Creative and Performativity Policies in Primary Schools

Primary schools face a new situation, one in which policies promoting creativity no longer have to be fought for but are being promoted at government and national educational level alongside policies that focus on the assessment of school performance in inspections and national tests and encourage target setting. We sought to ascertain how these policy discourses, the contents of which have been perceived as conflicting (Jeffrey and Woods 1998), were affecting primary school management, teachers and learners. In this climate of accountability schools appeared to embrace performance and act innovatively and creatively. Our professional primary school teachers were team players who contributed to the presentation of the school as a unified, creative, inclusive and effective managerial organisation. The merging of the two policies was not pervasive across schools or within schools but there were some examples involving cross-curricular projects. More prominent was a ‘bolt on’ activity of creative teaching and learning such as special creative curriculum weeks or days. Schools found it necessary to ensure success in national tests by institutionalising lengthy SATS preparation for, in some cases, the whole of the Spring term. However, performativity as a progression from one achievement to the next was valued. Teachers, learners and parents considered it beneficial to have information about levels because, in a spirit of openness, all knew what to expect. Professional Identities The stress levels found in the 1990s, (Menter, Muschamp et al. 1997; Osborn, McNess et al. 2000; Troman and Woods 2001) appear to have dissipated along with any resistance from teachers who appeared to be more focused on coping strategies such as team building and appropriating testing and target setting for their own professional benefit. The performativity imperatives were internalised and sometimes generated guilt if they were unrealised but teachers sought to ameliorate these tensions or to resolve them. Where resolution was not possible they accepted the tension and lived with it, (Jones, Pickard et al. 2008) facing daily dilemmas, tensions and constraints but acting creatively with colleagues to manipulate the situation. Conclusion The creativity and performativity policies were integrated at an organisational level through the construction of a school culture of performance and institutional positioning in an open market but less integrated at the level of pedagogy. Where the merging of the two pedagogies did take place – as in 'smart teaching' - teaching creatively was the preferred form over teaching for creativity. The progression narrative was a major feature around which curriculum and pedagogies were organised but where external performativity dominated such as national testing creative teaching was marginalised to ‘bolt on’ fun time slots

Quest for certainty regarding early discharge in paediatric low-risk febrile neutropenia : a multicentre qualitative focus group discussion study involving patients, parents and healthcare professionals in the UK

OBJECTIVES: A systematic review of paediatric low-risk febrile neutropenia found that outpatient care is safe, with low rates of treatment failure. However, this review, and a subsequent meta-ethnography, suggested that early discharge of these patients may not be acceptable to key stakeholders. This study aimed to explore experiences and perceptions of patients, parents and healthcare professionals involved in paediatric febrile neutropenia care in the UK. SETTING: Three different centres within the UK, purposively selected from a national survey on the basis of differences in their service structure and febrile neutropenia management. PARTICIPANTS: Thirty-two participants were included in eight focus group discussions. PRIMARY OUTCOMES: Experiences and perceptions of paediatric febrile neutropenia care, including possible future reductions in therapy. RESULTS: Participants described a quest for certainty, in which they attempted to balance the uncertainty involved in understanding, expressing and negotiating risk with the illusion of certainty provided by strict protocols. Participants assessed risk using both formal and informal stratification tools, overlaid with emotional reactions to risk and experiences of risk within other situations. The benefits of certainty provided by protocols were counterbalanced by frustration at their strict constraints. The perceived benefits and harms of previous inpatient care informed participants' appraisals of future treatment strategies. CONCLUSIONS: This study highlighted the previously underestimated harms of admission for febrile neutropenia and the paternalistic nature of decision making, along with the frustrations and challenges for all parties involved in febrile neutropenia care. It demonstrates how the same statistics, generated by systematic reviews, can be used by key stakeholders to interpret risk differently, and how families in particular can view the harms of therapeutic options as different from the outcomes used within the literature. It justifies a reassessment of current treatment strategies for these children and further exploration of the potential to introduce shared decision making