A critical challenge: Developing student's critical abilities

The work of educators includes grappling with the challenges of bringing theoretical concepts and approaches into day-to-day physical education practice for quality programmes and the betterment of student learning. One of our most exciting challenges is in capturing the potential the Health and Physical Education in the New Zealand Curriculum (MoE, 1999) and the New Zealand Curriculum (MoE, 2007) present to us as physical educators. The curriculum has encouraged the development of socio-critical perspectives and inquirybased approaches to teaching and learning programmes (Culpan & Bruce, 2007; Fitzpatrick, 2010; Gillespie & Culpan, 2000; Wright, 2004). We (the writers) have tackled the theory to practice challenge of the development of student’s critical abilities from a range of positions within education. Our involvement in initial teacher education, teacher professional development, secondary physical education teaching and physical education advisory roles has meant we have needed to not only develop our own practice as educators, but also consider how to successfully enable secondary school students, teacher education students and practicing physical education teachers to understand and implement a socio-critical physical education curriculum. This paper focuses on processes, knowledge and understandings that support the development of student’s critical abilities

Improving type 2 diabetes care and self-management at the individual level by incorporating social determinants of health

Objective: Suboptimal social determinants of health impede type 2 diabetes self-management. They are usually considered at population and community levels, not individually. The study objective was to draw on perspectives of people who have type 2 diabetes to identify and explore the impact of social determinants on self-management and ways to incorporate them into individual care. Methods: Purposively selected participants chose to partake in focus groups or interviews. Data were analysed and themes identified through deductive and inductive thematic analysis. Results: Social issues hinder type 2 diabetes self-management. Additionally, an individual’s feelings and poor mental health, competing priorities and understanding about diabetes are important considerations. Support was provided via health professionals, community supports, financial support, personal support and informal self-management support. Conclusions: Social determinants of health could be formally incorporated into individual care for people with type 2 diabetes if a socio-ecological view of health is taken as it considers the broader social and environmental circumstances in peoples lives. Implications for public health: Care for people with type 2 diabetes could be transformed if social determinants of health are formally assessed and responded to at an individual level. A socio-ecological view of health in individual care and clinical settings would enable social determinants of health to be formally incorporated into type 2 diabetes care

Indigenous Australian perspectives on incorporating the social determinants of health into the clinical management of type 2 diabetes

Introduction: Type 2 diabetes mellitus and social disadvantage are related. In Australia, this association is most pronounced among Indigenous Australians (Aboriginal and Torres Strait Islander peoples). Indigenous Australians are among the most socially disadvantaged in the country, having the worst social determinants of health (SDoH). SDoH are typically addressed at a population level, and not on an individual or a clinical level. However, the SDoH-related needs of individuals also require attention. The adverse link between type 2 diabetes and SDoH suggests that simultaneous consideration at an individual, clinical level may be beneficial for type 2 diabetes care and self-management. Identifying and addressing SDoH-related barriers to type 2 diabetes self-management may augment current care for Indigenous Australians. This study aimed to combine the perspectives of Indigenous Australians with type 2 diabetes and Indigenous health workers to explore the SDoH-related barriers and facilitators to self-managing type 2 diabetes, and how SDoH could be incorporated into the usual clinical care for Indigenous Australians with type 2 diabetes. Methods: Under the guidance of a cultural advisor and Indigenous health workers, seven Indigenous Australians with type 2 diabetes and seven Indigenous health workers from rural and remote north Queensland, Australia, participated in a series of semi-structured, in-depth face-to-face interviews and yarning circles. A clinical yarning approach to data collection was used, and both an inductive and a deductive data analysis were applied. Data were analysed, and themes were identified using NVivo v12. Results: Study participants described a holistic view of health that innately includes SDoH. Specific to type 2 diabetes care, participants identified that culturally responsive service delivery, suitable transport provision, an infinite flexible approach to accommodate for individuals' unique social circumstances, appropriate client education and appropriate cultural education for health professionals, support mechanisms and community support services were all essential components. These were not seen as separate entities, but as interrelated, and all were required in order to incorporate SDoH into care for Indigenous Australians with type 2 diabetes. Conclusion: SDoH are implicit to the Indigenous Australian holistic view of health. Consequently, an approach to type 2 diabetes care that complements this view by simultaneously considering SDoH and usual type 2 diabetes clinical management could lead to enhanced type 2 diabetes care and self-management for Indigenous Australians

A critical analysis process–bridging the theory to practice gap in senior secondary school physical education

Many contemporary international physical education curriculum documents have a socioculturaland critical orientation, which promotes the implementation of a critical pedagogy. Aotearoa New Zealand is no exception. This paper reflects our ongoing efforts to address, from a practical pedagogic perspective, the implementation of a sociocritical curriculum and articulation of critical pedagogy in senior secondary school physical education. We draw attention to the challenging nature of articulating critical pedagogical theory in school practice. We identify the understanding and interrelationship of social construction, multiple perspectives, and hegemony as key aspects in the teaching and learning process that support the development of student teachers’ criticality and in turn their ability to critically analyse. We present these concepts as part of a Critical Analysis Process, a model that is designed to facilitate questioning by student teachers of their own status quo beliefs and practices. It is a model that is a work in progress

A critical analysis process–bridging the theory to practice gap in senior secondary school physical education

Many contemporary international physical education curriculum documents have a socioculturaland critical orientation, which promotes the implementation of a critical pedagogy. Aotearoa New Zealand is no exception. This paper reflects our ongoing efforts to address, from a practical pedagogic perspective, the implementation of a sociocritical curriculum and articulation of critical pedagogy in senior secondary school physical education. We draw attention to the challenging nature of articulating critical pedagogical theory in school practice. We identify the understanding and interrelationship of social construction, multiple perspectives, and hegemony as key aspects in the teaching and learning process that support the development of student teachers’ criticality and in turn their ability to critically analyse. We present these concepts as part of a Critical Analysis Process, a model that is designed to facilitate questioning by student teachers of their own status quo beliefs and practices. It is a model that is a work in progress

Genital examination training: assessing the effectiveness of an integrated female and male teaching programme

Abstract Background Learning to undertake intimate female and male examinations is an important part of medical student training but opportunities to participate in practical, supervised learning in a safe environment can be limited. A collaborative, integrated training programme to provide such learning was developed by two university teaching departments and a specialist sexual health service, utilising teaching associates trained for intimate examinations in a simulated clinical educational setting. The objective of this research was to determine changes in senior medical students’ self- reported experience and confidence in performing male and female genital examinations, before and after participating in a new clinical teaching programme. Methods A quasi-experimental mixed methods design, using pre and post programme questionnaires and focus groups, was used to assess the effectiveness of the programme. Results The students reported greatly improved skill, confidence and comfort levels for both male and female genital examination following the teaching programme. Skill, confidence and comfort regarding male examinations were rated particularly low on the pre-teaching programme self- assessment, but post-programme was rated at similar levels to the female examination. Conclusions This integrated female–male teaching programme (utilising trained teaching associates as simulated patients in a supervised clinical teaching environment) was successful in increasing senior medical students’ skills and levels of confidence in performing genital examinations. There were differences between female and male medical students in their learning. Suggestions for improvement included providing more detailed instruction to some clinical supervisors about their facilitation role in the session

Incorporating social determinants of health into individual care—a multidisciplinary perspective of health professionals who work with people who have type 2 diabetes

Social determinants of health (SDoH) and type 2 diabetes mellitus (T2DM) are interrelated. The prevalence of T2DM is increased amongst those with suboptimal SDoH. Poor SDoH can also negatively impact T2DM self-management. Social determinants of health are mostly considered at population and community levels, rather than individually or clinically. This qualitative study combines the perspectives of a multidisciplinary cohort of health professionals to identify and explore the impact of social determinants on self-management, and ways they could be incorporated into individual clinical care. Purposively selected participants chose to partake in an in-depth, semi-structured, one-on-one interview or focus group. Data were analysed, and themes identified using a combination of deductive and inductive thematic analysis. Fifty-one health professionals volunteered for the study. Two small focus groups (n = 3 and n = 4) and 44 one-on-one interviews were conducted. The identified themes were: 1) Support for incorporating SDoH into T2DM care, 2) Effect of SDoH on T2DM self-management, 3) Identifying and addressing social need, 4) Requirements for incorporating SDoH into T2DM individual clinical care. Health professionals reported that poor social determinants negatively affect an individual’s ability to self manage their T2DM. Person-centred care could be enhanced, and people with T2DM may be more likely to achieve self-management goals if SDoH were included in individual clinical care. To achieve successful and sustained self-management for people with T2DM, health professionals require a thorough understanding of T2DM and the effect of social determinants, respect for client privacy, client trust and rapport, effective communication skills, validated tools for assessing SDoH, team champions, teamwork, ongoing education and training, adequate resources, guiding policies and procedures, and management support. Incorporating SDoH into individual, clinical care for people with T2DM was strongly supported by health professionals. If embraced, this addition to care for individuals with T2DM could improve self-management capacity and enhance person-centred care

Additional file 2: of Genital examination training: assessing the effectiveness of an integrated female and male teaching programme

Evaluation survey of student experience with genital examination (Post). This is the questionnaire administered to the students after the teaching programme. (DOC 58 kb