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Aims: To explore younger adults' experiences of stroke rehabilitation to inform practice, education and future health policy. Design: Qualitative analysis of digital and other media sources on public platforms. Methods: Between March and June 2020, the experiences of younger adult stroke survivors aged 18 to 45 at the time of the stroke were collected. Data were gathered from publicly available sources, including social media, and from English-speaking users. In total, 117 accounts from 103 participants were identified from films, autobiographical books, blogs, websites, videos, Twitter and Instagram. Data analysis followed narrative and multimodal analysis with a focus on rehabilitation needs. Results: Younger adult stroke survivors make sense of their experience by reflecting on how stroke has impacted their lives. Accounts reflected an emotional journey between the past self, the present self and evolving self, as well as associated challenges such as the impact on relationships and careers. The majority of accounts presented transitions as problematic, including the receipt of the initial diagnosis, or sometimes misdiagnosis, to returning home and achieving long-term rehabilitation goals. Specialist stroke nurses were considered essential in the rehabilitation process. Conclusion: A complex process of recovery follows stroke for younger adult stroke populations. Challenges to the rehabilitation process need to be better understood and the role of nursing highlighted in future service provision. A series of age-related challenges were highlighted that require attention to improve the care and support offered. Impact: This article informs clinicians, educators, and policymakers of the age-related needs of young adult stroke survivors. Focusing on the individual and the development of age-appropriate person-centred stroke care is important. The study highlights the role of stroke nursing and challenges the current policy focus on older stroke populations as well as arguing for greater awareness of age-appropriate stroke rehabilitation in younger adults following stroke.

Data walls are a data use practice increasingly being adopted in western, Anglophone countries to display student academic achievement data. The purpose of data walls is to improve teaching and learning by helping teachers and/or students to identify patterns of growth and achievement, set goals, and plan instructional interventions or self-regulate. This paper presents a systematic review of 30 empirical studies to explore how data wall use affectively impacts students and teachers, as well as related effects on their privacy and motivation. The review found that data wall displays elicited a range of positive and negative emotional responses, depending on variables such as the display’s location, contents, and associated social practices. Data walls were reported as enhancing motivation by helping stakeholders to sustain focus on and track progress towards goals, or by fostering comparison and competition. Data walls where class and/or individual students’ data could be identified, for example, through names, pictures, or small sample size, also generated concerns around privacy. These issues highlight the need to consider how data wall use aligns not only with relevant legislation, but also community expectations.

© Crown copyright 2013. Contains public sector information licensed under the Open Government Licence v3.0© Queen’s Printer and Controller of HMSO 2019. This work was produced by Harriset al.under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.20132019Crown copyrightQueen’s Printer and Controller of HMSOBackgroundThe government response to the care failures at the Mid Staffordshire NHS Foundation Trust led to the policy imperative of ‘regular interaction and engagement between nurses and patients’ (Francis R.Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery Office; 2013. © Crown copyright 2013. Contains public sector information licensed under the Open Government Licence v3.0) in the NHS. The pressure on nursing to act resulted in the introduction of the US model, known as ‘intentional rounding’, into nursing practice. This is a timed, planned intervention that sets out to address fundamental elements of nursing care by means of a regular bedside ward round.ObjectivesThe study aims were to examine what it is about intentional rounding in hospital wards that works, for whom and in what circumstances.DesignA multimethod study design was undertaken using realist evaluation methodology. The study was conducted in four phases: (1) theory development; (2) a national survey of all NHS acute trusts in England; (3) in-depth case studies of six wards, involving individual interviews, observations, retrieval of routinely collected ward outcome data and analysis of costs; and (4) synthesis of the study findings.SettingThe study was conducted in acute NHS trusts in England.ParticipantsA total of 108 acute NHS trusts participated in the survey. Seventeen senior managers, 33 front-line nurses, 28 non-nursing professionals, 34 patients and 28 carers participated in individual interviews. Thirty-nine members of nursing staff were shadowed during their delivery of intentional rounding and the direct care received by 28 patients was observed.Review methodsA realist synthesis was undertaken to identify eight context–mechanism–outcome configurations, which were tested and refined using evidence collected in subsequent research phases.ResultsThe national survey showed that 97% of NHS trusts had implemented intentional rounding in some way. Data synthesis from survey, observation and interview findings showed that only two of the original eight mechanisms were partially activated (consistency and comprehensiveness, and accountability). The evidence for two mechanisms was inconclusive (visibility of nurses and anticipation); there was minimal evidence for one mechanism (multidisciplinary teamwork and communication) and no evidence for the remaining three (allocated time to care, nurse–patient relationships and communication, and patient empowerment). A total of 240 intentional rounds were observed within 188 hours of care delivery observation. Although 86% of all intentional rounding interactions were observed to be documented, fidelity to the original intervention [i.e. the Studer Group protocol (Studer Group.Best Practices: Sacred Heart Hospital, Pensacola, Florida. Hourly Rounding Supplement. Gulf Breeze, FL: Studer Group; 2007)] was generally low.LimitationsIntentional rounding was often difficult for researchers to observe, as it was rarely delivered as a discrete activity but instead undertaken alongside other nursing activities. Furthermore, a lack of findings about the influence of intentional rounding on patient outcomes in the safety thermometer data limits inferences on how mechanisms link to clinical outcomes for patients.ConclusionsThe evidence from this study demonstrates that the effectiveness of intentional rounding, as currently implemented and adapted in England, is very weak and falls short of the theoretically informed mechanisms. There was ambivalence and concern expressed that intentional rounding oversimplifies nursing, privileges a transactional and prescriptive approach over relational nursing care, and prioritises accountability and risk management above individual responsive care.Future workIt is suggested that the insights and messages from this study inform a national conversation about whether or not intentional rounding is the optimum intervention to support the delivery of fundamental nursing care to patients, or if the time is right to shape alternative solutions.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

This paper examined Australian distance education teachers’ perspectives about how they drew on technological tools to support their primary and secondary students’ learning. Via two focus groups (n = 9, n = 7), teachers identified that technology greatly assisted them in relation to developing relationships with students and families, creating interactive lessons, differentiating learning, providing quality feedback, and connecting peers. However, they also reported experiencing ongoing challenges and constraints related to gaining technology expertise, overcoming technology faults, and coping with additional accountability. Data made it clear that teacher use of technology was driven by specific student needs and that teachers drew heavily on both core pedagogical knowledge and technological pedagogical content knowledge. Findings suggest the need for more distance education specific professional development to ensure that teachers have the knowledges needed to support diverse learners in this context.

Data walls, used to display student data within schools, are a growing phenomenon internationally. Drawing on a conceptual model of data use, this systematic review examined 32 empirical sources from compulsory education settings to evaluate claims about the impact of data walls on teaching and learning. The review found details regarding goals for data walls and the displayed information, but there was limited evidence of how data analysis was used to guide improvement action and evaluation of impact. The review concluded that there is currently insufficient empirical research evidence to substantiate or refute claims about their educational effects.

Background Compassion is integral to professional nursing practice worldwide and a fundamental value in healthcare. Following serious care failures at a healthcare provider in the United Kingdom, a government commissioned report (the Francis Report) made several recommendations for strengthening compassion in nursing care and consequently ‘intentional rounding’ was incorporated into nursing practice in the United Kingdom. Intentional rounding is a structured process implemented primarily in the United Kingdom, North America and Australia, whereby nurses conduct 1–2 hourly checks on every patient using a standardised protocol and documentation. Objectives To examine the role of intentional rounding in the delivery of compassionate nursing care in England from multiple perspectives. Methods This paper reports qualitative findings from one phase of a realist evaluation of intentional rounding which used a mixed-methods approach. Individual, semi-structured interviews were undertaken with 33 nursing staff, 17 senior nurse managers, 34 patients and 28 family carers from three geographically spread case study hospital sites in England. Interviews elicited detailed reflections on the contexts, mechanisms and outcomes of intentional rounding and how it impacted the interviewee and those around them. Results This study found little evidence that intentional rounding ensures the comfort, safety or dignity of patients or increases the delivery of compassionate care. The systematised approach of intentional rounding emphasises transactional care delivery in the utilisation of prescribed methods of recording or tick boxes rather than relational, individualised patient care. It has the potential to reduce the scope of nursing care to a minimum standard, leading to a focus on the fundamentals as well as the prevention of adverse events. Its documentation is primarily valued by nursing staff as a means of protecting themselves through written proof or ‘evidence’ of care delivered, rather than as a means of increasing compassionate care. Conclusions This large-scale, theoretically-driven study of intentional rounding – the first of its kind – demonstrates that intentional rounding prioritises data collection through tick boxes or a prescriptive and structured recording of care. Thus, intentional rounding neither improves the delivery of compassionate nursing care nor addresses the policy imperative it was intended to target. This study raises questions about the role, contribution and outcomes from intentional rounding and suggests a need for a wider, international debate within the nursing profession about its future use. If an intervention to increase compassionate nursing care is required, it may be better to start afresh, rather than attempting to adapt the system currently implemented.

Background Clinically assisted hydration (CAH) at end of life is a contentious issue (Cabanero-Martinez et al, 2016) There is disagreement as to its benefits and this can lead to a lack of concordance between medical and nursing opinions, with nurses feeling unable to challenge doctors (Churchman, 2010; Van Der Riet, 2008; Mayashita, 2007). Prior to introducing a feasibility study on CAH (Davies, 2018) on one hospice site, an unpublished survey of nursing staff revealed widespread dissatisfaction with the standard practice of not routinely offering CAH. Following completion of the study a staff survey was undertaken to see if attitudes had changed. Aims To determine if nurses feel coerced into accepting the current hospice policy on CAH. To examine how nurses interacted with families when asked about CAH. To explore staff engagement with research on CAH. Method A semi-structured questionnaire sent to all nursing staff including HCA’s, with closed and open-ended questions. The responses were analysed using descriptive statistics and thematic analysis. Results The responses indicated that; The majority accept standard care without feeling coerced (68%). Nurses felt they could challenge accepted practice (62%). An overwhelming majority felt the hospice should be engaged in research on CAH (80%). Nursing staff expressed the following; Nurses wanted to be more involved in decision making around CAH. Many felt that a standard practice should be replaced with individual patient decisions. Staff were frequently asked about CAH and felt able to discuss the risks and benefits with families. Conclusions Overall, nurses accepted hospice standard practice on CAH and did not feel coerced. A few opposed further research, most welcomed it to establish an evidence base.

Learning professional skills through exposure to real-world contexts demands sophisticated assessment practices. However, complex and often novel genres can be daunting for undergraduate students. This study examined student perspectives as they engaged in Portfolio assessment for the first time within a core undergraduate engineering unit. 42 students were surveyed (27%) with 11 participating in a follow-up telephone interview. Students rated content derived from their contributions to team projects as the most valuable component of their portfolio in terms of demonstrating the unit learning outcomes and developing the skills and dispositions needed in professional practice. The team structure of many learning opportunities encouraged students to collaborate and to draw on each other as instructional resources. The data indicated it is highly worthwhile for instructors to develop static resources that reduce students' need to contact instructors with trivial questions, though lecturer contact was deemed essential and effective for comprehending more complex tasks.

While online courses provide opportunities for a range of assessment tools and resources, little is known about how lecturers might best provide assessment cues to support diverse cohorts. This study explored how lecturers communicate messages about assessment expectations to first-year students in two courses at an Australian regional university (Nursing, n = 323; Engineering, n = 153), and how students accessed the assessment resources. A comparative case study methodology was used. Data included interviews with course coordinators to identify the assessment cues provided, course online content related to assessment and data recording student access of assessment resources. Diverse messaging systems were observed and verbal and written cues were abundant and embedded throughout both courses; however, not all students accessed all cues. What remains unclear is how students might bring together these cues in a productive way. Further research must explore the extent to which students can be better supported to improve their learning.

This paper explores the acceptance of a “silent period” as a stage in second language development for children acquiring English as an Additional Language in Early Years settings. Current views suggest that it is normal for children to very quickly stop using their mother tongue and enter a period of silence. A positive perspective on this is that children may be using this time to observe and grow in understanding of the second language. However, there may also be negative effects, as children may become withdrawn and miss out on opportunities to develop relationships and language. It is the argument of this paper that if this silent period is normalised, there is potential for ambivalence around the well-being of the child which may run counter to best Early Years practice. This study consisted of a qualitative content analysis which drew on twenty case studies collected by Early Years Educators documenting children’s progress over the initial weeks and months in Early Years settings. The main findings were that some children did indeed enter a silent period and shyness was a risk factor for this being prolonged. Non-verbal communication was used positively by some children to develop relationships with other children, but negatively by others, in the form of aggression and frustration, until they developed enough language to communicate. The children who did best continued to use their home language and non-verbal communication which enabled them to form relationships. Over time this became a bridge into the second language. Strategies used by educators included supporting children in small groups and bringing the home language into the setting in keeping with recommendations of policy documents in Ireland. Ultimately, this paper argues that the normalisation of a silent period may infringe on children’s rights to be active participants in their own learning. Moreover, it may limit the extent to which they are meaningfully valued, respected, empowered, cared for and included in Early Years settings.

Peer- and self-assessment (PASA) can lead to increased student self-regulation and achievement. However, few studies have examined the content of the feedback students in primary and secondary schools provide themselves and their peers. This study used Hattie and Timperley’s task, process, self-regulation and self feedback categories from their Review of Educational Research article ‘The power of feedback’ to (1) examine the content of a sample of naturally occurring student-written PASA comments (n = 471 utterances) and (2) explore the feasibility of using this model with student-generated feedback. Students provided primarily task feedback to both themselves and their peers, with self-regulation feedback only found in self-assessment. Students in higher grades tended to provide more task and process feedback, while giving less self feedback during self-assessment and more during peer assessment. More refinement of the model is recommended for both research and professional development purposes to better capture the quality and complexity of student-led feedback comments.

While feedback is a key factor for improving student learning, little is known about how students understand and experience feedback within the classroom. This study analysed 193 New Zealand primary and secondary students’ survey responses alongside drawings of their understandings and experiences of feedback to examine how they experience, understand, and respond to feedback. It found that despite New Zealand’s strong commitment to student-centred Assessment for Learning practices, the majority of students still drew, selected, and endorsed teacher-led feedback practices, with pictures dominated by written comments or grades. However, they generally depicted and described this feedback as positive and constructive, suggesting that negative emotional responses to evaluative comments and grades may be lessened if students perceive such feedback will help them improve.

Peer- and self-assessment (PASA) are student-led assessment practices with the potential to positively affect achievement. Case studies of three New Zealand classrooms were examined to explore teacher and student perspectives of and purposes for PASA. Four themes (i.e., improvement, accountability, social interaction, and accuracy) were identified. Teachers cited mainly improvement purposes for PASA, with students primarily focused on accuracy and social interaction concerns. Data indicated that these teachers and students needed deeper understanding of how to use PASA for improvement and self-regulation purposes. This suggests teachers must provide concrete instruction in PASA and carefully manage interpersonal issues for successful implementation.

Teachers’ understandings of feedback probably influence the type and quality of feedback that they provide. The beliefs of 518 New Zealand practicing teachers about feedback were evaluated with the Teachers’ Conceptions of Feedback (TCoF) inventory and related to practices these teachers considered to be feedback. Nine feedback factors and four practices factors were found and models were statistically invariant between primary and secondary teachers. New Zealand teachers’ understandings of feedback were strongly focused on improving learning instead of enhancing student well-being. Similar factors are expected in other contexts, though agreement rates should reflect local policy priorities and cultural values.

Within the Asia-Pacific community, the New Zealand Ministry of Education has been one of few educational authorities to adopt an Assessment for Learning (AfL) framework and actively promote formative uses of assessment. This paper reports the results of a qualitative study in which eleven New Zealand secondary teachers in two focus groups discussed their conceptions of assessment and feedback. These data were examined to see how teachers defined and understood assessment and feedback processes to identify how these conceptions related to AfL perspectives on assessment. Categorical analysis of these data found teachers identified three types of assessment (formative, classroom teacher–controlled summative and external summative) with three distinct purposes (improvement, reporting and compliance, irrelevance). Feedback was seen as being about learning, grades and marks, or behaviour and effort; these types served the same purposes as assessment with the addition of an encouragement purpose. This study showed that although these New Zealand teachers appeared committed to AfL, there was still disagreement amongst teachers as to what practices could be deemed formative and how to best implement these types of assessment. Additionally, even in this relatively low-stakes environment, they noted tension between improvement and accountability purposes for assessment.

Teacher actions can influence how students engage at school, making it relevant to understand their conceptions of student engagement and how to facilitate it. Reviews of existing literature suggested that a distinction between engagement in schooling and engagement in learning might help differentiate between social and academic outcomes. Data from a phenomenographic study of 20 Australian teachers were analysed to show how teacher thinking related to this distinction. While some teachers held complex conceptions centred on promoting cognitive engagement and student learning, others aligned with engagement in schooling, focusing on generating participation and emphasising positive student affective experiences.

Phenomenographers have developed two frameworks to enhance the study of conceptions. The first framework creates a distinction between what and how aspects; the second level of this framework also includes the act, direct object, and indirect object. This framework allows the conception to be analysed separately from the actions and intentions related to it. The second framework creates a distinction between referential and structural aspects which allows the parts and contexts of the conception to be identified; its second level includes the internal and external horizons. This article traces the origins of these frameworks and reviews 56 studies that have utilised them, examining similarities and differences in their usage. The review found heterogeneous definitions and usages of these frameworks, often with weak links to theory. It concluded by evaluating the utility of these frameworks, identifying that while they may not be strongly grounded in theory, when clearly defined, they can provide a method to ‘think apart’ important distinctions within conceptions.

Across Australia, recent policy initiatives have focused on student engagement in school and in learning. Although teachers play a significant role in the implementation of these policy reforms, little research has looked at student engagement from teachers’ perspectives or sought to identify and understand the strategies teachers report using to promote engagement in their classrooms. The study reported in this paper utilised a phenomenographic approach to investigate teacher conceptions of how to facilitate student engagement. Semi‐structured interviews were used to gather data and a phenomenographic process of analysis was employed to identify qualitative differences between participant understandings. The data from this qualitative study indicated that teachers hold diverse understandings about how to facilitate student engagement; three categories described teachers’ ways of engaging students. In the first category, teachers conceptualised delivering set activities and discipline to students to promo...

Teachers’ conceptions of assessment are important as they shape their usage of assessment practices. This study used a phenomenographic approach to examine the various purposes a sample of 26 New Z...

This study utilised role theory to investigate teacher aide roles within regional schools in Queensland, Australia. Twenty primary schoolteacher aides were interviewed; data were triangulated with 27 teacher aides' responses to a follow-up questionnaire and interviews with 6 administrative staff. Data suggest that classroom instructional support roles and small group instruction dominate teacher aide work; they also perform many non-instructional roles and work individually with students with diverse needs. School leaders must reconsider the roles expected of these professionals given their position, professional training and remuneration, better supporting teacher aides through improved communication, collaboration and sustained professional learning opportunities.

While creativity can be present with other aspects that constitute giftedness, it can also emerge as a distinct, separate strength that overshadows the presence of other areas. The creatively gifted child is often a divergent, lateral thinker in a convergent, sequentially ordered world.

While teacher aides often provide individual and group reading instruction for at-risk readers, research suggests these interventions may not always bring about reading gains. This Australian study investigated upper primary school teacher aides’ definitions of reading, drawing on semi-structured interview responses and written definitions examined via categorical analysis. The analysis identified six categories classifying participant understandings: Translating, Making sense, Contextualising meaning, Generating an affective response, Using texts for practical purposes, and Growing as a person, with Making sense the most prevalent actual definition. Definitions did not include critical understandings of reading or digital reading practices. The study identifies that teacher aides require better conceptual understandings of reading, especially within upper primary or secondary contexts. However, if teacher aides are expected to obtain further educational credentials or professional learning, careful consideration is also needed about how these increased expectations should impact teacher aide status, working conditions, and remuneration in schools.

The scene was from an unusual project for severely disadvantaged gifted children during 1985 and 1986 that made a difference, brought about change, and had longterm results. This chapter describes the field-based ethnographic research, the teacher training component, and the identification methods that preceded the curriculum project design and implementation.

Gifted children often demonstrate advanced ability in language arts early (Clark, 1992; Sousa, 2009), comprehend verbal implications, utilize sophisticated language and linguistic subtleties such as intonation, are able to argue convincingly, and develop writing, reading, and spelling skills rapidly (Stage & Wagner, 1992).

This chapter is directed to development of programs for students who demonstrate unusual gifts and talents in specific areas. Gifted children with special talents are as different from other gifted children as are gifted from average children. According to Osborn (1996), the intellectually gifted can be defined as those within an IQ range of 120 to 160+, with the range from mildly gifted to exceptionally gifted.

Formative assessment policies and self-regulation theories argue that student selfassessment of their own work and processes are useful for raising academic performance and self-regulatory skills. However, research into student self-evaluation raises serious doubts about the quality of self-assessment as an assessment process and identifies conditions which must be met if students’ judgments are to be useful, valid, and reliable. This paper recommends that student self-assessment should no longer be treated as an assessment, but instead as an essential competence for self-regulation. As such, we describe a potential curriculum approach that could guide teachers to appropriate use of self-assessment tools.

Originally published in 1991 as part of the Tavistock Classics in the History of Psychiatry series, this re-edition of J-M. Charcot’s Clinical Lectures on Diseases of the Nervous System provides a unique opportunity to examine the work of one of the last century’s most controversial and admired physicians. Widely esteemed for his work in neuropathology, Charcot was also an innovator in the study of hysteria, making important contributions to its study in both women and men. The Clinical Lectures reproduced here are especially important for two key reasons. First, they provide insight into Charcot’s often neglected study of male hysteria, especially traumatic shock, as well as, hysteria among children. Secondly, they give an opportunity to examine his clinical method and style. His presentations and scholarly compilations greatly influenced an entire generation of French and other physicians interested in the study of the ‘unconscious’ during the turn of the century. The introduction, which precedes the work, places the volume in its social, political and historical context. It highlights the key features of the historiographical debate surrounding Charcot, which ranges in scope from the social and intellectual history of the Third Republic through that of early psychoanalysis. It then proceeds with an examination of the key themes – both substantive and methodological – underlying Charcot’s researches, providing both a general entree into the history of medicine and society in this period, as well as an explication du texte which carefully analyses the lectures themselves.

A series of televised public service announcements (PSAs) about acquired immune deficiency syndrome (AIDS) was evaluated with 100 black participants attending a Sexually Transmitted Diseases Clinic in Atlanta, Georgia. Since the literacy level of the participants was suspected to be low, questions were administered orally and an electronic data collection technique was used which permitted the participants to push buttons, as opposed to speaking or writing responses. In this way, data were collected regarding: (i) the participants’ demographics; (ii) their self‐perceived AIDS knowledge and awareness; and (iii) their second‐by‐second continuous responses to the video presentation. Participants who perceived themselves to be at high risk of contracting human immunodeficiency virus (HIV) infection gave more positive continuous responses to the PSA sequence than did self‐perceived low‐risk participants. Men gave more approving responses than women. The results were considered in relation to previous ...

There has been substantial research on children's empathic responsiveness towards distressed people, and on the limited responsiveness of children with autism. To date, however, there have not been experimental studies to test how far children show concern towards someone who might be expected to feel badly, when that person has not (yet) expressed any negative feelings. We tested matched groups of children with autism and learning disability, and typically developing children of similar verbal mental age (approximately 6 years), with a novel procedure in which participants witnessed one person (E1) tearing the drawing of another (E2). In a comparison condition, a blank card was torn. In the torn-drawing condition, as predicted, fewer participants with autism orientated towards E2 with an immediate look, and as a group, they were rated as showing less concern for, and fewer concerned looks towards, E2. We discuss possible implications for theoretical perspectives on the early development of empathy in typically as well as atypically developing children.