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Background Study: As interest in programming education continues to grow, more educators are incorporating programming into K‐12 classrooms. There is evidence that programming can help develop essential skills for future societal advancement, known as 21st century skills. However, there has been limited research into which sub‐skills of 21st century skills are fostered through programming and the effect sizes thereof. Objective: This study presented a meta‐analysis to comprehensively understand the influence of programming instruction in K‐12 classrooms on the development of students' 21st century skills in different dimensions of sub‐skills. And further analysed the impact of key elements of programming instruction design on its effectiveness. Methods: A comprehensive meta‐analysis was conducted, covering 74 empirical studies published between 2000 and 2023, involving 136 effect sizes, and moderation analyzes on variables of instructional design. Results: This study indicated that implementing programming instruction in K‐12 schools can help develop students' multiple dimensions of 21st century skills, such as critical thinking, creativity, communication, collaboration, problem‐solving and decision, learning to learn, ICT literacy, and personal and social responsibility. Overall, programming demonstrates a moderate but significant effect on improving 21st century skills (Hedges's g = 0.621, p = 0.000 < 0.01). Furthermore, several best practices were identified to enhance students' 21st century skills, including initiating programming education from kindergarten, limiting the duration of programming interventions to 6 months, adopting interdisciplinary approaches to programming education, utilizing visual programming tools, and selecting appropriate assessment methods. Conclusion: Based on these findings, this study recommended the thoughtful design of programming education to maximize its advantages in various dimensions of 21st century skills. Lay Description: What is already known about this topic: Currently, 21st century skills have become critical skills that students should have.A popular practice in K‐12 schools is to use programming to develop students' 21st century skills, but results are inconsistent and quantitative synthesis of empirical research is lacking.Some factors of programming instruction may influence the effectiveness of programming on students' 21st century competencies. What this paper adds: A meta‐analysis of 74 studies was conducted to provide systematic evidence that programming has a moderate effect on improving K‐12 students' 21st century skills.Programming significantly improves students' eight sub‐skills in the 21st century.Educational level moderated the impact of programming on students' 21st century skills.Instructional duration moderated the impact of programming on students' 21st century skills. The implications of study findings for practitioners: Programming instruction is designed to be well‐planned and to take full advantage of technology to develop students' 21st century skills.Starting programming instruction at a younger age is more beneficial for students' 21st century skill development.Regarding intervention duration, it is noteworthy that interventions lasting within six months are more effective.Integrate programming across disciplines to promote students' multi‐dimensional 21st century skills. [ABSTRACT FROM AUTHOR]

Background: Health sciences education prepares students for social‐ and healthcare by developing evidence‐based nursing, leadership and working life skills, including collaboration. Due to the changes caused by the global pandemic, health sciences education has shifted more to online and hybrid contexts, which can challenge students' competence development. Students' competence development and interaction in collaborative hybrid learning is a little researched area. Objectives: To observe and evaluate health sciences students' competence development in a collaborative hybrid learning context. Methods: This quasi‐experimental mixed‐method study was implemented by providing educational intervention. First‐year Bachelor's degree health sciences students (n = 18) of a Finnish university completed an educational intervention with synchronous online and face‐to‐face learning. Students' collaborative hybrid learning and interaction were video observed, while self‐evaluation of competence development was made with a questionnaire. Results: In the collaborative interactions, the students showed analytical thinking, problem‐ solving and communication and technology skills. Extensive knowledge of health sciences and ethics skills was not strongly visible in interaction. The students effectively used collaborative work time to perform tasks. Cognitive interaction (monitoring and evaluating learning) was observed in 85% and socio‐emotional interaction (expressions of emotions and motivation) in 53% of the data. Related to the students' learning results, the students' ability to communicate and interact with culturally different people improved after the educational intervention. Conclusion: Collaborative learning methods in hybrid learning can create opportunities for students to construct their competence in interaction. Attention should be paid to different areas of competence and the role of socio‐emotional interaction. Lay Description: What is already known about this topic: Health sciences education prepares students for social and healthcare by developing working life skills, including collaboration.Hybrid learning brings benefits but challenges the equity of students with different attention modes.Collaborative learning is widely used but has not been studied much in hybrid context.Students' competence development and interaction in collaborative hybrid learning is a little researched area. What this paper adds: The purpose was to observe and evaluate health sciences students' competence development in a collaborative hybrid learning context.Hybrid collaborative interaction encourages students to construct knowledge in health sciences.The students utilised the collaborative time appropriately.Socioemotional interactions were very visible in collaborative learning. Implications for practice: This study helps educational organisations to design hybrid model education.The design requires pedagogical and technical competence and should include collaborative methods.Attention should be paid to different areas of competence in collaborative learning.The role of socio‐emotional interaction needs more focus in hybrid learning. [ABSTRACT FROM AUTHOR]

Background: Collaboration has commonly been integrated in computational thinking education to foster novice learning. While the majority of existing studies on developing students' CT skills have been based on competency or personality factors, social factors have been largely ignored. Objectives: This systematic review, framed by social cognitive learning theories, aims to unravel the influencing factors of collaboration in developing computational thinking skills in K‐12 education. Methods: We searched four databases and located 79 publications for synthesis analysis to identify 10 social cognitive factors from personal and learning environmental perspectives. Personal factors are gender, prior knowledge, and motivational attitudes, while the learning environmental factors are roles, partnership, interaction, culture, tools, tasks, and scaffolding. Results and Conclusions: We examined the following five major issues: (a) collaboration elements designed in learning activities; (b) social cognitive factors that might influence the development of computational thinking; (c) the influences caused by social cognitive factors; (d) students' perceived benefits of collaboration; (e) major challenges of integrating collaboration in computational thinking education. The most reported challenges in collaborative classrooms are students' misunderstanding of computational thinking knowledge, negative sentiments, and communication problems. Accordingly, a design framework to facilitate collaborative learning activities was proposed. The design framework can provide a more focused research avenue for examining the effects of collaboration in the development of computational thinking in K‐12 education. Lay Description: What is already known about the topic?: Collaboration has commonly been integrated in computational thinking (CT) education to foster novice learning in K‐12 education.There have been disputes regarding the effectiveness of collaboration in achieving learning outcomes.There is a need for further examination of the influencing factors of collaboration, which might influence students' CT performances. What does this paper add?: Our review identified personal factors (i.e., gender, prior knowledge, and motivational attitudes) and learning environmental factors (i.e., roles, partnership, interaction, culture, tools, tasks, and scaffolding), and revealed their influences in students' CT performances in K‐12 education.The synthesis of students' authentic opinions can yield insights to the possible mechanism of how collaboration can bring benefits to students' CT performances.The design framework generated from the review can shed lights on design an effective learning environment which integrates collaboration in K‐12 CT education. Implications for practice and/or policy?: The collaborative learning process of CT is complex, whereby the effects of social cognitive factors do not stand‐alone but are influenced by personal and learning environmental factors simultaneously.Taking the identified challenges of students, instructors, and operation can help smooth organization of collaborative learning activities of K‐12 CT education.Future students could look more in‐depth into the impacts of the social and situation factors in developing CT. [ABSTRACT FROM AUTHOR]

Introduction: There remains a dearth of easily implemented strategies for translating environmental and sustainability policy into practice within occupational therapy education. In this context, the research‐implementation time lag is problematic because time is of the essence when seeking evidence‐based educational strategies to address planetary health challenges. The undertaking of practical experimentation to develop strategies for policy implementation and translation is challenged by the urgency of the issues faced. Purpose: This paper aims to contribute to conversations around translating awareness of planetary health to practical action for occupational therapy education by proposing a framework for practical "doing" skills, based on conceptually sound, theoretical foundations that support likely efficacy. Methods: Three skills are suggested as a means to close the theory‐practice gap while incorporating what is known about educational processes supporting the transition from novice to expert occupational therapy practitioner. The first skill proposed is a rethinking of essential forms of clinical reasoning, with the introduction of environmental and sustainable reasoning as mandatory. Founded in an adoption of "two‐eyed seeing," the second skill emphasises bidirectional questioning for climate‐just, person‐centred care. The third skill explores interprofessional educational collaboration for environmental sustainability. Conclusions: Acknowledging the centrality of novice practitioner as part of occupational therapy learner professional identity requires appropriate strategies for learning clinical reasoning skills related to environmental sustainability, planetary health, and the potential discomfort of authentic bidirectional questioning. Implications of adopting these strategies are discussed in relation to their potential contribution to positive change for the occupational therapy profession and wider society. [ABSTRACT FROM AUTHOR]

Background: Although conventional writing procedures are still the dominant instructional procedures in English as a foreign language (EFL) contexts, instructors are still struggling with time limitations to improve EFL students writing skills properly. Additionally, EFL students are not engaged in the writing process since they lack the required information about the writing tasks. Objectives: The present study, therefore, applied a sequential explanatory mixed‐methods approach to explore the impact of a flipped writing classroom on EFL students' writing skills (i.e. writing content, writing organization, and language use) and writing motivation on the one hand and possibly recommend a better instructional procedure for students' writing skills and writing motivation in EFL context on the other hand. Methods: To this aim, two intact classes were selected as the participants of the study. The two classes were randomly assigned to a flipped classroom with 27 EFL students and a non‐flipped classroom with 24 EFL students. The non‐flipped classroom was instructed through conventional writing instruction over 16 sessions whereas the flipped classroom was taught with the same content in a flipped writing mode in 10 sessions. Two timed writing tasks, a writing motivation scale, and an individual semi‐structured interview were used to gather the required data. Results and Conclusions: The findings indicated that the flipped writing classroom outperformed the non‐flipped writing classroom in improving the EFL students' writing performance, writing organization, language use, and writing motivation; however, no significant differences were found between the two groups' writing content. Moreover, the data analysis from the individual semi‐structured interview indicated that the flipped students had positive attitudes and perceptions towards the flipped writing classroom which further supported the quantitative findings. Implications: Practical implications for collaborative writing instruction using video clips and other electronic materials are suggested. Lay Description: What is already known about this topic: In a flipped classroom model, English language students can view video clips prior to class time in order to use the class time for doing academic exercises and projects in a collaborative manner.As in student‐centred learning environments, a flipped classroom engages English language students in more active learning processes, encourages them to enquire about the video lectures, and tests and evaluates their skills in applying knowledge.Individual differences, such as motivational variables and affective factors disjointedly or conjointly affect writing processes, especially in English language contexts. What this paper adds: Flipping an English language collaborative writing course improves English language students' writing performance, writing organization, language use, and writing motivation.Flipped classroom is more effective than non‐flipped classroom in improving English language students' writing performance, writing organisation, language use, and writing motivation.Flipped English language students hold positive attitudes and perceptions towards flipped collaborative writing classroom. Pedagogical implications: English language instructors are recommended to design a flipped classroom to provide English language students with video clips before class time, so students can have more collaborative and evaluative writing activities during the class time.English language students can have and receive more peer/instructor writing mediations on the writing tasks and make better use of class time (based on the video clips) and develop their writing performance accordingly.By designing a flipped classroom, English language students can enhance their writing motivation, and also, they properly cover the required materials in a shorter time. [ABSTRACT FROM AUTHOR]

Background: The transition from teacher‐centred towards student‐centred approaches in English language teaching, accompanied by developments in educational technology, has attracted researchers' attention to reverse teaching or flipped class. The related literature asserts that this mode of instruction might influence instructors' and students' participation in the class. Objectives: To shed more light on the role of flipped class in affecting language learning strategies and skills, this study applied a sequential explanatory mixed‐methods approach to explore the impact of flipped class on English as a foreign language (EFL) learners' writing metacognitive strategies and writing skills. Methods: Forty‐six intermediate EFL learners with an age range of 21–27, studying at a private language institute, were randomly divided into two groups of 23 learners. The two groups were randomly assigned to a flipped class, which received writing metacognitive strategies and writing skills through video clips before the class time, and a non‐flipped class, which received writing metacognitive strategies and writing skills in a conventional way during the class time. Results and Conclusions: The results revealed that both flipped and non‐flipped classes improved the EFL learners' writing metacognitive strategies, writing performance, writing content, and writing organisation. Furthermore, one‐way ANCOVA analyses indicated that the flipped class outperformed the non‐flipped class in writing metacognitive strategies, writing performance, writing content, and writing organisation. Thematic analyses, which were used to help analyse individual semi‐structured interviews, uncovered a number of categories and themes, signifying the flipped learners' positive perceptions towards the flipped class, such as enhancing motivation, self‐confidence, and writing collaboration. Implications: Pedagogical implications were discussed for flipping writing metacognitive strategies and writing skills. Lay Description: What is already known about this topic?: Metacognitive strategies, including planning, monitoring, and evaluation strategies, help English language learners become more successful writers.Writing skills, including writing content, writing organisation, and language use, help learners deal with collaborative writing activities effectively.Flipped class has been shown to be an effective mode of instruction to improve English language learners' language learning strategies and skills. What this paper adds?: Flipped class improves English language learners' writing metacognitive strategies, writing performance, writing content, and writing organisation.Flipped class is more effective than non‐flipped class in improving English language learners' writing metacognitive strategies and writing skills.English language learners' motivation, self‐confidence, and writing collaboration are increased as a result of the flipped writing course. Pedagogical implications: Writing metacognitive strategies and writing skills need to be flipped in English language contexts in order to free up time for more effective in‐class collaborative writing activities. [ABSTRACT FROM AUTHOR]

Background: Although a 'person‐centred focus' is a legislated objective for both aged‐care and disability services sectors in Australia, evidence suggests limited translation into systems and practices due to entrenched silos. This paper proposes a Best Practice Framework to mitigate these silos. Methods: Mixed‐methods research comprising key informant interviews with major stakeholders across both sectors; a survey of people with/without intellectual disability aged 60+ years; qualitative in‐depth interviews; and survey of health professionals. Results: There is an urgent need to develop inter‐sectoral 'integrated care systems'. Key components include choice in accommodation; regular assessment of health and well‐being indicators; development and adoption of nationally consistent policies/standards across integrated aged‐ and disability‐care sectors; improved strategies for workforce planning; and upskilling of existing staff including place‐based collaboration. Conclusions: An integrated service model requires collaboration on broader public policy instruments, appropriate planning and resourcing. A strategic shift is required to ensure better quality person‐centred support systems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Teacher instructional competency, the set of essential knowledge and skills needed to guide teaching practice, is critical to the successful implementation of school health education. The purpose of this paper is to introduce the Health Education Teacher Instructional Competency (HETIC) framework, a new conceptualization describing teacher characteristics, essential knowledge, and essential skills, which can influence instructional practice and improve student learning outcomes in health education. METHODS: Data from 17 publicly available guidance documents, professional standards, published reports, and empirical studies relevant to the fields of public education, school health education, and sexual health education were abstracted and analyzed using qualitative thematic content analysis. RESULTS: The framework describes 3 domains: personal characteristics, essential knowledge, and essential skills, which are believed to contribute to teachers' instructional competencies in delivering health education. The knowledge domain asserts 5 key categories, while the essential skills domain includes 3 categories (learning environments, content and delivery, and collaboration and learning) and contains 11 unique skills. Collectively, these domains are influenced by the learner, school/community, and policy‐level factors that shape health education curriculum and instruction. CONCLUSIONS: The HETIC framework presents a conceptual roadmap to guide quality health education preparation, job‐embedded training, and delivery. Improving teachers' instructional competencies strengthens learning and prosocial environments that are inclusive, responsive, and affirming of students' health and learning needs. Teacher who demonstrate instructional competency can help students to achieve desired education and health outcomes, specifically acquiring the knowledge and skills needed to adapt, practice, and maintain healthy behaviors throughout their lifetime. [ABSTRACT FROM AUTHOR]

Context: The trajectory towards becoming a medical professional is strongly situated within the clinical workplace. Through participatory engagement, medical trainees learn to address complex health care issues through collaboration with the interprofessional health care team. To help explain learning and teaching dynamics within the clinical workplace, many scholars have relied on socio‐cultural learning theories. In the field of medical education, this research has largely adopted a limited interpretation of a crucial dimension within socio‐cultural learning theory: the expert who guides the trainee into the community is almost exclusively from the same profession. We contend that this narrow interpretation is not necessary. This limited focus is one we choose to maintain—be that choice intentional or implicit. In this cross‐cutting edge paper, we argue that choosing an interprofessional orientation towards workplace learning and guidance may better prepare medical trainees for their future role in health care practice. Methods: By applying Communities of Practice and Landscapes of Practice , and supported by empirical examples, we demonstrate how medical trainees are not solely on a trajectory towards the Community of Physician Practice (CoPP) but also on a trajectory towards various Landscapes of Healthcare Practice (LoHCP). We discuss some of the barriers present within health care organisations and professions that have likely inhibited adoption of the broader LoHCP perspective. We suggest three perspectives that might help to deliberately and meaningfully incorporate the interprofessional learning and teaching dynamic within the medical education continuum. Conclusion: Systematically incorporating Landscapes of Competence, Assessment, and Guidance in workplace‐based education—in addition to our current intraprofessional approach—can better prepare medical trainees for their roles within the LoHCP. By advocating and researching this interprofessional perspective, we can embark on a journey towards fully harnessing and empowering the health care team within workplace‐based education. Using a Landscapes of Health Care Practices perspective, the authors describe how medical education should be feeding both and intra‐ and interprofessional perspectives on effective workplace learning. [ABSTRACT FROM AUTHOR]

Learners in the process of developing complex skills need a rich mental model of what such skills entail. Textual analytics rubrics (TR) are a widely used instrument to support formative assessment of complex skills, supporting feedback, reflection, and thus mental model development of complex skills. However, the textual nature of a rubric limits the possibility to deliver contextual and dynamic (time‐and behaviour‐oriented) information. In the Viewbrics online tool, we developed a version supporting the delivery of contextual and dynamic information by adding video‐modelling examples with embedded self‐explanation prompts to textual analytics rubrics. We called this combination as video‐enhanced rubrics (VERs). Our current study investigates whether the Viewbrics online tool supports complex skills development and whether either textual‐ or video‐enhanced rubrics best support complex skills' mastery. The study was a three‐group (VERS n = 49, TR n = 54, control n = 50) within‐subjects design. Learners' performance of complex skills was measured through expert, peer, and self‐assessment using the Viewbrics online tool. A multilevel regression analysis shows learners in the TR and VERS conditions consistently outperforming the control condition to varying degrees across skills. However, no differences have been found between the two experimental conditions. Positive results across different complex skills indicate the Viewbrics online tool can be used to support the development of a wide range of complex skills in secondary education. Lay Description: Known about the subject matter: The acquisition of cross‐curricular complex skills such is crucial for pupils in secondary education.It is important that students and teachers develop a concrete and consistent picture of (aspects of) these so‐called 21st century skills in order to streamline both their acquisition.Textual rubrics may still have room for improvement, as many aspects of desired behavior can hardly be put into words.Many schools in secondary education are struggling with how to teach and assess cross‐curricular skills. What their paper adds to this: So, we designed a online (online) formative assessment methodology, with textual rubrics and the video‐enhanced rubrics.And measured complex skill performance in two secondary, pre‐university education schools for 24 weeks and compared with existing educational practice.Both experimental groups perform significantly better in the three complex skills compared to the control group.However, the video‐enhanced group did not outperform the textual rubric group. The implications of study findings for practitioners: Supporting the formative assessment of complex skills is a recommendable activity for practitioners, that will likely bear fruit.However, incorporating video modeling examples into an online assessment methodology does not result in improvement in complex skill mastery. [ABSTRACT FROM AUTHOR]

BACKGROUND: The need for mentorship in aging research among postdoctoral trainees and junior faculty across medical disciplines and subspecialties is increasing, yet senior personnel with expertise in aging are lacking to fulfill the traditional dyadic mentorship role. Facilitated peer mentorship is grounded in collaborative work among peers with the guidance of a senior mentor. METHODS AND RESULTS: We evaluated the Columbia University Mentor Peer Aging Research (CoMPAdRE) program, an interprofessional facilitated peer mentorship program for early stage investigators, using the Reach Effectiveness Adoption Implementation and Maintenance framework (RE‐AIM). Reach: A total of 15 participants, of which 20% were women, from five states and across six medical specialties participated. Effectiveness: Participants published 183 papers, of which more than 20% were collaborative papers between CoMPAdRE mentees or mentees‐mentor. Participants reported developing skills in negotiation, navigating the academic role, organizing a seminar, management, and leadership over the course of the program. According to the qualitative findings, the most important components of the program included alignment around the aging, learning from national leaders, developing leadership skills and career networking. Adoption: Individual‐level factors included selecting participants with a research track record, willingness to sign a compact of commitment and involvement in shaping the program. An institutional‐level factor that facilitated program adoption included strong commitment from department leaders. Implementation: The program cost $3,259 per participant. Maintenance: CoMPAdRE is being maintained and currently incorporating a second cohort of mentees. CONCLUSION: This RE‐AIM evaluation provides lessons learned and strategies for future adoption, implementation, and maintenance of an aging‐focused facilitated peer mentorship program. J Am Geriatr Soc 67:804–810, 2019. See related editorial by High et al. in this issue. [ABSTRACT FROM AUTHOR]

Context The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice. Objectives A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning. Methods Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners. Papers reporting studies conducted in dedicated training wards were excluded, leaving a total of 30 papers to be included in the review. Results Several educational formats that combined students from medicine, nursing, pharmacy and allied health professions were identified. These included: the use of engagement by student teams with a real patient through interview as the basis for discussion and reflection; the use of case studies through which student teams work to promote discussion; structured workshops; ward rounds, and shadowing. Meaningful interprofessional student discussion and reflection comprised the mechanism by which the outcome of learners acquiring knowledge of the roles of other professions and teamwork skills was achieved. The mechanism of dialogue during an interaction with a real patient allowed the patient to provide his or her perspective and contributed to an awareness of the patient's perspective in health care practice. Medication- or safety-focused interprofessional tasks contributed to improved safety awareness. In the absence of trained facilitators or in the context of negative role-modelling, programmes were less successful. Conclusions In the design of workplace education initiatives, curriculum decisions should take into consideration the contexts of the initiatives and the mechanisms for achieving the education-related outcomes of interest. [ABSTRACT FROM AUTHOR]

The present paper takes a translational approach in applying the themes of the current special section to prevention and intervention science in Latino families. The paper reviews the current literature on cultural processes in prevention and intervention research with Latino families. Overall, many prevention and intervention programs have either been developed specifically for Latino families or have been modified for Latino families with great attention paid to the socio-cultural needs of these families. Nevertheless, few studies have tested the role of cultural values or acculturation processes on outcomes. We make recommendations based on findings within basic science and in particular this special section on the incorporation of these values and processes into prevention and intervention science with Latino families. [ABSTRACT FROM AUTHOR]

Background This paper tells the story of Central England People First's ( CEPF) History Project. Method This was an inclusive research project, owned and controlled by members of CEPF which sought to chart its 21-year history, 1990-2012. Results It illustrates both the strengths of such a project and some of the challenges. Conclusion It concludes that using inclusive research methods enabled the story to be told, but that it was less successful in addressing questions about why the organization grew and prospered in the 1990s, only to struggle in its later years, and what this tells us about the conditions which enable self-advocacy to flourish. The paper was collaboratively written by the CEPF History Project team and an academic ally. Different fonts differentiate the contributions, although it is acknowledged that lots of the ideas were shared. Accessible Abstract This paper explores issues in telling the history of self advocacy using inclusive research methods. It explains how and why CEPF recorded its history, what we found out, and some of the questions we have had to think about: whose voices we hear, what to include, what to leave out, what parts of the research people with learning difficulties can do, what self advocacy means to different people, how to make use of research other people have done., It raises some new questions about directions for inclusive research. The Paper was written by the CEPF History team - Craig Hart, Ian Davies, Angela Still and Catherine O'Byrne - working with Jan Walmsley. We wanted to make it clear what were Jan Walmsley's ideas and what were our ideas. We have done this by writing our ideas in a different font. BUT lots of the ideas belong to all of us. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 748-756 Context Capacity-building programmes in low-income countries (LICs) are subject to a tension between the requirement to best train workers to fulfil national needs and the requirement to meet international expectations of their students, academics and institutions. This paper presents a theoretical framework developed from a case study of an undergraduate degree programme in Malawi and explores how national needs and international expectations can be managed in health profession settings in LICs to ensure successful curriculum development. Methods An inductive qualitative methodology, grounded theory, combined with open-ended interviews with students, graduates, tutors and external stakeholders in the programme, was used to develop a theoretical framework. Results A total of 22 interviews were performed; their analysis conceptualised the tension between national needs and international expectations, and resulted in 12 codes, in four categories: competing and advancing agendas; processes of collaboration; developing a programme or professional identity, and perceptions of programme change. Conclusions This study describes a conceptual framework highlighting three particular areas for analysis to aid in understanding how to best manage competing agendas. These areas refer to, respectively, the significance of international expectations, the organisational climate, and the development of a professional identity. [ABSTRACT FROM AUTHOR]

Background Analyses of adverse events in surgery reveal that many underlying causes are behavioural, such as communication failure, rather than technical. Non-technical (i.e. cognitive and interpersonal) skills are not addressed explicitly in surgical training. However, surgeons need to demonstrate these skills, which underpin their technical excellence, to maximise patient safety in the operating theatre. This paper describes the method used to identify surgeons' non-technical skills, and the development of a skills taxonomy and behavioural rating system to structure observation and feedback in surgical training. Methods Cognitive task analyses (critical incident interviews) were conducted with 27 consultant surgeons in general, cardiac and orthopaedic surgery. The interviews were coded and a multidisciplinary group of surgeons and psychologists used an iterative process to develop a skills taxonomy. This was supported by data gathered from an attitude survey, literature review, analysis of surgical mortality reports and observations in theatre. Results Five categories of non-technical skills were identified, including situation awareness, decision making, task management, leadership and communication and teamwork. This provided a structure for a prototype skill taxonomy (v1.1), which comprised 14 non-technical skill elements. Observable behaviours (markers) indicative of good and poor performance were developed for each element by 16 consultant surgeons to form a prototype behaviour rating system. Conclusions The prototype skills taxonomy and behaviour rating system are grounded empirically in surgery. The reliability of the system is currently being tested using standardised scenarios. If this evaluation proves successful, the system could be used to structure feedback and guide non-technical skills training. [ABSTRACT FROM AUTHOR]