A political economy of TVET professionalisation: a case study of chefs at a Canadian polytechnic

This thesis focuses on a political economy analysis of the relationship between the professional identity and professional development practices of instructors in the postsecondary educational sector of technical and vocational education and training (TVET). My study brings together the concept of the dual-professional identity of postsecondary TVET instructors, the practice of professional development in TVET, and a political economy approach. The research methods adapted for this postgraduate research study were from a qualitative perspective using a case study approach. The case study involved eight culinary instructors, the supervisor of the professional cooking programme, and the director of the hospitality and culinary careers school at a postsecondary polytechnic in Canada, selected using a non-probability sampling technique. My research explored what a political economy analysis would reveal about the relationship between the professional identity and the professional development practices of the culinary instructors/chefs. Throughout this thesis, I use the term, TVET professionalisation, to denote this relationship This case study contributes to knowledge and the TVET community in three intersecting ways. Its first contribution is in context – the research took place in the Canadian postsecondary TVET sector, for purposes of analysing the professional identity/professional development relationship in consideration of the historical, structural, and socio-cultural contexts of the institution. The case study’s second contribution is in extending the literature of the political economy of skills. The findings demonstrate that analysing the professionalisation of the TVET culinary instructors, in consideration of the inter-relationship among the cultural, economic, political, and social contexts of the TVET system, is a suitable extension of the literature on the political economy of skills. From another perspective, the study also adds to the literature on the professionalisation of TVET instructors by considering professionalisation as an extension of the TVET workforce development imperative, which I note in this study as the discourse promoting employability and the axiomatic assumptions of TVET as 'training-for-growth' and 'skills-for work' (Anderson 2008). Thus, the study contributes to wider debates about the applicability of a political economy analysis beyond skill formation systems. Lastly, the case study contributes a conceptual framework for TVET professionalisation by interpreting the relationship between TVET professional identity and professional development through a political economy lens. The findings demonstrate that both the professional identity and the professional development practices of the culinary instructors in the case study were shaped by various contextual factors within the field of practice: namely, the instructor's personal history and sense of agency, the socio-cultural conventions of the culinary trade under investigation, the social and structural setting of the postsecondary TVET institution, and the workforce development imperative of TVET. The conceptual framework for TVET professionalisation also contributes another perspective toward the dual-professional identity of TVET instructors. Dual-professional identity formation within this study, and drawing upon the language of the research participants, refers to the process where the 'recipe' for the chefs' base identity was written in the professional trade of culinary arts. Once they joined the polytechnic, though, the chefs used the institution as 'stage' to 'go beyond the recipe' and elevate their identities by adding the ingredient of 'becoming an educator'. Based on an interpretation of the case study’s findings, through a political economy lens of analysis, I suggest that the 'skilled-educator' identity of the culinary instructors is bound by the structural and socio-economic contexts of the postsecondary polytechnic, whereas the 'skilled-tradesperson' identity of the culinary instructors reflects the historical and socio-cultural contexts of the instructors' lived experience as chefs. Further, I posit that each instructor's perception of meaningful professional development reflects the individual's personal sense of agency; what constitutes both a personal and shared sense of legitimacy concerning the value of professional development; and, an allegiance to one of the dual-professional identities over the other

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

A political economy of TVET professionalisation: a case study of chefs at a Canadian polytechnic

This thesis focuses on a political economy analysis of the relationship between the professional identity and professional development practices of instructors in the postsecondary educational sector of technical and vocational education and training (TVET). My study brings together the concept of the dual-professional identity of postsecondary TVET instructors, the practice of professional development in TVET, and a political economy approach. The research methods adapted for this postgraduate research study were from a qualitative perspective using a case study approach. The case study involved eight culinary instructors, the supervisor of the professional cooking programme, and the director of the hospitality and culinary careers school at a postsecondary polytechnic in Canada, selected using a non-probability sampling technique. My research explored what a political economy analysis would reveal about the relationship between the professional identity and the professional development practices of the culinary instructors/chefs. Throughout this thesis, I use the term, TVET professionalisation, to denote this relationship This case study contributes to knowledge and the TVET community in three intersecting ways. Its first contribution is in context – the research took place in the Canadian postsecondary TVET sector, for purposes of analysing the professional identity/professional development relationship in consideration of the historical, structural, and socio-cultural contexts of the institution. The case study’s second contribution is in extending the literature of the political economy of skills. The findings demonstrate that analysing the professionalisation of the TVET culinary instructors, in consideration of the inter-relationship among the cultural, economic, political, and social contexts of the TVET system, is a suitable extension of the literature on the political economy of skills. From another perspective, the study also adds to the literature on the professionalisation of TVET instructors by considering professionalisation as an extension of the TVET workforce development imperative, which I note in this study as the discourse promoting employability and the axiomatic assumptions of TVET as 'training-for-growth' and 'skills-for work' (Anderson 2008). Thus, the study contributes to wider debates about the applicability of a political economy analysis beyond skill formation systems. Lastly, the case study contributes a conceptual framework for TVET professionalisation by interpreting the relationship between TVET professional identity and professional development through a political economy lens. The findings demonstrate that both the professional identity and the professional development practices of the culinary instructors in the case study were shaped by various contextual factors within the field of practice: namely, the instructor's personal history and sense of agency, the socio-cultural conventions of the culinary trade under investigation, the social and structural setting of the postsecondary TVET institution, and the workforce development imperative of TVET. The conceptual framework for TVET professionalisation also contributes another perspective toward the dual-professional identity of TVET instructors. Dual-professional identity formation within this study, and drawing upon the language of the research participants, refers to the process where the 'recipe' for the chefs' base identity was written in the professional trade of culinary arts. Once they joined the polytechnic, though, the chefs used the institution as 'stage' to 'go beyond the recipe' and elevate their identities by adding the ingredient of 'becoming an educator'. Based on an interpretation of the case study’s findings, through a political economy lens of analysis, I suggest that the 'skilled-educator' identity of the culinary instructors is bound by the structural and socio-economic contexts of the postsecondary polytechnic, whereas the 'skilled-tradesperson' identity of the culinary instructors reflects the historical and socio-cultural contexts of the instructors' lived experience as chefs. Further, I posit that each instructor's perception of meaningful professional development reflects the individual's personal sense of agency; what constitutes both a personal and shared sense of legitimacy concerning the value of professional development; and, an allegiance to one of the dual-professional identities over the other