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This article explores the experiences of those who lead undergraduate education-related programmes in further education (FE) colleges in England. Questionnaire and interview fieldwork with 14 further education-based programme leaders were supplemented by a comparison survey of equivalent professionals from higher education institutions (HEIs). Drawing on Hodgson and Spours's four-level lifelong learning ecology and Nardi and O'Day's keystone species concept, our analysis characterises the role of the undergraduate programme leader as distinctive and critical within the further education context. Extremely multifaceted and busy, this role is also poorly defined, often involving individuals relying on craft wisdom accrued within specific contexts. Three overall strands of responsibility emerged in participants' view of their role: the administrative and organisational demands of colleges and the validation/franchising of higher education partners; the provision to learners of appropriate support in their studies; and the recognition of and response to pastoral needs of students. Tensions were identified between these, with one strand tending to preoccupy programme leaders at any time, obscuring their view of other important role objectives. As such, we introduce the concept of sightlines to capture the importance of enabling programme leaders to see through and beyond their institutional context and engage outwards, rather than turn inwards. Practical recommendations include the provision of time and licence to study for advanced qualifications, to undertake research and to help nurture distinctive cultures of higher education learning. [ABSTRACT FROM AUTHOR]

Understanding people's perceptions of teaching as an occupation, and their motivation or otherwise to teach, can help identify which initiatives/policies are most promising in improving teacher recruitment. Previous studies have often sought only the views of teachers/teacher trainees to understand why people choose teaching as a career. Recruitment strategies based on evidence from such research are therefore only appealing to those who are already interested in teaching. It is the views of those who might otherwise have gone into teaching that can provide better clues to what we can do to get more people into teaching. This paper compares the views of 4469 undergraduate students and 788 trainee teachers in England. Our analysis goes beyond the usual approach by comparing young people completely uninterested in teaching, those who considered teaching but rejected it, those intending to be teachers, and those already in training. Our study found little or no difference between prospective teachers and others in terms of generic career drivers and the attraction of financial incentives, although prospective teachers tended to have lower levels of qualifications and to come from less prestigious occupational backgrounds. However, those not planning to be teachers are much less concerned about teachers' workload, suggesting that this is probably not a great deterrent for those considering teaching. Compared to those who intend to be teachers, those who have considered but rejected teaching are less likely to view teaching as intellectually stimulating. They are least likely to see teaching as a high-status profession, offering good promotion prospects and job security. Policies to improve recruitment need to make teaching more attractive to the second group by addressing these issues. Additionally, these policies should be distinct from policies to retain existing teachers. [ABSTRACT FROM AUTHOR]

Background: Health services are increasingly using digital tools to deliver care, and online consultations are being widely adopted in primary care settings. The intended consequences of online consultations are to increase patient access to care and increase the efficiency of care.Aim: To identify and understand the unintended consequences of online consultations in primary care.Design and Setting: Qualitative interview study in eight general practices using online consultation tools in South West and North West England between February 2019 and January 2020.Method: Thematic analysis of semi-structured interviews with 19 patients and 18 general practice staff.Results: Consequences of online consultations were identified that restricted patient access to care by making it difficult for some patients to communicate effectively with a GP and disadvantaging digitally-excluded patients. This stemmed from patient uncertainty about how their queries were dealt with, and whether practices used online consultations as their preferred method for patients to contact the practice. Consequences were identified that limited increases in practice efficiency by creating additional work, isolation, and dissatisfaction for some staff.Conclusion: Unintended consequences often present operational challenges that are foreseeable and partly preventable. However, these challenges must be recognised and solutions resourced sufficiently. Not everyone may benefit and local decisions will need to be made about trade-offs. Process changes tailored to local circumstances are critical to making effective use of online consultation tools. Unintended consequences also present clinical challenges that result from asynchronous communication. Online consultation tools favour simple, well-formulated information exchange that leads to diffuse relationships and a more transactional style of medicine. [ABSTRACT FROM AUTHOR]

This paper describes an independently evaluated randomised controlled trial of a self-affirmation intervention, replicating earlier studies, mostly conducted in the US with ethnic minority students. Self-affirmation theory suggests that some stigmatised groups, such as those from ethnic minority or poor families, face stereotype threats which undermine their academic performance. Engaging in value affirmation writing activities when such threats are most salient can give individuals a positive sense of value, negating harmful feelings, and fostering academic learning. The present study, involving 10,807 pupils aged 14 to 16 in England showed that the intervention can be successfully replicated with children from low socioeconomic backgrounds in England. The analysis showed positive effects for the intervention group. Pupils who completed more exercises also performed better. The findings are worth consideration given that it costs virtually nothing and does no harm. [ABSTRACT FROM AUTHOR]

Background: Health systems are seeking to harness digital tools to promote patient autonomy and increase the efficiency of care worldwide. The NHS Long Term Plan created the right for patients to access 'digital first' primary care by 2023-2024, including online patient access to full medical records., Aim: To identify and understand the unintended consequences of online patient access to medical records., Design and Setting: Qualitative interview study in 10 general practices in South West and North West England., Method: Semi-structured individual interviews with 13 patients and 16 general practice staff with experience of patient online access to health records., Results: Online access generated unintended consequences that negatively impacted patients' understanding of their health care, with patients finding surprising or difficult to interpret information. Online access impacted GPs' documentation practices, such as when GPs pre-emptively attempted to minimise potential misunderstandings to aid patient understanding of their health care. In other cases, this negatively impacted the quality of the records and patient safety when GPs avoided documenting speculations or concerns. Contrary to assumptions that workload would be reduced, online access introduced extra work, such as managing and monitoring access, and taking measures to prevent possible harm to patients., Conclusion: The unintended consequences described by both staff and patients show that, to achieve the intended consequences set out in NHS policy, additional work is necessary to prepare records for sharing and to prepare patients about what to expect. It is crucial that practices are adequately supported and resourced to manage the unintended consequences of online access, now that it is the default position. A table of potential unintended consequences and mitigation measures is provided to aid practice managers and clinicians implementing online access., (© The Authors.)