Siobhan Sharkey

Dr. John has gone: assessing health professionals' contribution to remote rural community sustainability in the UK

Due mainly to increasing difficulties in recruiting and retaining health professionals to work in remote and peripheral areas of Scotland, there is discussion of the need to implement new models of primary health care provision. However, innovative service models may imply a reduction in the number of health professionals who live and work in remote communities. Currently decisions about remodelling service provision are being taken by National Health Service stakeholders, apparently with little consideration of the wider social and economic impacts of change. This paper aims to argue that health professionals contribute to the fabric of rural life in a number of ways and that decisions about health service redesign need to take this into account. As well as fulfilling a wide health and social care role for patients, the authors seek to show that health professionals are important to the social sustainability of rural communities as, due to their unique position, they are often at the heart of networks within and between communities. The wider economic contribution of health services in remote communities is important, but often underplayed. The authors propose that theories of capital, principally the concept of social capital, could help in investigating the wider contribution of health professionals to their local communities. Ultimately, it is proposed that health services, as embodied in nurses, doctors and others, could be highly important to the ongoing livelihood and social infrastructure of fragile remote communities. Since this area is poorly understood, there is a need for prospective primary research and evaluation of service redesign initiatives.

A case study of transfer of learning in a family health nursing course for students in remote and rural areas

This paper describes a case study detailing one approach to tackling the problems of knowledge transfer in an undergraduate course on Research, Decision-Making and Evaluation in Family Health Nursing. Transfer is the ability to access and utilise ones intellectual resources in situations where these may be needed [Nursing Diagnosis 3(4) (1992) 148-154]. The discussion will explore the related issues of transfer of learning, casuistry, and teaching and learning on a course for experienced community practitioners. This course serves as a case example to tease out how teaching and learning can be structured to promote effective transfer of knowledge from the classroom and virtual classroom to clinical practice.

From the Beginning: Negotiation in Community Evaluation

This article focuses on negotiation and discusses its relevance for evaluators. Given the impetus for participatory evaluation, evaluators would benefit from improving skills that enable them to make collaborative decisions and work alongside stakeholders, in particular in community evaluations. Negotiation skills are explored through post hoc reflection of a Sure Start programme evaluation in a UK setting. Literature on stakeholder involvement and negotiation is discussed together with the UK evaluation. Recommendations are made on how to utilize elements of negotiation in community programme evaluation. Key skills are highlighted, including attention to: working with emotional situations, face-giving, rapport and creativity, timing, perceptions and improvisation.