Learning from MARQuIS: future direction of quality and safety in hospital care in the European Union.

This article summarises the significant lessons to be drawn from, and the policy implications of, the findings of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project--a part of the suite of research projects intended to support policy established by the European Commission through its Sixth Framework Programme. The article first reviews the findings of MARQuIS and their implications for healthcare providers (and particularly for hospitals), and then addresses the broader policy implications for member states of the European Union (EU) and for the commission itself. Against the background of the European Commission's Seventh Framework Programme, it then outlines a number of future areas for research to inform policy and practice in quality and safety in Europe. The article concludes that at this stage, a unique EU-wide quality improvement system for hospitals does not seem to be feasible or effective. Because of possible future community action in this field, attention should focus on the use of existing research on quality and safety strategies in healthcare, with the aim of combining soft measures to accelerate mutual learning. Concrete measures should be considered only in areas for which there is substantial evidence and effective implementation can be ensured

Seeing, grasping and constructing: pre-service teachers’ metaphors for ‘understanding’ in religious education

This is the author accepted manuscript. The final version is available from Taylor & Francis (Routledge) via the DOI in this record.  Despite its centrality to most, if not all educational endeavours, what is meant by understanding is highly contested. Using Religious Education (RE) in England as a case subject this paper examines pre-service secondary school teachers’ construals of understanding. It does so by employing conceptual metaphor theory to analyse their linguistic discourse. Specifically, it examines the metaphors employed by participants in a series of focus group discussions (FGD) and provides important insights into how understanding is conceptualised by these pre-service teachers who are preparing to enter the RE profession. The metaphors employed by these pre-service teachers (‘understanding is SEEING’; ‘understanding is CONSTRUCTING’; ‘understanding is GRASPING’), focus on the dynamic and developmental nature of understanding (rather than on the outcomes) and reveal subject specific ways of thinking and practicing. This paper argues that each of the three conceptual metaphors employed by participants suggest particular ways of acting towards understanding with significant implications for teaching and learning in RE.The Farmington Institut

‘Ah, now I see!’ Why the metaphors we use for ‘understanding’ in RE matter

This is the author accepted manuscript. The final version is available from Christian Education Publications via the link in this recordIn this article Karen Walshe shares with us the fruits of her recent research into the use of metaphors when people talk of understanding. This has significant importance for RE as much of the subject’s literature has understanding down as a major aim of RE but seldom explains what it might actually mean to understand.Farmington Institut

A Meta-Ethnographic Review of Paid Staff and Volunteers Working together in Palliative Care

Context Volunteers in palliative care settings are an essential part of care provision for patients and those important to them. Effective collaboration between volunteers and paid staff has been regarded as an important element of successful working, however, at times failures in coordination, information sharing and tensions within teams have been highlighted. Objectives To explore the views expressed by volunteers and paid staff about their experiences of working together in palliative care settings. Methods A systematic exploration of qualitative research using a meta-ethnographic approach. PsycINFO, CINAHL, Medline Complete, and AMED databases were searched from inception to December 2021 for the concepts “volunteers” and “palliative care.” Repeated in-depth reading and appraisal of papers identified metaphors and concepts, providing new interpretations. Results Included papers (n = 14) enabled the construction of five storylines: 1) “we are the cake, and they are the cream”: understanding the volunteer role—separate, but part of a whole. 2) “…we don't know what's wrong with people but sometimes we need to know”: access to information and importance of trust. 3) “everybody looks out for each other”: access to paid staff and their support. 4) “...we don't meddle in the medical”: boundaries. 5) "it's the small things that the staff does for me that makes me feel good about my work": sense of value and significance. Conclusions For effective working relationships between paid staff and volunteers, proactive engagement, recognition of each other's role and contribution, mutual sharing of information, and intentional interaction between both groups is needed

How do I sound to me? Perceived changes in communication in Parkinson's disease

Objective: To examine self and carer perceived changes in communication associated with Parkinson's disease and relate these to speech intelligibility, gender, age and other disease measures. Design: Cross-sectional survey of a hospital- and community-based sample of 176 people with Parkinson's disease and their carers using a questionnaire based on semantic differential techniques. Participants: One hundred and four people with Parkinson's disease with no history of communication difficulties prior to onset of their Parkinson's disease and 45 primary carers who returned completed questionnaires. Main outcome measures: Differences in ratings for `before' the onset of Parkinson's disease versus present status. Results: There was a strong perception of negative impact on communication between `before' and `now', irrespective of age and gender and largely independent of disease severity and duration, intelligibility and cognitive status. Activities of daily living (assessed by Unified Parkinson's Disease Rating Scale (UPDRS) II) and depression rating scale scores had the strongest association with change (adjusted R 2 0.27). There was a significant correlation between the rank order of perceived change in features examined in people with Parkinson's disease versus their carers, though in general carers rated change as having less impact. Conclusions: Parkinson's disease exercises a strong influence on communication even before apparent alterations to intelligibility or motor status

Pedagogical bricoleurs and bricolage researchers: The case of Religious Education

This is the author accepted manuscript. The final version is available from Taylor & Francis via the DOI in this record.This article reconceptualises school teachers and pupils respectively as ‘pedagogical bricoleurs’ and ‘bricolage researchers’ who utilise a multiplicity of theories, concepts, methodologies and pedagogies in teaching and/or researching. This reconceptualization is based on a coalescence of generic curricular and pedagogical principles promoting dialogic, critical and enquiry-based learning. Innovative proposals for reconceptualising the aims, contents and methods of multi-faith Religious Education in English state-maintained schools without a religious affiliation are described, so as to provide an instance of and occasion for the implications of these theories and concepts of learning. With the aim of initiating pupils into the communities of academic enquiry concerned with theology and religious studies, the ‘RE-searchers approach’ to multi-faith Religious Education in primary schools (5-11 year olds) is cited as a highly innovative means of converting these curricular and pedagogical principles and proposals into practical classroom procedures that are characterised by multi-, inter- and supra-disciplinarity; notions of eclecticism, emergence, flexibility and plurality; and theoretical and conceptual complexity, contestation and context-dependence.This work was supported by the Culham St Gabriel’s Trust and Hockerill Educational Foundation. It was undertaken in a partnership including the University of Exeter, The Learning Institute and Sir Robert Geffery’s Primary School

Pre-service teachers' understanding of understanding in religious education

This is the final versionThis report presents the findings of a collaborative research study, generously funded by The Farmington Institute, Oxford, conducted by two Russell Group Universities: one in the South West of England; the other, in the Midlands. Both universities are long standing providers of Secondary PGCE Religious Education courses as part of their Secondary PGCE provision (rated by Ofsted as Outstanding). In addition, both universities are research intensive institutions whose ITE programmes are inspired and informed by research in the field.The Farmington Institut

Implementing medical revalidation in the United Kingdom: Findings about organisational changes and impacts from a survey of Responsible Officers.

Objective To describe the implementation of medical revalidation in healthcare organisations in the United Kingdom and to examine reported changes and impacts on the quality of care. Design A cross-sectional online survey gathering both quantitative and qualitative data about structures and processes for medical revalidation and wider quality management in the organisations which employ or contract with doctors (termed 'designated bodies') from the senior doctor in each organisation with statutory responsibility for medical revalidation (termed the 'Responsible Officer'). Setting United Kingdom Participants Responsible Officers in designated bodies in the United Kingdom. Five hundred and ninety-five survey invitations were sent and 374 completed surveys were returned (63%). Main outcome measures The role of Responsible Officers, the development of organisational mechanisms for quality assurance or improvement, decision-making on revalidation recommendations, impact of revalidation and mechanisms for quality assurance or improvement on clinical practice and suggested improvements to revalidation arrangements. Results Responsible Officers report that revalidation has had some impacts on the way medical performance is assured and improved, particularly strengthening appraisal and oversight of quality within organisations and having some impact on clinical practice. They suggest changes to make revalidation less 'one size fits all' and more responsive to individual, organisational and professional contexts. Conclusions Revalidation appears primarily to have improved systems for quality improvement and the management of poor performance to date. There is more to be done to ensure it produces wider benefits, particularly in relation to doctors who already perform well

Teaching climate change and sustainability: A survey of teachers in England

This report shares detailed findings as to the current state of climate change and sustainability education in England in 2022-23, with a particular focus on teachers’ practice and professional development. The results reveal both strengths and gaps in the provision of climate change and sustainability education in England. The report serves as an evidence base for researchers, policymakers and practitioners who seek to support teachers to fulfil their important roles in society’s transformation to a sustainable future. UCL’s Centre for Climate Change and Sustainability Education (CCCSE) conducted a survey of teachers in England entitled ‘What do climate change and sustainability education have to do with me?’. Between October and December 2022, teachers were invited to respond to an online questionnaire about their views and experiences. Teachers were recruited through email lists, professional networks, social media and via the CCCSE website. The questionnaire investigated their teaching practice, professional development, and sense of confidence and preparedness to incorporate climate change and sustainability into their teaching. It included a range of question types and generated quantitative and qualitative data. The survey gathered 870 responses, with over two thirds (70.7%) teaching at secondary level, and geography (41.3%) and science (37.2%) being the most frequently reported subjects taught. Those who responded represented a wide range of teaching experience, from one year to 20+ years, with university-led PGCE programmes the most commonly reported route into teaching (87.2%). The significant majority of respondents were female (73.9%) and from white backgrounds (90.5%)