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Clinical education is an important component of undergraduate nurse education, in which clinical teachers facilitate students' application of theoretical classroom knowledge into the clinical practice setting. Mothering as part of clinical teachers' work was a major finding from a larger study exploring clinical teaching work to identify what shaped their work and barriers to their work in clinical settings. The study used semi-structured interviews, informed by the work of Foucault. Maternal discourses emerged as a predominant one as participants presented their relationships with students describing examples of nurturing, protecting, supporting, guiding and providing discipline. The unexpected finding contradicted the dominant view of students at adult learners, and potentially positions them as dependent in their learning in clinical environments. Exploration of this discourse in the context of the study forms the basis of this paper. It is argued that the overall impact of maternal discourses on clinical teaching and learning is unclear but warrants more detailed investigation. © 2008 Springer Science+Business Media B.V.

Background. Qualitative research on physical therapist students' conceptualizations of clinical reasoning (CR) is sparse. Objectives. The purpose of this study was to explore CR from students' perspectives Design. For this study, a qualitative, cross-sectional design was used. Methods. Thirty-one students were randomly selected from years 2, 3, and 4 of an undergraduate physical therapist program in New Zealand. Students were interviewed about their understanding of CR and how they used it in practice in a recent musculoskeletal placement. Interviews were recorded and transcribed verbatim. A 3-stage analysis included the categorization of students' conceptualizations on the basis of the meaning and the structure of each experience and the identification of cross-category themes. Results. Five qualitatively different categories were identified: A-applying knowledge and experience to the problem, patient, or situation; B-analyzing and reanalyzing to deduce the problem and treatment; C-rationalizing or justifying what and why; D-combining knowledge to reach a conclusion; and E-problem solving and pattern building. Cross-category analysis revealed 5 general themes: forms of CR, spatiotemporal aspects, the degree of focus on the patient, attributions of confidence, and the role of clinical experience. Conclusions. Categories formed a continuum of CR from less to more sophistication and complexity. Students were distributed evenly across categories, except for category E, which included only students from years 3 and 4. Each category comprised a logical, coherent experiential field. The general themes as critical dimensions suggest a new way of exploring CR and suggest a possible pathway of development, but further research is required. These findings have implications for teaching and the development of physical therapy curricula. © 2009 American Physical Therapy Association.

[No abstract available]

Aims This paper explores the collaborative development of a Master's level advanced practice programme in the context of the radical reform and remodelling of the UK's National Health Service. Some of the educational, managerial and practice challenges are discussed. Background Changes to education and training in response to key strategic reviews undertaken by the Greater Manchester Strategic Health Authority (North West of England) established a need to develop nurses and allied health care practitioners to advanced practitioner level. This paper considers how employers, commissioners and educationalists worked together to produce a Master's level programme to prepare nurses and other health care practitioners for sustainable advanced practice roles. Key issues Developing innovative and effective curricula to meet the needs of post graduate students from varied backgrounds preparing to practice in different contexts with different client groups is challenging. However, the development of individual learning pathways and work-based learning ensures that the student's work and intended advanced practice role remains at the centre of their learning. Analysis of each student's knowledge and skill deficits alongside an analysis of the organization's readiness to support them as qualified advanced practitioners (APs) is instrumental in ensuring that organizations are ready to support practitioners in new roles. Conclusion Work-based learning and collaboration between students, employers and higher education institutions can be used to enable managers and students to unravel the network of factors which affect advanced practice in health and social care. Additionally, collaborative working can help to create opportunities to develop strategies that will facilitate change. Implications for nursing management Sustainable change concerned with the introduction of advanced practitioner roles present a real challenge for managers at a strategic and operational level. Commissioning flexible, collaborative and service-led educational programmes can assist in ensuring that change is sustainable and produce practitioners who are fit for practice, purpose and award. © 2009 Blackwell Publishing Ltd.

[No abstract available]

Objective: Standardized patients (SPs) do not contribute scores in postgraduate psychiatry objective structured clinical examinations (OSCEs) in the United Kingdom. However, this may change in the near future. The primary aim of this study was to measure the degree of agreement between scores given by examiners and those given by SPs in an OSCE. Methods: The authors measured the degree of agreement in two consecutive postgraduate OSCEs for psychiatric residents on a London training scheme. Results: Fifty-five candidates participated in the two OSCEs. There was a moderate degree of agreement between examiner and SP scores for communication and for the overall mark. However, there was a stronger relationship between the examiner score for communication and the candidates' overall mark. Conclusion: Examiners and SPs scored candidates differently. Therefore, the decision to include SP scores in the marking scheme for postgraduate OSCEs would be a significant development. Copyright © 2009 Academic Psychiatry.

AIM: The aim of this study was to investigate whether recent changes in the National Health Service (NHS) dental contract may have caused increased anxiety and concern among vocational dental practitioners (VDPs). METHOD: A total of 606 questionnaires, which had previously been piloted, were distributed to VDPs across England and Wales at the end of the vocational training (VT) year in 2007. The questionnaires contained a range of questions about VDPs' attitudes and fears, the influence that they perceived the new dental contract for the General Dental Services of the NHS had on their VT training experience, and their expectations for the future. RESULTS: A 71% response rate was achieved. The results reflected changes in opinion about the dental profession among VDPs between when they applied for university and six years later on their completion of VT. During this period, they reported that their feelings of job security had declined from 93.1% (n=390) to 34.1% (n=145) and financial security from 94.8% (n=405) to 51.5% (n=219). Anxiety about the potential lack of funding in the NHS was felt by 77.6% (n=330). The effect of increasing numbers of dental graduates on employment prospects produced anxiety in 72.5% (n=305) of VDPs. On completion of VT, 19.4% (n=83) of VDPs did not have employment for the following year. CONCLUSION: At present, the future is more uncertain for new dental graduates than in the past. The dental profession needs to become more aware of the pressures that graduates are facing and further research is needed to investigate them and the effects that they are having on the future of dentistry.

We reviewed anaesthesia training program in Australia. Anaesthetists in Australia and New Zealand need to obtain the Diploma of Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA) to be recognised as specialists. The training sequence approved by ANZCA encompasses an initial two-year Prevocational Medical Education, Training (PMET) period, and the five-year period of ANZCA Approved Training, which included two-year Basic Training and three-year Advanced Training. On completion of all Training Program requirements the Trainee is awarded the Diploma of Fellowship and is entitled to use the qualification of FANZCA. The assessment of trainees in anaesthesia is principally by examination and the staff of the hospitals in which trainees work. There are a number of specific goals to be achieved during training. ANZCA accredits Hospital Departments of Anaesthesia and other training institutions across Australia, New Zealand, and South-East Asia, to provide approved training in anaesthesia for ANZCA trainees. Accreditation requires an onsite review by the College in order to assess a hospital's ability to provide training and supervision of the required standard, and its degree of compliance with ANZCA Professional Documents.

[No abstract available]

Aims: To find out to what extent The "Reflective Practice Guide" (RPG) (a semi-structured Portfolio guide) has been implemented in a Spanish Family Medicine Vocational Training Region (Unidad Docente Provincial) and the opinions of trainees and trainers after using it in actual conditions. Design: Cross-sectional study Setting: A Provincial Family Medicine Teaching Unit (a Spanish Vocational Training Region) Participants: 43 trainers and 70 residents (trainees). Methods: The participants carried out a formative assessment for 12 months on the competency areas described in the RPG. The information was collected by means of specific card notes. Trainers and Trainees filled in an ad hoc survey. Results: The trainees carried out 295 (80%) tasks and reflections out of those recommended in the GPR. First and third year trainees completed 81/108 (75%) and 65/108 (60%) of the tasks, respectively. Trainees and trainers considered that the new method is useful for reflecting on clinical practice, for knowing their own competencies better and for strengthening the trainer-trainee relationship. Conclusions: The GPR is a formative tool that trainees carried out with their trainers even to a greater extent than that recommended by the GPR. Both groups perceive this tool as useful for effectively reflecting the trainees practice and for strengthening their relationship. © 2009 Elsevier España, S.L. All rights reserved.