Assessing experiential learning – us, them and the others

This paper looks at the assessment of experiential learning primarily in the context of the learning and teaching of students using ‘hands-on’, interactive and reflective methods. It will, at various points, also refer to the evaluation of programmes and modules in terms of their impact and where improvements, in pedagogic terms, can be made. The ‘us’ here are the teachers/tutors who are employed to promote, support and otherwise facilitate the advancement of the students’/learners’ education. The ‘them’ is the student body on a particular course of study. The ‘others’ are those who have a vested interest in the form, content and means of measuring achievement of and in legal education – be they professional regulatory bodies, employers or the wider public.The term ‘experiential learning’ refers in this setting to an approach to education in which students are exposed to real or realistic legal issues and problems. In this process they are required, in a structured way, that may or may not lead to the award of academic credit, to apply theory to practice and then deconstruct and analyse what took place (or did not as the case may be) and why. In the world of legal education an experiential approach to study is often termed ‘clinical’ and the word ‘clinic’ will appear frequently throughout this paper in referring to the vehicle through which experiential learning may be presented and delivered.Finally, by way of introduction, the word ‘assessment’ is intended to include the measurement of both the quality and extent of student learning (regardless of whether academic credit is gained) and the perceived value of what is being delivered from a learning and teaching perspective, by the ‘us’, the ‘them’ and the ‘others’

「環太平洋の言語」日本班

初巻は別書誌『消滅に瀕した方言アクセントの緊急調査研究

Developing approaches to the collection and use of evidence of patient experience below the level of national surveys

National approaches to collecting patient feedback provide trust level information which although can provide a benchmark for trusts often doesn’t provide information about specific services or patients experiences of pathways of care. This more granular level of data could be more informative for local service development and improvement. This research explored the feasibility and usefulness of such approaches. A conceptual model and standard questionnaire of patient experience was developed that might work across a range of services and pathways of care. Seven trusts were recruited as collaborating sites in which the model and survey instrument was tested. These were from different geographical locations and settings. The impact of the pilot and survey results on the improvement and development of services was evaluated. The service- line approach to capturing patient feedback was generally more feasible and considered of value for service improvement. The collection of patients’ experiences across pathways of care was more challenging in terms of the development of the survey and interpretation of results. However, many sites identified specific actionable areas for improvement. This study has shown that it is possible to develop and apply a standardised survey in a range of services and provides evidence that a consistent unified approach to monitoring patient experiences is feasible. However several methodological problems are acknowledged such as the availability of resources and capacity for improvements to services and care. Evidence is now particularly needed to establish how best to produce positive impact from patient feedback

Dairy cows value an open area for lying down

As dairy cows are being housed for longer periods, with all-year-round housing growing in popularity, it is important to ensure housed environments are meeting the needs of cows. Dairy cows are motivated to access open lying areas, although previous motivation studies on this topic have confounded surface type and location (i.e. pasture outdoors vs cubicles indoors). This study measured cow motivation for lying down on an indoor open mattress (MAT; 9 m x 5 m) compared to indoor mattress-bedded cubicles, thus removing the confounding factor of surface type and location. This was repeated for an identically sized indoor deep-bedded straw yard (ST), to investigate whether surface type affected motivation for an open lying area. Thirty Holstein-Friesian dairy cows were housed in groups of 5 (n = 5 x 6) in an indoor robotic milking unit with access to six mattress-bedded cubicles. To assess motivation, cows were required to walk increasing distances via a one-way indoor raceway to access the open lying areas: Short (34.5 m), followed by Medium (80.5 m) and Long (126.5 m). Cows could choose to walk the raceway, leading to the MAT or ST, to lie down or they could lie down on the cubicles for ‘free’. Overall, cows lay down for longer on the open lying areas at each distance compared to the cubicles, with cows lying down slightly longer on ST than MAT, although lying times on the open lying areas did decrease at the Long distance. However, cows were still lying for >60% of their lying time on the open lying areas at the Long distance. This study demonstrates that cows had a high motivation for an open lying area, the provision of which could better cater for the behavioural needs of housed dairy cows and improve housed dairy cow welfare

Writing for Publication in Art Therapy: Reflections on an ATOL Workshop

“Do you feel there is something you would like to say? Do you have an idea but are unsure how to write about it? Clinical work stimulates ideas, which may or may not be shared with others, and the thought of going public may feel scary. Few of us are born writers but all it takes is a bit of know-how and some practice. This workshop is designed to help you focus your thinking, approach the task of writing with confidence, and to explain the process of publishing. It will be held at a private address and places will be limited to 6 participants on a first come basis.” – ATOL Workshop publicity statement

How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation

Funding Information: The authors would like to thank the following: the ward teams and senior management teams at the six participating case study sites. Neil Churchill, Angela Coulter, Ray Fitzpatrick, Crispin Jenkinson, Trish Greenhalgh and Sian Rees who were co-investigators on the study, contributing to the original design and conduct of the study. Esther Ainley and Steve Sizmur from Picker Institute Europe, who contributed to data collection and analysis. Prof. John Gabbay and Prof. Andr? le May, University of Southampton, for facilitating the learning community meetings. The members of the lay advisory panel: Barbara Bass, Tina Lonhgurst, Georgina McMasters, Carol Munt, Gillian Richards, Tracey Richards, Gordon Sturmey, Karen Swaffield, Ann Tomlime and Paul Whitehouse. The external members of the Study Steering Committee: Joanna Foster, Tony Berendt, Caroline Shuldham, Joanna Goodrich, Leigh Kendall, Bernard Gudgin and Manoj Mistry. At the time of conducting the research LL and SP were employed by the University of Oxford. Preliminary findings from the study have been presented publicly at the following conferences: European Association for Communication in Healthcare 2016; The International Society for Quality in Healthcare 2017; Health Services Research UK 2017; Medical Sociology 2018. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © The Author(s) 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Peer reviewedPublisher PD

Re-Inventing Public Education:The New Role of Knowledge in Education Policy-Making

This article focuses on the changing role of knowledge in education policy making within the knowledge society. Through an examination of key policy texts, the Scottish case of Integrated Children Services provision is used to exemplify this new trend. We discuss the ways in which knowledge is being used in order to re-configure education as part of a range of public services designed to meet individuals' needs. This, we argue, has led to a 'scientization' of education governance where it is only knowledge, closely intertwined with action (expressed as 'measures') that can reveal problems and shape solutions. The article concludes by highlighting the key role of knowledge policy and governance in orienting education policy making through a re-invention of the public role of education

Understanding how front-line staff use patient experience data for service improvement: an exploratory case study evaluation

Background and aim: The NHS collects a large number of data on patient experience, but there are concerns that it does not use this information to improve care. This study explored whether or not and how front-line staff use patient experience data for service improvement. Methods: Phase 1 – secondary analysis of existing national survey data, and a new survey of NHS trust patient experience leads. Phase 2 – case studies in six medical wards using ethnographic observations and interviews. A baseline and a follow-up patient experience survey were conducted on each ward, supplemented by in-depth interviews. Following an initial learning community to discuss approaches to learning from and improving patient experience, teams developed and implemented their own interventions. Emerging findings from the ethnographic research were shared formatively. Phase 3 – dissemination, including an online guide for NHS staff. Key findings: Phase 1 – an analysis of staff and inpatient survey results for all 153 acute trusts in England was undertaken, and 57 completed surveys were obtained from patient experience leads. The most commonly cited barrier to using patient experience data was a lack of staff time to examine the data (75%), followed by cost (35%), lack of staff interest/support (21%) and too many data (21%). Trusts were grouped in a matrix of high, medium and low performance across several indices to inform case study selection. Phase 2 – in every site, staff undertook quality improvement projects using a range of data sources. The number and scale of these varied, as did the extent to which they drew directly on patient experience data, and the extent of involvement of patients. Before-and-after surveys of patient experience showed little statistically significant change. Making sense of patient experience ‘data’ Staff were engaged in a process of sense-making from a range of formal and informal sources of intelligence. Survey data remain the most commonly recognised and used form of data. ‘Soft’ intelligence, such as patient stories, informal comments and daily ward experiences of staff, patients and family, also fed into staff’s improvement plans, but they and the wider organisation may not recognise these as ‘data’. Staff may lack confidence in using them for improvement. Staff could not always point to a specific source of patient experience ‘data’ that led to a particular project, and sometimes reported acting on what they felt they already knew needed changing. Staff experience as a route to improving patient experience Some sites focused on staff motivation and experience on the assumption that this would improve patient experience through indirect cultural and attitudinal change, and by making staff feel empowered and supported. Staff participants identified several potential interlinked mechanisms: (1) motivated staff provide better care, (2) staff who feel taken seriously are more likely to be motivated, (3) involvement in quality improvement is itself motivating and (4) improving patient experience can directly improve staff experience. ‘Team-based capital’ in NHS settings We propose ‘team-based capital’ in NHS settings as a key mechanism between the contexts in our case studies and observed outcomes. ‘Capital’ is the extent to which staff command varied practical, organisational and social resources that enable them to set agendas, drive process and implement change. These include not just material or economic resources, but also status, time, space, relational networks and influence. Teams involving a range of clinical and non-clinical staff from multiple disciplines and levels of seniority could assemble a greater range of capital; progress was generally greater when the team included individuals from the patient experience office. Phase 3 – an online guide for NHS staff was produced in collaboration with The Point of Care Foundation. Limitations: This was an ethnographic study of how and why NHS front-line staff do or do not use patient experience data for quality improvement. It was not designed to demonstrate whether particular types of patient experience data or quality improvement approaches are more effective than others. Future research: Developing and testing interventions focused specifically on staff but with patient experience as the outcome, with a health economics component. Studies focusing on the effect of team composition and diversity on the impact and scope of patient-centred quality improvement. Research into using unstructured feedback and soft intelligence