Investigating the relationship between student engagement and transition

Failure to establish meaningful and effective transition for undergraduates can lead to academic underachievement. Student engagement represents a key component of student success. This study sought to investigate the impact of a bespoke transition programme featuring a wide range of innovative, student-centred activities on enhancing students' engagement with educationally effective practices through examining student relations with others, learning and the discipline. For the study 104 undergraduates on a Sport Development course at a British university undertook a five-week transition programme. Data were collected via weekly questionnaires and focus groups at the end of weeks 1, 3 and 5. The investigation revealed that transition programmes require a high-intensity, novel and varied timetable supported by a student-centred staff team. Effective transition programmes can enhance students' engagement with educationally effective practices. Future research should investigate the longer-term impact of such programmes

The Registered Nurses' experiences of workplace culture and workplace climatic factors as influences on nursing workloads: a systematic review

The objective of this review is to identify and synthesise current evidence on workplace cultural and climatic factors that influence the daily work of nurses in an acute health care setting

Clinical effectiveness of the START (STrAtegies for RelaTives) psychological intervention for family carers and the effects on the cost of care for people with dementia: 6-year follow-up of a randomised controlled trial

Background: The START (STrAtegies for RelaTives) intervention reduced depressive and anxiety symptoms of family carers of relatives with dementia at home over 2 years and was cost-effective. Aims:To assess the clinical effectiveness over 6 years and the impact on costs and care home admission. Method: We conducted a randomised, parallel group, superiority trial recruiting from 4 November 2009 to 8 June 2011 with 6-year follow-up (trial registration: ISCTRN 70017938). A total of 260 self-identified family carers of people with dementia were randomised 2:1 to START, an eight-session manual-based coping intervention delivered by supervised psychology graduates, or to treatment as usual (TAU). The primary outcome was affective symptoms (Hospital Anxiety and Depression Scale, total score (HADS-T)). Secondary outcomes included patient and carer service costs and care home admission. Results: In total, 222 (85.4%) of 173 carers randomised to START and 87 to TAU were included in the 6-year clinical efficacy analysis. Over 72 months, compared with TAU, the intervention group had improved scores on HADS-T (adjusted mean difference −2.00 points, 95% CI −3.38 to −0.63). Patient-related costs (START versus TAU, respectively: median £5759 v. £16 964 in the final year; P = 0.07) and carer-related costs (median £377 v. £274 in the final year) were not significantly different between groups nor were group differences in time until care home (intensity ratio START:TAU was 0.88, 95% CI 0.58–1.35). Conclusions: START is clinically effective and this effect lasts for 6 years without increasing costs. This is the first intervention with such a long-term clinical and possible economic benefit and has potential to make a difference to individual carers

Reviews of theoretical frameworks: challenges and judging the quality of theory application.

Background Rigorous reviews of available information, from a range of resources, is required to support medical and health educators in their decision making related to their educational practice. Aim The aim of the paper is to highlight the importance of a review of theoretical frameworks specifically to supplement reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge to these types of review and some practical strategies to achieving this are presented. The paper also introduces the concept of theoretical quality to the methodology of literature reviews, arguing that a critique of how theory is applied should complement the methodological appraisal of the literature in a review. Method We illustrate the challenge of establishing a shared meaning of theory through reference to experiences of an on-going review of this kind conducted in the field of interprofessional education (IPE) and use a high scoring paper selected in this review to illustrate how theoretical quality can be assessed. We focus on theories that apply to IPE curriculum design but the findings are transferable to all reviews of theoretical frameworks. Findings In reaching a shared understanding of theory as a concept, practical strategies that promote experiential and practical ways of knowing (e.g. small group work and piloting of all phases of the review protocol) are required in addition to more propositional ways of sharing knowledge. Concepts of parsimony, testability, operational adequacy and empirical adequacy are explored as concepts that establish theoretical quality. Conclusions Reviews of theoretical frameworks used in medical education are required to inform educational practice. Review teams should make time and effort to reach a shared understanding of the term theory. Theory reviews, and reviews more widely, should add an assessment of theory application to the protocol of their review method.

Nominal group technique to establish the core components of home-based rehabilitation for survivors of stroke with severe disability

In the UK, over 20% of patients leaving hospital after a stroke will be severely disabled. Despite this, limited clinical guidance is available to teams tasked with providing support for this complex population at home. Additionally, many areas across the UK are not commissioned to treat this patient cohort, leaving them with no specialist support on discharge.Objectives: To establish core components of home-based rehabilitation for survivors of stroke with severe disability, based on expert panel consensus.Setting: Virtual Nominal group Technique (vNGT) across the UKParticipants: Experts in the field of stroke rehabilitation (n=14) including researchers, clinicians and those with lived experience.Methods: Two vNGT were completed using a freely available online platform, Microsoft Teams. The technique’s five stages were completed virtually; introduction, silent idea generation, round robin, clarifications and voting. Statements were analysed for consensus, those achieving consensus underwent content analysis to form rich overarching consensus statements.Results: A combined total of 421 statements achieved positive consensus (>75% in agreement), which formed 11 overarching consensus statements. These outline key components of home-based rehabilitation for survivors of stroke with severe disability including the structure and members of the team and the skills and knowledge required within the UK NHS.Conclusion: The consensus statements highlight the complexity of managing patients with severe stroke disability following discharge from hospital. This study has the potential to support the provision of services for this patient group, providing a benchmark for commissioners and clinicians as well as setting expectations for stroke survivors and their carers. What remains unknown is how many services currently offer this service to patients with severe disability

A cluster randomised controlled trial of an occupational therapy intervention for residents with stroke living in UK care homes (OTCH): study protocol.

BACKGROUND: The occupational therapy (OT) in care homes study (OTCH) aims to investigate the effect of a targeted course of individual OT (with task training, provision of adaptive equipment, minor environmental adaptations and staff education) for stroke survivors living in care homes, compared to usual care. METHODS/DESIGN: A cluster randomised controlled trial of United Kingdom (UK) care homes (n = 90) with residents (n = 900) who have suffered a stroke or transient ischaemic attack (TIA), and who are not receiving end-of-life care. Homes will be stratified by centre and by type of care provided and randomised (50:50) using computer generated blocked randomisation within strata to receive either the OT intervention (3 months intervention from an occupational therapist) or control (usual care). Staff training on facilitating independence and mobility and the use of adaptive equipment, will be delivered to every home, with control homes receiving this after the 12 month follow-up.Allocation will be concealed from the independent assessors, but the treating therapists, and residents will not be masked to the intervention. Measurements are taken at baseline prior to randomisation and at 3, 6 and 12 months post randomisation. The primary outcome measure is independence in self-care activities of daily living (Barthel Activities of Daily Living Index). Secondary outcome measures are mobility (Rivermead Mobility Index), mood (Geriatric Depression Scale), preference based quality of life measured from EQ-5D and costs associated with each intervention group. Quality adjusted life years (QALYs) will be derived based on the EQ-5D scores. Cost effectiveness analysis will be estimated and measured by incremental cost effectiveness ratio. Adverse events will be recorded. DISCUSSION: This study will be the largest cluster randomised controlled trial of OT in care homes to date and will clarify the currently inconclusive literature on the efficacy of OT for stroke and TIA survivors residing in care homes. TRIAL REGISTRATION: ISRCTN00757750.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Individual Health Trainers to support health and wellbeing for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT

No embargo require

Revisiting the Other Side of Eden (ROSE) – rural domestic violence project report

The former Eden District, roughly corresponding to the geographic area of the Eden Valley, is a significantly rural area with the lowest population density in England. The ONS notes that significant rurality may be an obstacle to accessing specialist services (ONS 2011) a concern that persists today (ONS 2023). Published over 20 years ago, ‘The Other Side of Eden’ (TOSE) uncovered the complexity of the situation relating to domestic violence (DV) in the area (King & Warbrick 2001). The findings of this report were meant to serve local organisations, members of the Eden Forum Against Domestic Violence - to improve the provisions for victims/survivors (Rouncefield, 2012). The original research carried out by academics at St Martin’s college, a University of Cumbria legacy institution, found that the wide dispersal of the community in the rural area of Eden District and sporadic public transport further limited access to key services, including those who could assist victims of domestic violence. At the same time, the close community bonds in small villages often worked against those wishing to escape domestic violence, making it harder to leave. Finally, the original research uncovered deficits in training and knowledge around DV amongst key service providers, including police. Over the past six years, Criminology staff and students have used the former Eden District case as a basis for ongoing tracking of changes to the findings of the report, under the umbrella of ‘ROSE – Revisiting the Other Side of Eden’. The aim of the project was to understand the dimensions of rural domestic violence. Some of the objectives included tracking the changes that have taken place since TOSE research took place, assessing the current provisions and barriers against the findings of the original report. We also hoped to identify areas of focus which were not present in the previous research, attending to the concept of ‘rurality’ in both its geographical and social aspects. By making ROSE a pedagogic tool in the classroom, this ‘close to home’, rural crime-oriented project on domestic violence and abuse was also aimed at empowering future justice advocates through action responses to teaching on DV&A (McQueeny, 2016). A strand of the work involved a rolling review of literature, with a thought experiment in applying it to the local, Cumbrian reality based on students’ experiences and knowledge. The successive student cohorts also undertook waves of documentary and mapping research, based on their interests or current conditions

The contribution of theory to the design, delivery, and evaluation of interprofessional curricula: BEME Guide No. 49

BACKGROUND: Interprofessional curricula have often lacked explicit reference to theory despite calls for a more theoretically informed field that illuminates curricular assumptions and justifies curricular practices. AIM: To review the contributions of theory to the design, delivery, and evaluation of interprofessional curricula. METHODS: Four databases were searched (1988-2015). Studies demonstrating explicit and a high-quality contribution of theory to the design, delivery or evaluation of interprofessional curricula were included. Data were extracted against a comprehensive framework of curricular activities and a narrative synthesis undertaken. RESULTS: Ninety-one studies met the inclusion criteria. The majority of studies (86%) originated from the UK, USA, and Canada. Theories most commonly underpinned "learning activities" (47%) and "evaluation" (54%). Theories of reflective learning, identity formation, and contact hypothesis dominated the field though there are many examples of innovative theoretical contributions. CONCLUSIONS: Theories contribute considerably to the interprofessional field, though many curricular elements remain under-theorized. The literature offers no "gold standard" theory for interprofessional curricula; rather theoretical selection is contingent upon the curricular component to which theory is to be applied. Theories contributed to interprofessional curricula by explaining, predicting, organizing or illuminating social processes embedded in interprofessional curricular assumptions. This review provides guidance how theory might be robustly and appropriately deployed in the design, delivery, and evaluation of interprofessional curricula