Roger Murphy

Developing alternative frameworks for exploring intercultural learning: a critique of Hofstede's cultural difference model

Hofstedes model of cultural difference has been used widely for exploring aspects of culture in educational settings. In this paper, we review Hofstedes model and explore some of its limitations, particularly in relation to the field of higher education. These limitations include an oversimplification of cultural differences, inconsistencies between his categories, lack of empirical evidence from educational settings and overall a model of culture as static (instead of dynamic). We argue that educationalists interested in the field of students’ experiences in internationally diverse settings ought to treat Hofstedes model more critically. Other models are recommended that take into account flexible notions of culture, based on research evidence from a range of educational settings, which can be critically and explicitly examined against different educational theories.

Professional tears: developing emotional intelligence around death and dying in emergency work

AIMS AND OBJECTIVES This paper explores how emergency nurses manage the emotional impact of death and dying in emergency work and presents a model for developing expertise in end-of-life care delivery. BACKGROUND Care of the dying, the deceased and the bereaved is largely conducted by nurses and nowhere is this more demanding than at the front door of the hospital, the Emergency Department. Whilst some nurses find end-of-life care a rewarding aspect of their role, others avoid opportunities to develop a relationship with the dying and bereaved because of the intense and exhausting nature of the associated emotional labour. DESIGN Qualitative study using unstructured observations of practice and semistructured interviews. METHODS Observation was conducted in a large Emergency Department over 12 months. We also conducted 28 in-depth interviews with emergency staff, patients with terminal illnesses and their relatives. RESULTS Emergency nurses develop expertise in end-of-life care giving by progressing through three stages of development: (1) investment of the self in the nurse-patient relationship, (2) management of emotional labour and (3) development of emotional intelligence. Barriers that prevent the transition to expertise contribute to occupational stress and can lead to burnout and withdrawal from practice. CONCLUSIONS Despite the emotional impact of emergency deaths, nurses who invest their therapeutic self into the nurse-patient relationship are able to manage the emotional labour of caring for the dying and their relatives through the development of emotional intelligence. They find reward in end-of-life care that ultimately creates a more positive experience for patients and their relatives. RELEVANCE TO CLINICAL PRACTICE The emergency nurse caring for the dying patient is placed in a unique and privileged position to make a considerable impact on the care of the patient and the experience for their family. This model can build awareness in managing the emotive aspects involved in care delivery and develop fundamental skills of nursing patients near the end of life.

Towards an integrated model of competence in midwifery

Currently in the UK, there is no consensus as to what constitutes an adequate definition of a competent midwife. Yet, given the rapidly changing midwifery needs of childbearing women and society, such clarification has never been more important. In this paper some concepts of competence taken from a review of midwifery, nursing, educational and industrial literature are reviewed, and it is hoped that discussion leading to conceptualisation of an integrated model of competence in midwifery will be stimulated. Questions raised include--What is it that makes midwives competent? Can competence be inferred from performance? How can capability be recognised? Can competence be broken into elements for assessment without losing meaning?

Trajectories of End-of-Life Care in the Emergency Department

STUDY OBJECTIVE The emergency department (ED) is the gateway to the hospital setting. Despite the intentions from the end-of-life care strategy in the UK to improve care provision, the ED has increasingly become the access site for end-of-life support. Little attention has been given to this aspect of the work of the ED, even as the quality of end-of-life care in hospitals has become the subject of increasing concerns. We explore end-of-life care in the ED and provide an understanding of how care is delivered to the dying, deceased and bereaved in the emergency setting. METHODS Observation was carried out in a large urban ED during 12 months. This was complemented by detailed interviews with emergency staff, patients diagnosed with a terminal condition, who had visited the ED in the previous 6 months, and their relatives. Data were analyzed thematically, following the normal conventions of ethnographic research. RESULTS Two distinct trajectories of end-of-life care were identified in the ED; the spectacular and the subtacular. Patients and family members experiencing end-of-life care in the ED have distinctly different care because of the nature of these 2 trajectories, frequently resulting in dissatisfaction for staff and distress and frustration for patients and their relatives. CONCLUSION The ED is priority driven, focused on resuscitation and the prolongation of life. As a result of the consuming nature of the spectacular death, a reluctance to build relationships with the dying, and a lack of educational support, the care needs of patients in the subtacular trajectory are somewhat neglected. These trajectories can be used to identify the shortfalls in end-of-life care in the ED and raise serious concerns for policy in regard to staffing, resources, and professional development.

Could do better? Media depictions of UK educational assessment results

The publication of A‐level examination results in England, Wales and Northern Ireland has become one of the major diary items in the news media’s calendar. This paper is based, in part, upon the findings of an inter‐disciplinary study funded by the Economic and Social Research Council (ESRC). It explores two key questions about the relationship between the education sector and news media in the UK. Firstly, it asks why educationalists appear to have become pessimistic about the possibilities for raising the quality of media debate about education. Secondly, it takes the example of the annual coverage of A‐level results, in order to discuss why education news coverage tends to adhere to templates that many educationalists criticize as producing ritualistic and polarized coverage. The paper concludes by exploring some suggestions for those who are seeking ways to influence the quality of education news coverage.

Feelings and Failing in Professional Training: the assessor's dilemma

Abstract Assessing individuals as failures in education and training is rarely something that is done lightly or without misgivings. Related to this, the challenges of setting clear threshold or passing standards, are considerable. Assessors’ affective responses during fail scenarios in professional training were explored during focused interviews with 30 academic and practice staff. The pattern of feelings reported at each stage of the decision‐making process, factors which influence judgements and the reactions of others are described. The strength and spread of feelings stand out as an important sources of evidence. Understanding more about these affective responses may assist assessors as they make critical judgements at the margins of professional competence.

New directions in school leadership

Different approaches to conducting and theorising school leadership have become a major preoccupation within school systems throughout the world. This reflects the importance placed upon school-level education and the belief that leadership issues can play a big part in increasing the effectiveness of pupils learning. This paper re-visits some findings from an earlier review and examines them in the light of more recent research both within education and from other fields, where leadership models have come under close scrutiny. The paper will argue that much is to be gained from sharing insights into leadership across different areas of professional activity and illustrate some of the benefits of such an approach.

Medical Education in Iran: An Exploration of Some Curriculum Issues

Abstract Background: Although Iran is a large and populous country, the state of medical education is poorly understood and under researched. However, it is apparent that, in recent years, calls for reform in medical education have not tended to lead to major changes. As a result, the curricula used are in danger of being perceived as dated and less effective than they should be. Purpose: This exploratory study is designed to investigate the perspectives and experiences of a group of the most influential medical education course planners in Iran. Its aim is to investigate their views about the nature of the undergraduate medical curriculum in Iran and explore with them ways in which such curricula could be modernized and improved. Methods: In-depth, semi-structured interviews were used to explore the perceptions of an elite group of medical education course planners who all work in prestigious universities in Tehran. Each of these 10 individuals was interviewed twice, over a period of several months, in order that an in-depth view of their perceptions could be unraveled. Results: A deep concern about the lack of an innovative medical education curriculum in Iran emerged as the strongest theme from the interviews. There is widespread agreement that the current curriculum is too oriented towards the students passively learning facts. There is also a perceived lack of integration between the two-year basic science courses and clinical learning. Furthermore, participants feel that poor teaching facilities and overcrowding of students has provided an unsuitable learning environment. Both positive and negative attitudes toward educational strategies in curriculum development were demonstrated. Some of the barriers to curriculum change were also discussed. Conclusions: There is a real need for major changes in the medical education curriculum in Iran. The results of this study suggest that a move towards a curriculum that engages students as active participants in a process of lifelong learning would be highly beneficial. As clinically qualified doctors they will face many challenges in the years ahead, and a modernized curriculum should help them to acquire the necessary knowledge and develop the clinical skills and problem solving abilities they will need.

Educating Doctors About Breaking Bad News: An Iranian Perspective

Background. The breaking of bad news is a frequent and well recognized task that is performed by a variety of health professionals including medical doctors. In this article, we explore both how this topic is dealt with in medical education in Iran and also consider how this aspect of the curriculum might be enriched in the future. Methods. This article is based on research, which was undertaken using a purposively selected sample of medical course planners in Iran. Semistructured interviews were conducted with each of 10 carefully selected participants. Their interview responses were analyzed in such a way as to provide an in-depth exploration and interpretation of both their perceptions and experiences in relation to this sensitive and highly important topic. Results. Four major themes emerged from the analysis of the interview transcripts: medical paternalism, religion, training issues, and professional barriers. Conclusions. On the basis of this analysis, there appears to be an urgent need for integrating more emphasis on techniques for breaking bad news into the Iranian medical education curriculum. This curriculum could in the future place more emphasis on addressing specific religious issues, which are unique to the local culture. A number of other specific recommendations are formulated and discussed.

Teachers’ assessments of students’ learning of mathematics

This paper reports a study of the classroom assessment practices of 12 sixth form college mathematics teachers in Malta. It explores the extent to which these teachers are knowledgeable about their students’ learning of mathematics and the implications that this has for their classroom practices. It reveals that these teachers’ knowledge of their students’ understanding of certain mathematical concepts is fairly limited. It then goes on to discuss this phenomenon in terms of a process that can hinder rather than promote learning. The research illuminates the position of teachers who appear to lack certain detailed information about their students which, it can be argued, could inform more effective teaching strategies. The paper concludes by exploring possible implications for similar situations where learning could be enhanced by more effective classroom assessment strategies and their use to inform future teaching and learning activities.