and New Zealand to highlight potential opportunities for shared learning on the advancement of nutrition in medical education.MethodsA comprehensive list of professional bodies, councils, organizations, and other groups relevant to education or nutrition was compiled for each country after a review of relevant white and gray literature. All documents that were published from 2000 onwards, and that provided guidance on nutrition education within undergraduate medical education for one of the identified countries were included in the review. Each curriculum guideline was evaluated for 1) the organization’s or group’s role in undergraduate medical education; 2) the extent of nutrition-related recommendations; and 3) mandatory implementation.ResultsIn the countries reviewed, a total of six nutrition-related curriculum guidelines were identified. All countries, aside from the Republic of Ireland, currently have externally visible curriculum guidelines to inform medical schools in undergraduate nutrition education, yet there is little evidence of mandatory enforcement. Curriculum guidelines predominantly focus on basic nutrition principles, nutrition assessment, the role of nutrition in health, interdisciplinary teamwork, and the provision of nutrition counseling. Notable differences exist regarding the scope and detail of curriculum guidelines for the reviewed countries.ConclusionThere are promising developments in nutrition curriculum guidelines for medical schools within the reviewed countries. Differences in the scope and detail of nutrition curriculum guidelines may influence the nutrition education provided to medical students, and the subsequent nutrition care provided by doctors in these countries. Consideration is required as to how to monitor and evaluate the nutrition competence of doctors in relation to routine health care practices, as well as the impact of their competency levels on patients’ nutrition behavior and health outcomes.

Singing and companionship in the Hawthorn University of the Third-Age Choir, Australia

The international University of the Third Age (U3A) embodies the principles of lifelong learning and personal fulfilment amongst members. The research reported in this article focused on the Choir of the U3A Hawthorn, Melbourne, Australia and the benefits perceived by members undertaking this active music engagement in non-competitive choral singing. This small-scale phenomenological qualitative case study is part of a wider study of active arts engagement by older people that began in 2008. This study was undertaken in 2013 and revealed that participants decided to join the group for a range of factors including a positive attitude to singing, convenience and a desire for social connectedness. Those interviewed considered ongoing choir membership an effective use of leisure time that also provided opportunities for shared learning and personal validation. The data were analysed using Interpretative Phenomenological Analysis (IPA) and are reported under two themes: music engagement and social connections. Membership of the Hawthorn U3A choir provided participants opportunities for friendship, companionship, happiness, a sense of belonging and acceptance.

Anthropogenic fires and local livelihoods at Chyulu Hills, Kenya

Anthropogenic fires are rife in rural Africa as people use fire to modify landscapes for their livelihoods. Although burning occurs as a significant traditional resource management practice and shows ecological advantages, human set fires are viewed by conservation authorities as destructive and a cause for environmental degradation. This study gains local perspective from three Kamba and three Maasai villages around Chyulu Hills on why fires are used and their influence on land resources and local livelihoods. Between June and July 2012, 12 focus group discussions and 6 transect walks were conducted with men and women Kamba and Maasai participants. They reported 22 reasons why they use fires, concurring on its important role in the management of grazing lands and, especially for the Kamba, in relation to resource extraction activities. Their narratives clarify differences between the ethnic groups, by gender, across seasons, and through time. Employing an applied research design that supports adaptive collaborative management (ACM), the study validates local knowledge on fire management and promotes opportunities for shared learning between park managers and local populations that are viewed critical toward better environmental conservation and livelihood security around Chyulu Hills National Park.

Engagement in clinical learning environment among nursing students: Role of nurse educators

Student engagement in a clinical learning environment is a vital component in the curricula of pre-licensure nursing students, providing an opportunity to combine cognitive, psychomotor, and affective skills. This paper is significant in Arab world as there is a lack of knowledge, attitude and practice of student involvement in the new clinical learning environment. The purpose of this review article is to describe the experiences and perspectives of the nurse educator in facilitating pre-licensure nursing students’ engagement in the new clinical learning environment. The review suggests that novice students prefer actual engagement in clinical learning facilitated through diversity experiences, shared learning opportunities, student-faculty interaction and active learning. They expressed continuous supervision, ongoing feedback, interpersonal relationship and personal support from nurse educators useful in the clinical practice. However, the value of this review lies in a better understanding of what constitutes quality clinical learning environment from the students’ perspective of engagement in evidence-based nursing, reflective practice, e-learning and simulated case scenarios facilitated by the nurse educators. This review is valuable in planning and implementing innovative clinical and educational experiences for improving the quality of the clinical teaching-learning environment.

Accountable care organizations and clinical commissioning groups face an uncertain challenge for improving public health.

Accountable Care Organizations (ACOs) in the United States of America (USA) and Clinical Commissioning Groups (CCGs) in the United Kingdom (UK) are newly proposed cross-organisational structures in health services both tasked with a role which includes improving public health. Although there are very significant differences between the UK and USA health systems, there appears to be some similar confusion as to how ACOs and CCGs will regard and address public or population health. This short perspective article gives an overview of ACOs in the USA and CCGs in the UK, with the underlying context of possible public health functions. It concludes by considering the challenges facing both countries and highlighting the opportunity for shared learning.Acknowledgmentsthis article was based on a research proposal prepared for the Commonwealth Fund’s Harkness Fellowship in Health Care Policy and Practice 2012/2013.

Service users' views of moving on from early intervention services for psychosis

Lester et al's paper is timely.1 Many early intervention in psychosis (EIP) teams have been in action for over 3 years and are refining discharge pathways to primary care. This interface is not just with colleagues but now also with commissioners. While there is robust economic evidence for EIP, this perhaps sits outside the regular reading of most GPs.2 This interface needs active management and should not be relied on to grow organically. Every interaction with GPs should name the team and provide opportunity for shared learning, enhanced by the many leaflets covering this area.3 There is a need to help GPs to understand what patients have been experiencing for the proceeding 3 years and not just to advise on subsequent management. In a world of ever changing services it is particularly important that they can be supported to navigate their way back in and EIP teams would tend to maintain responsibility for this, sometimes necessitating a brief period of re-engagement to do so. This is added value from an economically justified team. GPs are often left with a client who is still on medication and are quite reasonably asking for how long they may continue, when medication can be safely stopped, and what the considerations and risks in doing so may be. There is a concern that vocational aspects, that are particularly valued by clients, may be among the hardest to access from primary care.

Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review.

The care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, district nurses and others who have not undertaken specialist training in palliative care. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to suggest factors which support collaborative working between specialist and generalist palliative care providers. To explore factors that support partnership working between specialist and generalist palliative care providers. Systematic review. A systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until January 2011. Of the 159 articles initially identified, 22 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; and coordinated care. Multiple examples exist of good partnership working between specialist and generalist providers; however, there is little consistency regarding how models of collaborative working are developed, and which models are most effective. Little is known about the direct impact of collaborative working on patient outcomes. Further research is required to gain the direct perspectives of health professionals and patients regarding collaborative working in palliative care, and to develop appropriate and cost-effective models for partnership working.

A systematic review exploring factors supporting partnership working between generalist and specialist palliative care services: implications for older people

BackgroundThe care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, hospital staff and others...

Development of Greek-Cypriot teachers’ professional identities: is there a ‘sense’ of growth?

In an effort to explore Greek-Cypriot teachers’ development of professional identities, the current study reveals the ways in which seven teachers in one primary school in Cyprus perceive themselves as agents improving their teaching and growing as professionals. In-depth interviews indicate that teachers’ conceptions of good teaching reflect a focus on results rather than processes while respondents perceive of their professional growth throughout the years as minimal. Teachers further demonstrate unsophisticated understandings of their own professional development, shifting the emphasis to seminars and underlining the system’s – rather than their own – responsibility for development. Interestingly, respondents acknowledge the value of informal collegial exchange of views, naturally emerging in school settings. In this regard, building system-wide capacity for good teaching through opportunities for shared learning in schools along with enhanced teacher responsibilization for professional development are further discussed.

Learning to collaborate: a study of nursing students’ experience of inter‐professional education at one UK university

Collaborative working has been part of official government policy for some time and whilst a great deal has been claimed about its benefits, in terms of better quality services and improved outcomes, it would seem that translating policy intentions into practice has hitherto proved a challenge. Moreover, evidence concerning the effectiveness of collaborative working in education, health and social care remains limited and thinly spread. One response to this dilemma has been to introduce shared learning opportunities through the incorporation of inter‐professional education (IPE) modules into the curriculum of professional training programmes. This paper presents the findings from a study to evaluate the experience of a cohort of students from a range of different nursing specialities, undertaking a collaborative working module as part of their professional training at one UK university. The module aimed to critically analyse the philosophy of collaborative working and to encourage role appreciation and the values of different nursing, health and social care cultures. The module used shared learning during lectures, small group work and presentations in order to promote collaborative working within the educational setting. Using a mixed method design, incorporating a pre‐ and post‐survey and semi‐structured interviews, it was found that students revealed a strong commitment to collaborative working despite awareness of the problems that frequently have to be overcome. The major barriers identified from the survey were professional tribalism along with status and power differentials. These themes were explored in greater depth during the interviews where the module was seen to have enabled students to develop greater confidence in applying their professional knowledge, alongside developing improved communication and teamwork skills. The study offers some fresh insights into the most effective way of training nurses for collaborative working and the importance of promoting critical models of collaborative practice.

Acute and General Medicine on Opposite Sides of the World

The environments in which General, Acute and Emergency Medicine have evolved in Australia, New Zealand and the United Kingdom have differed significantly. As a result of this, the development and the role of Acute Medicine have also had significant contrasts but there are also many similarities and opportunities for shared learning. We are now in a position to look maturely at our services and allow a little constructive ‘compare and contrast’. Confidence in our own models means now we can each embrace diversity rather than believe one size fits all – not just across the world but also in our own backyards.

A new workforce in the making?

This paper seeks to describe the exploration of human resource issues in one large-scale program of innovation in healthcare. It is informed by established theories of management in the workplace and a multi-level model of diffusion of innovations. A realist approach was used based on interviews, ethnographic observation and documentary analysis. Five main approaches ("theories of change") were adopted to develop and support the workforce: recruiting staff with skills in service transformation; redesigning roles and creating new roles; enhancing workforce planning; linking staff development to service needs; creating opportunities for shared learning and knowledge exchange. Each had differing levels of success. The paper includes HR implications for the modernisation of a complex service organisation. This is the first time a realist evaluation of a complex health modernisation initiative has been undertaken.

Sustainability transdisciplinary education model: interface of arts, science, and community (STEM)

PurposeThe purpose of this paper is to describe the components of a sustainability transdisciplinary education model (STEM), a contemporary approach linking art, science, and community, that were developed to provide university and K‐12 students, and society at large shared learning opportunities. The goals and application of the STEM curriculum will be discussed.Design/methodology/approachThe STEM integrates the sciences, arts and aesthetics, and the university with the greater New Britain community, and beyond. Academic areas included geography, environmental science, communication, art history, aesthetics, and teacher education. The transdisciplinary methodology was integrated in a learner‐centered design. To achieve a cycle of community engagement regarding sustainability, university students were placed within the greater New Britain community. This included interaction with K‐12 urban public schools, the New Britain Museum of American Art (NBMAA), numerous nongovernmental organizations, state and federal governmental elected officials, and the general public.FindingsAs a result of the mutual learning implicit in the STEM, all participants expanded each other's understandings of sustainability. Students were learning from instructors, instructors were learning from students, students were learning from students, instructors were learning from instructors, and all were learning and sharing knowledge with the greater community. As a result, all participants gained a deeper and broader understanding about human‐environment relationships and how humans impact natural resources.Practical implicationsBecause the assignments given to the university students were authentic performance tasks embedded in sustainability issues, students developed a broader disposition for thinking and learning and therefore become metacognitive. The STEM emphasized aesthetic education, integrating science and the arts. As a result, the participants developed their ability to connect academic domains of knowledge and creatively address sustainability challenges.Originality/valueThe convergence of science, art, and aesthetics enabled the participants to develop a deeper spiritual awareness and understanding of eco‐justice for the promotion of a sustainable society. The STEM utilized cultural resources of the university and New Britain community (i.e. institutional members of the NBMAA and The Central Connecticut State University). Students were introduced to the concept of mutual learning with all the communities and organizations involved.

Introducing students to patient safety through an online interprofessional course

Interprofessional education (IPE) is increasingly called upon to improve health care systems and patient safety. Our institution is engaged in a campus-wide IPE initiative. As a component of this initiative, a required online interprofessional patient-safety-focused course for a large group (300) of first-year medical, dental, and nursing students was developed and implemented. We describe our efforts with developing the course, including the use of constructivist and adult learning theories and IPE competencies to structure students’ learning in a meaningful fashion. The course was conducted online to address obstacles of academic calendars and provide flexibility for faculty participation. Students worked in small groups online with a faculty facilitator. Thematic modules were created with associated objectives, online learning materials, and assignments. Students posted completed assignments online and responded to group members’ assignments for purposes of group discussion. Students worked in interprofessional groups on a project requiring them to complete a root cause analysis and develop recommendations based on a fictional sentinel event case. Through project work, students applied concepts learned in the course related to improving patient safety and demonstrated interprofessional collaboration skills. Projects were presented during a final in-class session. Student course evaluation results suggest that learning objectives and content goals were achieved. Faculty course evaluation results indicate that the course was perceived to be a worthwhile learning experience for students. We offer the following recommendations to others interested in developing an in-depth interprofessional learning experience for a large group of learners: 1) consider a hybrid format (inclusion of some face-to-face sessions), 2) address IPE and broader curricular needs, 3) create interactive opportunities for shared learning and working together, 4) provide support to faculty facilitators, and 5) recognize your learners’ educational level. The course has expanded to include students from additional programs for the current academic year.

The British Academy of Childhood Disability 2009 – something for everyone

The British Academy of Childhood Disability (BACD) holds its Annual Scientific Meeting this month. This meeting has become a regular event in the calendars of child development centre teams nationally. I believe the multidisciplinary focus of this conference makes it unique in the United Kingdom, where paediatricians, paediatric therapists, speech and language therapists, occupational and physiotherapists meet together with teachers, other educational colleagues, paediatric nurses, psychologists, and members of voluntary organisations. This is familiar to our American and European colleagues who have similar organisations. This year will be the first year that we will be hosting a poster session and, thanks to this journal, we are able to offer a prize for the most outstanding entry. This development reflects the growing shared relationship between the BACD and DMCN, which we hope will continue to flourish and be mutually beneficial, to our shared goal of improving care to the children and young people we serve. The BACD, in particular, wants to enhance shared learning opportunities with all the teams engaged in delivering care to children and young people with a disability. Shared learning and shared evaluation of practice will in turn lead to improved evidence-based practice. Our conference programme this year titled ‘Interventions in neurodisability – what works?’, reflects this aim. We are looking forward to a rich set of presentations discussing treatments for sensory disorders, motor disability, and autism from leading experts in these fields. What has the BACD achieved since our conference last year? We have continued to work towards achieving our aims to ‘make a difference’ at a primary, secondary, and tertiary level, both locally, nationally, and outside the UK. At the primary level we are proud to have a parent representative on our committee who keeps our feet on the ground and reminds us of the fact that the main carers for our patients are indeed the carers within the home. We also are proud of our Newsletters, which we know have an ever-increasing circulation. We hope they will also be of interest to the non-UK readers of this journal. At the secondary level we have a close relationship with the British Association of Community Child Health (BACCH). In the UK, children and young people with a disability may have their main paediatric care delivered locally by a paediatrician based in the community (community paediatrician), a general paediatrician in a hospital, a paediatric neurodisability specialist in a child development centre or hospital, or a paediatric neurologist. Our membership reflects this spectrum. Many other countries do not have community paediatricians. One of the roles of these paediatricians is to manage the needs of children and young people who have a chronic illness and translate their problems to the education teams so that they can be successfully included in school. Also, these paediatricians are often the first who are asked to see the late walking or talking child, and so have to be skilled in neurodevelopmental delay and disorder. This points to the need for the BACD to maintain joint learning with tertiary paediatric specialists both medical and therapeutic. We are keen to keep up to date with paediatric therapists’ training and academic development – facilitated by the therapy representation we have on our Executive Committee. However, lack of funding for therapists to be involved in multidisciplinary professional development opportunities is an ongoing problem. To try to alleviate this difficulty we have developed a network of regional paediatric and therapy representatives who are active in planning regular local training opportunities. Outside the UK we are proud of our relationship with the European Academy of Childhood Disability that allows us to link with our European colleagues. Lastly, I am keen to draw attention (for those who work in the UK) to the National Framework for Children’s Continuing Care1 which is about to be published. This is relevant to acute paediatric neurologists as well. This publication could aid families and carers in receiving appropriate support in a more timely fashion. In a future journal it may be interesting to hear from other countries about models of planning care for children and young people who have complex health needs. For those in the UK, and even those working in childhood disability outside the UK, I encourage you to attend this year’s BACD conference, which promises to have something for everyone.

How Learning from Automotive Sound Quality can Inform Urban Soundscape Design

From an inter-disciplinary perspective, we explore how approaches from the engineering discipline of automotive sound quality are being applied to inform and inspire the design of positive user experiences in the built environment. Sound is often overlooked in design, but its role in creating a positive user experience can be just as important as designing for the visual sense. The sound of cars is important for automotive companies in helping to differentiate their vehicle brands; but we can also draw parallels here with the soundscapes (or “audible landscapes”) of urban environments, which are important for providing our towns and cities with a unique identity. Decision makers in urban planning have historically considered soundscapes just in terms of a required reduction in sound levels to meet legislation. However this fails to take into account the character of the sound, and who is to say that quieter is necessarily better? Automotive sound quality techniques, which allow engineers to design car sounds which produce a desired emotional response have advanced significantly in recent years, and we propose that this knowledge can be successfully applied to other domains where it is equally as important to create a positive user experience. Here, we present how our automotive sound quality methods are now informing our approach to urban soundscape design. We identify and reflect on the opportunities for shared learning and the areas where a different approach is needed.

This is my truth, tell me yours: exploring the internal tensions within collaborative learning disability research

Accessible summary People labelled with learning disability are now more involved in research that is about them and their lives. When research about the lives of people labelled with learning disability gets published in journals the accounts are written by professionals or academics. Working and writing together is a good idea but we all need to decide on who is in control. Being in control of language often means being in control. SummaryCollaboration within the research and publishing process provides opportunities for shared learning and increased knowledge production and dissemination. It can also provide opportunities for conflict if the contributors are divided over issues of authority and authorship. While this situation can be managed, the potential for misunderstanding to arise is heightened when the combination of academics/professionals and individuals labelled with learning disability work together. The scenario described here outlines some of the difficulties that can threaten successful collaboration. Possible remedies are suggested.Disclaimerthe six o’clock news this is thi six a clock news thi man said n thi reason a talk wia BBC accent iz coz yi widny wahnt mi ti talk aboot thi trooth wia voice lik wanna yoo scruff. if a toktaboot thi trooth lik wanna yoo scruff yi widny thingk it wuz troo. jist wonna yoo scruff tokn. thirza right way ti spell ana right way ti tok it. this is me tokn yir right way a spellin. this is ma trooth yooz doant no thi trooth yirsellz cawz yi canny talk right. this is the six a clock nyooz. belt up. Tom Leonard (1984)