Training Pack Research Articles

2308 A pilot project implementing a dysphagia screening tool for femoral fracture patients.

Abstract Background Evidence suggests 30–40% of patients with a neck of femur fracture (NOF#) develop oropharyngeal dysphagia (OPD) during the perioperative period. 1–2 Our data, collected over two months, shows our Speech and Language Therapy Team (SLT) identified only 12% of cases. Given the importance of nutrition and medication in the perioperative period, early identification of OPD is critical. We launched a new dysphagia screening tool for all patients admitted to our hospital with a NOF#. Methods A retrospective review of patient notes allowed collection of data regarding age, hip injury, frailty score, comorbidities, and staff compliance with tool. Patients with a completed screening tool had outcomes recorded (low, medium, high risk), timeliness of referral to SLT if appropriate, and if OPD was present on assessment. Balancing measures included length of time kept nil by mouth. We completed four PDSA cycles over 5 months. Results During this period, 157 patients were admitted with a NOF# and 58 had a completed screening tool. By producing a training pack and expanding into the emergency department, compliance improved by 33% over the 4 cycles. 19 of the 58 patients with a completed screening tool had OPD; 79% had mild, 14% moderate and 7% severe. The screen was adjusted during each cycle improving the suitability of SLT referrals from a 25% identification rate in cycle 1 to 100% in cycle 4. No patients were kept nil by mouth. Conclusions The screening tool has increased OPD identification by 21%. However, this requires staff training and high compliance rates to be effective. Next steps include adding the tool to the NOF# proforma, creating a training pack for the wider MDT, and improving the specificity of the tool.

Building reflective spaces for junior doctors to promote ethical, legal and professional learning relating to clinical practice.

Concerns have been raised surrounding the training of Foundation Doctors on the ethical, legal and professionalism(ELP) aspects of clinical practice, leading to some to claim a degree of educational neglect. Foundation Doctors are junior doctors in the United Kingdom within the first 2 years of their medical career since graduating from medical school. Lancaster University and Health Education England North West (HEE NW) introduced a series of training materials specially created to meet the ELP training needs of Foundation Doctors, which were piloted by Foundation Schools. The training was delivered to Foundation Doctors in first and second year of their training either online or in person. The facilitators were clinical senior doctors and did not have an academic qualification in ELP. Some large Foundation Schools used two training packs to provide an optional ELP day for their Foundation Doctors, while individual hospitals within a Foundation School used the training packs to provide training as part of their mandatory weekly training for Foundation Doctors. Feedback was gathered from Foundation Doctors and training facilitators when a training pack was piloted. Foundation Doctors were able to make links between the messages delivered in the training to their own clinical practice. Foundation Schools have incorporated the training packs into the 2-year Foundation Programme, which creates the possibility for ELP training to become standardised across Foundation Schools.

Effect of E-Training, E-Leadership, Work-Life Balance, and Work Motivation on Performance of Employees in a Work from Home Setup

Enabled by digital technology, the prevalence of working from home arrangements has been widely used amidst the COVID 19 pandemic. This study determined the effect of e-training, e-leadership, and work-life balance on work motivation and on employee performance in a work from home setup. In the same manner, it tested the effect of work motivation on employee performance. The researcher employed descriptive and causal research designs. The survey was done by sending the Google form link to the chief executive officer (CEO) of the BPO company in San Pedro Laguna which in turn was emailed by the latter to the employees. Regression analysis was used to evaluate the collected data. The research found out that e-training positively and significantly affects work motivation and employee performance. In the same manner, e-leadership positively and significantly affects work motivation and employee performance. At the same time, work-life balance positively and significantly affects work motivation and employee performance and lastly, work motivation positively and significantly affects employee performance. With this, a training pack for the leaders is developed to teach them how to enhance e-training and remote leadership of their subordinates. Further, the training pack contains strategies so that at least the leader can contribute to developing a subordinate mindset of how to balance his work and life concerns.

Medical anthropology and spiritual activism in education

Editor’s note: this article is based on the author’s workshop for the Section Annual Conference Transpersonal Activism on 11–12 September 2021.The aim of the workshop was to raise awareness with the conference participants, of strategies to develop spiritual activism with medical and health care staff, to benefit people who used the services. The author had practised transpersonal spiritual activism in medical schools and hospitals since 2007, and taught university courses on anthropology and spirituality before then. This workshop offered an overview of her courses and summarised current practices of spiritual activism in medical schools.Workshop Aims. The aims of the workshop were to raise awareness of spiritual activism in medical schools, and address issues around social inclusion. Within the discipline of medical anthropology, this workshop offered a Tool-Kit and practical Resource Training Pack for discussion, so conference participants who were prospective practitioners and activists might consider using it. The aim was to enhance participants’ own skills and knowledge base, to support their actions towards applied transpersonal activism, based on their own knowledge. The workshop participants brainstormed ways they might use the material available, to present a strategy to their colleagues on potential ways forward to address social inclusion.

Redesigning community care for safer staff and patient experiences: quality improvement project to improve safety and reduce incidents of violence and aggression in a community mental health team

AimsViolent or aggressive incidents can be relatively common in community settings, and perhaps more difficult to manage than at inpatient wards due to the relative isolation and peripatetic delivery model, which can put staff at higher risk during incidents. Carshalton and Wallington Recovery Support team was identified as an outlier in the Trust and was invited to partake in a Safety Collaborative across South London Partnership.Stakeholders agreed on the aim of reducing incidents by 20% over 1 year by the end of 2020.MethodData about incidents were analysed and staff surveys conducted to evaluate violent events. Patient discharge was highlighted as a particular time of increased aggression. Involvement of patients and carers through patient focus groups and co-production was essential to elicit areas of improvement. These included staff confidence and awareness of existing guidelines. Additional secondary drivers were communication with patients, care pathway development, discharge process and multidisciplinary approach, which each had associated change ideas.The team identified change ideas that have been tested over one year using the Quality Improvement methodology of small-scale testing and PDSA. Example ideas tested include multidisciplinary Risk meetings, Safety huddle tool, Staff Safety training, co-produced Welcome and Discharge Packs with informed care pathways.ResultThere has been a 30% reduction in incidents by December 2020 across a total of 280 patients. Surveys have shown an increase in staff confidence and safety protocol awareness from 40% to 70% by October 2020. 100% of patients in focus groups found the Welcome and Discharge Packs helpful.ConclusionA structured improvement approach focused on staff safety and minimisation of known and potential contributing factors can lead to a reduction in incidents. Safety huddles and risk meetings allow a formal multidisciplinary approach to management of violence and aggression. Staff feel more reassured about safety policies in the trust, with better communication between senior management and colleagues to highlight risk and provide support. A culture of open discussion and transparency was implemented through provision of Welcome Packs including Care and Discharge Pathways details at point of entry to the service. Support was provided to patients with Discharge Packs including information about community services. This enabled a meaningful support model at the end of their recovery journey and an improved discharge process.The team is now working with additional teams and administrative and clerical staff to improve safety. We hope to replicate this approach in our Trust.

Radiographer led implanted cardiac defibrillator (ICD)/Permanent pacemaker (PPM) monitoring

Keywords – Pacemaker, PPM, ICD, Implanted Cardiac Defibrillator, monitoring, pacing, radiographer led, training. Introduction – It is not possible to predict the exact behaviour of a PPM/ICD when it is within or close to a radiotherapy treatment field therefore they must be closely monitored [1]. Pre 2018 the standard practice for any patient with a cardiac device was for either a clinician or a member of the pacing team to be present for each fraction of Radiotherapy. This could often lead to delays for the treatment unit and patients whilst waiting for the appropriate member of staff to arrive. Also, at our satellite centre we were unable to treat any patient with a cardiac device due to lack of available clinicians and pacing support. A core team of Radiographers received training to enable them to monitor patients themselves. Method – First time policy was presented and approved. A training package which consisted of a study day and practical training session was created. A team of Radiographers attended both sessions and then completed a competency framework under the supervision of the pacing team. After completing the competency pack, the Radiographers were deemed competent to monitor the patients during treatment. In addition to the core team, further amended training sessions have been implemented to increase the number of Radiographers able to monitor. We have evaluated the training using feedback questionnaires. A staff survey was undertaken to assess service improvement. Results – 22 Radiographers across 2 sites have now completed their training and competency packs. Conclusion - Patients with a cardiac device are now able to receive treatment closer to home at our satellite centre. Delays due to monitoring staff availability are vastly reduced. Patients are treated in a timely manner and the treatment machines run a more efficient service. All trained staff agreed that the training met their expectations and they felt confident to begin monitoring. Numerical

Assessment of groundwater quality status by using water quality index (WQI) and geographic information system (GIS) approaches: a case study of the Bokaro district, India

One hundred two groundwater samples were collected from the Bokaro district of Jharkhand state, India, during the pre-and post-monsoon seasons of the year 2014–2015. In the present study, groundwater samples were analysed for pH, TDS, TH, Ca2+, Mg2+, Na+, K+, Cl−, SO42−, HCO3−, F− and NO3− to evaluate the suitability of the groundwater for drinking purposes through geographic information system (GIS)-based water quality index (WQI) model. For quality assessment, values of analysed parameters of the groundwater samples were compared with the Bureau of Indian standards (BIS) and World Health Organization (WHO) water quality standards. The analytical results indicate slightly acidic to slightly alkaline nature of the groundwater in the study area. Concentrations of Ca2+, Mg2+, HCO3−, F−, NO3−, TDS and TH exceeded the desirable as well as permissible limits of drinking water quality standards recommended by the BIS (Indian Standard Drinking Water Specification, 2012) and WHO (Guidelines for drinking water quality: training pack, WHO, Geneva, 2004) in the study area during the pre- and post-monsoon seasons, respectively. However, Na+, K+, Cl− and SO42− concentrations were within the permissible limits during both seasons. The hydrochemical analysis of the studied groundwater samples documented with ternary and Durov diagram revealed that most of the groundwater samples belong to HCO3− type of anions facies and no dominant type of cation facies. The GIS-based WQI maps for the study area indicate that the poor quality of water was found the maximum in the pre-monsoon season as compared to the post-monsoon season in the study area, respectively. The high values of WQI in the several groundwater samples of the Bokaro district indicate that water is not suitable for direct consumptions and it required sustainable treatment before its utilization for drinking uses.

Assessment of Self-Administration of Romiplostim in Patients with Immune Thrombocytopenic Purpura after Receipt of Home Administration Training Materials: a Cross-Sectional Study.

IntroductionRomiplostim is a subcutaneously administered thrombopoietin-receptor agonist approved in the European Union for self-administration (or administration by a caregiver) in selected adult patients with chronic primary immune thrombocytopenia refractory to other treatments. To mitigate the risk of medication errors due to self-administration, the manufacturer has implemented additional risk minimisation measures (RMM) in the form of a Home Administration Training (HAT) pack to support the training of both healthcare professionals (HCPs) (guide and checklist for patient selection and training) and patients (a preparation mat, quick guide booklet, step-by-step guide, self-administration diary and DVD/video).ObjectiveThe primary objective was to estimate the proportion of patients/caregivers who administered romiplostim correctly after HAT pack training.MethodsA multicentre observational study was conducted to evaluate the effectiveness of the HAT pack by recording data on a standardised collection form during direct observation of patients/caregivers in the act of administering romiplostim at the first standard-of-care visit 4 weeks after training with the HAT pack.ResultsAmong the 40 patients/caregivers enrolled across 12 study centres in eight European countries, 35 [87.5%; 95% confidence interval (CI) 73.9–94.5] administered romiplostim correctly, and five (12.5%; 95% CI 5.5–26.1) did not.ConclusionThe correct administration of romiplostim by most patients/caregivers supports the effectiveness of the HAT pack as an additional risk minimisation tool in the population and setting of this study.

The effect of exercise prescription of primary care physician on the quality of life in patients.

PurposeThe aim of this study was to examine the effect of exercise prescribed by primary care physicians (PCPs) on the quality of life (QoL) of elderly people.MethodRandomisation was performed at PCPs level from 16 primary healthcare centers. Patients were divided into intervention and control groups. Both groups of physicians received theoretical training (14 h), and the intervention group received additional practical training on exercise prescription (10 h). Patients in the intervention group were prescribed endurance, flexibility, balance, and strength exercises and were given training packs. QoL was measured using Short Form-36. Measurements were taken at the beginning of the study, after the 3rd month, and at the end of the 6th month to evaluate the effectiveness of the intervention.ResultsThe age of participants (Intervention group n = 69, Control group n = 110) was 57.68 ± 5.08 years. At the end of the study, physical function, physical role function, social role function, mental health, vitality, general health perception, and emotional role function scores increased and body pain scores decreased in the intervention group. Significant differences (p < 0.05) between the intervention and control groups were observed for physical function, physical role function, body pain, mental health, vitality, and emotional role function scores but not for social role function or general health perception scores.ConclusionsExercise prescriptions given by PCPs containing endurance, strength, flexibility, and balance exercises improve QoL in elderly people.

Information Technology Implications of IFRS Implementation in Nigeria: Challenges to Auditors

The adoption of IFRS as the reporting standards in Nigeria has brought with it changes in the accounting systems. IT changes is one essential aspect of concern in the IFRS implementation especially considering its effects on audit practice. These issues defined the focus of this paper. The survey research design was adopted. Auditors in audit accounting firms in Anambra and Akwa Ibom states of Nigeria were the targeted respondents. 120 auditors were randomly selected using convenience and judgemental technique. Data were collected using a 5-point Likert scale questionnaire. The data were analysed using the descriptive statistic such as averages, weights and ranking. It was discovered that the technology changes as a result of IFRS implementation requires high IT expertise from auditors as they need to understand the up to date software. It was therefore recommended that auditors should take up the challenge of updating their knowledge and skills with regard to IFRS and information technology in order to brace up for the challenges ahead. Similarly, accountancy training institutions such as tertiary institutions and professional tuition homes should update their curriculum to be in tune with the demands of IFRS; IFRS training packs and software should be made affordable in Nigeria.

Assessment of Self-Administration of Romiplostim after Receipt of Home Administration Training Materials: A Cross-Sectional Study of Patients with Immune Thrombocytopenic Purpura and Caregivers

Background: Romiplostim is a subcutaneously administered thrombopoietin-receptor agonist approved for use in the EU for adult patients with chronic immune thrombocytopenia (ITP) refractory to other treatments. Initially approved for administration by healthcare providers (HCP), romiplostim was further approved by the European Medicines Agency in December 2012 for self-administration by select patients/caregivers. Romiplostim-treated chronic ITP patients with stable platelet count ≥ 50 x 109/L for ≥ 4 weeks without dose adjustment eligible for self-administration should be trained in self-administration procedures, and be supervised again after the first 4 weeks of self-administration while reconstituting and injecting romiplostim. To mitigate medication error risk due to self-administration, an additional risk minimisation activity in the form of a Home Administration Training (HAT) pack was designed to support HCPs in selecting patients and training of patients/caregivers. For subcutaneous self-administration of romiplostim, each patient (or caregiver) is supplied with self-administration kit (250/500 mcg romiplostim vial, plunger rod, prefilled sterile water syringe, disposable syringe with Luer-lok, safety needle, vial adapter) and a HAT pack, including placemat to lay out the administration components, checklist, instructions for use, self-administration diary, and instructional video.Aims: To estimate the proportion of adult patients and caregivers who administered romiplostim correctly after being trained with HAT pack.Methods: This multicentre, non-interventional, cross-sectional study was conducted at 12 study centres across 8 countries (Austria, Belgium, France, Germany, Greece, The Netherlands, Spain, and The United Kingdom) from 07 July 2014 to 20 November 2015. Adult (≥ 18 years of age) chronic ITP patients prescribed romiplostim self-administration or caregivers new to administering romiplostim, who provided informed consent at beginning of HAT pack training, received HAT pack training, and were available at first standard-of-care 4-week visit after training, were consecutively enrolled in the study. HCPs directly observed the patient/caregiver in the act of administering romiplostim at the first standard-of-care 4-week visit after HAT pack training, and completed a standardized data collection form. Variables collected included patient demographics, prescribed and administered injection volume per syringe, appropriate alcohol wipe use at injection site, clinically appropriate handling of syringe to avoid contamination, and clinically appropriate subcutaneous injection technique. The primary endpoint, correct administration of romiplostim, was defined as romiplostim dose accuracy within 10% margin of error between prescribed and administered romiplostim dose, and correct romiplostim reconstitution, and successful romiplostim injection, and no HCP intervention during administration to correct patient/caregiver error. All analyses were descriptive and no formal hypothesis was tested.Results: A total of 40 patients/caregivers were enrolled in the study (Table 1). At the first standard-of-care visit, 4 weeks (range: 2 - 8 weeks) after HAT pack training, 35 patients/caregivers (87.5%) administered romiplostim correctly. Romiplostim dose accuracy was within 10% margin of error for all patients. HCP intervention was required in 5 instances (3 patients, 2 caregivers): 1 patient did not ensure all romiplostim was dissolved, 1 patient and 1 caregiver needed verbal encouragement, 1 patient needed nursing intervention to read the correct dose from the vial due to poor eyesight, and 1 caregiver needed guidance with syringe and vial connection. Further follow-up data was available for 2 of these 5 patients/caregivers; they both administered romiplostim correctly at a subsequent visit.Conclusion: Given that this study was conducted on a convenience instead of random sample of patients, generalizability of the results may be limited. Direct observation can be susceptible to observation bias and to the Hawthorne effect with the patients/caregivers acting differently when observed. Nonetheless, the success of most patients and caregivers in correctly administering romiplostim after HAT pack training suggests that self-administration of romiplostim is a feasible option for suitable romiplostim-treated ITP patients. [Display omitted] DisclosuresSchipperus:Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Partial sponsorship(50% of costs)ASH 2015. Taylor:Amgen: Consultancy. Wetten:Amgen: Employment, Equity Ownership. Bennett:Amgen: Employment. Kreuzbauer:Amgen: Employment, Equity Ownership. Boshier:Amgen: Employment, Equity Ownership. Seesaghur:Amgen: Employment, Equity Ownership.

A platform for change?

Accessible summary The governments in the UK want people with learning disabilities to have a voice about what happens in their own life and also in policy. One way of doing this is through research. This paper looks at two inclusive research projects, which were about people using direct payments and personal assistants. The projects both employed people with learning disabilities. Each of these projects made a training pack from the research, so that they would help people with learning disabilities and their supporters. They also had some effects in ways that were not planned, because the government wanted to learn from them about inclusive research. All research seems to have most effect when there are many voices seeking change, including those of policy makers themselves. Inclusive research is a way of achieving ‘choice and control’. But just like with direct payments and personal budgets, the best way in these projects was to have good support from other people who will listen to you, and help you decide things for yourself. SummaryParticipation, voice and control have long been central concerns in the research at Norah Fry. This paper focuses on inclusive research relating to choice and control, as experienced by people with learning disabilities who use personal budgets and direct payments, and aims to question how the process of inclusive research can be linked to wider outcomes. The paper gives a brief overview of two studies carried out by Norah Fry Research Centre, which were in partnership with self‐advocacy groups and employed people with learning disabilities, between 1999 and 2007. Both in research and in everyday life, we question individual notions of ‘choice and control’, showing how relational autonomy was at the heart, both of the process of the inclusive research and also of the outcomes and findings. However, all social research seems to have greatest impact when there is a ‘bandwagon effect’ of policy and practice initiatives. The discussion considers how the impact of inclusive research designs can be at policy, practice and ‘direct’ user level and is often achieved by people with learning disabilities having a voice at the dissemination stage.

Teacher Training for Embedding Life Skills into Vocational Teaching

This paper aims to present the results of the research conducted within the LIFE2 project in order to identify the need of vocational teachers and trainers on what would help them to embed life skills into their specialist subject teaching. The needs of employers and learners, in terms of life skills required for increasing the employment prospects, and the opinions of the organisations working with disadvantaged young people were also considered for developing a training pack addressed to vocational teachers and trainers. The key recommendations from the research are focused on the following aspects: teachers and trainers’ needs for practical training; needs of learners as VET future professionals; support activities for teachers and trainers in their organisations.

HYDROGEOPHYSICS TECHNIQUES TO AQUIFER LOCATING AND MONITORING FOR INDUSTRIAL ZONE NORTH THANGLONG AND QUANGMINH, HANOI

HYDROGEOPHYSICS TECHNIQUES TO AQUIFER LOCATING AND MONITORING FOR INDUSTRIAL ZONE NORTH THANGLONG AND QUANGMINH, HANOI

The Development of a Training Pack for Band 7 Intensive Care Pharmacists

Traditionally, training of intensive care pharmacists has been ‘on the job,’ with little support from organised training programmes or specialised courses. The UK Clinical Pharmacy Association Critical Care Group developed key competencies for intensive care pharmacists and a syllabus to accompany this. This enabled individual pharmacists to map their skills, but there was no structured training programme to support it. The Midlands Critical Care Network pharmacist group identified this as a development need – both to support individual pharmacists in their training, and also to provide reassurance to Trusts of the type and breadth of training that band 7 pharmacists had undergone, particularly when moving from one Trust to another. This paper describes the development of a training pack for band 7 intensive care pharmacists by a collaborative group, and its subsequent dissemination nationally.

Nutritional screening of elderly patients: a health improvement approach to practice

Almost 60% of elderly care in-patients are at risk of malnutrition. Malnourished patients have poorer clinical outcomes and this is a key factor with respect to prolonging the length of stay. Since 2003, the Malnutrition Universal Screening Tool (MUST) has been advocated as a method for identifying these at-risk patients. Screening should take place on admission; however, the Trust has set a stretch target of aiming to document the score accurately within 6h of admission. Three 'care of the elderly' wards participated in the project. Each month, the timeliness (within 6h of admission) and accuracy (compared to a dietician assessment) of the MUST scores on the wards were reviewed. Plan-Do-Study-Act cycles were used to rapidly test changes in the ward areas. Tests included a study day, one-to-one ward-based nutrition training, a focus on the use of alternative anthropometric measurements, the development of a training pack and the identification of the challenges for undertaking accurate and timely assessments. Baseline data identified that a MUST was documented in <60% of patients within 6h of admission and that only 70% were accurate. After implementation of the change package, all the wards achieved an improvement and documented MUST within 6h of admission; one ward achieved 90% accuracy in the scores. Ward teams receiving training and monthly feedback of their results creates ownership, momentum and maintains enthusiasm for striving to reach stretch targets. The team continues to work on improving accurate nutritional screening across the Trust by using quality improvement methodologies.

Potential for development of haemophilia link nurse role within UK hospitals

Link nurses are practising nurses with an expressed interest in a given specialty, with formal links to clinical nurse specialists and other specialist staff. The role involves attending meetings to discuss ideas and new developments, and relaying findings to other ward nurses to improve their practice. Such nurses are common in many specialties such as diabetes and tissue viability. In haemophilia, the role has the potential to enhance the care of haemophilia patients on general hospital wards. In April 2012, a focus group of five haemophilia nurses was convened to discuss their experiences of 'link nurse' programmes within district general hospitals and the potential value of developing the haemophilia link nurse role, and to consider the materials needed to support such role development. It was agreed to test whether other haemophilia nurses perceived such a need by means of a short five-item questionnaire devised by the group and made available to all members of the UK's Haemophilia Nurse's Association via Survey-Monkey. Final responses from 59 haemophilia nurses across the UK have been analysed. Most nurses agreed that there was value in the development of a haemophilia link nurse role within UK hospitals and thought their trusts would support it. While barriers and potential downsides were acknowledged, this was seen as a useful way of sharing information and knowledge with colleagues from different specialties and of raising awareness of bleeding disorders among the general nursing community. Haemophilia nurses should coordinate the development of a Haemophilia Link Nurse training and education pack.

Development of a care pathway to improve the management of asthma or viral induced wheeze for children admitted to the paediatric unit at Wishaw General Hospital

BackgroundThe Scottish Patient Safety Programme for Paediatrics (SPSPP) has a medicines management workstream of which medicines reconciliation is a primary driver to reduce harm to children from medicines.1 The British...

Peer evaluation to develop benchmarking in the public sector

PurposeThe urgency to strengthen the effectiveness and efficiency of public administrations has led to the adoption in the public sector – in Italy as well as in other countries – of tools and models inspired by the total quality management (TQM) approach, such as the common assessment framework (CAF). A parallel need was felt within public structures to train people, the “peers”, who aside from being able to implement the self‐evaluation activities of their own administration, also needed to be equipped with the necessary skills to complete external evaluation activities, namely “peer evaluations”, with the ultimate aim of spreading quality management culture and best practices in the field through an approach based on benchmarking. The purpose of this paper is to present the results of a survey designed to determine the training requirements that a “peer” should acquire in order to perform “evaluation” activities.Design/methodology/approachThe paper has strong empirical connotations and is essentially based on, first, a questionnaire given to evaluators/self‐evaluators to identify the problems emerging with the application of the CAF model in administrations that have adopted it. In this sphere a great deal of attention has been paid to – in addition to the preparation of the questionnaire – the delicate task of codifying the answers to open questions proposed to interviewees; and second, the investigation inherent in the current educational choices in Italy in the TQM arena, specifically addressing the public sector.FindingsApart from the analysis of data obtained from the investigation, presented with descriptive statistics, the paper identifies the training content necessary: first, to place “peers” in a position to be able to autonomously and fully carry out their evaluation work on the basis of the CAF model; and second, to render the evaluation activities systematically comparable among the various administrations.Research limitations/implicationsAt the present time the research deals with the Italian context. However, future investigations involving different European countries could be carried out, taking the present results as a starting point for a benchmarking activity.Practical implicationsThe paper puts forward the creation of a “network” of actors who manage all the “peer evaluation” activities, from the provision of the training pack and monitoring the “peer” exchange process, up to benchmarking initiatives and the dissemination of best practices.Originality/valueThe paper presents original data and information in order to identify the training needs of individuals that actually use CAF, starting from the assumption that the training of evaluators is the primary condition for promoting the adoption and diffusion of CAF in Italian public administrations and thus maximizing its benefits.

Training Teachers of Languages to Meet the Needs of Inclusive Classrooms

The inclusion of special needs learners into mainstream schools is a key issue on the European agenda which poses new challenges to the training of future teachers (including teachers of languages to young learners) who need to receive adequate knowledge about various special needs categories and develop professional skills for identifying, assessing and meeting the needs of special needs learners. In response to this new demand and in relation to the growing number of primary school children with special needs who attend mainstream classrooms in Bulgaria, the University of Ruse introduces a new training pack of materials for initial teacher training. The training materials' aim is to equip the student teachers with the relevant knowledge and competences for approaching diversity in their classroom in such a way that allows all children (including those with special educational needs) to demonstrate their potential as learners.The goal of this paper is to present the pedagogical and methodological underpinnings, planned outcomes and challenges in the design and development of the in-service teacher training materials and to motivate the need for such type of training in the Bulgarian educational context.http://dx.doi.org/10.5755/j01.sal.0.18.419