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930 research outputs found
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Shared Medical Appointments for Multimorbidity: Harnessing the Relational
Full text linkBackground: Shared medical appointments (SMAs) involve a clinician seeing more than one patient at a time and are often thought of as advantageous in terms of saving human and financial resources and may be especially helpful in multimorbidity management in primary care. SMAs are typically rated highly by both patients and the clinicians delivering them.
Aim: The aim of the study was to explore staff and patients' views about SMAs, in particular the dynamics and relational processes underpinning their experiences of the SMAs.
Design and Setting: The study utilised qualitative inquiry within a general practice setting.
Method: Focus groups were carried out with staff and patients who had been involved with an SMA pilot in general practice.
Results: Results stemming from thematic analysis suggest that the holistic care and space for relational processes provided by SMAs underpin the satisfaction of patients, GPs, and the wider primary care team.
Conclusion: SMAs offer an opportunity for both patients and GPs to have an enhanced experience of managing chronic multi-morbid health conditions
Pretty Poverty: Rural School Participation and Belonging in Cornwall with International Perspective
No full textSchool attendance crises are rarely understood through the lens of place-based disadvantage. This paper examines how rural poverty systematically undermines educational belonging and school participation, using Cornwall, England, as an exemplar case study with broader international significance. Drawing on qualitative data from the Pretty Poverty Report (Ovenden-Hope et al., 2025), I analyse how transport dependency, employment precarity, housing displacement, healthcare withdrawal, and educational isolation create cascading barriers to participation and belonging in rural contexts. I situate Cornwall's experience within international evidence, demonstrating that rural educational disadvantage is a persistent global phenomenon requiring place-sensitive policy responses. The paper argues that belonging-centred, place-based approaches offer more promising pathways to improving attendance than individualised interventions
Making the implicit explicit: Leadership in primary care dental practice
No full textObjectives: This paper reports on research aimed at understanding leadership activities in primary care dental
practice, an under-explored area within the extant literature.
Methods: The research employed a qualitative, exploratory paradigm, using Video Reflexive Ethnography (VRE)
and Activity Theory (AT) to capture the lived experiences of seven participating dentists.
Results: The research outlines the ways in which dentists demonstrate leadership skills in their daily work,
identifying three interacting activity systems that define leadership in this setting: Patient Care (PC), Running the
Surgery (RS), and Running the Practice (RP). Findings emphasise that leadership is directly related to patient
care and is informed by explicit and implicit ‘rules’ governing these activities, which are often learnt and
developed tacitly over the course of a dentist’s career.
Conclusions: Leadership is based on relationships and emotional intelligence and effects dentists’ general wellbeing in addition to the effective delivery of clinical care.
Clinical Significance: Unconscious, implicit and often automatic behaviours, skills and activities related to leadership and teamwork have been uncovered and linked directly to patient care. Findings and conclusions can
enhance patient outcomes and experience alongside clinician wellbeing; and underpin effective surgery and
practice management. Relevant in the clinical patient care context for every clinician
Re-thinking nature-connection: Practitioners’ worldviews as multi-paradigmatic entanglements
No full textNature-connection is increasingly promoted as a way of prompting care and concern for nature and encouraging pro-environmental behaviours. Yet its conceptual foundations remain unclear and contested with researchers defining the construct in divergent ways. In this study, a situational analysis of interviews with nature-connection practitioners is used to provide empirical evidence demonstrating entwined and contradictory discourses at work in their talk about nature-connection theory and practice. The analysis illustrates the ways in which cartesian dualism and relational ontologies occupy the same discursive space. The data are used to discuss possible routes toward a more coherent premise for an environmental ethic than the ubiquitous biophilia hypothesis, in-troducing panpsychism as a promising rationale for the moral consideration of nonhumans and the fostering of cultural intuitions of animacy in relationship to urban environments and human-made artefacts. Conservationists and educators are encouraged to explore panpsychism for its potential to provide an ethical framework for promoting a greater sense of ecological responsibility
Redefining assessments in the age of AI
No full textGenerative AI (GAI) offers a challenge to traditional modes of assessment, raising issues of academic integrity and reliability of grading, particularly in coursework essays. Much of the academic and media coverage of the GAI revolution has been negative about its potential impacts on education, yet it does offer an opportunity to reassess and transform outmoded assessment practices. This chapter aims to provide a balanced view of the topic, discussing the challenges of GAI in assessment, whilst offering practical strategies for educational enhancement, with a view to promoting assessments that are both reliable and authentic
Building Vital Relationships Between Young Learners And Key Persons
No full textThe role of the Key Person is a statutory requirement within UK Early Childhood Education and Care (ECEC) as stipulated within the Early Years Foundation Stage (EYFS) Framework (Department for Education, 2024). The rationale for the role is rooted in an understanding of the importance of relationships between people who are most influential in a child’s world (Bronfenbrenner, 1979), as well as the importance of building attachments with children (Ainsworth et al., 1978; Bowlby, 1969).
Guidance for practitioners in enacting the Key Person approach (Elfer et al., 2013) is further supported by non-statutory guidance (DfE, 2023; Early Years Coalition, 2021) which seeks to recognise and address the capacity for the Key Person approach. This includes addressing issues of parent/carer partnership and engagement, workforce development and outcomes for children through appreciation of the significance of relationships in promoting child development outcomes holistically
Female Immigrant Entrepreneurship:Enhancing Entrepreneurial Capabilities Through Education and Training
No full textThis groundbreaking monograph explores the urgent need for tailored support systems that empower female immigrant entrepreneurs to navigate the complex challenges and unlock the opportunities they encounter in their host countries. Anchored in the Andragogy-in-Practice framework, the book critically examines the alignment between existing Entrepreneurship Education and Training provision and the entrepreneurial needs of female immigrants, drawing on qualitative research conducted in the Irish context. It highlights the systemic gaps in current training offerings while showcasing the potential of adult learning principles to foster inclusive, culturally responsive education. Offering both academic insight and practical guidance, this volume serves as a valuable resource for educators, trainers, policymakers, and support organisations. It provides a clear, evidence-based roadmap for designing and delivering impactful programmes that recognise and build upon the unique strengths, aspirations, and lived experiences of this often underrepresented yet economically vital group
Engagement in group-based self-management support programmes for people living with long-term conditions: a realist evaluation
Full text linkGroup-based self-management support (SMS) interventions are advocated to help individuals to manage long-term health conditions, which are a growing health concern. Engagement with group-based SMS programmes is a frequently cited challenge to programme success yet the concept is often ill-defined and focuses on individual states and behaviours.
A realist evaluation, a type of theory-driven evaluation, was adopted to generate explanatory theory of how engagement occurs in group-based SMS programmes. Programme theories, which explain how informal and formal elements of interventions work, were developed and tested using a suite of person-centred health and wellbeing programmes provided by a university in partnership with local healthcare organisations in the Southwest of England. Programme theories were developed using realist interviews with programme architects and practitioners, historic patient feedback from programmes delivered by the health and wellbeing (H&W) team, and data from a concurrent study. Programme theories were refined and verified using a multi-case study design which adopted non-participant observations of three types of group�based SMS programmes, and realist interviews with programme practitioners and participants. The three programmes were a Back Wellbeing Programme, a Living Well With and Beyond Cancer Programme, both of which were delivered at the university campus, and a Leg Wellbeing Programme, which was delivered at the university campus and three other sites in and around the city.
The output of this realist evaluation comprises a conceptual framework for engagement in group-based SMS programmes within which seven programme theories explain how various aspects of programme architecture impact engagement, for whom, in which circumstances and why. The choice afforded to participants when participating in programmes, feedback and differentiation of activities, the emotional and physical environment, informal space for connection and time to develop relationships, helping individuals to identify how programmes may support their individual needs, the active involvement of students in programme delivery, and co�constructed engagement between practitioners and participants were all identified to support engagement in programmes. Key contexts influencing these mechanisms and their outcomes were also identified. The generation and empirical confirmation of these programme theories support a wider argument for expanding the focus of engagement beyond individuals and to shift away from viewing non-engagement as a patient problem, which has dominated the literature to date.
The portable theories presented in this work can be used to guide the support and evaluation of engagement in group-based SMS programmes and offer a platform for further testing and refinement of engagement theory in similar programmes in different contexts. Further, the theories may be used to inform programme design and support the training of practitioners delivering group-based SMS programmes to improve the success of these complex interventions
Lifelong learning: Sustaining social transformation through and beyond higher education
No full textPlymouth Marjon University’s archive contains a wealth of materials from its history, which spans almost two centuries. Before doing primary research, the Brian Simon Research fellowship fund project, Far away from the ivory tower, engaged with this rich repository, selecting sources that provoked questions and ideas related to the team’s focus on understanding and exploring disadvantage in education. These sources, with questions and prompts to stimulate discussion, were used in informal meetings with participants, who were first-in-family to attend university; many participants had experienced disadvantage, and the selected sources enabled powerful reflection on experience and life stories
The Need to Nurture – Supporting Early Years Staff through Continuing Professional Development
No full textThe ongoing changes to early years funding in England, coupled with recent ratio changes for 2-year-olds (Ofsted, 2023a; Department for Education, 2024), the current Government policy to increase school-based nursery provision (Department for Education, 2025) and the ongoing recruitment and retention crisis within the early year workforce (Early Years Alliance, 2021; Wallace & Cooper, 2020), continues to disrupt the English early years sector. A strong and stable early years workforce is paramount in helping settings navigate the current early years landscape and ensure that our youngest children receive the very best care and early education. Much has been written regarding the importance of staff qualifications and training within the early years and the impact this has on the quality of early years provision (Sylva et al,2004; Bonetti, & Blanden, 2020), yet access to Continuing Professional Development (CPD) opportunities is not what it was 10 to 15 years ago. Local authorities used to provide an abundance of free, in-person, early years training and most settings were in the financial position, and had enough staff available, to release staff to attend CPD opportunities. Austerity measures have led to significant reductions in the number of early years advisors employed by local authorities and the loss of almost all free early years training provided by local authority early years teams in many areas. In addition, paid-for training opportunities provided by local authority early years teams have also reduced significantly. Despite evidence that high-quality CPD opportunities can help retain staff within early years and make them feel valued, employers do not feel they can afford to provide their staff with high-quality CPD opportunities (Wallace & Cooper, 2020). A 2020 report by the Social Mobility Foundation identified early years staff felt there were limited opportunities for career progression and CPD, which contributed to them feeling undervalued (Wallace & Cooper, 2020). The report also suggests that there is evidence that employers who offer high-quality and relevant training, advice and professional support, and where staff are compensated for time they take to train, are more likely to retain qualified staff.
Since this 2020 report, there has been some shift in the CPD landscape within early years. The Covid-19 pandemic led to training opportunities being available online in a way they had not previously been. Additionally, the launch of the Stronger Practice Hubs in November 2022 has gone some way to improving access to CPD opportunities for the early years workforce. However, two and half years after their launch, many early years leaders and practitioners are still unaware of their existence. Additionally, there is recognition that despite the Government's commitment to a graduate-led early years workforce and the ongoing (although places are much depleted) funding of Early Years Teacher Status, graduates working within the early childhood education and care sector have limited opportunities for level six and seven CPD. The limited training available is generally focussed at levels two and three. Having worked in the early years sector for more than 20 years and having watched the changing nature of training available, we sought to understand how accessible those working in the early years workforce find the training opportunities available and whether this training meets their needs