scholarly journals Workforce Experience of the Implementation of An Advanced Clinical Practice Framework in England: A Mixed Methods Evaluation

2020 ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary

Abstract Background This study aims to understand how the implementation of the Advanced Clinical Practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The Advanced Clinical Practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey freetext were analysed using thematic analysis using NVivo 10. Results: The questionnaire received over 500 respondents (a response rate ten times that expected) and 15 interviews were carried out. Advanced Clinical Practice was considered by many the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ACP was the right job title. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing Advanced Clinical Practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employers training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework, that of Advanced Clinical Practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions: Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary

Abstract Background This study aims to understand how the implementation of the advanced clinical practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The advanced clinical practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10. Results The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced clinical practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing advanced clinical practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of advanced clinical practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.


2020 ◽  
Author(s):  
Jessica Lawler ◽  
Katrina Maclaine ◽  
Alison Leary

Abstract Background This study aims to understand how the implementation of the Advanced Clinical Practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The Advanced Clinical Practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service.Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10.Results: The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced Clinical Practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing Advanced Clinical Practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of Advanced Clinical Practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model.Conclusions: Efforts to establish further clarity and structure around advanced clinicalpractice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.


2020 ◽  
Vol 31 (1) ◽  
pp. 31-36
Author(s):  
Sarah Barea

In this quantitative study, Sarah Barea analyses the current advanced practice roles in primary care in Cornwall Aim: To analyse current primary care advanced practice roles in Cornwall, measured against Health Education England's Multi-Professional Framework for Advanced Clinical Practice. Method: A quantitative questionnaire was sent to all primary care practitioners in the county practicing with an advanced title. Findings: In total, 34 respondents (approximately 60% of those invited) took part. Practitioners have a broad spectrum of experience and education and varied scope of clinical practice. The grading of roles does not compare with educational level, experience or scope of practice. This is consistent with current literature which explores the need to regulate the role. Conclusion: If the Advanced Practice Framework is implemented as planned, then there are gaps in current practice that need to be addressed in order to ensure practitioners have the competencies to provide safe, autonomous practice.


2019 ◽  
Vol 7 (1) ◽  
pp. 9-20
Author(s):  
Inna Yeung

Choice of profession is a social phenomenon that every person has to face in life. Numerous studies convince us that not only the well-being of a person depends on the chosen work, but also his attitude to himself and life in general, therefore, the right and timely professional choice is very important. Research about factors of career self-determination of students of higher education institutions in Ukraine shows that self-determination is an important factor in the socialization of young person, and the factors that determine students' career choices become an actual problem of nowadays. The present study involved full-time and part-time students of Institute of Philology and Mass Communications of Open International University of Human Development "Ukraine" in order to examine the factors of career self-determination of students of higher education institutions (N=189). Diagnostic factors of career self-determination of students studying in the third and fourth year were carried out using the author's questionnaire. Processing of obtained data was carried out using the Excel 2010 program; factorial and comparative analysis were applied. Results of the study showed that initial stage of career self-determination falls down on the third and fourth studying year at the university, when an image of future career and career orientations begin to form. At the same time, the content of career self-determination in this period is contradictory and uncertain, therefore, the implementation of pedagogical support of this process among students is effective.


2018 ◽  
pp. 1-34
Author(s):  
Andrew Jackson

One scenario put forward by researchers, political commentators and journalists for the collapse of North Korea has been a People’s Power (or popular) rebellion. This paper analyses why no popular rebellion has occurred in the DPRK under Kim Jong Un. It challenges the assumption that popular rebellion would happen because of widespread anger caused by a greater awareness of superior economic conditions outside the DPRK. Using Jack Goldstone’s theoretical expla-nations for the outbreak of popular rebellion, and comparisons with the 1989 Romanian and 2010–11 Tunisian transitions, this paper argues that marketi-zation has led to a loosening of state ideological control and to an influx of infor-mation about conditions in the outside world. However, unlike the Tunisian transitions—in which a new information context shaped by social media, the Al-Jazeera network and an experience of protest helped create a sense of pan-Arab solidarity amongst Tunisians resisting their government—there has been no similar ideology unifying North Koreans against their regime. There is evidence of discontent in market unrest in the DPRK, although protests between 2011 and the present have mostly been in defense of the right of people to support themselves through private trade. North Koreans believe this right has been guaranteed, or at least tacitly condoned, by the Kim Jong Un government. There has not been any large-scale explosion of popular anger because the state has not attempted to crush market activities outright under Kim Jong Un. There are other reasons why no popular rebellion has occurred in the North. Unlike Tunisia, the DPRK lacks a dissident political elite capable of leading an opposition movement, and unlike Romania, the DPRK authorities have shown some flexibility in their anti-dissent strategies, taking a more tolerant approach to protests against economic issues. Reduced levels of violence during periods of unrest and an effective system of information control may have helped restrict the expansion of unrest beyond rural areas.


Author(s):  
Marisa Abrajano ◽  
Zoltan L. Hajnal

This book provides an authoritative assessment of how immigration is reshaping American politics. Using an array of data and analysis, it shows that fears about immigration fundamentally influence white Americans' core political identities, policy preferences, and electoral choices, and that these concerns are at the heart of a large-scale defection of whites from the Democratic to the Republican Party. The book demonstrates that this political backlash has disquieting implications for the future of race relations in America. White Americans' concerns about Latinos and immigration have led to support for policies that are less generous and more punitive and that conflict with the preferences of much of the immigrant population. America's growing racial and ethnic diversity is leading to a greater racial divide in politics. As whites move to the right of the political spectrum, racial and ethnic minorities generally support the left. Racial divisions in partisanship and voting, as the book indicates, now outweigh divisions by class, age, gender, and other demographic measures. The book raises critical questions and concerns about how political beliefs and future elections will change the fate of America's immigrants and minorities, and their relationship with the rest of the nation.


Author(s):  
Aysegul Altunkeser ◽  
Zeynep Ozturk Inal ◽  
Nahide Baran

Background: Shear wave electrography (SWE) is a novel non-invasive imaging technique which demonstrate tissue elasticity. Recent research evaluating the elasticity properties of normal and pathological tissues emphasize the diagnostic importance of this technique. Aims: Polycystic ovarian syndrome (PCOS), which is characterized by menstrual irregularity, hyperandrogenism, and polycystic overgrowth, may cause infertility. The aim of this study was to evaluate the elasticity of ovaries in patients with PCOS using SWE. Methods: 66 patients diagnosed with PCOS according to the Rotterdam criteria (PCOS = group I) and 72 patients with non-PCOS (Control = group II), were included in the study. Demographic and clinical characteristics of the participants were recorded. Ovarian elasticity was assessed in all patients with SWE, and speed values were obtained from the ovaries. The elasticity of the ovaries was compared between the two groups. Results: While there were statistically significant differences between the groups in body mass index (BMI), right and left ovarian volumes, luteinizing hormone and testosterone levels (p<0.05), no significant differences were found between groups I and II in the velocity (for the right ovary 3.89±1.81 vs. 2.93±0.72, p=0.301; for the left ovary 2.88±0.65 vs. 2.95±0.80, p=0.577) and elastography (for the right ovary 36.62±17.78 vs. 36.79±14.32, p=0.3952; for the left ovary 36.56±14.15 vs. 36.26±15.10, p=0.903) values, respectively. Conclusion: We could not obtain different velocity and elastography values from the ovaries of the patients with PCOS using SWE. Therefore, further large-scale studies are needed to elucidate this issue.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Young-Dan Cho ◽  
Woo-Jin Kim ◽  
Hyun-Mo Ryoo ◽  
Hong-Gee Kim ◽  
Kyoung-Hwa Kim ◽  
...  

Abstract Background The Encyclopedia of DNA Elements (ENCODE) project has advanced our knowledge of the functional elements in the genome and epigenome. The aim of this article was to provide the comprehension about current research trends from ENCODE project and establish the link between epigenetics and periodontal diseases based on epigenome studies and seek the future direction. Main body Global epigenome research projects have emphasized the importance of epigenetic research for understanding human health and disease, and current international consortia show an improved interest in the importance of oral health with systemic health. The epigenetic studies in dental field have been mainly conducted in periodontology and have focused on DNA methylation analysis. Advances in sequencing technology have broadened the target for epigenetic studies from specific genes to genome-wide analyses. Conclusions In line with global research trends, further extended and advanced epigenetic studies would provide crucial information for the realization of comprehensive dental medicine and expand the scope of ongoing large-scale research projects.


2021 ◽  
pp. 103530462110176
Author(s):  
Anna Sturman ◽  
Natasha Heenan

We introduce a themed collection of articles on approaches to configuring a Green New Deal as a response to the current capitalist crisis marked by ecological breakdown, economic stagnation and growing inequality. The Green New Deal is a contested political project, with pro-market, right-wing nationalist, Keynesian, democratic socialist and ecosocialist variants. Critiques of the Green New Deal include pragmatic queries as the feasibility of implementation, and theoretical challenges from the right regarding reliance on state forms and from the left regarding efforts to ameliorate capitalism. They also include concerns about technocratic bias and complaints about lack of meaningful consultation with Indigenous peoples on proposals for large-scale shifts in land use. Debates over the ideological orientation, political strategy and implementation of the Green New Deal must now account for the economic and employment impacts of COVID. JEL Codes: Q43, Q54, Q56, Q58


Author(s):  
Mike Armour ◽  
Debra Betts ◽  
Kate Roberts ◽  
Susanne Armour ◽  
Caroline A. Smith

Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor induction. However, it is unclear what role, if any, peer-reviewed research plays in guiding practice. Methods: Acupuncturists with a significant women’s health caseload were interviewed online in three small groups to explore factors that contribute to acupuncturists’ clinical decision made around treatment approaches and research. Results: Eleven practitioners participated in the focus groups. The overarching theme that emerged was one of ‘Not mainstream but a stream.’ This captured two themes relating to acupuncture as a distinct practice: ‘working with what you’ve got’ as well as ‘finding the right lens’, illustrating practitioners’ perception of research needing to be more relevant to clinical practice. Conclusions: Acupuncture practitioners treating women’s health conditions reported a disconnect between their clinical practice and the design of clinical trials, predominantly due to what they perceived as a lack of individualization of treatment. Case histories were popular as a learning tool and could be used to support increasing research literacy.


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