Narcie Kelly

Pupils' views on inclusion: moderate learning difficulties and bullying in mainstream and special schools

This study examined the views of 101 boys and girls aged 10–11 and 13–14 with statements of special educational needs for moderate learning difficulties. Questions centred on their experiences of school, teaching and learning in mainstream and special schools. The study is set in the context of the international move towards more inclusion of children with disabilities into mainstream schools and the greater importance attached to the childs voice in decision-making in education. Most children expressed positive evaluations of their schools and the teaching they received, while a significant minority expressed mixed views. A significant proportion in the mainstream preferred learning support in withdrawal settings. While the majority in both settings preferred their current school, a significant minority in special school preferred to be in a mainstream setting. A notable emergent theme from the study was the high incidence of ‘bullying’ that was experienced. Though experienced in both settings, those in...

Understanding Young People's Citizenship Learning in Everyday Life: The Role of Contexts, Relationships and Dispositions

In this article we present insights from research which has sought to deepen understanding of the ways in which young people (aged 13—21) learn democratic citizenship through their participation in a range of different formal and informal practices and communities. Based on the research, we suggest that such understanding should focus on the interplay between contexts for action, relationships within and across contexts, and the dispositions that young people bring to such contexts and relationships. In the first part of the article we show how and why we have broadened the narrow parameters of the existing citizenship discourse with its focus on political socialization to encompass a more wide-ranging conception of citizenship learning that is not just focused on school or the curriculum. In the second part of the article we describe our research and present two exemplar case studies of young people who formed part of the project. In the third part we present our insights about the nature and character of citizenship learning that we have been able to draw from our research. In the concluding section we highlight those dimensions of citizenship learning that would have remained invisible had we focused exclusively on schools and the curriculum. In this way we demonstrate the potential of the approach to understanding citizenship learning that we have adopted.

Moderate Learning Difficulties and the Future of Inclusion

1. Introduction 2. Are there children with MLD: categories, history and current issues? 3. MLD and inclusion: curriculum, teaching and inclusion issues 4. Childrens perspectives on their special provision 5. Perceptions of self and of labels 6. Social interaction, acceptance and bullying pupils with MLD 7. Survey of LEA policy and practice for moderate learning difficulties 8. The future for children with MLD: as a special educational need or not?

Supervised learning events in the Foundation Programme: a UK-wide narrative interview study

Objectives To explore Foundation trainees’ and trainers’ understandings and experiences of supervised learning events (SLEs), compared with workplace-based assessments (WPBAs), and their suggestions for developing SLEs. Design A narrative interview study based on 55 individual and 19 group interviews. Setting UK-wide study across three sites in England, Scotland and Wales. Participants Using maximum-variation sampling, 70 Foundation trainees and 40 trainers were recruited, shared their understandings and experiences of SLEs/WPBAs and made recommendations for future practice. Methods Data were analysed using thematic and discourse analysis and narrative analysis of one exemplar personal incident narrative. Results While participants volunteered understandings of SLEs as learning and assessment, they typically volunteered understandings of WPBAs as assessment. Trainers seemed more likely to describe SLEs as assessment and a ‘safety net’ to protect patients than trainees. We identified 333 personal incident narratives in our data (221 SLEs; 72 WPBAs). There was perceived variability in the conduct of SLEs/WPBAs in terms of their initiation, tools used, feedback and finalisation. Numerous factors at individual, interpersonal, cultural and technological levels were thought to facilitate/hinder learning. SLE narratives were more likely to be evaluated positively than WPBA narratives overall and by trainees specifically. Participants made sense of their experiences, emotions, identities and relationships through their narratives. They provided numerous suggestions for improving SLEs at individual, interpersonal, cultural and technological levels. Conclusions Our findings provide tentative support for the shift to formative learning with the introduction of SLEs, albeit raising concerns around trainees’ and trainers’ understandings about SLEs. We identify five key educational recommendations from our study. Additional research is now needed to explore further the complexities around SLEs within workplace learning.

Evaluating Children’s Participation in SEN Procedures: Lessons for educational psychologists

This paper reports the findings from a study of the participation of children with special educational needs (SEN) in decision‐making about their needs in a sample of mainstream schools which were self‐selected for having promising practices. The findings show promising practices in eliciting views, the importance of a school participation ethos and inconsistencies between policy and practices. The study also illustrates the complexity and challenge of consulting and sharing decision making with children and young people. The outcomes are discussed in terms of educational psychologists becoming involved in research and in supporting whole school developments of participation practices.

Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives

Objectives The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders’ views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis. Setting Four UK study sites, one in each country. Participants 185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25). Results We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and ‘sign off’ to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a ‘radical review’ of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal. Conclusions A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers’ decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical practice and professionalism domains need development, and good practice in postgraduate supervision and support must be shared.

Improving preparedness of medical students and junior doctors to manage patients with diabetes

Objective New medical graduates are the front-line staff in many hospital settings and manage patients with diabetes frequently. Prescribing is an area of concern for junior doctors, however, with insulin prescribing reported as a particular weakness. This study aimed to produce an educational intervention which aimed to improve preparedness to manage patients with diabetes and evaluate it using a mixed methods approach. Research design and methods An e-resource (http://www.diabetesscenariosforjuniordoctors.co.uk) was created to contain commonplace and authentic diabetes decision-making scenarios. –32 junior doctors (n=20) and year 5 students (n=12) in South West England worked through the scenarios while ‘thinking aloud’ and then undertook a semistructured interview. Qualitative data were transcribed verbatim and analyzed thematically. Participant confidence to manage patients with diabetes before, immediately after, and 6 weeks after the educational intervention was also measured using a self-rating scale. Results Participants reported that patients with diabetes were daunting to manage because of the wide array of insulin products, their lack of confidence with chronic disease management and the difficulty of applying theory to practice. The e-resource was described as authentic, practical, and appropriate for the target audience. Junior doctors’ self-rated confidence to manage patients with diabetes increased from 4.7 (of 10) before using the e-resource, to 6.4 immediately afterwards, and 6.8 6 weeks later. Medical students’ confidence increased from 5.1 before, to 6.4 immediately afterwards, and 6.4 6 weeks later. Conclusions Providing opportunities to work with authentic scenarios in a safe environment can help to ameliorate junior doctors’ lack of confidence to manage patients with diabetes.

New graduate doctors’ preparedness for practice: a multistakeholder, multicentre narrative study

Objective While previous studies have begun to explore newly graduated junior doctors’ preparedness for practice, findings are largely based on simplistic survey data or perceptions of newly graduated junior doctors and their clinical supervisors alone. This study explores, in a deeper manner, multiple stakeholders’ conceptualisations of what it means to be prepared for practice and their perceptions about newly graduated junior doctors’ preparedness (or unpreparedness) using innovative qualitative methods. Design A multistakeholder, multicentre qualitative study including narrative interviews and longitudinal audio diaries. Setting Four UK settings: England, Northern Ireland, Scotland and Wales. Participants Eight stakeholder groups comprising n=185 participants engaged in 101 narrative interviews (27 group and 84 individual). Twenty-six junior doctors in their first year postgraduation also provided audio diaries over a 3-month period. Results We identified 2186 narratives across all participants (506 classified as ‘prepared’, 663 as ‘unprepared’, 951 as ‘general’). Seven themes were identified; this paper focuses on two themes pertinent to our research questions: (1) explicit conceptualisations of preparedness for practice; and (2) newly graduated junior doctors’ preparedness for the General Medical Council’s (GMC) outcomes for graduates. Stakeholders’ conceptualisations of preparedness for practice included short-term (hitting the ground running) and long-term preparedness, alongside being prepared for practical and emotional aspects. Stakeholders’ perceptions of medical graduates’ preparedness for practice varied across different GMC outcomes for graduates (eg, Doctor as Scholar and Scientist, as Practitioner, as Professional) and across stakeholders (eg, newly graduated doctors sometimes perceived themselves as prepared but others did not). Conclusion Our narrative findings highlight the complexities and nuances surrounding new medical graduates’ preparedness for practice. We encourage stakeholders to develop a shared understanding (and realistic expectations) of new medical graduates’ preparedness. We invite medical school leaders to increase the proportion of time that medical students spend participating meaningfully in multiprofessional teams during workplace learning.