Every Day is a School Day: Educators Experiences of Utilising an Integrative Framework within Social Care Education in Ireland

Within an evolving regulatory context, this paper identifies some of the emergent challenges and opportunities for social care education in Ireland. The paper discusses the potential offered by the Integrative Framework for Practice Teaching to address some of these contextual demands and examines the pedagogy underpinning this approach. A number of educators’ experiences of using this framework are provided, demonstrating how they innovatively integrated the framework with commonly used teaching and assessment strategies within social care education, such as mind-mapping, problem-based learning and the use of creative media. These experiences are offered to other educators who may wish to utilise authentic assessment and create space for integrated thinking within the classroom. Based on the learning gleaned from the above experiences, a number of key points were identified, including: (i) the role of community of practices in supporting innovation within the classroom; (ii) the value of an integrated pedagogical approach in developing core graduate attributes for social care; (iii) opportunities offered by authentic assessment to build, refine and integrate skills and knowledge, and (iv) the importance of self in working reflexively within a dynamic and sometimes challenging environment. This paper contributes to the wider discussion on social care identity formation and explores the possibilities to reframe and reimagine social care education from a practice position

An Evaluation of the use of Problem Based Learning and Film as a Method of Teaching and Assessment for Social Care Students

This paper presents the results of a student evaluation of Problem Based Learning (PBL) and film as a pedagogical tool that is used to help students to experience the challenges, advantages and complexities of working in a social care context. Problem Based Learning is combined with the Hollywood film “Precious” which is used as a case study. The “problem” that students are faced with is to prepare a risk assessment and care plan for their client Precious (age 16) and her son Abdul, mirroring the real world experience and challenges of social care work. This has been evaluated by qualitative questionnaires which explore the student experience of PBL as a pedagogical tool, particularly focusing on advantages and disadvantages of PBL, emotions experienced during PBL, the value of a PBL approach in helping social care students link theory and practice and the students’skill development and the use of film as a case study. Cet article présente les résultatsd\u27une évaluation des élèvesd\u27apprentissage par problèmes (APP) et le film comme un outilpédagogique qui estutilisé pour aider les élèves à découvrir les enjeux, les avantages et les complexités de travaillerdans un contexte de prise en charge sociale. D\u27apprentissage par problèmesestcombiné avec le film hollywoodien "Precious" qui estutilisécommeuneétude de cas. Le «problème» auquel les étudiantssontconfrontés est la préparation d\u27uneévaluation des risques et le plan de soins pour leurs client "Precious" (16 ans) et sonfils Abdul, reflétantl\u27expérienceconcrèteainsique les défis du travail social. Cela a étéévalué par des questionnaires qualitatifset les résultatsdonnent un aperçu de l\u27expérience des étudiants de l\u27APPcomme un outilpédagogique, notamment en mettantl\u27accentsur les avantages et lesinconvénients de PBL, les émotionsvécues au cours de PBL, le développement des compétences et l\u27utilisation du film commeuneétude de cas

Effectiveness of nurse-led clinics in the early discharge period after percutaneous coronary intervention: A systematic review

Background: Readmission after percutaneous coronary intervention is common in the early postdischarge period, often linked to limited opportunity for education and preparation for self-care. Attending a nurse-led clinic within 30 d after discharge has the potential to enhance health outcomes. Objective: The aim of the study was to synthesise the available literature on the effectiveness of nurse-led clinics, during early discharge (up to 30 d), for patients who have undergone percutaneous coronary intervention. Review method used: A systematic review of randomised and quasi-randomised controlled trials was undertaken. Data sources: The databases included PubMed, OVID, CINAHL, EMBASE, the Cochrane Library, SCOPUS, and ProQuest. Review methods: Databases were searched up to November 2018. Two independent reviewers assessed studies using the Cochrane risk-of-bias tool. Results: Of 2970 articles screened, only four studies, representing 244 participants, met the review inclusion criteria. Three of these studies had low to moderate risk of bias, with the other study unclear. Interventions comprised physical assessments and individualised education. Reported outcomes included quality of life, medication adherence, cardiac rehabilitation attendance, and psychological symptoms. Statistical pooling was not feasible owing to heterogeneity across interventions, outcome measures, and study reporting. Small improvements in quality of life and some self-management behaviours were reported, but these changes were not sustained over time. Conclusions: This review has identified an important gap in the research examining the effectiveness of early postdischarge nurse-led support after percutaneous coronary intervention on outcomes for patients and health services. More robust research with sufficiently powered sample sizes and clearly defined interventions, comparison groups, and outcomes is recommended to determine effectiveness of nurse-led clinics in the early discharge period.</p

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used