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Background: Speech and language therapy (SLT) education must meet the needs of the future workforce, training enough students who are competent practitioners able to meet the workforce demands. Increasing student numbers and the impact on placement providers mean students must be equipped for learning on placement. Simulation is a way of supporting students to develop their clinical skills and decision‐making in a safe, supportive environment. Aims: To explore the perspectives of SLT students who were introduced to simulation during their undergraduate degree at a UK university as part of a pilot study. The aim of the pilot was to listen to the students' voices to begin to understand their lived experiences of simulation and to gather views on how simulation can support their clinical learning. Methods & Procedures: Focus groups and semi‐structured interviews were carried out with second‐year BSc SLT students in semester 2 following the simulated learning activities and clinical placement. Qualitative data were gathered and thematic analysis was applied to the data to identify the barriers and enablers to students' clinical learning in simulation. Outcomes & Results: A total of 11 students responded out of a cohort of 38. Three key themes were identified from the analysis: individual learning needs, facilitator skill and programme‐level organization. Conclusions & Implications: Student experience of simulation was positive. One of the key elements students found to support their clinical skills was the importance of the safe space; support for learning instead of correction led them to engage in active learning. Key barriers to simulation related to having sufficient prior knowledge, the skills of the facilitator, group size and the wider learning landscape of the programme. In response to this pilot, there are plans to continue developing this model of simulation and embed simulation across the programme, led by a sound pedagogical approach with clear preparation and planning and building the necessary infrastructure. Other SLT programmes and practice educators developing simulation as part of their programmes or placement may wish to consider some of these findings to support the use of simulation in their workplace. What this paper adds: What is already known on this subject: Simulation as a teaching methodology is widely used in medicine and nursing programmes. It is now used in various allied health professions and in some SLT programmes. There is evidence to suggest simulation increases student confidence and clinical skills without increasing the capacity on those offering clinical placements in practice. What is already known on this subject: This study offers a practical example of introducing simulation in an established undergraduate programme for SLT students. It explains the background to this innovative way of teaching clinical skills and explains why this approach could be beneficial for the future speech and language therapist. What are the clinical implications of this work?: This study gives practical examples of how simulation can work to facilitate student clinical learning and knowledge. It may offer ideas to those working in clinical practice to organize placements differently or add simulation elements to improve the student experience. Other educational establishments and placement educators may find the recommendations helpful in developing their own simulation approach. [ABSTRACT FROM AUTHOR]

Following the Francis report into shockingly deficient standards of care at an English hospital, this paper examines UK nurse education and revisits the premises on which the professional narrative of nursing was built. The UK government's response to the report is to introduce the 'associate nurse' role, to be nationally trained to do fundamental care in place of the registered nurse, and a nursing apprenticeship scheme-on-the-job training for a nursing degree. UK nursing bodies do not address the report's recommendations in regard to registered nurse education; rather, they advocate a further perpetuation of the current system. This shows deep uncertainty about what the 'true' nurse is. To those familiar with the Nightingale model that characterised nursing in England and elsewhere for a century before the introduction of Project 2000 in 1986, there is an intriguing historical echo in the Francis report. One might wonder whether Francis is really recommending a return to a virtue-based, practice-driven, nationally standardised version of nursing education developed by Nightingale and evidenced in nursing syllabuses in England and Wales 1860-1977. This paper supports this position, and shows from a review of historical and contemporary evidence that this Nightingale model has current relevance. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

There has been little previous scholarship regarding the aims, options and impact of ethics education on residential care-givers. This manuscript details findings from a pragmatic cluster trial evaluating the impact of three different approaches to ethics education. The focus of the article is on one of the interventions, an immersive simulation experience. The simulation experience required residential care-givers to assume the profile of elderly care-recipients for a 24-hr period. The care-givers were student nurses. The project was reviewed favourably by a university ethics committee, and participants provided informed consent. Data from six postsimulation experience focus groups were analysed thematically and three themes were identified: the experience of vulnerability, dignity in care and the organisation of care. Findings suggest that the immersive simulation experience had a powerful immediate impact as participants described epiphanous insights relating to their care experiences. It is suggested that reflecting on and recording epiphanous events has the potential to sustain ethical care practices. Further research is required to evaluate the impact of different ethics education interventions in different cultural contexts. Exploration is also required regarding the meaning and significance of care epiphanies, those 'most delicate and evanescent of moments,' for the sustainability of ethical care. [ABSTRACT FROM AUTHOR]

Context Longitudinal integrated clerkships ( LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. Objectives This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Methods Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Results Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Conclusions Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context. [ABSTRACT FROM AUTHOR]

The Supervisory Relationship Questionnaire (SRQ) is one of the few theoretically sound and psychometrically valid questionnaires for measuring the SR within clinical supervision. However, its length can make it difficult to use in clinical practice and research. This study aimed to produce a shorter version of the SRQ (the Short Supervisory Relationship Questionnaire: S-SRQ) that retained its reliability and psychometric validity. The SRQ's 67 items were initially reduced using the criteria of external, internal and face validity. Two hundred and three UK trainee clinical psychologists then completed a series of online questionnaires including the S-SRQ and other clinical supervision measures. A Principal Component Analysis identified three components of the S-SRQ: 'safe base', 'reflective education' and 'structure', and an 18-item version was produced. Analyses revealed that the S-SRQ has high internal reliability, adequate test-retest reliability and good convergent, divergent and predictive validity. Participants also rated the S-SRQ as easy to use and potentially helpful for providing feedback on the SR in supervision. The S-SRQ (three subscales, 18 items) is a valid and reliable measure of the SR from the supervisee perspective. The current findings also support aspects of existing models of the SR. The S-SRQ is a promising measure for use in clinical, training and research settings. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message The Short Supervisory Relationship Questionnaire (S-SRQ) is a psychometrically reliable and valid 18-item measure of the supervisory relationship based on the SRQ., Clinically, the measure represents a quick and accessible means for supervisees to assess the quality of their supervisory relationship and discuss this with their supervisors., It can also be used in conjunction with the supervisor-completed Supervisory Relationship Measure to support a dyadic discussion about clinical supervision and the supervisory relationship. [ABSTRACT FROM AUTHOR]

Context The ability to interpret visual cues is important in many medical specialties, including surgery, in which poor outcomes are largely attributable to errors of perception rather than poor motor skills. However, we know little about how trainee surgeons learn to make judgements in the visual domain. Objectives We explored how trainees learn visual cue interpretation in the operating room. Methods A multiple case study design was used. Participants were postgraduate surgical trainees and their trainers. Data included observer field notes, and integrated video- and audio-recordings from 12 cases representing more than 11 hours of observation. A constant comparative methodology was used to identify dominant themes. Results Visual cue interpretation was a recurrent feature of trainer-trainee interactions and was achieved largely through the pedagogic mechanism of co-construction. Co-construction was a dialogic sequence between trainer and trainee in which they explored what they were looking at together to identify and name structures or pathology. Co-construction took two forms: 'guided co-construction', in which the trainer steered the trainee to see what the trainer was seeing, and 'authentic co-construction', in which neither trainer nor trainee appeared certain of what they were seeing and pieced together the information collaboratively. Whether the co-construction activity was guided or authentic appeared to be influenced by case difficulty and trainee seniority. Co-construction was shown to occur verbally, through discussion, and also through non-verbal exchanges in which gestures made with laparoscopic instruments contributed to the co-construction discourse. Conclusions In the training setting, learning visual cue interpretation occurs in part through co-construction. Co-construction is a pedagogic phenomenon that is well recognised in the context of learning to interpret verbal information. In articulating the features of co-construction in the visual domain, this work enables the development of explicit pedagogic strategies for maximising trainees' learning of visual cue interpretation. This is relevant to multiple medical specialties in which judgements must be based on visual information. [ABSTRACT FROM AUTHOR]

Context In prior research, the scores assessors assign can be biased away from the standard of preceding performances (i.e. 'contrast effects' occur). Objectives This study examines the mechanism and robustness of these findings to advance understanding of assessor cognition. We test the influence of the immediately preceding performance relative to that of a series of prior performances. Further, we examine whether assessors' narrative comments are similarly influenced by contrast effects. Methods Clinicians ( n = 61) were randomised to three groups in a blinded, Internet-based experiment. Participants viewed identical videos of good, borderline and poor performances by first-year doctors in varied orders. They provided scores and written feedback after each video. Narrative comments were blindly content-analysed to generate measures of valence and content. Variability of narrative comments and scores was compared between groups. Results Comparisons indicated contrast effects after a single performance. When a good performance was preceded by a poor performance, ratings were higher (mean 5.01, 95% confidence interval [ CI] 4.79-5.24) than when observation of the good performance was unbiased (mean 4.36, 95% CI 4.14-4.60; p < 0.05, d = 1.3). Similarly, borderline performance was rated lower when preceded by good performance (mean 2.96, 95% CI 2.56-3.37) than when viewed without preceding bias (mean 3.55, 95% CI 3.17-3.92; p < 0.05, d = 0.7). The series of ratings participants assigned suggested that the magnitude of contrast effects is determined by an averaging of recent experiences. The valence (but not content) of narrative comments showed contrast effects similar to those found in numerical scores. Conclusions These findings are consistent with research from behavioural economics and psychology that suggests judgement tends to be relative in nature. Observing that the valence of narrative comments is similarly influenced suggests these effects represent more than difficulty in translating impressions into a number. The extent to which such factors impact upon assessment in practice remains to be determined as the influence is likely to depend on context. [ABSTRACT FROM AUTHOR]

The article discusses the roles of workplace affordances, longitudinal relationships with medical facilities, and trust in medical education. It references the article "Clinical Participation of Medical Students in Three Contemporary Training Models" by S. Rashmi, L. Walters, H. Ward, R. Woodman, and D. Prideaux, which appears elsewhere in the issue. Particular focus is given to learner engagement. Other topics include longitudinal integrated clerkships (LICs) and entrustable professional activities (EPAs).