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Objectives: Although there is much evidence to support the use of simulation‐based education (SBE) in undergraduate education of health care professionals, less attention has been paid to how SBE, viewed as a complex intervention, is implemented and becomes embedded and sustained. This paper aims to explore factors that inhibited or promoted SBE becoming normal practice in undergraduate health care professional programmes. Methods: Participants involved in the organisation, design and delivery of SBE in the north of England were recruited purposefully from higher education institutions (HEI) and National Health Service (NHS) Trusts through local networks for qualitative telephone interviews. Transcripts were analysed inductively using a hybrid approach involving simultaneous inductive open coding and deductive coding using normalisation process theory (NPT) as a theoretical lens. Findings: A total of 12 NHS staff from 11 trusts and seven individuals from four HEIs were interviewed. There was considerable variation in the approach taken to implementation across organisations, which resulted in varying degrees of embeddedness. Implementation was challenged or enabled by organisational leadership, professional buy‐in and the development and maturity of the strategic approach. Variation in understanding of the scope and pedagogical aims of SBE led to inequity between professions and organisations in investment and participation, as well as design and delivery of SBE. Conclusions: Given the complexity of SBE, best practice in implementation should be considered fundamental to the successful delivery of SBE. The findings provide an explanation of how contextual factors can support or hinder implementation to maximise potential benefits and learning outcomes; this understanding can be used to better inform development of SBE strategies and highlight potential factors needed to navigate contextual barriers so that learning outcomes can be maximised. Although "validity" is a central concept for educators, this research outlining the conversion of outcome frameworks to assessment practice illustrates that the concept can easily get lost in translation. [ABSTRACT FROM AUTHOR]

Introduction Career choice, sense of professional identity and career behaviour are influenced, subject to change and capable of development through interaction with the learning environment. In this paper workplace learning discourses are used to frame ongoing concerns associated with higher specialist training. Data from the first stage of a multimethods investigation into recruitment into and retention in specialties in the West Midlands is used to consider some possible effects of the specialist learning environment on recruitment and retention. Methods The aim of the study was to identify issues, through interviews with 6 consultants and questionnaires completed by specialist registrars from specialties representing a range of recruitment levels. These would inform subsequent study of attributes and dispositions relevant to specialist practice and recruitment. The data were analysed using NVivo© software for qualitative data management. Results Participants' perceptions are presented as bipolar dimensions, associated with: curriculum structure, learning relationships, assessment of learning, and learning climate. They demonstrate ongoing struggle between different models of workplace learning. Conclusion Changes in the postgraduate education of doctors seem set to continue well into the future. How these are reflected in the balance between workplace learning models, and how they influence doctors' sense of identity as specialists suggests a useful basis for examination of career satisfaction and recruitment to specialties. [ABSTRACT FROM AUTHOR]

Purpose This paper reports a study which attempted to examine the influence of a varied assessment programme on student motivation to learn in an undergraduate therapy degree course. Methods In March 1997 a questionnaire was distributed to 98 third-year occupational therapy and physiotherapy students at the Southampton University School of Occupational Therapy and Physiotherapy. Using closed and open questions the questionnaire required the students to consider all the assessments they had taken in their 3 years of study and provide information about which type of assessment they found most motivating for their learning, and why. Results and conclusions The results revealed that students found a wide range of assessments motivating. There was some satisfaction with the mix and range of assessments. Three assessments emerged as the most motivating for student learning: Clinical/fieldwork II and III and Methods of inquiry III. In addition, four factors associated with assessment appeared to influence student motivation: perceived relevance and content of the assessment, enthusiastic lecturers and group influences. These factors need to be explored in more detail but in order to do so, educators need to be prepared to engage in an open dialogue with students about the learning climate that is created within higher education. [ABSTRACT FROM AUTHOR]