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1 – 10 of 21Alina Haines, Elizabeth Perkins, Elizabeth A. Evans and Rhiannah McCabe
The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK.
Abstract
Purpose
The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK.
Design/methodology/approach
Mixed methods, including qualitative face to face interviews with professionals and service users, video observations of MDT meetings and documentary analysis. Data were collected from 142 staff and 30 service users who consented to take part in the research and analysed using the constant comparison technique of grounded theory and ethnography.
Findings
Decisions taken within MDT meetings are unequally shaped by the professional and personal values and assumptions of those involved, as well as by the power dynamics linked to the knowledge and responsibility of each member of the team. Service users’ involvement is marginalised. This is linked to a longstanding tradition of psychiatric paternalism in mental health care.
Research limitations/implications
Future research should explore the nuances of interactions between MDT professionals and service users during the meetings, the language used and the approach taken by professionals to enable/empower service user to be actively involved.
Practical implications
Clear aims, responsibilities and implementation actions are a pre-requisite to effective MDT working. There is a need to give service users greater responsibility and power regarding their care.
Originality/value
While direct (video) observations were very difficult to achieve in secure settings, they enabled unmediated access to how people conducted themselves rather than having to rely only on their subjective accounts (from the interviews).
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Eva Davidsson and Martin Stigmar
Previous research has pointed to a lack of studies concerning supervision training courses. Consequently, the literature has little to suggest, and the research field is…
Abstract
Purpose
Previous research has pointed to a lack of studies concerning supervision training courses. Consequently, the literature has little to suggest, and the research field is underexplored, so questions around the content and design of supervision training courses remain unanswered and need to be addressed systematically. The main aim of the present study is to explore and map whether shared content and design exist in supervisor training courses across different vocations.
Design/methodology/approach
A syllabus analysis is used in order to investigate characteristic features in supervisor training courses related to the professions of dentist, doctor, psychologist, police officer and teacher.
Findings
The results point to the existence of shared content in the different courses, such as an emphasis on learning and supervision theories, feedback, ethics, assessment and communication. Furthermore, the results conclude similarities in design of the courses, such as a problem-based approach, seminars, lectures and homework. Thus, there are common theoretical approaches to important supervisory competences.
Practical implications
Our results intend to offer possibilities to learn from different professions when improving supervisor training courses but may also constitute a starting point for developing a shared model of interprofessional supervisor competences. Furthermore, the results may support possible cooperation in interprofessional courses. This could include arranging interprofessional courses, where one part is shared for participants from the included professions and another part is profession-specific.
Originality/value
We seek to contribute to the research field of supervision at workplaces with knowledge and ideas about how to learn from different professions when developing and improving supervisor training courses.
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Sarah Wigham, Eileen Kaner, Jane Bourne, Kanar Ahmed and Simon Hackett
Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to…
Abstract
Purpose
Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being.
Design/methodology/approach
Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence.
Findings
A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions.
Research limitations/implications
Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate.
Practical implications
The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas.
Social implications
It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities.
Originality/value
The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.
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The purpose of this paper was to explore the development of the professional identity of South African intern psychologists during the COVID-19 pandemic. This paper – that…
Abstract
Purpose
The purpose of this paper was to explore the development of the professional identity of South African intern psychologists during the COVID-19 pandemic. This paper – that presents a historical reflection borne from a significant moment in time – aimed to capture what the authors can learn from this specific cohort of intern psychologists and their experiences of work-based learning.
Design/methodology/approach
Through the lens of the interpretative phenomenological approach, the authors analysed seven semi-structured interviews. Data analysis involved a line-by-line analysis of each individual transcript, where after a thorough, in-depth analysis was conducted across all the cases.
Findings
Against the background of the COVID-19 pandemic, the findings demonstrated the interns' initial uncertainties, severe exhaustion, perceived gaps in their training, and resilience despite unusual and difficult circumstances in their WBL internship.
Research limitations
The study was limited to seven intern psychologists in South Africa.
Practical implications
The findings suggest that support – during and after the COVID-19 pandemic – is crucial throughout the training of psychologists and means to facilitate and develop professional identity and resilience. This will provide the opportunity to safeguard emerging healthcare professionals from burnout while simultaneously advocating for supportive WBL and continual professional development spaces protecting healthcare professionals and the public.
Originality/value
With this article, we explored the impact of the COVID-19 pandemic on the professional identity development of intern psychologists (psychologists in training). The authors expand on the aforementioned original contribution, since the authors situate their research within the Global South. More specifically, the authors explored how intern psychologists' developed their professional identities against the backdrop of a largely resource-scarce context of South Africa.
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Lyn Kathryn Sonnenberg, Lesley Pritchard-Wiart and Jamiu Busari
The purpose of this study was to explore inter-professional clinicians’ perspectives on resident leadership in the context of inter-professional teams and to identify a definition…
Abstract
Purpose
The purpose of this study was to explore inter-professional clinicians’ perspectives on resident leadership in the context of inter-professional teams and to identify a definition for leadership in the clinical context. In 2015, CanMEDS changed the title of one of the core competencies from manager to leader. The shift in language was perceived by some as returning to traditional hierarchical and physician-dominant structures. The resulting uncertainty has resulted in a call to action to not only determine what physician leadership is but to also determine how to teach and assess it.
Design/methodology/approach
Focus groups and follow-up individual interviews were conducted with 23 inter-professional clinicians from three pediatric clinical service teams at a large, Canadian tertiary-level rehabilitation hospital. Qualitative thematic analysis was used to inductively analyze the data.
Findings
Data analysis resulted in one overarching theme: leadership is collaborative – and three related subthemes: leadership is shared; leadership is summative; and conceptualizations of leadership are shifting.
Research limitations/implications
Not all members of the three inter-professional teams were able to attend the focus group sessions because of scheduling conflicts. Participation of additional clinicians could have, therefore, affected the results of this study. The study was conducted locally at a single rehabilitation hospital, among Canadian pediatric clinicians, which highlights the need to explore conceptualization of leadership across different contexts.
Practical implications
There is an evident need to prepare physicians to be leaders in both their daily clinical and academic practices. Therefore, more concerted efforts are required to develop leadership skills among residents. The authors postulate that continued integration of various inter-professional disciplines during the early phases of training is essential to foster collaborative leadership and trust.
Originality/value
The results of this study suggest that inter-professional clinicians view clinical leadership as collaborative and fluid and determined by the fit between tasks and team member expertise. Mentorship is important for increasing the ability of resident physicians to develop collaborative leadership roles within teams. The authors propose a collaborative definition of clinical leadership based on the results of this study: a shared responsibility that involves facilitation of dialog; the integration of perspectives and expertise; and collaborative planning for the purpose of exceptional patient care.
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The purpose of this paper is to make the case for bringing compassion to students in educational settings, preschool through graduate school (PK-20).
Abstract
Purpose
The purpose of this paper is to make the case for bringing compassion to students in educational settings, preschool through graduate school (PK-20).
Design/methodology/approach
First, the author defines what is meant by “compassion” and differentiates it from the related constructs. Next, the author discusses the importance of bringing compassion into education, thinking specifically about preschool, K-12 (elementary and middle school/junior high/high school), college students, and graduate students (e.g. law, medical, nurses, counselors and therapists-in-training). The author then reviews the scant empirical literature on compassion in education and makes recommendations for future research. In the final section, the author makes specific and practical recommendations for the classroom (e.g. how to teach and evaluate compassion in PK-20).
Findings
While there is a fair amount of research on compassion with college students, and specifically regarding compassion for oneself, as the author reviews in this paper, the field is wide open in terms of empirical research with other students and examining other forms of compassion.
Research limitations/implications
This is not a formal review or meta-analysis.
Practical implications
This paper will be a useful resource for teachers and those interested in PK-20 education.
Social implications
This paper highlights the problems and opportunities for bringing compassion into education settings.
Originality/value
To date, no review of compassion in PK-20 exists.
Caroline Fisher, Lisa Hebel, Laura Bray and Toni D. Withiel
Background: Family violence (FV) is a significant problem that has a bidirectional link with mental health functioning. This research aimed to investigate family violence…
Abstract
Background: Family violence (FV) is a significant problem that has a bidirectional link with mental health functioning. This research aimed to investigate family violence screening and response practices in a Victorian public adult mental health service, NorthWestern Mental Health, from the consumer perspective.
Methods: A prospective, cross-sectional, electronic consumer survey was created, utilising the Royal Melbourne Hospital Patient Survey FV screening and response tool. Data were collected over a two-month time period, via iPad. Clinicians invited all consumers (age range 18 to 64 years) attending the service to participate on data collection days, unless any of the exclusion criteria were present: a) clinical interaction occurring in a non-confidential environment; b) acute distress/crisis; c) clinician concerns about affecting rapport; and d) cognitive impairment, known disability or diminished capacity preventing them from reading or understanding the survey questions. Categorical and Likert type survey responses were explored descriptively. All variables collected in the survey were provided, specifically the percentage of responses in each category for each question. Free-text responses were analysed using qualitative description of the text-box response content.
Results: 35 consumers participated. 47% reported being screened for at least one family violence issue on at least one occasion. 26% reported disclosing FV concerns. All those disclosing felt mildly or very supported by the clinician’s response, and two-thirds received assistance they found helpful. 9% reported wanting to disclose FV concerns but not feeling comfortable to do so. Consumers indicated that FV should be spoken about more, that receiving assistance is helpful, but that responses varied in quality depending on the discipline of the clinician.
Conclusion: FV screening rates were found to be suboptimal as unmet needs were identified. Further training and services changes are required to improve screening rates, increase client comfort to disclosure, and optimise the clinical response to disclosures.
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Elodie Allain, Célia Lemaire and Gulliver Lux
Within societies in the 21st century, individuals who are embedded in a controlled context that impedes their political actions deal with the tensions they are experiencing…
Abstract
Purpose
Within societies in the 21st century, individuals who are embedded in a controlled context that impedes their political actions deal with the tensions they are experiencing through attempts at resistance. Several studies that examine individual infrapolitics in organizations explain how the subtle mix of compliance and resistance are constructed at the level of individual identity in a complex mechanism that both questions the system and strengthens it. However, the interplay between managers' identities and management accounting tools in this process is a topic that deserves more investigation. The aim of this article is to understand how the subtle resistance of individuals constructs neoliberal reforms through management accounting (MA).
Design/methodology/approach
The authors conducted a case study on three health and social organizations two years after major reforms were implemented in the health and social services sector in Québec, a province of Canada. These reforms were part of a new public management dynamic and involved the implementation of accounting tools, here referred to as New Public Management Accounting (NPMA) tools.
Findings
The authors’ findings show how managers participate in reforms, at the same time as attempt to stem the dehumanization they generate. Managers engage in subtly resisting, for themselves and for their field professional teams, the dehumanization and identity destruction that arises from the reforms. NPMA tools are central to this process, since managers question the reforms through NPMA tools and use them to resist creatively. However, their subtle resistance can lead to the strengthening of the neoliberal dynamic of the reform.
Originality/value
The authors contribute to both the literature of infrapolitics and MA by showing the role of NPMA tools in the construction of subtle resistance. Their article enriches the MA literature by characterizing the subtle forms of resistance and showing how managers engage in creative resistance by using the managerial potential flexibility of NPMA tools. The article also outlines how NPMA tools play a role in the dialectic process of resistance, since they aid managers in resisting reform-induced dehumanization but also support managers in reinventing and reinforcing what they are trying to fight. The authors’ study also illustrates the dialectic dynamic of resistance through NPMA in all its dimensions: discursive, material and symbolic. Finally, the authors contribute to management accounting literature by showing that NPMA tools are not only the objects of neoliberalization but also the support of backstage resistance to neoliberalization.
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W. Marcus Lambert, Nanda Nana, Suwaiba Afonja, Ahsan Saeed, Avelino C. Amado and Linnie M. Golightly
Structural mentoring barriers are policies, practices and cultural norms that collectively disadvantage marginalized groups and perpetuate disparities in mentoring. This study…
Abstract
Purpose
Structural mentoring barriers are policies, practices and cultural norms that collectively disadvantage marginalized groups and perpetuate disparities in mentoring. This study aims to better understand structural mentoring barriers at the postdoctoral training stage, which has a direct impact on faculty diversity and national efforts to retain underrepresented groups in research careers.
Design/methodology/approach
A diverse sample of postdoctoral scholars (“postdocs”) from across the USA were asked to participate in focus groups to discuss their training experiences. The authors conducted five 90-min focus groups with 32 biomedical postdocs, including 20 (63%) women and 15 (47%) individuals from underrepresented racial/ethnic groups (URG).
Findings
A social-ecological framework was used to categorize both the upstream and downstream manifestations of structural mentoring barriers, as well as mentoring barriers, overall. Notable structural barriers included: academic politics and scientific hierarchy; inequalities resulting from mentor prestige; the (over) reliance on one mentor; the lack of formal training for academic and non-academic careers; and the lack of institutional diversity and institutional mentor training. To overcome these barriers, postdocs strongly encouraged developing a network or team of mentors and recommended institutional interventions that create more comprehensive professional development, mentorship and belonging.
Originality/value
For postdoctoral scientists, structural mentoring barriers can permeate down to institutional, interpersonal and individual levels, impeding a successful transition to an independent research career. This work provides strong evidence for promoting mentorship networks and cultivating a “mentoring milieu” that fosters a supportive community and a strong culture of mentorship at all levels.
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Jacqueline E. McLaughlin, Kathryn Morbitzer, Margaux Meilhac, Natalie Poupart, Rebekah L. Layton and Michael B. Jarstfer
While known by many names, qualifying exams function as gatekeepers to graduate student advancement to PhD candidacy, yet there has been little formal study on best qualifying…
Abstract
Purpose
While known by many names, qualifying exams function as gatekeepers to graduate student advancement to PhD candidacy, yet there has been little formal study on best qualifying exam practices particularly in biomedical and related STEM PhD programs. The purpose of this study is to examine the current state of qualifying exams through an examination of the literature and exploration of university-wide policies.
Design/methodology/approach
The authors conducted a literature review of studies on qualifying exams and completed an external evaluation of peer institutions’ and internal institutional qualifying exam requirements to inform our discussion of qualifying exams practices in PhD training at a research-intensive US institutions.
Findings
This study identified the need for more research on qualifying exams to establish evidence-based best practices. The authors found a wide variety of qualifying exam formats, with little evidence in support for specific formats. The authors also found little evidence that student expectations are made clear. The lack of evidence-based best practices coupled with insufficient clarity for students has a real potential to disadvantage PhD students, particularly first generation, underrepresented minority, international and/or other trainees who are not privileged or socialized to navigate training environments with vague landmarks such as the qualifying exams.
Originality/value
There are very few studies that evaluate qualifying exams in US doctoral education, particularly in STEM fields, and to the authors’ knowledge, there has been no analysis of campus-wide policies on qualifying exams reported. The lack of evidence for best practices and the need for to evaluate the implementation and effectiveness of qualifying exams are discussed.
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