Safe Learning Space Research Articles

Academic nursing administrators perceptions of replacing clinical hours with simulation

BackgroundNursing education has seen a shift towards simulation-based education (SBE) to meet the demands of a rapidly evolving healthcare landscape. Maryland's Clinical Simulation Resource Consortium (MCSRC) aimed to enhance SBE utilization; however, noted a decline in SBE usage post pandemic prompting an investigation into nurse administrators' perspectives on replacing clinical hours with SBE. MethodsThis descriptive quality improvement study was informed by Rogers' Diffusion of Innovation (DOI) Theory. Semi-structured interviews were conducted with four academic nurse administrators from various pre-licensure nursing programs in Maryland. The data collected were analyzed using thematic analysis. ResultsNurse administrators who value SBE as a safe learning space are integral when building and maintaining infrastructure to support simulation usage. Identified barriers related to faculty buy-in, workload, and inadequate human resources to deliver high-quality simulations can hinder sustained adoption of clinical simulation. ConclusionsThis study highlights the necessity of continuous faculty training in SBE and dedicated resources to support simulation infrastructure. Recommendations include sustained investment in faculty development, creating specialized roles for simulation champions, and fostering collaborations to strengthen simulation integration. The findings emphasize the pivotal role of nurse administrators in navigating challenges and maximizing SBE's potential to replace clinical hours in nursing education, urging ongoing support and strategic planning for successful integration.

Pedagogical uses of AI tools: reflection on a case study

Academic writing is central to assessment in UK universities (Goodfellow, 2005). The emergence of easily accessible generative artificial intelligence (GenAI) tools took the sector by storm, with some voices raising critical concerns about academic integrity and the de-skilling of writing, while others pointed to the developmental and time-saving opportunities these tools can offer (OpenAI, 2023; UNESCO, 2023). This presentation reflected on the author’s experience of designing and delivering a workshop on ‘Introduction to proofreading techniques using AI tools’. The workshop was developed as part of a broader Academic Innovation Project designed to support the developmental and ethical use of GenAI tools by student writers at one institution in line with internal and emerging sector policies (such as Russell Group, 2023). The presentation outlined the workshop plan, including learning outcomes and sample activities, alongside highlighting some of the challenges experienced during the design process. It also offered critical insights into the delivery and impact on student learning, with reference to the author’s reflections as well as student engagement and feedback. A major challenge that can be transferable to other pedagogical uses of GenAI tools was the difficulty in navigating the thin line between, on the one hand, encouraging workshop participants to experiment with a range of tools in a safe learning space and, on the other hand, raising their awareness of the ethical implications and potential risks that over-reliance on such tools may pose to their learning, particularly the development of their academic writing.

Team roles and challenges in experiential learning in sustainability accounting education: A four-stage learning cycle

ABSTRACT This study aims to provide insights into the process of team-based experiential learning in a sustainability accounting course. A case study of a postgraduate course on material flow cost accounting at a German university was applied. Data were collected from learning journals and in-depth interviews. The findings provide insights into the process of team-based experiential learning. The process is indicated by four team roles of students: interpersonal, information, analytic, and action roles, which move around the four-stage learning cycle. Six challenges in students' experiential learning in teams were found at different stages: the characteristics of team dynamics, the selection of relevant information from the case, confusion and frustration, connecting information in a meaningful manner, time constraints, and the increasingly complex level of the tasks. The study contributes to the accounting education literature and experiential learning literature by extending knowledge about team roles and learning challenges around the learning cycle. Practical implications for educators are discussed to facilitate team-based experiential learning toward sustainability education. These include the adoption of educator role profiles to support students' learning, the creation of a safe learning space for students, and the design of experiential learning activities on the foundation of four-stage learning processes.

Imajinasi Poskolonial dan Interdependensi Pembebasan dalam Upaya Pendidikan Agama Kristen yang Interreligius-Interkultural di Indonesia

Abstract Tolerance should be a two-way communication between different groups in society, not just from the minority to the majority. Interreligious and intercultural religious education can contribute significantly to the deep tolerance of Indonesian society. This paper identifies and analyzes the potential collaboration between postcolonial imagination and liberating interdependence in interreligious-intercultural Christian religious education, using qualitative research based on a literature study with postcolonial analysis supported by interviews with five Christian religious leaders in Indonesia. Postcolonial imagination and liberating interdependence result in interreligious and intercultural education that promotes dialogue, liberation, tolerance, and social justice in Indonesia’s pluralistic context. This educational approach will widen the learning space so that it is not limited to the classroom or church walls only. A safe learning space will be created for various local narratives in their encounters with diverse religious stories and their connection to economic structure, politics, race, and gender. This learning space also allows both women and men to share their life stories in connection to God the Liberator. Keywords: Education, Interreligious, Intercultural, Postcolonial Imagination, Interdependence.

Athletic training students’ experiences and perceptions of exertional heat stroke simulated encounters: A qualitative analysis

Introduction: Athletic trainers are trained to recognize exertional heat stroke (EHS), which is critical to implementing lifesaving measures. Rectal thermometry is the best practice for recognizing EHS, and the Commission on Accreditation of Athletic Training Education (CAATE) requires students to learn rectal thermometry. Rooted in transformative learning theory, this study explored the perceptions and experiences of athletic training students following simulated EHS encounters with either high-fidelity (HF) simulators or standardized patients (SPs). Methods: This was a qualitative study using phenomenological theory. Through semi-structured qualitative interviews, we explored participants' personal experiences and perceptions following their simulation interventions. Participants included sixteen first-year Master of Athletic Training students (HF=8, SP=8; 4 males and 4 females in each group) ages 21-38 (23.69±4.48) who were enrolled in a course discussing exertional heat illnesses. Data Analysis: We recorded and transcribed the interviews verbatim. We used qualitative software, Nvivo (Denver, CO), to categorize the data into themes and codes. To ensure trustworthiness, we used member checking and investigator triangulation. Results: Three themes emerged from the data: 1) Simulation environment, 2) Mindset shifts, and 3) Perceptions of other simulation types. Participants from both groups described positive learning experiences in a foreign yet low stakes learning environment emphasizing repetition for learning the skill. The HF group shared beneficial aspects of patient-history-taking opportunities. The SP group shared the benefits and applicability of developing a patient-provider relationship through communicating with their SP. Most participants from both groups could immerse themselves in the encounter for a realistic experience. Both groups discussed how their mindset towards EHS and rectal thermometry changed after their encounter. Lastly, both groups agreed their simulation intervention was superior to practicing on a task trainer. Conclusions: Instructors of athletic training programs should strive to implement realistic simulated encounters for emergency skills training of athletic training students. A safe space for learning in a low-stakes environment should be fostered. Based on the shared perceived benefits of SP encounters for building provider-patient rapport and feedback opportunities, instructors should consider implementing SPs throughout their curriculum.

To speak or not to speak: Factors influencing medical students’ speech and silence in the operating room

PurposeThe surgical clerkship provides medical students with valuable hands-on experience. This study examined why medical students speak or remain silent in the OR to improve progression from novice to engaged surgical team member. MethodsUsing Constructivist Grounded Theory 37 interviews were conducted concerning expectations and behaviors that encourage or discourage students from speaking during their clerkship. Transcripts were coded, analyzed, and triangulated to develop a conceptual model. ResultsStudents’ decision to speak or remain silent was based on their perception of the OR as a safe learning space. Our findings suggest that better preparation, awareness of critical moments, and informal communication with team members encouraged student speech. ConclusionsMedical students remain conflicted about their speaking in the OR and their evaluation. Key to improving students’ psychological safety is establishment of interpersonal relationships, awareness of OR mood, and assignment of case-related tasks to assist with OR assimilation and improved learning.

Autistic re-creation: Live action role-play as a safe and brave space for social learning

Live action role-play (larp) is an improvised and embodied form of storytelling that develops through co-creation. While autistic individuals generally dislike unpredictable situations and social interaction in larger groups, anecdotal reports suggest that they often are found in the larping community. Through interviews with 10 autistic, experienced adult larpers, this study investigates larp as a scene for social learning. The examination focuses on the attraction of larps; what the participants learn about social interaction through larping; and how such insights transfer to everyday life. From a cognitive point of view, larping comes through as an optimal autistic space where players feel safe enough to dare push their social boundaries, which conceivably contributes to the formation of more precise social predictions since experimentation and mistakes facilitate embodied learning. From the participants’ point of view, larping improved their understanding of social nuances, which in turn increased social confidence and well-being in everyday life.

Qualitative study of new doctor induction and socialisation

AimJunior doctors joining EDs are required to rapidly acquire new knowledge and skills, but there is little research describing how this process can be facilitated. We aimed to understand what...

Building Back Better: Exploring the Resilience of Schools in Disaster Recovery

As natural and human-made disasters escalate globally, the urgency to rebuild resilient communities is increasingly evident. With this study, Building Back Better: Exploring the Resilience of Schools in Disaster Recovery explores the experiences, disaster recovery, challenges, coping mechanisms, and insights of three school administrators and four teachers designated as school Disaster Risk Reduction coordinators in the Monkayo East District of Davao de Oro. This study utilized qualitative phenomenological study to delve into the lived experiences of educational professionals during post-disaster recovery. This research aims to gain a deep understanding of the challenges, coping mechanisms, and insights from a purposive sample of four teachers designated as school Disaster Risk Reduction coordinators and three school administrators who have directly engaged with the recovery processes following natural disasters. The data were gathered through an in-depth face-to-face interview and used an audio recorder to record the discussion. The significant finding from the study is the multifaceted and long-lasting impact of disasters on students' learning environments. This finding highlights how disasters not only cause physical damage to school infrastructure but also disrupt the educational process, widen achievement gaps, and affect the emotional well-being of students. The disruption of normal routines and the psychological stress experienced by students underscore the critical need for comprehensive recovery strategies, including academic support and mental health resources, to help students regain stability and continue their education effectively. This emphasizes the importance of preparedness and resilience in educational institutions to mitigate the impact of such crises. This study highlights the need for timely assessments, repairs, and coordination with local authorities to ensure the structural integrity of school facilities. It underscores the importance of disaster preparedness and the implementation of robust recovery strategies to mitigate the impact on the educational environment and maintain a safe and conducive learning space. This focus on infrastructure is foundational, as it directly influences the ability of schools to function effectively post-disaster. Teachers and school heads are pivotal in disaster risk reduction within educational institutions. They create safety plans, organize drills, and educate students on emergency procedures, fostering a culture of preparedness. School heads provide leadership, while teachers act as first responders, guiding students to safety and offering necessary care. Collaboration between teachers, school heads, and stakeholders is crucial for a resilient school environment. By involving the entire school community in planning and implementing safety measures, schools can effectively respond to disasters, ensuring the safety and well-being of everyone involved. This partnership promotes a proactive approach to disaster preparedness, making safety a priority in all school activities.

Student choice and barriers to physical activity in Latino boys in the REACH after-school program

ABSTRACT Background After-school programs (ASP) provide safe and enjoyable setting for youth to participate in sports and physical activities (PA). The flexibility in the structure of ASPs can facilitate non-traditional approaches to teaching PA which consider the context of the community, students’ backgrounds, and focuses on positive youth development. REACH takes a non-traditional approach that aims to provide youth in under-resourced communities with a safe space for PA and learning through a sport-centered curriculum. Purpose The objective was to highlight the perspectives of Latino boys regarding their lived experiences in an after-school soccer and literacy program in a diverse urban school. The research questions were: (a) what are the lived experiences of young boys in a year-long after-school program in a diverse urban setting? (b) What opportunities did REACH provide that helped the young boys negotiate barriers to being physically active? Method Twenty-three Latino boys participated in the REACH after-school sessions over a school year. Four pre-service teachers facilitated soccer sessions at REACH. Data were collected through boys’ weekly journals across 28 weeks and interviews with ten boys at the end of the year. Coaches’ reflexive journals were used to triangulate the data. Data were independently coded using constant comparison and analyzed following a collaborative qualitative analysis procedure. Trustworthiness included triangulation of data, negative cases checks, multiple coders, and peer-debriefing. Results The results presented in this article are part of a larger year-long mixed-methods curriculum intervention. Two themes are presented to represent the perspectives of the boys in participating in REACH. In the first theme, we discuss student choice that was expressed in the way youth chose to participate in REACH and engage in PA during out-of-school hours. The second theme presents the students’ identifying the barriers they face to being physically active and the ways REACH provided a space for them to reflect on those barriers. Discussion Students’ choice was expressed in participants’ engagement in physical activities and sports in and outside of REACH and as a fundamental aspect that enhanced enjoyment in the program. Thus, participating in the program led students to enhance their physical activity enjoyment in and out of the program as well as learn about life skills through sport. With a focus on positive youth development, discussions and journaling in REACH encouraged the boys to reflect on life skills that focused on character and the development of positive relationships. Participants described varied barriers they faced to being physically active in and out of schools. REACH provided a safe space where participants could talk about and develop awareness about aspects of their community such as violence. Conclusion REACH provided a safe space for students to be active, learn sports skills, and engage in interest-based activities. The safe space provided in REACH also encouraged Latino boys to reflect on the barriers to being physically active outside of the program with the intent of possibly transferring what was learned in the program to their lives. Having a choice was a fundamental aspect to enhancing the boys’ enjoyment in REACH.

Nursing Students’ Perspectives on Caring Pedagogical Relationship Within the Context of Simulation: A Phenomenological Inquiry

Abstract:This phenomenological research aimed to describe and understand nursing students’ meaning of the lived experience of a caring pedagogical relationship within the context of high-fidelity clinical simulation. Being inspired by a relational emancipatory pedagogy perspective, our findings highlighted an authentic engagement of educators as the cornerstone to fostering a safe, caring, and inclusive learning space, allowing them to co-create a humanistic collaboration with students to transform their learning process. Innovative and various avenues arising from our findings have been suggested in different domains of nursing practice to promote students’ learning and develop a caring inclusive learning community within simulation centers.

Deaths, Destructions and Displacements (DDD): The Impact of Boko Harm Insurgency on Education Development in North-East Nigeria

Boko Haram insurgency has affected every sector in the Northern part of Nigeria, especially the Northeast region. It is understood that even before the emergence of the Boko Haram in Northeastern part of Nigeria, the region was characterized with the poorest rate of socio-economic and human development index. The paper examined consequences of Boko Haram insurgency on education sector in Northeast Nigeria. The research being qualitative in nature, obtained data through the primary and secondary sources and analyzed thematically. The study found that there are several associated consequences of Boko Harm insurgency on education in the region including but not limited to death, destruction, and displacement. The consequences have had serious implications of manpower shortage, destruction of infrastructure and facilities, displacement of teachers and students, and the mass abduction of school children among others. It is noted that these consequences have repeatedly posed a serious threat or set back to conducive teaching and learning environment much needed for by teachers ‘and students alike and by extension to the education sector at large. To advance a conducive teaching and learning atmosphere, the research recommends that government and stakeholders alike must work hand in hand to provide practical and realistic steps to address the recurring security challenges associated with schools. It is believed that with an enhanced safe learning space for both teachers and students alike their performance in major education outcomes will improve as well enhance the overall educational development not only in the Northeast region but across Nigeria as a whole.

Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study.

Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician-specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke. To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke. We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi-structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method. Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: 'Following what other people have done', (2) need for collaborative learning: 'A safe space to share and train', (3) variation between settings impacts on continuity of care: 'There's a difference between community and acute', and (4) working effectively with multidisciplinary teams (MDT): 'An MDT which can listen to the voice of speech pathology'. Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke. What is already known on this subject Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variability in clinical practice. Clinician-specific and workplace factors influence clinical practice and may contribute to variability in dysphagia rehabilitation. What this study adds Professional relationships influence speech pathologists' clinical practice, including relationships between senior and junior clinicians, between inpatient and community settings and with peers and multidisciplinary teams. Workplace norms and hierarchies, poor continuity of care between settings and competing priorities from other disciplines can hinder dysphagia rehabilitation. However, collaborative learning, positive workplace cultures and respectful transdisciplinary care can improve the quality and consistency of clinical practice. What are the clinical implications of this work? Flattening hierarchies in the workplace can foster a safe learning space. Further, questioning workplace norms and seeking out peer learning within and across settings can build clinical skills and confidence. Developing positive workplace cultures that support continuous development may be key for empowering speech pathologists to provide high-quality and consistent dysphagia rehabilitation.

Modelling of Library Activity: Analytical Tools

The purpose of the research is to systematise and summarise known and new knowledge about analytical tools for modelling the activity of modern libraries in Ukraine. The research methodology is based on general scientific principles of comprehensive knowledge, complexity, systematicity, unity of theory and practice. The achievement of the set goal was facilitated by the use of general scientific (observation, analysis, synthesis, modelling, system approach, generalisation) and special (bibliographic, information diagnostics (express analysis), grouping) methods at the theoretical and empirical levels of research. The scientific novelty of the work consists in the systematization and generalisation of known (about models and modelling) and new knowledge (about the use of analytical modelling tools in the practical activities of Ukrainian libraries) from the point of view of the present and the perspectives of their development within the scope of one study. Conclusions. The place and role of the modern library in the global system of civilizational development is determined by its ability to be an information base for the development of human potential. That is, in today's changing world, the library is responsible for preserving, spreading and multiplying knowledge, comprehensive communication, providing a free, safe and comfortable space for learning and development, uniting communities and individual citizens. Researchers propose various models of modern library development: "Library – cultural and educational centre", "Library – scientific and information centre", "Library – public educational centre", "Library – digital hub", "Library – information and analytical centre" and others. It is clear that some models can be prioritised or combined. To build one or another effective model of the functioning and development of a modern library, appropriate analytical tools are involved in modelling: building a model canvas, brainstorming, visualisation, empathy map, SWOT analysis, and others. They help specialists generate innovative ideas, change the "rules of the game" to more effective ones, and practically transform the established form of library activity into a more perfect and modern one. Accordingly, during the implementation of the new model, document and information resources are updated, the level of communication is increased, the technological infrastructure is strengthened, the level of informatisation is increased, and the development of new competencies of specialists takes place. Keywords: library, information and analytical activity, model, modelling, information process, innovation.

HOW ORGANIZATIONS CAN ADDRESS AGEISM AS PART OF THEIR DIVERSITY, EQUITY, AND INCLUSION INITIATIVES AND PROGRAMS

Abstract The Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Health System created a diverse inter-disciplinary committee to advance and promote DEI activities centered in advocating for a socially just, diverse, equitable, inclusive, and anti-racist workplace. Research shows that anti-ageism is a largely neglected component of diversity, equity, and inclusion programs. Thus, many institutions are not learning how age biases and discrimination show up in the workplace and the intersection of age across other dimensions of diversity. Ageism is a vital workplace issue as over a third (37.3%) of the U.S. workforce are aged 50 and older. We aimed to address this by incorporating the topic of anti-ageism via our various DEI initiatives available to all faculty and staff: “Humanities, Arts, and Books Initiative” on Combatting Ageism - structured workday sessions designed to provide a safe virtual space for reflection, discussion, and learning. We also held “Learning Pathway series” on Reframing Aging as well as Caring for Older Adults with HIV – structured sessions focused on knowledge building, and expert-led discussion. Attendance ranged from 40 to 60 participants at each session. Quantitative and qualitative assessment revealed a steadfast interest to address ageism and bias; appreciation of the semi-structured format for dialogue and reflection on relevant topics and finally ongoing education to create a more informed and collegial department. This type of programming can potentially serve as an additional resource for other institutions that are planning in incorporating anti-ageism activities in their DEI programs and everyday practices.

A30Safe Interdepartmental Learning from clinical incidents using a Quality Improvement Framework

Mistakes are an inherent learning opportunity within healthcare that can be used to prevent future loss of lives and reduce suffering. We aim to create a safe learning space within our organization that can be embedded within our quality improvement (QI) process. We have designed a bespoke framework ( Safe Interdepartmental Learning with a Quality Improvement Framework Our tertiary hospital clinical governance team in collaboration with the multi-professional education, simulation, and patient safety departments has identified 5 topics based on the root cause analysis of serious clinical incidents. This description from our recent cohort involves the recruitment of 5 different specialty teams, each consisting of 1 experienced consultant faculty and 3 other facilitating clinicians with different levels of experience in healthcare simulation. The teams prepared and designed the most suitable clinical scenario progression to address the learning objectives based on their allocated topics. Learner and peer feedback along with reflections on the session, highlighted possible change ideas to modify the subsequent scenario running. Over a period of 6 months, different learner sets were involved in the same simulation exercise with 2 further iterative modifications. The 5 teams have generated a total of 15 hours of simulation sessions using standard pre-briefing, debriefing, and evidence-based simulation techniques. The level of independent facilitation and mentoring by more advanced debriefers has been adjusted to fit the individual pace of experiential learning. To further enhance the embedded faculty development a total of 270 minutes of online discussion, reflections, and 15 topics were presented by the facilitators to create a multi-professional learning experience. The content was structured to reflect the national outcome’s framework for faculty development and the ASPIH standards guidance for simulation-based education. The recorded simulation sessions, debriefing, and topic discussions have generated a useful asynchronous online reference for the current and future cohorts. The feasibility of implementing this simulation programme integrated with a QI framework is a major step for our future prospective evaluation of the impact of translational simulation as theorized in the current literature [2] on patient outcomes and healthcare performance indicators. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Emergency medicine resident perceptions of simulation-based training and assessment in competence by design.

With the launch of competence by design (CBD) in emergency medicine (EM) in Canada, there are growing recommendations on the use of simulation for the training and assessment of residents. Many of these recommendations have been suggested by educational leaders and often exclude the resident stakeholder. This study sought to explore their experiences and perceptions of simulation in CBD. Qualitative data were collected from November 2020 to May 2021 at McMaster University and the University of Toronto after receiving ethics approval from both sites. Eligible participants included EM residents who were interviewed by a trained interviewer using a semi-structured interview guide. All interviews were recorded, transcribed, coded, and collapsed into themes. Data analysis was guided by constructivist grounded theory. A total of seventeen residents participated. Thematic analysis revealed three major themes: 1) impact of CBD on resident views of simulation; 2) simulation's role in obtaining entrustable professional activities (EPAs) and filling educational gaps; and 3) conflicting feelings on the use of high-stakes simulation-based assessment in CBD. EM residents strongly support using simulation in CBD and acknowledge its ability to bridge educational gaps and fulfill specific EPAs. However, this study suggests some unintended consequences of CBD and conflicting views around simulation-based assessment that challenge resident perceptions of simulation as a safe learning space. As CBD evolves, educational leaders should consider these impacts when making future curricular changes or recommendations.

'A human face and voice': transgender patient-educator and medical student perspectives on gender-diversity teaching

BackgroundTransgender and gender diverse (TGD) people face many obstacles in accessing health care, including discrimination, institutional bias, and clinician knowledge deficits. We developed a clinical skills and education module on gender-affirming care for pre-clinical medical students, in collaboration with a TGD-led civil society organisation. The module consisted of an educational session followed by preceptor-facilitated small group tutorials, led by TGD patient-educators (n = 22) who used their lived experience to explore medical history-taking and broader issues related to TGD healthcare with students (n = 199). This study aimed to explore the views of students and TGD patient-educators on the structure, delivery and impact of the module.MethodsAnalysis of responses of TGD patient-educators and students to the module (2020 and 2021), in post-intervention surveys using open-ended questions for TGD patient-educators (18 responses from 22 educators) and free text comments as part of a quantitative survey for medical students (89 responses).ResultsResponses from students and patient-educators to the session were highly positive. Students and patient-educators emphasised that the teaching session succeeded through elevating the centrality of shared experience and creating a safe space for learning and teaching. Safety was experienced by patient-educators through the recognition of their own expertise in a medical environment, while students reported a non-judgemental teaching space which allowed them to explore and redress recognised limitations in knowledge and skill. Patient-educators described their motivation to teach as being driven by a sense of responsibility to their community. Preceptor attitudes may function as a barrier to the effectiveness of this teaching, and further attention should be paid to supporting the education of clinical facilitators in TGD health.ConclusionThe experiences of TGD patient-educators and medical students in this study suggest that this model of teaching could serve as a transferable template for TGD health and the inclusion of other historically marginalised groups in medical education.

'I feel more part of the world': Participatory action research to develop post-diagnostic dementia support.

Many people living with dementia are 'on the margins', not accessing services and support, despite policy and care advancements. The COVID-19 pandemic exacerbated this, with the closure of face-to-face support during lockdowns in the UK and globally. The aim of the 'Beyond the Margins' project was to develop, implement, and evaluate a face-face programme of support with, by and for people with direct experience of dementia who are on the margins of existing services and support. In March 2020 the project was interrupted by the outbreak of the COVID-19 pandemic and it changed to an online format. The three-phase participatory action research project included 40 people living with dementia, 26 care partners and 31 health and social care practitioners. A seven-week online personal development programme called Getting On with Life (GO) was developed, delivered, and evaluated. This paper focuses on the participatory approaches used to develop and implement the GO programme, and the resulting aspects of its approach to facilitation and content. Key features include the GO Programme's principles of providing a safe and a respectful space, and the programme's values of: Everyone who comes already knows things, can learn things and can teach things; Doing things 'with' each other, rather than 'for' or 'to' each other; Personalised goals-led by the needs of participants rather than an imposed agenda. A key finding was the importance of developing post-diagnostic programmes as a 'sandwich', providing a safe space for learning that is preceded by understanding pathways to access the programme and followed by explicit consideration of the next steps in increasing social engagement.

The Māori Student Nurse Experience of Cohorting: Enhancing Retention and Professional Identity as a Māori Nurse

Despite decades of work by tertiary providers to increase the Māori nursing workforce, there has been little change in the numbers of Māori nurses graduating from schools of nursing. The call for more culturally responsive teaching and learning strategies saw one tertiary provider implement Māori student cohorts for labs and tutorials in year one and two of the Bachelor of Health Science Nursing programme. This research explored the student experience of the cohorts using a hermeneutic methodology within a Māori-centred approach. Students in year two and three of the programme who had participated in the cohorts were invited to join focus groups to share their experiences. Data from the focus groups was analysed using van Manen’s approach with a Māori lens. The themes of whanaungatanga (connection), tikanga (correct practice), wānanga (learning conversation) and manaakitanga (ethic of care) emerged from the data. Cohorting was identified as a culturally responsive teaching and learning strategy. It provided a safe space for learning in what is a predominantly western monocultural system. It was not suffient on its own however. Cohorting of Māori students needs to be supported by teaching practices which include tikanga Māori, wānanga as a formal teaching strategy and the overt demonstration of manaakitanga to ensure it meets the needs of Māori nursing students. When integrated into programmes of study, Māori student cohorts have the potential to not only support retention, but also the development of the student’s professional identity as a ‘Māori’ nurse. TE REO MĀORI TRANSLATION Ngā wheako o ngā tapuhi Māori mō te urutomo ā-rōpū: Te whakapiki i te purutanga kaimahi me te tuakiri ngaio hei tapuhi Māori Ngā Ariā Matua Ahakoa te huhua o ngā mahi i roto i ngā ngahuru tau a ngā kaihora mātauranga matua, he iti noa ngā panonitanga o te tokomaha o ngā tapuhi Māori e tohia ana ki ō rātou tohu i roto i ngā kura tapuhi. Nā ngā karanga mō ētahi rautaki whakaako urupare ki te ahurea, rautaki ako pērā hoki, i tahuri tētahi kaihora mātauranga matua ki te whakatinana rōpū ākonga Māori mō ngā mahi pūtaiao, akoako hoki i ngā tau tuatahi, tuarua o tā rātou hōtaka Tohu Paetahi Pūtaiao Hauora mō te Mahi Tapuhi. I āta tūhura ēnei rangahau i ngā wheako o aua rōpū, mā te whakamahi tikanga whakamārama, i roto i tētahi ara whakaaro ao ki te Māori. I pōwhiritia ngā ākonga i te tau tuarua, tuatoru hoki o ngā rōpū kia piri mai ki ētahi rōpū arotahi, ki te whakaatu i ō rātou wheako. I tātaritia ngā raraunga mai i ngā rōpū arotahi mā te whakamahi i te ara a van Manen me te whakamahi i tētahi aronga Māori. I puta ngā tāhuhu o te whanaungatanga, o ngā tikanga, o te wānanga, me te manaakitanga, i ngā raraunga. I tautohutia te whakarōpū hei rautaki whakaako, ako hoki ka urupare ki te ahurea. Nā tēnei rautaki ka hua he mokowā haumaru mō te ako, i roto i tētahi pūnaha nō te hauāuru o te ao, te nuinga o ōna tikanga. Ko te karanga kia kaua e mutu noa i reira. Me mātua tautoko ngā mahi whakarōpū i ngā ākonga Māori mā ngā tikanga whakaako kei roto nei ngā tikanga Māori, ko te wānanga hei rautaki whakaako ōkawa, me te putanga nui o te manaakitanga, kia tutuki pai ngā hiahia o ngā ākonga Māori. Ina tuia mai ki roto i ngā hōtaka akoranga, he whai pito mata ngā rōpū ākonga Māori hei tautoko i te purutanga ākonga, me te whanaketanga o te tuakiri ngaio o te ākonga hei tapuhi Māori. Ngā kupu matua: te whakarōpū; ngā tikanga whakaako urupare ki te ahurea; taketake; tapuhi tohu paetahi; tuakiri ngaio; purutanga ākonga