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Breaking boundaries: a model of student-led knowledge exchange for higher education
Full text linkKnowledge exchange (KE) is increasingly important in higher education internationally, yet relatively little attention has been paid to it as a pedagogic opportunity for students. This paper draws on 26 interviews with stakeholders within and outside HE to develop a model of student- led knowledge exchange as a guide for learning through KE. The model includes the following elements: Preconditions, Prior Knowledge, Planning and Place, Pedagogic Context and Product, and offers an analysis of different forms of KE which occur between individuals in a learning triad consisting of student, facilitator and external participant. The research foregrounds a social view of learning where valid knowledge comes from diverse participants in the exchange, including students themselves. Students act as a catalyst for multi-directional KE – a finding which challenges the implied hierarchies evident in much of the literature on this topic. The model is offered as a starting point for developing a pedagogy of KE in higher educatio
How to facilitate NHS professionals to recognise and use skills gained from global health engagement when back in the UK workforce? A participatory action research project to design, pilot and evaluate a series of online leadership workshops
Full text linkObjectives: Leadership knowledge and skills are known to be developed by health professionals during global health experiences overseas. However, volunteers struggle to recognise and use these new skills on return to their workplace. A series of bespoke leadership workshops were designed, delivered and evaluated by leadership experts to help enhance the transferability of leadership skills back to the UK National Health Service. Design: A mixed-methods participatory action research methodology was employed to explore the impact of the workshops. This approach lends itself to a complex, situated project involving multiple partners. Quantitative and qualitative descriptive data were collected via online survey (n=29 participants) and focus groups (n=18 focus groups) and thematically analysed. Setting: The authors delivered the tailored leadership workshops online to globally engaged National Health Service (NHS) healthcare professionals based in England who had all worked overseas within the past 5 years. Participants: 29 participants attended: 11 medical doctors; 6 nurses/midwives; 10 allied health professionals; 1 NHS manager and 1 student nurse (who was also working as a healthcare assistant). Results: Participants were able to network both during the large group discussions and while in smaller breakout groups. Data highlighted the substantial benefits obtained from this networking, with 91% of participants reporting it enriched their learning experience, particularly within a multi-disciplinary context, and by having the time and space for facilitated reflection on leadership. Furthermore, 78% agreed that they learned new skills for influencing change beyond their position and 76% reported they could maximise the impact of this change for themselves and their employer. Participants also reported the development of systems and ethical leadership knowledge that they felt they could transfer to their NHS roles. Conclusions: This study extends explorations of global health experiences by moving beyond the skills gained while working in low-income and middle-income countries. The innovative online leadership workshops gave agency to individuals to recognise and use the skills gained from global health placements on return to the NHS
Learning to Identify Fake News and Digital Misinformation: Lessons for Educators
No full textThis UK-based study examines how people learned to identify digital misinformation. This included what experiences enabled this development, and the skills that were acquired in the process. This is a small-scale qualitative study of participants who self-reported as being confident in spotting digital misinformation and the data was analysed using a thematic network model. Three main organizing themes identified were: ‘Formal Learning’, ‘Informal Learning’, and ‘Sense of Self’. Participants reported that their formal educational experiences at primary and secondary school were largely unhelpful in their development of digital media literacy. Although a university education was identified as enabling the acquisition of some useful skills such as cross-referencing and critical thinking. Participants acquired most of their abilities to identify digital misinformation from what is best characterised as their informal learning experiences, most notable of which was the establishment of a strong sense of self-awareness. This was pivotal to the monitoring of emotional triggers which are often the crux of digital misinformation. This paper also highlights the importance of critical pedagogy which promotes an awareness of wider power structures underpinning what is now being widely referred to as ‘surveillance capitalism’. In conclusion, it is suggested that formal education could learn much from these informal educational processes which have been identified as being helpful in building criticality which is in turn integral to producing more digital media-literate citizens, and a population more resilient to digital misinformation
Far away from the ivory tower: The impact of university education on disadvantaged people & their communities
Full text linkThis report presents the findings of the Plymouth Marjon University (PMU) Brian Simon Research Project, which explored the experiences of individuals in higher education (HE), with a specific emphasis on those who were the first in their family to attend university. The project, conducted by a multidisciplinary team, aimed to explore the impact of HE on individuals from disadvantaged backgrounds, utilising artefacts from the university's extensive archive to scaffold discussion
Student academic representation in the UK: An exploration of recruitment, training, and impacts
No full textAbstractStudent academic representation is a staple feature in UK and international higher education. It provides a vital quality function whereby students, who are elected representatives of their programme, canvas the opinions of peers to inform quality assurance processes. In the UK, there is increasing regulatory pressure for universities and student unions to be dual owners of representation activity and much work has been done to enact this model. Nonetheless, little is known about the experiences of those serving as student representatives, despite this being a community of thousands of students across the UK, who hold an instrumental position in institutional quality assurance. We developed an instrument (SARA) to evaluate experiences of 773 active student representatives from 15 UK HE institutions. It explored key areas, including recruitment, training, working approaches and development outcomes. Data indicated low engagement in training in some key areas (e.g., representation of diverse groups and data gathering) and a narrow range of working approaches. These patterns may compromise the value of student representation both from the institutional perspective and that of individual representatives seeking to enhance their skills. Recommendations are suggested for enhancing future practice
Impact 22 Editorial: From the Editor
No full textEvidence-based and evidence-informed teaching have become increasingly important aspects of educational practice and policy in the UK, with a growing emphasis on teachers as researchers and schools as research collaborators. Evidence-based teaching is the ‘seeking out and using: quantitative and qualitative research findings’ (Coldwell et al., 2017, p. 4) to develop pedagogy and practice. Research-informed and evidence-informed teaching are terms used interchangeably and emphasise that ‘teaching, as a complex, situated professional practice, draws on a range of evidence and professional judgment, rather than being based on a particular form of evidence’ (Coldwell et al., 2017, p. 5). Evidence-informed teaching therefore positions educators not only as consumers of research or evidence, but also as professionals who engage critically with it and apply it thoughtfully to their specific contexts. Evidence-informed teaching also includes evidence generated by teacher researchers or in partnership with other educational researchers, to be used to improve pedagogy and practice
Reflecting on Reflexivity in Realist Evaluation: A Call to Action
Full text linkRealist evaluation is increasingly utilised across disciplines due to the value of identifying which mechanisms may explain how, and why, particular outcomes are generated in specific contexts. In theory, realist evaluation provides a tangible way to analyse the inherent complexity in many pressing societal challenges. Realist evaluation encourages a mixed methods approach and choosing a suite of methods that are most relevant within a specific project. Yet, navigating a plurality of methods with abstract philosophical concepts brings operational challenges such that, further methodological guidance is needed. Research processes can be opaque and although the relativist epistemology in realist evaluation is acknowledged, the role of the researcher within the research is often unclear. Reflexivity broadly concerns the overt practice to consider how subjective perspective is intertwined in knowledge production. Reflexivity has been a peripheral consideration in realist evaluation to date and this paper outlines what reflexivity entails, how it enhances integrity to realist principles, and practical ways to exercise it. Through a realist lens the evaluation process is itself subject to the impact of mechanisms and reflexivity provides the apparatus to guard against tunnel vision, undertake robust theory generation and adjudication and increase one’s awareness of the influence of personal and organisational entities on research processes and outputs. We conclude with a call to action to the realist community to mobilise reflexivity in a consistent and explicit manner
The Early Career Framework: Why Context Matters for Teacher Professional Development
Full text linkThe Department for Education developed the Teacher Recruitment and Retention Strategy in 2019 for state-funded schools in England as a response to increasing challenges in teacher supply. Core to the strategy was a mandatory, nationally funded, two-year Early Career Framework (ECF) of professional development for Early Career Teachers (ECTs) in state-funded schools. The ECF began in September 2021 and provided a nationally standardised programme of professional development for Year One and Two teachers. This paper presents the findings of qualitative research that contribute to the understanding of the ECF for ECTsʹ professional development. Semi-structured interviews were used to explore ECTs’ (n = 25) and mentors’ (n = 17) experiences of the first two years of the ECF (2021–2023). System mapping was used to contextualise data, with primary data examined via coding and theme analysis. Using a complexity theory lens, we conclude that the ECF system affects ECTs and mentors in a non-linear way. Feedback loops that effected change were present, but the ECF’s effec�tiveness was highly context-dependent with tension between structure and flexibility. We contend that future enhancements to the ECF should focus on adaptability, fostering positive feedback loops, and recognizing the context-dependent nature of teacher development
Characteristics and phenotypes of a COPD cohort from referral hospital clinics in Uganda
Full text linkIntroduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with varied clinical and pathophysiological characteristics. Although there is increasing evidence that COPD in low-income and middle-income countries may have different clinical characteristics from that in high-income countries, little is known about COPD phenotypes in these settings. We describe the clinical characteristics and risk factor profile of a COPD population in Uganda. Methods: We cross sectionally analysed the baseline clinical characteristics of 323 patients with COPD aged 30 years and above who were attending 2 national referral outpatient facilities in Kampala, Uganda between July 2019 and March 2021. Logistic regression was used to determine factors associated with spirometric disease severity. Results: The median age was 62 years; 51.1% females; 93.5% scored COPD Assessment Test >10; 63.8% modified medical research council (mMRC) >2; 71.8% had wheezing; 16.7% HIV positive; 20.4% had a history of pulmonary tuberculosis (TB); 50% with blood eosinophilic count >3%, 51.7% had 3 or more exacerbations in the past year. Greater severity by Global initiative for Chronic Obstructive Lung Disease (GOLD) stage was inversely related to age (aOR=0.95, 95% CI 0.92 to 0.97), and obesity compared with underweight (aOR=0.25, 95% CI 0.07 to 0.82). Regarding clinical factors, more severe airflow obstruction was associated with SPO2 <93% (aOR=3.79, 95% CI 2.05 to 7.00), mMRC ≥2 (aOR=2.21, 95% CI 1.08 to 4.53), and a history of severe exacerbations (aOR=2.64, 95% CI 1.32 to 5.26). Conclusion: Patients with COPD in this population had specific characteristics and risk factor profiles including HIV and TB meriting tailored preventative approaches. Further studies are needed to better understand the pathophysiological mechanisms at play and the therapeutic implications of these findings
PATHOMECHANICS OF THE TIBIAL NERVE IN ASSOCIATION WITH LUMBAR RADICULOPATHY
Full text linkDysfunctional neural pathomechanics are thought to be an underlying feature of numerous spinal pathologies and peripheral nerve disorders, and have been shown to have a direct effect on patient pain and functional ability levels. In particular, a reduction in the ability of a peripheral nerve to slide and glide is associated with increased pain and disability and often occurs with lumbar disc herniation due to compression of the nerve root in the intervertebral canal. Consequently, tibial nerve pathomechanics are an essential consideration with respect to lumbar radiculopathy, however, this association has not been widely investigated. In particular, there is limited research involving neural pathomechanics in symptomatic patients who have been diagnosed with intervertebral disc disease. The research studies undertaken for this PhD all involved symptomatic patients with intervertebral disc disease, some who had undergone lumbar decompression surgery and others who had not received any surgical intervention. However, all participants had a confirmed diagnosis of lumbar spinal pathology. To my knowledge, each of the five studies undertaken for this PhD are all innovative studies involving the investigation of tibial nerve pathomechanics in symptomatic patients.
The first aim of this thesis was to assess tibial nerve mobility in patients following lumbar decompression surgery, to determine if there was a relationship between nerve excursion and the development of Failed Back Surgery Syndrome (FBSS). A novel method of assessing and measuring tibial nerve excursion via diagnostic ultrasound at the popliteal fossa behind the knee had previously been developed and validated by our research group and this method was utilised throughout the research studies. The first three studies all involved patients who had previously undergone lumbar decompression and subsequently developed FBSS, with the first study identifying that FBSS was associated with decreased tibial nerve mobility. The second study investigated the effect of a nerve mobilisation exercise on nerve mobility in post-lumbar surgical patients who were suffering from FBSS. This study identified that a single session of a nerve mobilisation exercise could improve tibial nerve mobility and reduce tibial nerve mechanosensitivity as determined by a straight leg raise (SLR) test. The third study aimed to determine the strength of correlation between both the leg pain experienced by patients post-lumbar decompression surgery and the patient-reported global rate of change scale (GRCS) with specific biomechanical and clinical variables; lumbar flexion, hip flexion, nerve excursion (painful leg), straight leg raise angle (painful leg) and back pain (VAS). This study identified that there was a strong correlation between tibial nerve movement and lumbar flexion with both leg pain and GRCS, with hip flexion and back pain also significantly associated with post-surgical leg pain and GRCS. This has clear clinical implications for the management of patients following lumbar decompression surgery as the identified variables are all potentially modifiable by clinical interventions.
The final two studies involved patients who had not undergone any lumbar surgery but whom all had a diagnosis of a single-level lumbar disc herniation and were all experiencing leg pain associated with the disc herniation. These studies aimed to investigate the potential effects of lumbar traction on leg pain and/or tibial nerve mobility. Study four investigated tibial nerve mobility during traction, measured at 5 minutes and then 30 minutes during continuous mechanical lumbar traction, and observed significantly increased tibial nerve excursion during traction in patients with a recently confirmed diagnosis of a lumbar disc herniation. These results suggested that traction could be a beneficial intervention with regard to improving tibial nerve mobility in symptomatic lumbar disc herniation patients that have not undergone surgery. These results led to the development of study five which consisted of a viability study to investigate the effects of a course of eight sessions of sustained, mechanical lumbar traction, with and without a nerve mobilisation exercise, on nerve mobility, leg pain, back pain, SLR angle, Oswestry Disability Index (a back and/or leg pain specific disability score) and the global rate of change scale (GRCS) in patients with a recently confirmed single-level lumbar disc herniation in patients aged 18-60 years inclusive.
Study five identified that both treatment groups; traction and traction with a nerve mobilisation exercise, resulted in a significant increase in nerve mobility in patients with a confirmed diagnosis of a single-level lumbar disc herniation. In addition, leg and back pain levels were significantly reduced following treatment in both groups, SLR angle and GRCS significantly improved and ODI score significantly decreased in both traction treatment groups. However, there was no difference in outcomes between the two treatment groups which suggested that traction alone can improve symptoms in people with a herniated lumbar disc and it is not necessary to perform a nerve mobilisation exercise during the traction.
All five studies in this thesis present innovative research that, to my knowledge, has not been previously investigated or reported. The findings of the five studies are relevant to clinical practice and also to the design of future research trials to further investigate the effect of sustained mechanical traction on people with a confirmed diagnosis of a lumbar disc herniation