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The Language of Inclusion and its Impact on the Leadership of Equity within Scottish Secondary Schools
Full text linkLanguage and power are inextricably linked, and our use of language influences our attitudes, beliefs and values as human beings. This study focuses on how representations of inclusion frame our collective understanding of the term. It uses Critical Discourse Analysis to analyse how inclusion is represented in key Scottish policies, media headline representations and through professional association discourse. These different representations contribute to a variance in understanding and the narrative within education about inclusion. Empirical research was undertaken with head teachers in a case study local authority to consider how these representations feature within their settings, and examine any impact on the leadership of equity.
Ultimately, language impacts on our attitudes and collective understanding about inclusion. This paper considers how varying attitudes potentially undermine the leadership of equity within secondary schools
Collaboration to Support the Development of Inclusion: Reflections on a Strategic Change Initiative
No full textIncluding all children in education is one of the biggest challenges facing global systems (Ainscow, 2023). This paper presents research findings of a strategic change initiative (SCI) that both recognises and addresses the challenges of the inclusion of children with additional support needs (ASN) within the Scottish educational context. In Scotland, pupils learn in both mainstream and specialist provisions. Scottish Government (2023a) data shows year on year trends that more children and young people are being identified with ASN. In the local authority (LA) context presented, data analysis indicates rising referrals and requests from mainstream to specialist provision for pupils with ASN, stressing the challenges of including these learners in mainstream and the dilemmatic nature of placement in learning. Furthermore, recent financial restraints on education budgets in Scotland (The Scotsman, 2024) create further challenges for the inclusion of pupils, as reported by the Educational Institute for Scotland (EIS, 2019)
This study examines the first year of a three-year SCI led by a depute head teacher (researcher) at a Scottish mainstream primary school with a co-located additional learning needs provision. The paper outlines how, in the first year of the SCI, within-school collaboration has enhanced ASN learner inclusion across school settings. Evidence demonstrates that strategic leadership (Johnson, 2013; Quong & Walker, 2010) and practitioner collaboration (Ainscow, 2023; Hargreaves & O’Conner, 2018) have positively impacted learner inclusion and the development of inclusive teaching practices. In the second year, within-school collaboration will continue with an advancement towards between-school collaboration. The objective to fully embed both collaboration models will be achieved in the third year.
The findings suggest that the SCI model is both financially viable and scalable and provides school leaders with a framework that can be replicated locally to address current challenges to inclusion in educational settings
Table of Contents
No full textThese are the contents of Pirandello Studies 45, 2025.
Issue 45 is available online to subscribing institutions via the MLA International Bibliography with Full Text.
Print copies can be purchased for £26 (postage included) by contacting Prof. John Barnes ([email protected]).
Tables of contents for all past issues can be found at https://www.ucd.ie/pirsoc/journal/
Surgo Vision Competition
No full text"A picture is worth a thousand words" - Confucius
To encourage intellectual curiosity, critical thinking, observational and diagnostic skills, the ability to empathize with patients, and promote a general sense of well-being, Surgo will publish up to 5 images submitted by medical students in each issue.
Images can be in the form of a painting, cartoon, photograph, still life drawing, doodle ... the list is endless - limited only by your imagination.
Selection criteria:
The image must be an original piece, submitted via email to the Editor in Chief, Surgo (format - JPEG or TIFF)
It should be certified as original and be accompanied by a short description of what it represents/means to you / why it should be published.
The best 5 will be selected for publication in Surgo by Professor Cindy Chew.
Each successful submission is awarded £20.
At the end of the year, all published images are eligible to compete for the Best Medical Vision prize - up to £100.
A few years ago, I looked in the mirror and made a declaration: I was going to commit to growing my hair as long as possible. Albeit a fairly small decision in the moment, it grew to become a feature that would softly shape the edges of my cementing teenage identity. I began to be acknowledged as ‘the girl with the long hair’ in school. In times of self-doubt, it could become a veil of confidence. On many more joyful occasions, it acted as a fun conversation starter, offering countless little moments of connection.
A couple of years ago, I looked in the mirror and had a realisation: my hair was no longer growing as it used to. As I began to juggle health problems alongside university demands in my second year, getting through exams and coursework grew more challenging. Less time was available to be spent on ‘unproductive’ hobbies: taking extra time for haircare and carving out quiet moments of creativity was no longer possible. As the ends of my hair began to grow a little more ragged, the fringes of my broader identity began to fray slightly.
Last year, I gave myself the space to really see my reflection, and I realised I needed to reconnect with the person I used to see in that mirror. During my intercalation year, I have regularly been making space for health, creativity, and some wonderfully therapeutic unproductiveness. A couple of months ago I observed that my hair was starting to look healthy again.
As one of the first drawings I have done since I was around thirteen, this sketch felt like a moment of recoupling parts of my younger identity with the person I want to be now. I feel very fortunate to know that I am on a career pathway which aligns so deeply with my core values - it is truly the greatest privilege to know I will be in a position to help so many people at such vulnerable moments - though I don’t doubt there will be many more challenging periods ahead.
It has felt significant to see this physical, visible representation of the importance of filling my own cup. My hair isn’t as long as this yet, but as I continue to prioritise self-care, perhaps someday it can be. To me, this image is a reminder that I always have the power to make positive changes: I can relearn to draw at 22; I can be joyously unproductive when I need to be; and, as my hair has taught me, it’s always possible to make some positive growth
Tail Lights
No full textI hope everyone has enjoyed the wonderful Spring weather, this academic year and is now looking forward to the Summer holidays! (Not too long to go now till you too are done, MB4!)
What a busy few months it has been for you. MedChir Revue in May was of course a highlight in the calendar. A fantastic array of talent was on display – from high culture opera to artistic sports people. Wonderful to see the (it-must-be-a-record-breaking-number-of) judges unanimously award the top prize to the terrific Otago Street Boys (final years William Heeley, Rueben Heaton and William Strachan). Bravo and totally well deserved!
It is great to see some of your audits being submitted as Visual Abstracts. Keep them coming! Remember: submissions accepted for publication receive £20 and is legitimate CV fodder (citable DOI)!
Students presenting their work at conferences is always impressive. Everyone was blown away by one of our 3rd year students competing against Radiology Residents at the Scottish Radiological Society Spring Meeting for the SRS Dr Sarah Jenkins QI Prize. It was a close run thing and she was just pipped to the post. You can read Shraddha’s visual abstract in this issue of Surgo and the other works here: https://www.radiology.co.uk/spring-2025-qi-presentations.
Graduation is in a couple of weeks while 335 MB5’s are heading to Crieff for their Graduation Ball. Epsilon 2025 is a significant cohort for many reasons. As a 25-year old Epsilonian myself, I am extra proud of this group of graduands. Not only are they the first cohort to officially sit the GMC Medical Licencing Assessment, they also did this after starting their medical school journey during the COVID pandemic. What a fantastic achievement! Super well done everyone! YOU ARE THE OG! Remember you have resilience in spades – the world is your oyster: go make your mark!
Dr Christine McAlpine is the subject of this issue’s interview. Be inspired by her incredible journey from being the first woman president of MedChir Society to Consultant Stroke Physician at Glasgow Royal Infirmary today.
Until the next Tail Lights, have a fabulous summer and see you all in the Autumn! Remember to send in your holiday pictures as Surgo Vision or turn your audits into Visual Abstracts!
Why Language Matters in Medicine
No full textLanguage barriers are widely recognised as a major determinant of health equity. Such barriers in healthcare hinder effective communication between patients and clinicians, compromising patient safety through increased rates of adverse outcomes, diagnostic errors, and medication inaccuracies. They also diminish patient and healthcare professional satisfaction, reduce overall quality of care, and indirectly lead to prolonged consultation times along with increased healthcare costs.1
French is the fifth most spoken language globally, with 321 million speakers across Europe, Africa, North America, and Asia. It serves as an official language in 29 countries.2 For medical students, proficiency in French constitutes both a cultural asset and a practical means of lowering language barriers among diverse patient populations.
The Anglo-French Medical Society (AFMS) organised an annual Medical French Weekend Residential Course in Lille. This program provided students with the opportunity to approach language as a clinical tool rather thana purely academic pursuit.
The AFMS was established to foster collaboration and partnership between British and French healthcare professionals. Its annual Lille course is one of its leading student initiatives, intended to equip attendees with the history-taking skills, clinical vocabulary, and the opportunity to apply those skills in French. The programme merged specialty-based teaching, stimulated scenarios, and practical workshops. The sessions comprised of multiple disciplines, including emergency medicine, psychiatry, respiratory medicine, obstetrics and gynaecology, and cardiology along with a focus on humanitarian practice with tutors sharing their experiences of practising in Francophone healthcare systems. Above all, the course welcomed students of all levels, from beginners with a basic knowledge of the French language to near-fluent speakers focused on refining their clinical terminology.
This inclusion embodies the ethos of organiser, Dr Zara Bieler, a clinician practising in both the UK and France. She stressed that language is not peripheral but central to medicine:
“History-taking is the key part of the whole consultation. Even if you only speak a little of someone’s first language, it’s a very human part of the interaction and can go a long way.”
This perspective highlights the integral role of language in clinical encounters. In the absence of a shared language, clinicians may fail to acknowledge necessary details during the history-taking process.
Additionally, Dr. Bieler emphasised the global relevance of French for medical students and healthcare professionals pursuing international work or humanitarian medicine:
“There are large parts of the world where French is one of the main languages. For someone wanting to work with Médecins Sans Frontières or abroad, it can open many doors.”
French is one of the two official working languages of Médecins Sans Frontières (MSF). For those preparing for humanitarian vocations, command of French is not only advantageous but often imperative.
Lastly, Dr. Bieler illustrated the clinical consequences of language skills with a case from her own training:
“A patient of mine developed pre-eclampsia, and I was able to pick it up quickly. I was able to get her into hospital, that baby was born safely. I really think about her and having had that language skill, and that continuity of care really made a difference in that case."
Dr. Bieler reflection on a case early in her training involving care for a Congolese refugee in the United Kingdom demonstrates that communication in a patient\u27s primary language can have a direct, significant influence on clinical outcomes.”
This emphasis on cultural as well as linguistic understanding was echoed by Dr Margaret Cant, a practising physician in France after many years as a GP in the UK, who tutors on the course in respiratory medicine. She underscored that the significance of language learning goes beyond vocabulary.
“Apart from the obvious advantages of speaking the same language as the patient, learning a foreign language creates an awareness and sensitivity to cultural differences which might, if not recognised, create difficulties in the doctor-patient consultation.”
Dr Cant exemplifies this notion with the phrase “la crise de foie”, which is directly translated to “liver crisis”, but in French it’s commonly used to describe digestive upset. If taken literally, it could mislead a non-native speaker. When understood culturally, it illustrates the different ways illness can be expressed and conceptualised.
“Learning a foreign language helps you, as a doctor, to ‘tune in’ to the different ways in which the health of the body is understood by people not brought up with standard British ideas. And this sensitivity is a transferable quality, causing you to question the assumptions you make about the ideas and understanding of the patient in every doctor-patient consultation, whatever language is spoken by the patient.”
Such perspective enhances clinical practice. By questioning assumptions and adjusting to and comprehending various explanatory models of illness, doctors can communicate more effectively with patients from diverse backgrounds. As Dr Cant concluded:
“It enriches your experience as a doctor as well as enabling the patient to feel understood - a sentiment that is highly valued by patients but not necessarily recognised as such by doctors.
From my own standpoint, the weekend I spent in Lille taught me that learning a new language in medicine does not demand fluency to be clinically valuable. Even partial proficiency, such as asking about allergies, explaining a diagnosis, or simply greeting in a patient’s native language, can build trust and rapport and reduce miscommunication.
This lesson was particularly evocative. Arabic, my first language, has refined my outlook of how central communication is in medicine, even prior to significant clinical exposure. French, as another global language, offers a complementary dimension. It diversifies and expands the scope of patients I might one day connect with. Therefore, developing competency in both languages offers a pragmatic approach to breaking down those linguistic and communication barriers and preparing to practice in global healthcare settings.
The AFMS Medical French weekend ultimately depicts the fundamental principle that language should be seen as a clinical skill rather than merely an optional adjunct. Apart from enhancing vocabulary, initiatives like this foster cultural competence and promote clinician-patient language concordance, outcomes that have been associated with improved patient safety, increased satisfaction, and consolidating trust and rapport between clinician and patients.
With the ongoing globalization and diversification of healthcare, learning new languages offers medical students an effective approach to address health inequalities. Whether serving diverse communities in the NHS or working abroad with organisations such as Médecins Sans Frontières, the means to communicate with patients in their own language is crucial to providing equitable care.
References:
1.Al Shamsi H et al. Implications of language barriers for healthcare: a systematic review. Oman medical journal, 2020, v35(2):e122.
2.Ministry for Europe and Foreign Affairs. The French language in figures. Ministry for Europe and Foreign Affairs, 2025.
Landscapes, Languages and Lessons: Reflections From The Summer of 2025
No full textWhile setting out the agenda for a new year, making the most of the summer holidays has always been one of my key priorities. The definition of seasons in Glasgow is often imprecise; however, the summer of 2025 has presented a notable departure from previous years. A combination of intermittent rainfall and periods of sustained sunshine had given Glasgow the weather reminiscent of a continental European summer; and at the time of publication, the MET Office even projected 2025 to be the warmest year on record.
Family tradition reminded me that summer has always been a time for experimenting, trying new things, pursuing side quests and most importantly, reflecting on past adventures to make the next one better. This year, I wanted a combination of experiences which could both provide opportunities for rest and renewal, while also positively contributing towards my professional development.
I knew I had to act quickly if I wanted to make the best of it, and the summer of 2025 seemed to arrive sooner than expected. The morning after my final MBChB2 exam, I set off to join the Glasgow University Catholic Society’s week-long pilgrimage across Poland. Starting off in Krakow and then to Czestochowa, we visited countless churches while also weaving through museums, markets and sampling some authentic Polish cuisine.
Poland offered numerous highlights, but celebrating my friend Daniel Hirshorn’s birthday at the terrace of the Sanctuary of St. John Paul II, and biking through the quiet streets of Czestochowa at midnight were certainly a few of the best memories. Apart from being one of the first pilgrimages I could participate in, visiting Poland proved to be not only a source of spiritual renewal but also a meaningful cultural experience — one that set the tone for the rest of my summer. An aspect I could reflect on was the benefit pilgrimages could offer both for the health of mind and body.
For my next adventure, I turned East, making a spontaneous three-day stopover in Abu Dhabi, United Arab Emirates before arriving in Chengdu, China. The fragile nature of global travel quickly became apparent, as my onward journey was disrupted by the Iran–US–Israel strikes taking place at the time. Nevertheless, thanks to the University of Glasgow’s GoAbroad Fund, along with an all-inclusive waiver from the University of Electronic Science and Technology (UESTC) in Chengdu, I was lucky to join their three-week Chinese Language and Culture Summer School.
Our days followed a full rhythm: 09:00 – lectures on the Chinese phonetic system (pinyin) 13:00 – lunch in one of the eleven vast UESTC canteens 15:00 – cultural excursions to museums, heritage sites, or blended activity classes 19:00 – dinners featuring a variety of local delicacies and Sichuan specialities 22:00 – games night (and pre-drinks) at one of our hotel rooms 02:00 – bedtime (or 04:00 on the nights we went clubbing).
On the weekends, we took trips to neighbouring cities such as Chongqing – a city that felt like a vast maze of skyscrapers rising from steep hillsides, neon bridges stretching across wide rivers, and monorails that disappear into the sides of buildings.
Immersing myself in Chinese culture alongside students from universities across the globe made this summer school one of the most memorable experiences of my holiday. What truly defined it, however, were the people I met along the way — many from countries I might never otherwise have had the chance to engage with. From Australia to Russia, each new friendship taught me that the key to meaningful connections lies not in dwelling on differences, but in celebrating shared experiences and finding common ground. It was a mindset that enriched every part of this trip.
Language barriers aside, visiting China was an incredible experience. From witnessing the country’s technological advancements to observing the discipline and work ethic of its people, my admiration for China only grew stronger. It was difficult to categorise the trip: on the one hand, it felt like a holiday, with 4* hotel accommodation, all meals, travel, and excursions fully covered; yet on the other, it was deeply educational, offering invaluable opportunities to learn about China and its culture. As for the highlights, eating a Sichuan-style frog hotpot and singing a Chinese song for the closing ceremony was a fascinating experience.
Each journey this summer seemed to build upon the last, drawing me deeper into new cultures, traditions, and communities. It felt only natural, then, that my travels would culminate in Italy – the heart of Roman Catholicism – for the Jubilee of Youth 2025, a once-in-a-generation gathering I had long anticipated. Together with one of my best friends, Matthew Donegan, we set out on a hybrid itinerary through Rome, Milan, and Bergamo, carefully balancing the pilgrim spirit of the trip with moments of sightseeing and spontaneous side quests.
Italy offered an experience unlike any other: a seamless blend of pilgrimage and holiday. Our initial focus for the first few days was attending events centred around the Jubilee of Youth, with a key highlight being participating in mass celebrated by the newly elected Pope Leo XIV. We then shifted gears, allowing us to wander more freely through Italy’s cities, history, and landscapes – savouring the country’s beauty at a gentler pace.
An aspect of this itinerary I was not prepared for was the evening vigil with Pope Leo XIV at Tor Vergata. Surrounded by herds of young Catholics, estimating to roughly 1 million – several aspects of the common belief, hope, and unity we all possessed were on display. Notably, some parts of this experience were truly remarkable – the feeling of being around a million Catholics, prayers offered for people in countries affected by conflicts, and most importantly the opportunity to attend the Benediction of the Blessed Sacrament. The next phase of my Italian adventure took us northwest to Milan and Bergamo, where we immersed ourselves in the cities’ rich cultural and historical heritage. From exploring grand cathedrals and bustling piazzas to tracing the quieter rhythms of local life, each stop revealed a different facet of northern Italy. A touch of spontaneity also carried us further afield to Lake Como, where the serene waters and dramatic mountain backdrop provided a sharp contrast to the energy of our cities.
Returning to Glasgow, I knew there was still room to advance the professional development goals I had set before the summer began. Thanks to the generous support of Medical Research Scotland’s Undergraduate Vacation Scholarship, I began work on a novel project in collaboration with the General Practice & Primary Care team at the University of Glasgow’s School of Health and Wellbeing. Our research focused on exploring how access to parks – and the quality of those green spaces – can influence mental health outcomes, an area that felt both timely and deeply relevant.
Looking back, the summer of 2025 became far more than a sequence of trips and projects – it was a season of growth, marked by faith, friendship, and discovery. From pilgrimages in Poland and Italy to cultural immersion in China, and finally to research back home in Glasgow, each experience added a new dimension to how I see the world and my place within it. What began as a desire to balance rest, renewal, and professional development evolved into a journey that challenged me, broadened my horizons, and left me eager to carry these lessons into the years ahead.
Tail Lights
No full textWelcome everyone to the new Academic Year 2025/6.
I hope you have enjoyed the fabulous weather this summer. Big welcome to all the first-year students who are joining the best medical school in the world! (COI : I graduated from UofG). Everyone else – I hope you had a restful summer and are ready for another exciting educational year ahead.
I am very excited to work with Surgo’s new Editor-in-Chief Innes Crawford. Innes is bursting with new ideas for Surgo and is technically savvy to boot! I cannot wait to see all the great things he will deliver this year.
We all know the Glasgow Coma Scale (GSC), which has revolutionised how doctors around the world manage Head Injury. Dr Oliver Blatchford of the Glasgow-Blatchford Score (risk of requiring intervention from an upper GI bleed) gives us an insight to his life as a medical student, as part of MedChir and shares valuable advice for medical students today.
I am sad to report the recent passing of another inspirational figure - Professor Sir Kenneth Calman. Sir Ken fostered and kept close links with MedChir and Glasgow. When he and Lady Anne came to support our \u27Uncertainty work\u27 with Medical students last year – he was sharp as a tack, generous with his time/advice and incredibly supportive. Our condolences to his family. You can read more about Sir Ken\u27s life here:
https://www.theguardian.com/education/2025/aug/07/sir-kenneth-calman-obituary
Medicine is grounded in Politics and Policy (see above interview with Sir Ken). You will all be aware of the upcoming Scottish Elections in 2026, while England has just published their 10 Year Plan for Health Services, built on their proposals from 2023. These culminated in reports this summer of 20,000 doctors missing out on training posts: and a decade-high number of doctors leaving the UK.
https://www.itv.com/news/granada/2025-05-07/bma-we-could-potentially-see-thousands-of-unemployed-doctors
Being good doctors to our patients is fundamentally what we all aspire to – competitive job market or not. To that end – I commend you to find a good book to anchor your studies and learning. Kumar and Clark [continuously published for over 37 years with biennial updates] or the medical student-friendly version Essentials of Kumar and Clark might be ones to check out for Medicine (get them free here: https://go.exlibris.link/94J4zxyB, https://go.exlibris.link/4yJ9ZZpC). The latest edition (July 2025) has a new chapter contributed by yours truly – lots of pictures included of course!
Life at university is not all work. Do look to sports, the arts, Unions and MedChir for outlets to meet friends and enjoy life as a medical student in Glasgow!
Finally, don’t forget to send in your holiday pictures as Surgo Vision or turn your audits into Visual Abstracts! Top 5 submitted get published, win some money AND compete for the £100 top prize at the end of the year.
Until the next Tail Lights, have a fabulous start to the new year and see you at the next MedChir event!
References:
1.Oldtimer Fastback And Rear Lamp (158700099).jpeg - Wikimedia Commons [Internet]. Wikimedia.org. 2022 [cited 2025 Sep 14] https://commons.wikimedia.org/wiki/File:Oldtimer_Fastback_And_Rear_Lamp_(158700099).jpeg
University of Glasgow - University news - Sir Kenneth Calman [Internet]. Gla.ac.uk. 2025 [cited 2025 Sep 14] https://www.gla.ac.uk/news/headline_1197845_en.html
What\u27s On This Semester?
No full textThe Medico-Chirurgical Society (MedChir) host a range of social and educational events throughout the year on a Thursday night which are attended by students across all year groups.
Kicking off the year is the Welcome Event; a relaxed evening the Glasgow University Union where you can meet classmates and get to know what the society is all about. A fortnight later, dust off those dancing shoes and show off those impeccable dance moves at their annual ceilidh. Want to meet new friends for life? The Medic Families event is a firm favourite, with hundreds of first years gaining Medic siblings and parents, who coach you through the first of medical school an beyond. Scottish and Northern Ireland Medical Students sports (SNIMS) is a fun two-night trip away to Dundee to play sports and explore the sights that Tayside has to offer! Finally, the MedChir ball at the end of November, is the perfect way to dress up let off some steam before the Christmas exam fun
Leading Physician Makes Medical Breakthrough
Full text linkAsha Waugh graduated from the University of Glasgow with an Honours degree in Human Biology, but she has always had an interest in history and literature. Throughout the course of her degree, Asha read about Addison’s disease and was particularly intrigued by it. She was inspired to write this fictional paper combining physiology and history after reading about Thomas Addison’s life in a local magazine and being moved by his story