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Rationale A multidisciplinary primary care clinic in Sydney, Australia, was planning to use electronic questionnaires to measure patient-reported outcomes. Methods Semi-structured interviews with 20 patients were undertaken to explore, among other things, practical issues regarding different questionnaire formats. The response rates and costs of email versus postal invitations were also evaluated. Results Compared with postal invitations, email invitations offered a cost-effective and practical alternative, with a greater proportion of patients volunteering for an interview. Assuming the interface is well-designed and user-friendly, many patients were happy to use the Internet to answer questionnaires. Most patients thought alternate formats should also be offered. Patients discussed advantages and disadvantages of the Internet format. Although more younger patients and females had given the clinic an email address; both sexes, and young and old patients, expressed strong preferences for either wanting or not wanting to use the Internet. Conclusion Researchers should consider using email invitations as a cost-effective first-line strategy to recruit patients to participate in health services research. Internet questionnaires are potentially cheaper than paper questionnaires, and the format is acceptable to many patients. However, for the time being, concurrent alternate formats need to be offered to ensure wider acceptability and to maximize response rates. [ABSTRACT FROM AUTHOR]

Aim: To explore the effectiveness and acceptability of a pilot mentoring program for alcohol and other drug (AOD) nurse practitioners (also known globally as addiction nurse practitioners). Design: Mixed method evaluation. Methods: Two‐phase evaluation comprising survey (demographics, pre‐ and post‐program perceived competency and confidence) with 15 participants completing the pre survey and 10 participants completing the post survey, and qualitative interviews after the program with 10 participants. Results: The quantitative results indicate statistically significant increases in some domains of perceived competence and confidence in treatment. Qualitative findings indicate that participants valued peer support and mentoring from experienced nurse practitioners. Where formal residency or internship programs for nurse practitioners do not exist, informal mentoring programs may address issues inherent in nurse practitioner transition that may impact retention. We recommend further exploration of mentoring programs with larger sample sizes to determine if self‐reported clinical improvements are noted. Implications for Profession and/or Patient Care: Nurse practitioners are a vital part of the healthcare system; their advanced skills and knowledge place them in an ideal position to address prescriber shortages and access to care for populations underserved by healthcare. However, literature indicates that they are often underutilised, and transition to autonomous practice remains a challenge. Our exploration of a pilot mentoring program for nurse practitioners shows that their knowledge and perceived skills are high, yet peer assistance is valued in transitioning from advanced practice registered nurse to autonomous nurse practitioner. We recommend further trialling and evaluation of nurse practitioner mentoring programs to both increase supply of nurse practitioners and provide greater access to quality healthcare for underserved populations. Impact: What problem did the study address?: The ability of nurse practitioners to offer advanced practice interventions such as diagnosis and medication management potentially provides a solution to healthcare resource shortages. However, current literature indicates that advanced nurses transitioning to nurse practitioner roles suffer transition shock, leading to burnout and poor retention. What were the main findings?: Although this pilot mentoring program shows significant improvements in survey responses on confidence and capability, qualitative data shows that neophyte nurse practitioners value peer support and mentoring from more experienced practitioners. Participants described maintaining ongoing connections with both mentors and fellow mentees, which aided transition to the role of autonomous nurse practitioner. Where and on whom will the research have an impact?: The results of this pilot mentoring program indicate that there is benefit to these programs for neophyte nurse practitioners in many specialties. This paper indicates that mentoring programs for nurse practitioners may provide a community of practice and may have a positive impact on transition shock. Reporting Method: Good Reporting of a Mixed Methods Study (GRAMMS) checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation‐STakeholder Engagement Model (I‐STEM) in the context of an international, large‐scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I‐STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. Methods: In‐depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet‐based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first‐ and third‐generation Grounded Theory, including constant comparative method. Results: We conducted 55 interviews and observed 19 implementation‐related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I‐STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. Conclusion: The I‐STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I‐STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. Patient or Public Contribution: Patient contribution to ImpleMentAll trial was facilitated by GAMIAN‐Europe at all stages—from grant development to dissemination. GAMIAN‐Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN‐Europe was involved in pilot testing the ItFits‐toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits‐toolkit. Trial registration: ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018. [ABSTRACT FROM AUTHOR]

Background: Given students' lack of self‐directed learning skills and the growing concern about implementing massive online open courses (MOOCs) in K12 education, learning strategies are needed to facilitate MOOC learning. Many studies have provided different strategies for effective learning in MOOCs. However, there is still limited research to confirm whether these strategies effectively support MOOC learning when deployed by secondary schools, which are not MOOC developers. Objectives: This mixed‐method study examines the provision of different learning strategies, including a learning guide, an academic mentoring programme, a training workshop, and a reimbursement scheme, and investigates the impact of these strategies on student learning in MOOCs. Methods: The study uses two data sources: (1) surveys with 40 participants and (2) semi‐structured interviews with 12 participants. The quantitative data were analysed with descriptive statistics and Fisher's exact test, and the qualitative data were analysed with thematic analysis. Results and Conclusion: The findings indicate that MOOC learners had positive attitudes towards the overall school support, with mentoring enjoying great popularity amongst the students. In terms of the effectiveness of the school support, the mentoring programme and reimbursement scheme were more effective than the university training and learning guide. The paper discusses the implications for researchers and educators. Lay Description: What is already known about this topic: There are a large number of K12 MOOC implementations, which are (i) STEM‐related and computer science courses, and (ii) from Europe and the USA.Limited studies provided different learning strategies for MOOC learning from the perspective of K12 schools, which are not MOOC developers.There is a need to explore MOOC initiatives encompassing a wide variety of subjects, including computer science MOOCs and non‐computer science MOOCs, in regions beyond Europe and the USA.There is also a need for further scrutiny of the effectiveness of learning strategies provided by the K12 school. What this paper adds: Our study launched the first MOOC implementation in K12, encompassing several subject areas beyond computer science in the region of Asia.Our study provided different learning strategies adopted by the K12 school, and the analysis revealed that MOOC learners took positive attitudes towards overall school support with mentoring enjoying great popularity with these students.Our study examined the effectiveness of school support and identified that mentoring and reimbursement are more effective than university training and the learning guide. Implications for practitioners: The insights gained from the study enable other K12 schools and educators to implement MOOC into existing school infrastructures successfully.These strategies provided in the MOOC implementation program can be helpful in many different online learning contexts. [ABSTRACT FROM AUTHOR]

Background: Globally, it is estimated that one in three adults live with two or more long‐term conditions (multiple long‐term conditions, MLTCs), that require self‐management. People who experience socioeconomic deprivation face significant health inequalities due to a range of interrelated characteristics that lead to a lack of resources and opportunities. Previous research with underserved populations indicate low levels of trust towards primary care providers and potential barriers for developing patient‐healthcare professional relationships. The purpose of this paper is to explore the barriers and facilitators to self‐managing MLTCs, amongst people who experience socioeconomic deprivation. Methods: Semistructured one‐to‐one interviews with adults (n = 28) living in London and Sheffield, United Kingdom with MLTCs who are experiencing socioeconomic deprivation. Participants were recruited through general practices, community channels and social media. Data were analysed in NVivo using reflexive thematic analysis methods. Findings: Four analytical themes were developed: (1) challenges in accessing healthcare services, financial assistance, and cultural awareness; (2) empowerment and disempowerment through technology, including digital exclusion, and use of technology; (3) impact and causes of exclusion on self‐management, including social isolation, area‐based and economic exclusion, and health‐related stigma and (4) adapting self‐management strategies, including cost‐effective, and culturally/lifestyle appropriate strategies. Conclusions: Future health interventions and services need to be developed with consideration of the combined complexities of managing MLTCs while experiencing socioeconomic deprivation. Increased awareness in practitioners and commissioners of the complexities surrounding the lives of people experiencing socioeconomic deprivation, and the need for targeted strategies to promote self‐management of MLTCs are of great importance. Patient or Public Contribution: A patient advisory group contributed to all stages of the study, including providing important feedback on study documents (topic guides and recruitment materials), as well as providing critical insights surrounding the interpretation of interview data. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) do not always access specialist outpatient services in a timely manner in Ireland. The perspectives of people living with PD, relating to service access, are largely absent in the existing literature. Aim: To explore experiences of PD service access for people living with PD, using a qualitative approach. Methods: Purposive maximum variation sampling was used. Semi‐structured telephone interviews were conducted with 25 service users, including people with PD (n = 22) and supporting carers (n = 3). Informed consent was obtained from all participants. Interviews ranged in duration from 30 to 90 min. Data were managed in NVivo 12 and interpreted inductively using thematic analysis. The researchers were reflexive throughout the research process. The Consolidated Criteria for Reporting Qualitative Research checklist was employed to maximise transparency. Results: The findings highlight several key barriers to and facilitators of equitable and timely service access. Three key themes were identified comprising experiences of PD service access including 'geographical inequity', 'discriminatory practices', and 'public and private system deficits'. Together, these themes illustrate how a two‐tiered and under‐resourced health system lacks capacity, in terms of infrastructure and workforce, to meet PD needs for both public and private patients in Ireland. Conclusions: These findings point to problems for PD care, relating to (i) how the health system is structured, (ii) the under‐provision and under‐resourcing of specialist outpatient PD services, including medical, nursing, and multidisciplinary posts, and (iii) insufficient PD awareness education and training across health settings. The findings also show that telemedicine can provide opportunities for making access to certain aspects of PD care more flexible and equitable, but the feasibility and acceptability of technology‐enabled care must be assessed on an individual basis. Implications for policy, practice and research are discussed. Patient or Public Contribution: The design and conduct of this study were supported by an expert advisory group (EAG) of 10 co‐researchers living with PD. The EAG reviewed the interview schedule and the protocol for this study and provided detailed feedback from their perspective, to improve the methods, including the interview approach. The group also reviewed the findings of the study and contributed their insights on the meaning of the findings, which fed into this paper. [ABSTRACT FROM AUTHOR]

Background: Early identification and intervention for hearing loss is important for supporting language development. Despite this, parents are required to overcome barriers to access hearing assessments for their children. Aims: To identify the enablers and barriers to accessing hearing assessments for Australian children identified by their parents, and to compare between metropolitan, regional and rural areas. Methods & Procedures: This sequential, explanatory mixed‐methods study was undertaken online and included participants in metropolitan, regional and rural area of Queensland, New South Wales, Victoria, South Australia, Western Australia and the Northern Territory. A total of 56 participants participated in the surveys, and 10 participated in semi‐structured interviews. Outcomes & Results: Participants in metropolitan areas were more likely to have services in their area; however, access to hearing assessment was related more to individual circumstances (including health literacy skills) rather than geographical location. Many participants experienced long wait times, reduced flexibility, and a lack of audiologists experienced in working with children. Conclusions & Implications: Barriers to hearing assessments (which assist with early identification and intervention for hearing loss) should be addressed so that children have access to clear auditory information to assist with their speech and language development. WHAT THIS PAPER ADDS: What is already known on the subject: Poor audiological input can lead to poor speech, language and literacy outcomes for children. What this paper adds to the existing knowledge: Although previous research indicates that people in regional and remote locations experience difficulty accessing health services within a reasonable timeframe, in this study barriers were experienced regardless of geographical location, and were dependent on individual circumstances. Many parents are unaware of the impact of hearing on speech and language. What are the potential or actual clinical implications of this work?: Further research might examine how health literacy affects access to hearing assessment. Parents shared several potential solutions to these access barriers which should be considered by service providers. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well‐being for staff experiencing perimenopausal and menopausal symptoms at work. Design: It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541–548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization. Methods: CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study. Results: The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in‐depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person‐centred support mechanisms and an organizational approach for all employees. [ABSTRACT FROM AUTHOR]

Background: In order to conduct research that is meaningful to speech and language therapy services and their patients, it is often desirable to conduct the research within routine clinical services. This can require considerable time and commitment from speech and language therapists (SLTs). It is therefore important to understand the impact that such participation in research can have. Aims: To explore the impact of research participation in the Big CACTUS study of self‐managed computerized aphasia therapy conducted in 21 UK NHS speech and language therapy departments. Methods & Procedures: An online survey was sent to SLTs who took the lead role for the study at their NHS Trust to evaluate the impact of study participation in three domains: capacity‐building, research development and health services. The questionnaire, based on the VICTOR framework for evaluating research impact, included Likert scale statements and closed and open‐ended questions. The results from open‐ended questions were coded and analysed using framework analysis in NVivo 12 and the data from closed questions were analysed descriptively. Outcomes & Results: A total of 12 SLTs returned the survey. Nine codes were identified from open‐ended questions and 20 predefined from the literature. Analysis of the responses demonstrated the perceived impact including improvements in practices and access to therapy, investments in infrastructure, increased SLT profile, and impact on research culture among SLTs. The usefulness of the intervention during the COVID‐19 pandemic was also highlighted. Conclusions & Implications: The results suggest participation in Big CACTUS has resulted in improvements in patient care and SLT research capacity and culture in speech and language therapy departments. What This Paper Adds: What is already known on the subject: Practice‐based research is encouraged to assist with the clinical relevance of the research findings. Participation in research can be seen as an activity that is additional to the core business of patient care and it can be difficult to secure time to participate or conduct research in clinical settings. Impact evaluation initiatives of individual trials facilitate early identification of benefits beyond the trial. What this paper adds to existing knowledge: This study describes specific examples of the impact on services, staff and patients from SLT participation and leadership in the Big CACTUS speech and language therapy trial in clinical settings. What are the potential or actual clinical implications of this study?: Clinical services participating in research may benefit from improved clinical care for patients both during and after the study, an improved professional reputation, and increased research capacity and culture within the clinical settings. [ABSTRACT FROM AUTHOR]

Background: Dysphagia impacts negatively on quality of life, however there is little in‐depth qualitative research on these impacts from the perspective of people with dysphagia. Aims: To examine the lived experiences and views of people with lifelong or ongoing dysphagia on the impacts of dysphagia and its interventions on quality of life, and barriers and facilitators to improved quality of life related to mealtimes. Methods & Procedures: Nine adults with lifelong or acquired chronic dysphagia engaged in in‐depth interviews and a mealtime observation. The observations were recorded and scored using the Dysphagia Disorders Survey (DDS). Interviews were recorded, transcribed and de‐identified before content thematic and narrative analysis, and verification of researcher interpretations. Outcomes & Results: Participants presented with mild to severe dysphagia as assessed by the DDS. They viewed that dysphagia and its interventions reduced their quality of life and that they had 'paid a high price' in terms of having reduced physical safety, reduced choice and control, poor mealtime experiences, and poor social engagement. As part of their management of dysphagia, participants identified several barriers to and facilitators for improved quality of life including: being involved in the design of their meals, being adaptable, having ownership of swallowing difficulties, managing the perceptions of others and resisting changes to oral intake. Conclusions & Implications: This research improves understanding of the primary concerns of people with dysphagia about their mealtime experiences and factors impacting on their quality of life. Clinicians working with people with dysphagia need to consider how self‐determination, autonomy and freedom of choice could be improved through involvement in food design of texture‐modified foods. It is important that future research considers the views of health professionals on how these findings could impact on policy and practice particularly in ways to address the barriers and enhance facilitators to improved quality of life for people with dysphagia. What this paper adds: What is already known on the subject: Dysphagia impacts on quality of life, particularly as the severity of the dysphagia increases. Research to date has focused on people with dysphagia associated with an acquired health condition and has used quantitative assessment methods to measure quality of life. What this paper adds to existing knowledge: This study provides a qualitative examination of the impacts of dysphagia on quality of life from the perspective of people with lifelong or ongoing acquired dysphagia and their supporters. This study also provides qualitative insights into the barriers and facilitators of mealtime‐related quality of life. What are the potential or actual clinical implications of this work?: Health professionals should engage in open communication with their clients with dysphagia regarding the impacts of dysphagia on their lifestyle and quality of life. By considering these impacts, health professionals may be able to recommend interventions that are more acceptable to the person with the dysphagia which may have a positive impact on their mealtime experience. [ABSTRACT FROM AUTHOR]

Background: Acquired laryngotracheal stenosis (LTS) is a rare condition that causes breathlessness and dyspnoea. Patients have reconstructive airway surgery to improve their breathing difficulties, but both LTS and the surgery can cause voice difficulties. The existing evidence base for management of voice difficulties for adults with LTS focuses on symptoms. There is limited information to provide clinical guidance for speech and language therapists (SLTs) and a limited understanding of the impact of voice changes on adults with LTS. Aim: To investigate the lived experience of adults with laryngotracheal stenosis (LTS), who have had reconstructive surgery; here focussing on voice concerns with the aim of guiding clinical care for SLTs. Methods and Procedures: A phenomenological, qualitative study design was used. Focus groups and semi‐structured interviews were completed with adults living with LTS who had had reconstructive surgery. Audio recordings were transcribed and inductive thematic analysis was used by the research team to identify themes and sub‐themes. Outcomes and Results: A total of 24 participants (five focus groups and two interviews) took part in the study before thematic saturation was identified in analysis. Three main themes were identified specific to the experience of living with LTS: the Medical, Physical and Emotional journey. All participants referenced voice difficulties as they related to each of these overall themes. Sub‐themes directly related to voice included experience of surgery, information provision, staff expertise/complacency, symptoms, symptom management, identity, support networks, impact on life and living with a chronic condition. Conclusions and Implications: In this qualitative study participants have described the integral part voice difficulties play in their lived experience of LTS and reconstructive surgery. This is considered in the context of their clinical care and the need for individualised management and information provision throughout the course of their condition. The broader research literature relating to voice difficulties is explored with links made to people with LTS and recommendations made for future research into people living with LTS and dysphonia. What this paper adds: What is already known on this subject: Adults with laryngotracheal stenosis (LTS) experience voice changes as a result of their condition, and the surgeries necessary as a treatment. These changes can lead to altered pitch, vocal fatigue, loss of pitch range and loss of volume control. Although there are known psychosocial implications both to living with a chronic condition and voice difficulties there has been no research exploring this in adults with LTS, and there is minimal clinical guidance for speech and language therapists (SLTs) working with these patients. What this paper adds to existing knowledge: This research is the first study to explore the lived experience of adults with LTS who undergo reconstructive surgery, focusing on their voice concerns. This study demonstrates the multifactorial impacts of voice changes on all aspects of the lives of adults with LTS and the need for individualised information provision and clinical care to help support them. What are the potential or actual clinical implications of this work?: Adults with LTS want expert SLTs to facilitate their care and support them throughout their LTS journey alongside other support networks. They want to be carefully prepared for reconstructive surgery and given clear information about symptoms and management of their voice difficulties. This has led to the reorganisation of the care pathway at our centre, and the introduction of a patient‐led pretreatment session. [ABSTRACT FROM AUTHOR]

Background: Increasing attention is paid to the effectiveness of high‐intensity speech intervention in children with a cleft (lip and) palate (CP±L). It is, however, unknown if high‐intensity intervention is acceptable to the intervention recipients. Parents have an integral role in supporting their children with intervention highlighting the importance of intervention acceptability to parents. Aims: To compare the retrospective acceptability of high‐intensity speech intervention (10 1‐hr speech therapy sessions divided over 2 weeks) with the retrospective acceptability of low‐intensity speech intervention (10 1‐hr speech therapy sessions divided over 10 weeks) for children with a CP±L from the parents' point of view. Methods & Procedures: Twelve parents of 12 children, aged 6–0 years who received high‐intensity speech intervention (n = 6) or low‐intensity speech intervention (n = 6), were invited to participate in this study. Seven parents (n = 3 in the high‐intensity group and n = 4 in the low‐intensity group) agreed to participate (total response rate: 7/12, 58.33%). A qualitative study design using semi‐structured interviews was applied. To investigate the retrospective acceptability of the two intervention intensities, deductive coding according to the Theoretical Framework of Acceptability (TFA) was used. Outcomes & Results: With regard to the TFA construct 'affective attitude', results demonstrated that parents had positive feelings about the provided speech intervention regardless of the intensity. Parents of children who received high‐intensity speech intervention reported two specific benefits related to the high intervention intensity: (1) it improved their relationship with the speech‐language pathologist and (2) it improved their child's ability to make self‐corrections in his/her speech. Even though both high‐intensive and low‐intensity speech intervention were considered burdensome (TFA construct 'burden'), parents were less likely to drop out of high‐intensity intervention because the total intervention period was kept short. Conclusions & Implications: In conclusion, high‐intensity speech intervention seemed acceptable to parents. More positive codes were identified for some of the TFA constructs in the high‐intensity intervention group than in the low‐intensity intervention group. Considering that some parents doubted their self‐efficacy to participate in high‐intensity speech intervention, speech‐language pathologists need to counsel them so that they can adhere to the high intervention intensity. Future studies should investigate whether high‐intensity speech intervention is also acceptable to the children who receive the intervention and to the speech‐language pathologists who deliver the intervention. What this paper adds: What is already known on this subject: Increasing attention is paid to the effectiveness of high‐intensity speech intervention in children with a cleft (lip and) palate (CP±L). Different quantitative studies have shown positive speech outcomes after high‐intensity cleft speech intervention. Despite this increasing attention to high‐intensity speech intervention, it is unknown whether high‐intensity intervention is also acceptable to the intervention recipients. This study compared the retrospective acceptability of high‐intensity speech intervention (10 1‐hour speech therapy sessions divided over 2 weeks) with the retrospective acceptability of low‐intensity speech intervention (10 1‐hour speech therapy sessions divided over 10 weeks) in children with a CP±L from the parents' point of view. What this paper adds to existing knowledge: More positive codes were identified for some of the TFA constructs in the high‐intensity intervention group than in the low‐intensity intervention group. Nevertheless, some parents doubted their self‐efficacy to participate in high‐intensity speech intervention. What are the potential or actual clinical implications of this work?: The findings of this study forces us to reconsider the traditional cleft speech intervention delivery models which usually consist of low‐intensity intervention. Speech‐language pathologists need to counsel parents and so that they can adhere to the high intervention intensity. [ABSTRACT FROM AUTHOR]

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Introduction: Facilitators to implement shared cancer follow‐up care into clinical practice include mechanisms to allow the oncologist to continue overseeing the care of their patient, two‐way information sharing and clear follow‐up protocols for general practitioners (GPs). This paper aimed to evaluate patients, GPs and radiation oncologists (ROs) acceptance of a shared care intervention. Methods: Semi‐structured interviews were conducted pre‐ and post intervention with patients that were 3 years post radiotherapy treatment for breast, colorectal or prostate cancer, their RO, and their GP. Inductive and deductive thematical analysis was employed. Results: Thirty‐two participants were interviewed (19 patients, 9 GPs, and 4 ROs). Pre intervention, there was support for GPs to play a greater role in cancer follow‐up care, however, patients were concerned about the GPs cancer‐specific skills. Patients, GPs and ROs were concerned about increasing the GPs workload. Post intervention, participants were satisfied that the GPs had specific skills and that the impact on GP workload was comparable to writing a referral. However, GPs expressed concern about remuneration. GPs and ROs felt the model provided patient choice and were suitable for low‐risk, stable patients around 2–3 years post treatment. Patients emphasised that they trusted their RO to advise them on the most appropriate follow‐up model suited to their individual situation. The overall acceptance of shared care depended on successful health technology to connect the GP and RO. There were no differences in patient acceptance between rural, regional, and cancer types. ROs presented differences in acceptance for the different cancer types, with breast cancer strongly supported. Conclusion: Patients, GPs and ROs felt this shared cancer follow‐up model of care was acceptable, but only if the RO remained directly involved and the health technology worked. There is a need to review funding and advocate for health technology advances to support integration. Patient or Public Contribution: Patients treated with curative radiotherapy for breast, colorectal and prostate cancer, their RO and their GPs were actively involved in this study by giving their consent to be interviewed. [ABSTRACT FROM AUTHOR]

Background: Engagement is recognized as an important factor in aphasia treatment response and outcomes, yet gaps remain in our understanding of engagement and practices that promote engagement from the client perspective. Aims: The purpose of this phenomenological study was to explore how clients with aphasia experience engagement during their inpatient aphasia rehabilitation. Methods & Procedures: An interpretative phenomenological analysis approach guided the study design and analysis. Data were collected through in‐depth interviews with nine clients with aphasia, recruited through purposive sampling, during their inpatient rehabilitation admission. Analysis was completed using a variety of analytic techniques including coding, memoing, triangulation between coders and team discussion. Outcomes & Results: The analysis revealed that for clients with aphasia in the acute phrase of recovery, the rehabilitation process resembles travelling on a journey through a foreign land. Successful engagement in the journey was accomplished when one had a therapist who served as a trusted guide and was able to be a friend, invested, adaptable, a co‐creator, encouraging and dependable. Conclusions & Implications: Engagement is a dynamic, multifaceted and person‐centred process involving the client, provider and rehabilitation context. Findings from this work have implications for measuring engagement, training student clinicians to be skilled facilitators in engaging their clients and implementing person‐centred practices that promote engagement within clinical settings. WHAT THIS PAPER ADDS: What is already known on the subject: Engagement is recognized as an important factor in rehabilitation treatment response and outcomes. Prior literature suggests that the therapist plays a critical role in facilitating engagement within the client–provider relationship. Communication impairments associated with aphasia may negatively impact a client's ability to develop interpersonal connections and participate in the rehabilitation process. There is a dearth of research directly exploring the topic of engagement in aphasia rehabilitation, particularly from the perspective of clients with aphasia. Capturing the client perspective can provide novel insights regarding practices to foster and maintain engagement in aphasia rehabilitation. What this paper adds to existing knowledge: This interpretative phenomenological study revealed that for individuals with aphasia in the acute phase of recovery, the rehabilitation process resembles travelling on a sudden and foreign journey. Successful engagement in the journey was accomplished when one had a therapist who served as a 'trusted guide' and was able to be a friend, invested, adaptable, a co‐creator, encouraging and dependable. Through the client experience, engagement is seen as a dynamic, multifaceted and person‐centred process involving the client, provider and rehabilitation context. What are the potential or actual clinical implications of this work?: The current study highlights the complexity and nuance of engagement within the rehabilitation context, which has implications for measuring engagement, training student clinicians to be skilled in engaging their clients and implementing person‐centred practices that promote engagement within clinical settings. It is necessary to recognize that client and provider interactions (and thus engagement) are embedded in and influenced by the broader healthcare system. With this in mind, a patient‐centred approach to engagement in aphasia care delivery cannot be achieved through individual efforts only and may require prioritization and action at the systems level. Future work is needed to explore barriers and facilitators to enacting engagement practices, in order to develop and test strategies to support practice change. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has brought about disruptions in healthcare for adults with intellectual and developmental disabilities. There is a need to explore ways to promote proactive healthcare and better prepare individuals for healthcare encounters. Methods: A co‐designed tool, the COVID Check‐in Tool, was introduced as part of a virtual health education programme to encourage proactive healthcare. Implementation of this Health Check‐in was evaluated with 36 adults with intellectual and developmental disabilities and 96 family caregivers who completed the programme using surveys, structured interviews and focus groups. Findings: Forty‐four percent of participants engaged in the Health Check‐in process, resulting in many reported benefits for those who participated. However, there were also barriers to initiating the Check‐in, along with challenges using the COVID Check‐in Tool, according to both the adults with disabilities who were interviewed and the family caregivers. Conclusions: The study underscores the importance of considering ways to integrate tools into routine healthcare practices, to facilitate improved healthcare delivery for people with intellectual and developmental disabilities during pandemic recovery efforts. As well, involving people with lived experience in the development and implementation of healthcare resources is critical. Accessible Summary: Our team worked together to make a tool that would help people with intellectual and developmental disabilities talk to their doctor about health problems after not seeing them a lot because of the pandemic. We called this tool the 'COVID Check‐in'.Then people from our team taught online health courses about how to use the COVID Check‐in Tool and other health topics.After the courses were over, we asked 36 adults with intellectual and developmental disabilities and 96 family caregivers if they had a Health Check‐in with their doctor and how it went, or what problems they had with it.Almost half of the people who took the courses had a Health Check‐in and most of the people thought it was helpful. Some people did not do it or did it but had problems with it.We end the paper with some ideas of how to make it easier to check in with the doctor and why it is important to include people with disabilities and family caregivers when making healthcare tools. [ABSTRACT FROM AUTHOR]

This paper explores how the COVID‐19 pandemic affected care leavers in Quebec, a social group already facing obstacles to social integration. Semi‐structured qualitative interviews were conducted with 48 participants and analysed through Castel's zones of vulnerability model. Results suggest that youth who entered the pandemic with more vulnerabilities were more affected by it in all dimensions of their lives. However, results also suggest that the presence of a strong social support network protects even the most vulnerable ones from being overly afflicted, highlighting the importance of interventions that reinforce care leaver's social support network during times of crisis. [ABSTRACT FROM AUTHOR]

Background: A resurgence in teaching coding in primary school classrooms has led to a pedagogical swing towards using physical computing and coding to develop students' use of algorithms, computational thinking, and problem‐solving skills. Two obstacles impede the optimal development of these objectives: the availability of a suitable pedagogy and an instructional sequencing model for primary school teachers to effectively present coding and computational thinking concepts and skills to students in alignment with their developmental stage. Objective: This study aims to address both obstacles by introducing the 3C Model, a newly developed instructional sequence grounded in established pedagogies and designed to effectively teach coding and computational thinking skills to primary school students based on their developmental stage. Methods: The qualitative study employed two data sources to triangulate findings, using: (1) semi‐structured interviews and thematic analysis to investigate 11 primary school students' perceptions of their learning experiences with the 3C Model, and (2) researcher observations along with reflections of the students' developed and demonstrated learning through the method of knowing‐in‐action, reflection‐in‐action, and reflection‐on‐action. Results and Conclusions: The findings of this study fill a gap in the existing literature by demonstrating that the pedagogical and sequential approach embedded in the 3C Model not only enhanced students' engagement levels but also resulted in improved curriculum learning outcomes. The 3C Model provides teachers with a coherent and age‐appropriate instructional structure. It uses physical computing devices and digital coding platforms to introduce coding concepts, furthering the development of computational thinking skills in primary school students beyond mere procedural and rote learning. Implications: The study holds important implications for practical applications, as it addresses an absence in the literature of an established pedagogy and instructional sequencing model for effectively teaching coding and computational thinking concepts and skills to primary school students. Drawing on established pedagogical and developmental learning theories, the 3C Model provides primary school teachers with an engaging, age‐appropriate instructional method that avoids decontextualised teaching and surface‐based learning. Instead, it encourages collaborative student work and contextualised learning, steering away from isolated and generic approaches. Lay Description: What is currently known about this topic: Teaching coding and computational thinking concepts and skills is complex due to their abstract nature.Teaching resources such as work samples, curriculum connections and tools are available to primary school teachers.There is no consensus on the most effective methods to teach these abstract concepts and skills.Primary school teachers default to applying general teaching strategies due to the lack of an age‐appropriate, specific activity sequencing model to use during coding instruction. What does this paper add: The study fills the existing gap by presenting a newly conceptualised instructional model, which considers the students' developmental stage of learning and pedagogical best practices.The study trialled the 3C Model with primary school students in a classroom setting.The study found that employing the pedagogical approach of the 3C Model increased students' engagement levels and resulted in enhanced curriculum learning outcomes. Implications for practitioners: Without an age‐appropriate instructional sequencing model students may not be grasping the underlying concepts.Simply focusing on the code without emphasising concepts such as decomposition and algorithmic thinking will result in shallow learning.Key considerations in using the 3C Model are ensuring that conceptual development occurs using physical computing devices and language students are familiar with prior to introducing coding language and its symbolic representations.Primary school teachers should consider incorporating physical interactive digital devices, physical movement, staged language development and subsequent coding procedures within the context of an engaging and authentic problem. This approach enables students to effectively grasp and represent coding and computational thinking concepts and skills, surpassing mere procedural and rote learning. [ABSTRACT FROM AUTHOR]

Background: Some studies have researched the correlation between flipped learning and cognitive learning outcomes; however, there is a paucity of research elaborating on the effects of flipped language learning on cognitive load (CL). Objectives: This study investigates the effects of using flipped learning designs (student‐led, teacher‐led and collaboration‐led) on learning outcomes and CL management during out‐of‐class activities versus during‐class activities. Methods: A mixed methods research was used to concurrently triangulate different strands of data on the effects of flipped learning designs on English as foreign language (EFL) learners' learning outcomes and CL. A total of 122 EFL learners were randomly assigned to either the control or experimental group and participated in the study. The interpretations were made based on running one‐way analysis of variance between four groups. Results and Conclusion: This study evidenced the efficacy of the interactive use of collaboration‐led flipped learning design over student‐led and teacher‐led designs for improving learning outcomes and lowering CL during computer‐assisted language learning (CALL) course. Pedagogically, CALL practitioners need to develop and integrate a well‐organized combination of student‐led and teacher‐led flipped learning activities for during‐class and out‐of‐class phases with respect to the CL and learning material complexity, while also considering the specific contexts and goals of their instructional settings. Theoretically, the results indicate the necessity of merging active learning and sociocultural theories into an instructional design to take advantage of the identified affordances of flipped language learning approach in terms of psychological effects (CL management) and learning effects (CALL outcomes). Lay Description: What is already known about this topic: The flipped language learning approach involves receiving online instruction outside the classroom and is a learner‐centered pedagogy. What this paper adds: This study contributes by triangulating different strands of data on the effects of flipped learning designs on learning outcomes and cognitive load.The findings highlight the effectiveness of collaboration‐led design for flipped language learning, facilitating engagement in both out‐of‐class and during‐class activities. Implications for practice: The findings emphasize the importance of designing and implementing instructional designs that align with emerging educational technologies.Teachers should consider the flexibility, fluency and novelty of the learning material when designing flipped learning activities. [ABSTRACT FROM AUTHOR]

Background: With the rapid proliferation of online education, it is incumbent upon teachers to find ways to provide online students with science laboratory experiences. Existing research on online labs focuses heavily on computer‐supported inquiry learning environments, such as virtual laboratories and remote laboratories. There are limited studies on kitchen labs or home labs. Objectives: This study investigated the effectiveness of home labs using lab kits from two perspectives: students' perceptions and experiences of labs conducted in a home environment, as well as whether home labs help with students' knowledge acquisition. Methods: This study employed lab quizzes to assess students' performance and lab reports to evaluate students' ability to interpret the lab results accurately in the authentic home lab contexts. Surveys and semi‐structured interviews were used to collect students' perceptions and experience data regarding these hands‐on experiments at home. Results and Conclusions: We found that students' perceptions of home labs are similar to that of face‐to‐face labs, but they generally perceive home labs to be less complex. Students' performances on lab quizzes and lab reports indicate that the majority of them were able to apply the key scientific concepts to accurately interpret lab results in authentic home lab contexts. Students perceived that home labs provide flexibility and help in connecting learning to the real world. However, they also face challenges such as unexpected results and ambiguity during the process. Implications: Based on the key findings from this study and our reflections, four practice guidelines were provided for teaching hands‐on experiments online. Lay Description: What is already known about this topic: Science‐laboratory activities play a critical role in science education. The lack of best practices for teaching science laboratory activities online has become one of the most significant barriers to online education.Existing online labs research focuses heavily on computer‐supported inquiry learning environments, such as virtual laboratories and remote laboratories. There are limited studies on kitchen labs or home labs and some research has mainly an exploratory nature. What this paper adds: The value of authentic hands‐on learning experience is more than the acquisition of laboratory design skills, but also the acquisition of problem‐solving skills in real‐world.This study reported findings of the evaluation of hands‐on home laboratory activities in an online science course from both students' perception and their knowledge acquisition perspectives.This study also explored the benefits and challenges students faced in home labs. Implication for practice and/or policy: Practical guidance and implications for teaching and learning science online using laboratory activities were provided by sharing our experience and lessons learned through the whole process.We recommend that practitioners incorporate more scaffolding and peer collaboration opportunities as well as key concept reflection as teaching strategies to improve the effectiveness of home lab activities. [ABSTRACT FROM AUTHOR]

Background: Evidence supports the effectiveness of shared book reading for promoting language and literacy development, but it is known that families experiencing vulnerability may have reduced access to books and are less likely to share books regularly at home. Community hubs often provide support to families experiencing vulnerability and may provide an opportunity to create environments that support families to engage in shared book reading, especially if families are invited into the creation of these environments through co‐design. However, there is currently little evidence regarding the impact of co‐designing shared book reading environments with families in community settings. Aims: The current study is part of a broader project which used co‐design to develop a shared book reading environment in collaboration with stakeholders in a community hub. This small‐scale study aimed to provide a preliminary evaluation of the impact of this co‐designed shared book reading environment at the community hub on (1) the frequency of shared book reading at the hub; (2) participants' confidence and enjoyment of reading with children at the hub; and (3) participants' experiences of shared book reading at the hub. Method & Procedures: The co‐design project was carried out in four phases with families, staff and community partners at the community hub. A convergent mixed‐methods approach was used to collect and analyse quantitative and qualitative data in the first and last phase of the project to evaluate project outcomes. Quantitative data (environmental observations of reading at the hub and participant ratings of confidence and enjoyment of reading with children at the hub) were analysed using descriptive statistics and nonparametric statistical tests. Qualitative data (participants' responses regarding their experiences of changes implemented in the community hub) were analysed using inductive content analysis. Outcome & Results: An increased frequency of shared book reading was observed within the community hub after changes were implemented, and positive changes in enjoyment of book reading were recorded. Qualitative responses from participants following conclusion of the project were organised into three main categories, which showed that (1) children and families were reading more and enjoying reading activities that were happening; (2) children and families were borrowing more books; and (3) families had changed the way they were reading at home with their children. Conclusions & Implications: A co‐designed shared book reading environment within a community hub had a positive impact on shared book reading experiences for families in areas with high levels of vulnerability. WHAT THIS PAPER ADDS: What is already known on this subject: Community hubs provide a unique opportunity to support early language and literacy development in partnership with families in areas of vulnerability; however, there is limited literature investigating the impacts of these supports. A previous study utilised co‐design to develop a shared book reading environment with stakeholders at a community hub in an area where a high proportion of children are considered to be 'vulnerable' in terms of language and literacy development. It was found that co‐design enabled the development of collaborative changes to support shared book reading that were valued and owned by families, staff and community partners at the community hub. What this study adds: The current study focused on evaluating the impact of a co‐design project on the frequency of shared book reading at the hub and participants' experiences, confidence and enjoyment of reading with children at the hub. Analysis of pre‐ and post‐data provide preliminary evidence that a co‐designed shared book reading environment in a community hub can have a positive impact on increasing families' awareness and engagement with book borrowing, engagement in shared book reading activities in the community and at home, and participants' confidence and enjoyment of reading with children. What are the clinical implications of this work?: Speech pathologists have an important role to play in prevention and promotion. This study has shown that collaboration with families experiencing vulnerability can support the implementation of strategies to promote shared reading in a community hub and demonstrate increased quality and frequency of shared book reading. The utilisation of a community hub also highlights the opportunities for the speech pathology profession to deliver community‐based promotion and prevention initiatives as a strategy to address equitable language outcomes. [ABSTRACT FROM AUTHOR]

Background: People with post‐stroke dysphagia often require informal care from family to facilitate safe swallowing, modify food/drink or administer tube‐feeds. Previous survey studies have found dysphagia may increase family caregiver burden. However, the experiences of family members in this population have not been fully explored. Aims: To explore family members' experiences of living with a spouse with post‐stroke dysphagia. Methods & Procedures: This exploratory qualitative study used one‐to‐one semi‐structured interviews to explore family members' experiences. They were asked open questions about previous eating routines, dysphagia onset, their role and future hopes. Interviews were audio‐recorded, transcribed and analysed thematically with an inductive approach to determine key features of family members' experiences. Outcomes & Results: Five spouses aged 70–93 years participated. Their relatives' strokes happened 3 months to 3 years before the interview. Five themes were identified: 'I do all of it'; making sense of dysphagia; emotional responses; reflecting on relationships; and redefining lifestyle. Conclusions & Implications: It is important to consider family members' perspectives as they often provide vital care to loved‐ones with dysphagia. In relation to eating and drinking, maintaining elements of previous routines seems important to families. Healthcare professionals should consider these when making recommendations for rehabilitation. Family members have differing perspectives of the comparative impact of dysphagia; patient and family priorities should be explored for healthcare professionals to provide better‐targeted support. What this paper adds: What is already known on the subject: Informal caregivers, often spouses, play a vital role in supporting the health and well‐being of older people with health conditions. The presence of post‐stroke dysphagia may present increased challenges for the informal caregiver. There are limited studies qualitatively exploring the experiences of informal caregivers in this population. What this paper adds to existing knowledge: Current health and social care provision for this population leaves informal caregivers feeling they have been left to manage dysphagia alone. Informal caregivers demonstrate a breadth of knowledge about their spouse's dysphagia, problem‐solving effective solutions. Informal caregivers have a range of interpretations of the nature and cause of dysphagia; leading to miscommunication with health professionals and complex emotional responses. What are the potential or actual clinical implications of this work?: Healthcare professionals might consider ways in which to support dysphagic patients' families later in their care pathway, through scheduling reviews or running dysphagia patient and family groups. Health and social care professionals and policymakers should learn from informal caregivers' expertise to promote better health and quality‐of‐life outcomes for the patient and caregiver. Equal, open conversations between health and social care professionals and patients/families on their understanding of dysphagia may help informal caregivers to better voice their concerns and support mutual understanding. This has implications for adherence to recommendations, psychological well‐being and patient safety. [ABSTRACT FROM AUTHOR]

Background: Developmental language disorder (DLD) is a condition which affects an individual's ability to use and understand language. Terminological confusion, and the use of non‐evidence‐based diagnostic criteria has impacted access to services for this population for several decades. Changes in terminology and diagnosis were proposed as part of a UK‐based consensus study, Criteria and Terminology Applied to Language Impairments (CATALISE), in 2016 and 2017. Since the publication of the recommendations, there have been active efforts across several English‐speaking countries to support uptake of these recommendations into policy and practice. Aims: The aim of the study was to explore the experiences of individuals who have been leading the dissemination of the CATALISE recommendations since their publication in 2017. The study was undertaken to inform future implementation efforts aimed at facilitating the adoption of the recommendations into policy and practice. Methods & Procedures: Researchers, practitioners and parents from nine countries were recruited to the study (n = 27). Online focus groups and semi‐structured interviews were conducted using topic guides informed by the Consolidated Framework for Implementation Research. Inductive thematic analysis was undertaken. Preliminary findings were member‐checked prior to completion of the analysis. Outcomes & Results: CATALISE recommendations were described as partially adopted by participants. Dissemination strategies included building a coalition, conducting educational meetings, and developing educational materials. Common barriers to implementation related to the complexity and compatibility of the recommendations, and practitioner confidence. Four themes were identified across the data set to guide future implementation efforts: (a) ride the wave, craft the narrative (b) reach across the divide, be brave (c) create space for multiple voices and, (d) support for speech and language therapistss on the front line. Conclusions & Implications: Individuals with DLD and their families should be included in future implementation planning. Engaged leadership is essential to address issues of complexity, compatibility, sustainability and practitioner confidence if CATALISE recommendations are to be integrated into service workflow and processes. Implementation science can provide a useful lens to progress future research in this area. WHAT THIS PAPER ADDS: What is already known on this subject: Dissemination efforts have been undertaken to facilitate the uptake of recommendations from a UK‐based consensus study (CATALISE) in relation to developmental language disorder since publication across several countries. What this study adds to existing knowledge: The required changes in diagnostic practice are complex to implement. A lack of compatibility with healthcare processes and low practitioner self‐efficacy were also identified as a challenge to implementation. What are the potential or actual clinical observations of this work?: Parents and individuals with developmental language disorder need to be engaged as partners in future implementation planning. Organisational leaders need to facilitate the contextual integration of the changes within service systems. Speech and language therapists require ongoing case‐based opportunities to enhance their confidence and clinical reasoning skills to implement CATALISE recommendations successfully in their everyday practice. [ABSTRACT FROM AUTHOR]

This paper reports an Australian project designed to simultaneously explore and capacity build professional practice when working at the intersection of parental mental health and/or problematic substance use and domestic violence (DV). Data from this paper are derived from two main sources: observations and ethnographic notes obtained during 28 Community of Practice (CoP) meetings and semi‐structured interviews with 28 CoP participants. Participants were front‐line workers from a range of government and non‐government organizations providing services to families experiencing DV across three Australian states who participated in The STACY Project: Safe and Together Addressing ComplexitY. Thematic analysis was employed to examine the research questions: How do professionals and organizations understand and respond to families experiencing DV, parental mental health difficulties and problematic substance use issues? How did practitioners report participation in the STACY Project reorienting professional practice with families experiencing DV, parental mental health difficulties, and substance misuse issues? This paper reports workers' exploration of practice implications. The research found that 'domestic violence blind' practice has become entrenched at the intersections of child protection, substance misuse and mental health problems, but a shared framework could bring practitioners from diverse sectors together to generate new ways of working with these complex problems. [ABSTRACT FROM AUTHOR]

Drawing on the findings from a longitudinal study of vulnerable young people's transitions to adulthood, this paper explores the ideas of shame and recognition. The young people, aged between 12 and 17 years at the first interview, had experienced chronic exposure to adversity from an early age (abuse, violence, mental health issues, addictions, and expulsion from school). They were clients of statutory and non‐governmental services: child welfare, juvenile justice, remedial education, and mental health services. This paper draws on the qualitative phase of the study (n = 107); young people and a trusted other, nominated by the young person, participated in three annual qualitative interviews. Interviews focused on young people's experiences of services, key transitions, their relationships, and the strategies they used to locate support and resources. Experiences of shame, misrecognition, and seeking recognition emerged as dominant themes in the young people's accounts, and these are explored in this paper. The paper concludes with a discussion on responsive social work interventions that generate a deeper understanding of young people's experiences of shame and misrecognition. Central to this practice are critical and relational social work practices that actively support young people to achieve recognition. [ABSTRACT FROM AUTHOR]

Background: People with post‐stroke aphasia (PWA) are more likely to experience serious mood disorders compared with those without. Emotional regulation may be important for influencing life participation after stroke. Understanding emotional regulation in the context of aphasia is important for promoting personally defined recovery, psychological well‐being and life participation. Aims: To explore how individuals experience and regulate negative emotional responses to aphasia as part of re‐engaging with life. Methods & Procedures: In‐depth semi‐structured qualitative interviews with 14 PWA were conducted. The focus and design were developed with public and patient involvement contributors. Reflexive thematic analysis was applied. Outcomes & Results: Analysis generated three themes, which captured inherent diversity across participants in terms of emotional experiences, responses and regulation strategies: (1) emotional upheaval at all stages of recovery; (2) regulating emotional upheaval; and (3) discerning possibilities for life participation. Emotional regulation occurred both within and without the context of formal support services. Conclusions & Implications: Individuals may be differently (en)abled in responding positively, with implications for aphasia psychological support and self‐management interventions. The findings may inform future interventions to optimize well‐being and personally meaningful outcomes for PWA. WHAT THIS PAPER ADDS: What is already known on the subject: PWA experience significant psychosocial upheaval and are at risk of mood disorders. Emotional regulation may be important for influencing one's emotional state, social participation and relationships after stroke. There is a need to better understand the ways in which PWA experience and regulate their emotions to develop better support for personally defined recovery. What this paper adds to existing knowledge: PWA may experience significant and pervasive mood disorders in the long term after stroke. This may be compounded by worries for their children's well‐being. Some, but not all, regulate emotions by drawing on positivity, determination, gratitude or stoicism. Having (supportive) opportunities to experience the impact of aphasia is important for discerning helpful strategies and participation opportunities. What are the potential or actual clinical implications of this work?: Confronting altered abilities requires supportive, responsive opportunities sensitive to emotional responses. Opportunities for peer support and/or meaningful emotional support and compassion from family and friends are important therapeutic targets. Therapeutic input should pay attention to any familial and parenting concerns that may be compounding low mood. Although emotional regulation and recovery may occur without formal support, mental health services must be organized in such a way that PWA can access as needed. [ABSTRACT FROM AUTHOR]

Background: Limited research on the effectiveness of additional online and face‐to‐face practise opportunities for promoting active learning among Chinese EFL learners in higher education. Current understanding of self‐regulated and collaborative learning theories in educational contexts. Objectives: To establish the efficacy of interactive online and face‐to‐face practise opportunities for enhancing active learning among Chinese EFL learners. Methods: Employed mixed methods research to assess the impact of different types of practise opportunities on 116 EFL learners. Utilised methodological triangulation of QUAN + QUAL data and one‐way ANOVA for interpretation. Results and conclusions: The study demonstrated the effectiveness of integrating online and face‐to‐face practise opportunities to enhance active learning. Empirical evidence supports the pedagogical and theoretical benefits of these opportunities for promoting active learning among EFL learners. Lay Summary: What is currently known about this topic: Limited scholarly exploration of supplementary practise opportunities for active learning among Chinese EFL learnersExisting understanding of self‐regulated and collaborative learning theories in educational contexts What does this paper add: Establishes the effectiveness of interactive online and face‐to‐face practise opportunities for promoting active learningProvides empirical evidence supporting the integration of these opportunities to enhance active learning Implications for practise/or policy: Advocates for the combined use of online and face‐to‐face practise opportunities to enrich engagement, problem‐solving, feedback, and motivation among EFL learnersSuggests the development of instructional frameworks based on self‐regulated and collaborative learning theories for enhanced CALL courses [ABSTRACT FROM AUTHOR]

Background: Introducing new technologies in education sparks debates, disrupting traditional practices, and requiring teacher adaptation. ChatGPT is an example. Research explores its benefits and concerns in education, with recommendations for classroom use. Nevertheless, limited evidence supports ChatGPT as a tool for supporting English as a Foreign Language (EFL) students' research competency. Moreover, while the literature primarily focuses on the perspectives of scholars and teachers, it is essential to incorporate students' viewpoints in order to maximize the potential of this technology. Objectives: The present study investigated EFL undergraduates' perceptions and practices of ChatGPT as a tool for promoting their research competency. Additionally, the study examined the potential influence of metacognitive awareness (MA) levels in this context. Methods: The study utilized a mixed‐method research design, collecting quantitative and qualitative data from 27 EFL undergraduates (12 with low MA and 15 with high MA) over one semester. Data sources included a self‐report questionnaire, self‐study log, and semi‐structured interviews. Results and conclusions: Quantitative analysis showed significant differences between low and high MA groups in their perceptions of ChatGPT (U = 37.500, Z = 2.570). Regression analysis revealed a positive correlation between MA scores and students' perceptions and practices of ChatGPT. Qualitative analysis revealed diverse perceptions and practices of ChatGPT between the high MA and low MA groups, showcasing behaviours ranging from replication to using ChatGPT as a thought‐stimulating and supportive tool, accessing supplementary information, and seeking guidance. Key factors for effective ChatGPT use included prompt formulation, systematic thinking, self‐regulation strategies, and trust in AI. Lay Description: What is currently known about this topic: Research competency and metacognitive awareness are important for EFL undergraduates.Technology has been explored for promoting research competency.ChatGPT is used as a learning tool in EFL instruction contexts. What does this paper add: It provides a deeper understanding of the practical application of AI tools like ChatGPT for developing research competency among EFL students.It enhances understanding of metacognition's role in successful learning in digital environments by exploring MA's impact on using ChatGPT for research purposes. Implications for practice/policy: Provide explicit instructions and guidelines for EFL students to effectively use ChatGPT for research competency, emphasizing clear prompt design and fostering responsible use through critical thinking and awareness of biases and limitations.Enhance EFL students' metacognitive awareness through scaffolding, explicit instruction, and activities.Implement assessments and monitoring mechanisms to track metacognitive development and guide instructional interventions.Offer professional development opportunities for EFL teachers to enhance their understanding and skills in integrating AI tools into research instruction and other EFL aspects. [ABSTRACT FROM AUTHOR]

Background: Game‐based learning can frame problem‐solving as a sense‐making experience with domain‐specific tasks for school students. However, multiple challenges arise when trying to support learners in such a complex, problem‐oriented learning environment. Objectives and Methods: With an architecture‐themed mathematics learning game, we conducted two mixed‐method studies to explore the impact and design of game‐based mathematical experience on the math problem‐solving performance of middle school students. Results and Conclusions: The study findings suggested a positive impact of game‐based math experience on math problem‐solving for middle school students. Problematization‐oriented game‐based math tasks with structuring features enhanced students' reasoning with problems and channelled it to doing mathematics. Takeaways: The current research findings support the initiative to frame learning as a sense‐making experience with domain‐specific tasks and inform the design of game‐based mathematical experience and learning support. Lay Description: What is already known about this topic: Realistic mathematical practices frame learning as a sense‐making experience.Challenges arise when involving learners in realistic mathematical experiences driven by domain‐specific tasks. What this paper adds: Game‐based simulation of math tasks framed learning as sense‐making experience.Game‐based math experiencing promoted math contextual problem‐solving performance.Structuring features enhanced problematized experiencing with math tasks. Implications for practice and/or policy: Teachers can integrate and facilitate game‐based math experiencing in class.Efforts should be made to make game‐based math tasks meaningful for students. [ABSTRACT FROM AUTHOR]

Aim: The risk of Type 2 Diabetes is 10 times higher after a pregnancy with Gestational Diabetes. Physical activity can independently reduce this risk, yet engagement with physical activity remains low after Gestational Diabetes. Therefore, the present study aimed to explore the barriers and facilitators to the uptake of physical activity after Gestational Diabetes in the United Kingdom, using a socio‐ecological approach. Methods: The paper was written following the Standards for Reporting Qualitative Research. Patient and Public Involvement contributed to the study's conceptualisation and design. Participants were recruited through an audit of Gestational Diabetes cases at a local Teaching Hospital in 2020. Twelve participants took part in semi‐structured one‐to‐one interviews. Reflexive thematic analysis was used to generate themes in iterative rounds of refinement. The final themes were then organised using the socio‐ecological model. Results: Participants were all over 31 years old, predominantly self‐identified as White British and were all in employment but were evenly spread across UK‐based deprivation deciles. Ten themes were generated and organised according to the four levels of the socio‐ecological model: intrapersonal (beliefs about activity, recovering from birth), social (health care professionals, family and partner, role as a mother), organisational (access and cost, environment, childcare and work) and community (connecting women with recent Gestational Diabetes). Conclusions: Many of the amenable barriers and facilitators to physical activity were beyond the intrapersonal level, based on higher levels of the socio‐ecological model (social, organisational and community). Multi‐level interventions are needed to effectively address all barriers. [ABSTRACT FROM AUTHOR]

Background: Education is, after gaming, the second largest sector embracing augmented reality (AR) at an accelerated pace, yet studies on AR's potential as an efficient learning environment had mixed results. Objectives: This study's primary objective is to test students' interaction with graphical 3D elements in AR and its impact on information retention. The second objective is to compare information retention from AR engagement with information retention from exposure to identical 3D content delivered via instructional video. Finally, the third objective explores students' perceptions of AR as a learning environment. Methods: Sixty‐five college students participated in a two‐arm experiment followed by semi‐structured interviews. Results and Conclusion: AR can efficiently deliver a meaningful learning experience and promotes information retention. Nevertheless, AR's interactive features and novelty may distract learners while they engage with the virtual environment. Objective data obtained through eye tracking and video monitoring showed similar levels of engagement with a 3D model for both environments. While both AR and video groups showed significant knowledge gain from pre to post‐intervention, the video format was overall significantly more effective than AR in increasing topic‐related information retention. However, participants preferred the AR learning environment significantly more than the video. Takeaways: Although effective, AR is still a distracting instructional environment. Designing learning experiences tailored explicitly for AR environments requires additional research to ensure its successful deployment as a learning tool. Lay Description: What is already known about this topic: Education is the second‐fastest growing sector to adopt and experiment with augmented reality (AR).Hardware and software tools to create AR environments have reached the consumer level.The advantage of immersing learners in dedicated virtual environments seems obvious.Research has had mixed results in validating AR as a proper learning environment. What this paper adds: AR is a viable environment which supports information retention.For many students, the medium's novelty promotes engagement with the content.Students prefer AR to video lectures, but it may distract them from learning.Regarding information retention, video lectures do better than AR. The implications of study findings for practitioners: Learning experiences in AR should be reserved for some specific topics and designed purposedly.Progressive exposure of learners to AR environments may produce habituation and decrease distraction. [ABSTRACT FROM AUTHOR]

Background: Tele‐collaborative projects serve as invaluable platforms for students from diverse countries to engage in cross‐cultural communication and exchange cultural knowledge. These projects offer immense benefits in terms of fostering intercultural competence among participants. However, one challenge arises when participants engage in spoken communication rather than written. Those who may not share a common first language often rely on a lingua franca such as English for intercultural communication. In such spoken exchanges, varying levels of language proficiency can lead to communication errors that hinder the intercultural learning process and impede the development of intercultural competence in their fellow participants. Objectives: In the present trial study, our primary objective was to tackle the language‐related challenge associated with spoken communication head‐on. Our focus centred on addressing the discrepancies arising in spoken communication, and we aimed to mitigate these discrepancies by utilizing speech‐enabled corrective feedback technology. Methods: In a tele‐collaborative project involving 28 graduate students from the People's Republic of China and Republic of Kazakhstan, the participants engaged in spoken communication and cultural exchange in English via the internet. Given the emphasis on spoken communication and the recognition that English was not their first language, we implemented a speech‐enabled corrective feedback (SECF) technology to ensure effective communication in terms of pronunciation, grammar, and word choice. The SECF technology detected and provided instant feedback on any speech mistakes, enabling participants to make corrections accordingly. The main aim of our study was to explore the potential benefits of integrating SECF technology into a tele‐collaborative project for the development of participants' intercultural competence. Additionally, we sought to gather insights into the students' perceptions of the SECF support. Results and Conclusions: The results of our study revealed significant improvements in the participants' intercultural competence across dimensions such as knowledge, skills, attitude, and awareness. Furthermore, the participants expressed positive perceptions of the SECF technology. Drawing from our findings, we offer valuable implications and recommendations for educators and researchers in the field, enhancing their understanding of the role of SECF technology in supporting intercultural competence development in tele‐collaborative settings. Lay Description: What is currently known about the subject matter: Tele‐collaborative projects are widely utilized to enhance intercultural competence.Low language proficiency of participants often poses a significant challenge in tele‐collaborative projects. What this paper adds: The present study addressed the language barrier by incorporating speech‐enabled corrective feedback (SECF) technology to support our tele‐collaborative project.The study explored how our tele‐collaborative project, supported by SECF, facilitated the development of intercultural competence. The implications of study findings for practitioners: Scholars and practitioners should consider implementing SECF technology to address language‐related barriers in tele‐collaborative projects.Guidelines based on our study can be utilized to design tele‐collaborative projects with SECF support.Training on technology and constant support needs to be provided to participants. [ABSTRACT FROM AUTHOR]

Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation—the COM‐B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM‐B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia. [ABSTRACT FROM AUTHOR]

Research demonstrates that relationships are key when working to support young people affected by sexual violence. Within these relationships, young people show a preference for non‐judgemental, flexible, consistent and informal support. Peer support – defined here as support provided by those with similar experiences – is however an uncharted area for assisting young people affected by sexual violence. This paper draws on interviews with 25 respondents with knowledge and experience of setting up, supervising and/or participating in peer support initiatives for young people impacted by different forms of sexual violence in Europe and North America. The article highlights how one form of peer support, peer or 'survivor' mentoring, can provide emotional and social support; create space for 'normality'; and give choices to young people. It outlines three unique dimensions to the support provided by peers more generally: relatability, credibility and translatability. The discussion reflects on what this might mean for traditional support provided by professionals. It also draws attention to the significance of recognising both the variety of experience and identity of young survivors of sexual trauma and the impact this may have on promoting relatability within relationships. [ABSTRACT FROM AUTHOR]

Background: Social media is increasingly used by young people, including those with communication disability. To date, though, little is known about how speech–language therapists (SLTs) support the social media use of young people with communication disability. Aims: To explore what services SLTs provide to facilitate the social media use of young people with communication disability, including what these services look like, and the factors that impact SLTs' professional practices. Methods & Procedures: A sequential mixed methods approach was employed including an online survey and in‐depth semi‐structured interviews. Participants were qualified practising SLTs in Australia with a caseload that included clients aged 12–16 years. Quantitative data were analysed with SPSS. A thematic analysis of qualitative data was conducted with NVivo. Outcomes & Results: Survey responses from 61 SLTs were analysed. Interviews were conducted with 16 participants. Survey data indicated that SLTs do not systematically assess or treat young people's use of social media as part of their professional practice. Interview data revealed that where SLTs do support young people's use of social media, they transfer knowledge and practices typically used in offline contexts to underpin their work supporting clients' use of social media. In terms of factors that affect SLTs' practices, three major themes were identified: client/family factors, SLT factors, and societal factors. Conclusions & Implications: While young people with communication disability may desire digital participation in social media spaces, SLTs' current professional practices do not routinely address this need. Professional practice guidelines would support SLTs' practices in this area. Future research should seek the opinions of young people with communication disability regarding their use of social media, and the role of SLTs in facilitating this. WHAT THIS PAPER ADDS: What is already known on the subject: Young people with communication disability use social media, but digital inequality means that they may not do so to the same extent as their typically developing peers. Services targeting a young person's social media use is within the SLT scope of practice. Whether or not SLTs routinely address the social media use of young people with communication disability as part of their professional practice is unknown. What this study adds to existing knowledge: This study found that SLTs in Australia do not systematically provide professional services targeting young people's use of social media. When services do address a young person's use of social media, knowledge and practices typically used by SLTs in offline contexts are adapted to support their work targeting online social media contexts. What are the potential or actual clinical implications of this work?: This study indicates that SLTs should consider a range of factors when deciding whether to address a young person's social media use. Adapting existing offline professional practices to online environments could support SLTs' work in providing services targeting social media use. Professional practice guidelines would support SLTs' work facilitating the social media use of young people with communication disability. [ABSTRACT FROM AUTHOR]

Background: Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom‐heard voices, to ensure that a range of voices are heard and that research is meaningful to them. Objective: We explored how researchers involve and engage seldom‐heard communities around big data research. Methods: This is a qualitative study. Researchers who had experience of involving or engaging seldom‐heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio‐recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. Results: The analysis highlighted the complexity of involving and engaging seldom‐heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. Conclusion: The study offers researchers a better understanding of how to involve and engage seldom‐heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project‐specific and dependent on the public contributors, researchers' needs, resources and time available. Patient and Public Involvement: Two public contributors are authors of the paper and they were involved in the study design, analysis and writing. [ABSTRACT FROM AUTHOR]

Background: Involving patients is a key premise of national and international policies on patient safety, which requires understanding how patients or carers want to be involved and developing resources to support this. This paper examines patients' and carers' views of being involved in patient safety in primary care and their views of potentially using a co‐designed patient safety guide for primary care (PSG‐PC) to foster both involvement and their safety. Methods: A qualitative study using semistructured face‐to‐face interviews with 18 patients and/or carers in primary care. Interviews were transcribed and analysis was conducted using an inductive thematic approach. Results: Overall participants expressed enthusiasm for the PSG‐PC as a tool to support patients and carers to be involved in patient safety in primary care. However, for some participants being involved in patient safety was seen as taking on the role of General Practitioner and had the potential to add an additional workload for patients. Participants' willingness or ability to be involved in patient safety was influenced by a range of factors including an invisible, often underacknowledged role of everyday safety for patients' interactions with primary care; the levels of involvement that patients wanted in their care and safety and the work of embedding the PSG‐PC for patients into their routine interactions with primary care. Participants identified components of the PSG‐PC that would be useful to them, in particular, if they had a responsibility for caring for a family member if they had more complex care or long‐term conditions. Conclusion: Involving patients and carers in patient safety needs a tailored and personalized approach that enables patients and carers to use resources like the PSG‐PC routinely and helps challenge assumptions about their willingness and ability to be involved in patient safety. Doing so would raise awareness of opportunities to be involved in safety in line with personal preference. Patient or Public Contribution: Patient and public involvement were central to the research study. This included working in partnership to develop the PSG‐PC with patients and carers and throughout our study including in the design of the study, recruiting participants, interpretation of findings. [ABSTRACT FROM AUTHOR]

The gathering of 'wishes and feelings' in UK child protection proceedings (s.53 Children Act 2004) should highlight the child's opinion of social work intervention and services provided. However, with no statutory social work guidance on participation currently in place, children frequently miss opportunities to be involved in their own child protection planning. This paper is drawn from a 3‐year study into participation in child protection social work. It includes findings from qualitative interviews, and one focus group, with social workers, parents, children and participation workers, from three local authorities in the United Kingdom. The findings revealed some examples of significant gaps in service provision, particularly from the perspective and understanding of the child. The skewed translation of wishes and feelings legislation, along with its subsequent (and often inadequate) application to practice, prevents children from understanding and responding to social work intervention and can lead to idiosyncratic practice. This paper provides recommendations for a practical response to practitioner dilemmas regarding wishes and feelings and bridges the gap between research and practice. [ABSTRACT FROM AUTHOR]

Background: Despite emerging evidence of validity and reliability, speech and language therapists' (SLT) uptake of telehealth has been limited and barriers remain to the effective and confident use of this service model. The COVID‐19 pandemic has caused significant disruption to essential health services, including speech and language therapy assessment and intervention, meaning that telehealth must now be considered as part of the suite of service delivery options for all clinicians. Aims: To explore the perceived barriers and facilitators of telehealth among community paediatric SLTs before and after their use of a telehealth platform with an embedded standardised assessment tool. Methods & Procedures: Mixed‐methods questionnaires were developed for this study and completed by SLTs before and after the 3‐month trial of the telehealth platform. A total of 38 SLTs completed the pre‐trial questionnaire and training in the use of telehealth platform (Coviu), including instruction in using a standardised, norm referenced language test as an integrated tool within the Coviu platform. A total of 27 SLTs went on to use the telehealth platform, and 25 of these completed the post‐trial questionnaire on which subsequent qualitative and quantitative analysis was completed. Outcomes & Results: Prior to using the platform, perceived barriers included technology issues, limited clinician experience and concerns around parent acceptance of the service. Potential facilitators included access to appropriate platforms, tools and resources as well as increased clinician confidence with telehealth. Following the trial, barriers to telehealth use continued to include technology barriers, particularly internet stability, and client issues, including suitability for telehealth services. Facilitators for future telehealth use included access to appropriate platforms for telehealth, stable and appropriate internet connectivity, and more extensive telehealth resources for both assessment and intervention for this mode of service delivery. Conclusions & Implications: This study provides insights into the perceptions of the barriers and facilitating factors for telehealth use among community‐based SLTs. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery beyond the pandemic. What this paper adds: What is already known on the subject: Research about telehealth has shown that it is a reliable and valid way of delivering speech pathology services, yet many clinicians have been wary of its use and uptake of telehealth prior to COVID‐19 had been limited. We wanted to know what SLTs thought about using telehealth before and after participating in a 3‐month trial of a telehealth platform with an embedded formal language assessment. What this study adds to existing knowledge: This study indicates that technology issues including internet stability are a barrier to effective telehealth services, but that appropriate telehealth platforms, resources and experience are facilitators of uptake and successful use of telehealth. What are the potential or actual clinical implications of this work?: This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery for children during and beyond the pandemic, including those isolated by geographical or transport barriers. [ABSTRACT FROM AUTHOR]

Introduction: The OSCE is a sociomaterial assemblage—a meshing together of human and material components producing multiple effects. Materials matter because they shape candidate performance, with potentially calamitous career consequences if materials influence performance unjustly. Although the OSCE literature refers to materials, few papers study the sociomateriality of OSCEs. Therefore, we explored OSCE stakeholders' talk about sociomaterial assemblages to better understand their importance for candidate performance. Methods: We conducted 15 focus groups with OSCE candidates (n = 42), examiners (n = 20) and simulated patients (n = 17) after an Australian postgraduate nursing OSCE. Sociomateriality informed our team‐based framework analysis of data. Results: Participants identified a multiplicity of OSCE materials (objects, technologies and spaces) thought to matter for candidate performance. Candidates' unfamiliarity with materials and missing or malfunctioning materials were reported to yield numerous negative impacts (eg cognitive overload, negative affect, time‐wasting), thereby adversely affecting candidate performance. Both examiners and candidates made micro‐adjustments to sociomaterial assemblages during the OSCE in order to make it work (eg candidates saying what they would do rather than doing it). Sometimes, such tinkering extended so far that sociomaterial assemblages were ruptured (eg examiners ignoring rubrics to help pass candidates), potentially influencing OSCE standardisation. Discussion: Our novel empirical study extends previous conceptual work by illustrating wide‐ranging sociomaterial assemblages influencing OSCE candidate performance. Further research is now needed employing sociomaterial approaches to further elucidate sociomaterial entanglements in diverse OSCEs. We encourage OSCE stakeholders to become more attuned to the productive nature of materials within all stages of OSCE design and implementation. The authors demonstrate the extent to which materials really matter in shaping candidate performance in OSCEs [ABSTRACT FROM AUTHOR]

Background: Speech disorders in children with a cleft palate with or without a cleft lip (CP±L) are complex given the magnitude of influencing factors. Providing intervention to eliminate these speech errors is often challenging. Speech–language pathologists (SLPs) might have negative perceptions of the treatment of children with a CP±L. Aims: To explore how community SLPs perceive and experience the provision of speech intervention to children with a CP±L. Methods & Procedures: A total of 18 female community SLPs, aged between 23 and 62 years, were included in this study. Semi‐structured interviews were conducted. The interviews were analysed using an inductive thematic approach aiming to identify themes driven by the data. Trustworthiness of the data was achieved by including researcher triangulation (involving three researchers with different research backgrounds) and deviant case analysis of two cases. Outcomes & Results: Initial responses demonstrated that the community SLPs were excited and enthusiastic to treat children with a CP±L. Expanding on these initial reports, however, they revealed that their excitement turned into professional self‐doubt and insecurity when confronted with the treatment challenges inherent with this population. To cope with this self‐doubt, they outlined several responsibilities for the cleft team SLPs. They expressed a strong desire to receive confirmation and approval on their treatment practices from more experienced SLPs (i.e., the cleft team SLPs). Their perceptions were dominated by a polarized thinking pattern. Treatment approaches were divided in categories as 'right' or 'wrong' and 'good' or 'bad'. Conclusions & Implications: The community SLPs are lacking professional confidence when treating children with a CP±L. They put themselves in a subordinate position towards the cleft team SLPs and expect the latter to provide ready‐made answers to problems and questions. This expectation can perhaps be explained by their fear of making mistakes during therapy preventing treatment progress. If they handle in accordance with the experts' advice, they cannot blame themselves in cases where no treatment progress is seen. Educational programmes need to pay more attention to gaining professional confidence (in the search for the most optimal treatment approach for each individual patient) rather than merely focusing on competency‐based learning tools. What this paper adds: What is already known on the subject: Speech disorders in children with a cleft palate with or without a cleft lip (CP±L) are complex given the magnitude of influencing factors. Providing intervention to eliminate these speech errors is often challenging. What this paper adds to existing knowledge: This study explored how community SLPs' perceive and experience the provision of speech intervention to children with a CP±L. The perceptions of community SLPs are dominated by a polarized thinking pattern. Treatment approaches are divided into categories as "right" or "wrong" and "good" or "bad". They lack professional confidence when they treat children with a CP±L. The community SLPs put themselves in a subordinate position towards the cleft team SLPs and expect the latter to provide ready‐made answers to problems and questions. What are the potential or actual clinical implications of this work?: Educational programs in speech‐language pathology need to pay more attention to gaining professional confidence rather than merely focusing on competency‐based learning tools. [ABSTRACT FROM AUTHOR]

Some media have suggested that many youths who have previously completed a gender transition are "detransitioning". Their experience is often framed around the idea of regrets but rare are the articles that provide a nuanced examination of their journey. This article presents the perspectives of youths who have detransitioned or discontinued a transition regarding their experiences and feelings on their journey from transition to detransition. Semi‐structured interviews were conducted with 20 youths between the age of 16 and 25 years who were recruited on social media and who transitioned and detransitioned or discontinued their transition. Data were analysed according to thematic analysis. Regrets and feelings of satisfaction can both coexist. The processes of transition and discontinuation or detransition appear to be non‐linear and participants do not necessarily return to a cisgender identity. Ambiguous loss theory is applied to frame youth experiences and feelings and to suggest way forward for intervention. Highlights: This paper examines the experiences and feelings of youth on their journey from transition to detransition.Their journey is experienced as non‐linear, and often comprised mixed feelings and experiences about transition and detransition steps.Ambiguous loss theory allows a nuanced understanding of feelings and experiences of their journey from transition to detransition. [ABSTRACT FROM AUTHOR]

Aims: To measure the effectiveness of educational programmes for nurses regarding knowledge and practice of advanced resuscitation for newborn infants. Design: This is a quasi‐experimental study in (Sudan, White Nile state), to evaluate the effectiveness of designed guidelines regarding advanced neonatal resuscitation for midwives during the period November 2020–January 2021. Methods: Data were collected using two tools: semi‐structured questionnaire and checklist. The number of the respondents to the questionnaire is 75 nurses. Statistical analyses were conducted using SPSS (version 22). Data were expressed as percentages. The results show that the level of knowledge is improved significantly after training programme interventions, with safe practice reaching (98.70%) compared with a pre‐test percentage of (11.5%). This indicates a steep rise in safe practice after the simulation section, a sharp decrease in unsafe practice after the practical section, followed by subsequent decrease in neonatal mortality rate. This paper has been guided by (STROBE, cohort study) checklist. Results: The study concluded that the majority of nurses and midwives have some knowledge regarding advanced neonatal resuscitation but still, there is a practice gap because of a shortage of facilities and lack of training, However, training programmes do add value on knowledge and practice for nurses and eventually decrease neonatal mortality rate. [ABSTRACT FROM AUTHOR]

Background: There are challenges to person‐centred care provision in Emergency Medical Services (EMS) settings. The environment is often busy and noisy which can influence the experience of older people and their carer/partners when they attend emergency departments. Older people with mental health needs are a vulnerable group of people who are at risk of not having their needs met in acute care settings. This is due to complex presentations and increased pressures on the EMS system. Aim: The aim of the paper was to explore the care experience of older people with mental health needs and their carer/partners in pre‐hospital and in‐hospital Emergency Medical Services settings. Method: This study used an interpretive qualitative approach incorporating in‐depth, individual interviews to gather information on the experience of the older person with mental health needs and carers/partners. Data were analysed using Braun and Clarke's (2006) thematic analysis. Results: Fifteen individual interviews were carried out with older people with mental health needs (n = 10) and with carers/partners (n = 5). Six themes on 'Getting there, getting in and getting out', 'Seeing the person', 'Perceptions and experiences of the pre‐hospital and Emergency Department (ED)', 'The effects of the experience on personal well‐being', 'Older person/carer/partner perceptions and experiences of the EMS staff' and 'Making it better' emerged from the data. Conclusions: The results suggest that previous experiences with the emergency care system influence the way older people with mental health needs and their carers make decisions on current and future care needs. Negative experiences can be influenced by the layout and organisation of the ED. Participants remain reluctant to discuss or disclose their diagnosis in the Emergency Medical Services setting due to a perceived stigma. Health and social care systems and services need to undergo transformations to ensure that all people who access services are treated fairly and effectively. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative case study of postgraduate mental health nurses participating in a monthly facilitated action learning set (ALS) in order to support them while they transition from PGMHN to independent professional practice. The aim of the study was to determine what the impact of participating in an ALS would have on how they perceived clinical practice issues. The ALS comprised a small group of PGMHN supported by a facilitator in order to explore issues from clinical practice by using Socratic questions to challenge their thinking. Data were collected via a single focus group and a 20‐item survey. Focus group textual data were coded line by line, and codes were synthesized thematically. The major theme to emerge from the qualitative results was as follows: 'Learning from doing an action learning set'. Three subthemes were identified: Think outside the box: Developing Socratic questions; there's rarely one right way: Applying action learning to practice; and Not easy to implement: Action plans in action. A 20‐item evaluative survey indicated that ALS increased participant's confidence as a mental health nurse. Using critical questions increased participants' confidence to explore different perspectives when engaged in problem‐solving. [ABSTRACT FROM AUTHOR]

Background: Stroke and aphasia can have a profound impact on people's lives, and depression is a common, frequently persistent consequence. Social networks also suffer, with poor social support associated with worse recovery. It is essential to support psychosocial well‐being post‐stroke, and examine which factors facilitate successful adjustment to living with aphasia. Aims: In the context of a feasibility randomized controlled trial of peer‐befriending (SUPERB), this qualitative study explores adjustment for people with aphasia in the post‐acute phase of recovery, a phase often neglected in previous research. Methods & Procedures: Semi‐structured interviews were conducted with 20 people with aphasia and 10 significant others, who were purposively sampled from the wider group of 56 people with aphasia and 48 significant others. Interviews took place in participants' homes; they were analysed using framework analysis. Outcomes & Results: Participants with aphasia were 10 women and 10 men; their median (interquartile range—IQR) age was 70 (57.5–77.0) years. Twelve participants had mild aphasia, eight moderate–severe aphasia. Significant others were six women and four men with a median (IQR) age of 70.5 (43–79) years. They identified a range of factors that influenced adjustment to aphasia post‐stroke. Some were personal resources, including mood and emotions; identity/sense of self; attitude and outlook; faith and spirituality; and moving forward. Significant others also talked about the impact of becoming carers. Other factors were external sources of support, including familial and other relationships; doctors, nurses and hospital communication; life on the ward; therapies and therapists; psychological support, stroke groups; and community and socializing. Conclusions & Implications: To promote adjustment in the acute phase, hospital staff should prioritize the humanizing aspects of care provision. In the post‐acute phase, clinicians play an integral role in supporting adjustment and can help by focusing on relationship‐centred care, monitoring mental health, promoting quality improvement across the continuum of care and supporting advocacy. What this paper addsWhat is already known on the subjectAnxiety and depression are common consequences of stroke, with depression rates high at 33% at 1 year post‐onset. There is evidence that the psychological needs of people with aphasia are even greater than those of the general stroke population. Social support and social networks are also negatively impacted. Few studies have examined adjustment when people are still in hospital or in the early stages of post‐stroke life in the community (< 6 months). Further, many stroke studies exclude people with aphasia.What this paper adds to existing knowledgeAdjustment to living with stroke and aphasia begins in the early stages of recovery. While this partly depends on personal resources, many factors depend on external sources of help and support. These include doctors, nurses and hospital communication, their experience of life on the ward, and their therapists' person‐centred care.What are the potential or actual clinical implications of this work?Clinicians play an integral role in facilitating people with aphasia to utilize their personal resources and support systems to adjust to life after stroke. They can help by focusing on relationship‐centred care, monitoring mental health, promoting quality improvement across the continuum of care and supporting advocacy. [ABSTRACT FROM AUTHOR]

Background: Formative online multiple‐choice tests are ubiquitous in higher education and potentially powerful learning tools. However, commonly used feedback approaches in online multiple‐choice tests can discourage meaningful engagement and enable strategies, such as trial‐and‐error, that circumvent intended learning outcomes. These strategies will not prepare graduates as self‐regulated learners, nor for the complexities of contemporary work settings. Objectives: To investigate whether providing only a score after formative online multiple‐choice test attempts (score‐only feedback) increases the likelihood of students to engage in self‐regulated learning compared with more directive feedback. Measurable outcomes included deeper learning, collaboration, information seeking, and satisfaction. Methods: Data in this mixed methods study were collected from nursing students through surveys, test results, focus groups, and student discussion board contributions. A quasi‐experimental design was used for quantitative data, and qualitative data were analysed thematically against domains of self‐regulated learning. Results and Conclusions: Students receiving score‐only feedback were more cognitively engaged with the content, collaborated constructively, and sought out richer sources of information. However, it was also associated with lower satisfaction. In this study, minimal feedback created states of uncertainty, which resulted in the activation of self‐regulatory actions. Implications for Practice: Providing overly directive feedback for formative online multiple‐choice tests is conducive to surface‐level learning strategies. By minimising feedback and allowing for extended states of uncertainty, students are more likely to regulate their learning through self‐assessment and problem‐solving strategies, all of which are required by graduates to meet the challenges of real‐world work settings. Lay Description: What is already known about this topic: Formative online multiple‐choice tests are widely used in higher education.Feedback is a critical element in the design of effective online multiple‐choice tests.Formative feedback should promote self‐regulated learning.Feedback types used in multiple‐choice tests facilitate strategies not conducive to self‐regulation. What this paper adds: Online multiple‐choice test feedback can influence how students self‐regulate their learning.Less feedback can result in greater self‐evaluation and performance in summative assessment.Less feedback can encourage richer help‐seeking strategies (collaboration and information seeking).However, less feedback can result in student dissatisfaction. Implications for practice and/or policy: Judicious use of feedback is required in the design of online multiple‐choice tests.Educators should consider providing less feedback to promote learner self‐regulation.Satisfaction with online multiple‐choice tests does not necessarily equate to greater learning. [ABSTRACT FROM AUTHOR]

Background: Flipped classroom (FC) model has become increasingly popular in dental education (DE) with its strengths for students. However, major concerns are lack of interaction, unwillingness to complete the assignments, low engagement during the pre‐class activities because of an unwell‐designed instructional setting of FC. Objectives: The recent study aims to investigate the effects of video‐driven discussions integrated into the flipped classroom (VdDs‐FC) model on dental students' (DSs) learning achievement, practical performance, and higher‐order thinking skills in a restorative dentistry course. Methods: This study adopted a sequential explanatory design from mixed‐methods research. A total of 96 DSs participated in a dentistry faculty of Türkiye. They were randomly divided into two groups: VdDs‐FC group and the conventional flipped classroom (c‐FC) group. Results and conclusions: The results showed that the VdDs‐FC model had significant positive effects on the practical performance of DSs in practical subjects and their problem‐solving and critical thinking skills. However, there was no significant difference between the two groups in learning achievement and creativity. The use of FC in the c‐FC group did not lead to any difference in the students' achievements. Moreover, the qualitative results indicated that the VdDs‐FC model has the potential for enhancing peer learning, practical classroom activities, and higher‐order thinking skills. Implications: This study also includes several instructional implications and suggestions for educators, researchers, and practitioners on use of FC in dentistry. Lay Description: What is already known about this topic: Flipped learning has become a rapidly growing area of dentistry research.Discussion board could be beneficial to increasing dental students' higher order thinking skills, especially problem solving and critical thinking.Video‐driven discussions into flipped classroom provide several opportunities for practical performance in dental education, not for theoretical knowledge. What this paper adds: Video‐driven discussions into flipped classroom model is proposed.We compared two learning environments by including traditional flipped classroom.We found that the integrated model with flipped classroom can have a positive impact on students' achievement.Online discussions usage contributed to higher cognitive, affective, and behavioural learning outcomes.Based on interview data, the proposed model supports peer learning. Implications for practice and/or policy: Dental educators should integrated the digital discussion boards as out‐of‐class activities in the pre‐clinical dental training.From dental educators' perspective, they should be carefully trained in FC design (interaction elements, material design, integration with different methods, etc.).From instructional design perspective, micro videos should have case‐based or problem‐based activities to discuss.From learner perspective, an integration of the flipped classroom with different technologies could have a positive effect on increasing learning. [ABSTRACT FROM AUTHOR]

Background: The number of artificial intelligence (AI) literacy studies in K‐12 education has recently increased, with most research focusing on primary and secondary education contexts. Little research focuses on AI literacy programs in early childhood education. Objectives: The aim of this mixed‐methods study is to examine the feasibility of an AI literacy program called "AI4KG" and explore how it might affect kindergarteners' perceptions of robots and attitudes towards engineering and science. Methods: A total of 26 child–parent dyads recruited from a Hong Kong kindergarten were involved in this study, consisting of 26 children (Mage = 4 years, SD = 0.28) and their parents. Quantitative and qualitative data were collected through surveys and interviews designed to explore children's perceptions of robots and attitudes towards engineering and science, and parents' perceptions of the AI4KG intervention. Results: It is found that children have increased their perceptions of robots after the AI literacy program, but the AI4KG curriculum had no significant effects on kindergarten children's engineering and science attitudes. Most parents (22 out of 26) agreed that their children's AI knowledge, AI skills, and AI attitudes have been enhanced after learning through the AI4KG curriculum. Conclusions: This study suggests that the AI4KG curriculum is potentially effective in promoting early AI literacy and favourable attitudes towards the technology, but further research is needed to develop age‐appropriate measures and assess its long‐term impact on children's education and career paths. Lay Description: What is currently known about this topic?: AI literacy is becoming important as AI transforms society, but few studies have explored AI literacy in early childhood education.Prior research found AI activities can positively influence older children's views of robots and engineering. What does this paper add?: It evaluates an 8‐week AI literacy curriculum called AI4KG for kindergarteners in Hong Kong.The curriculum used tools like Teachable Machine and taught concepts through play and storytelling.It improved children's perceptions of robots but did not significantly impact engineering/science attitudes.Parents perceived improvements in children's AI knowledge, skills, and attitudes after the curriculum. Implications for practice/policy: The curriculum provides an example for developing age‐appropriate AI literacy activities.More rigorous research on impacts over time is needed, but results suggest potential benefits of AI literacy in early childhood.Policymakers could consider incorporating AI literacy into kindergarten curricula to prepare children for the future. [ABSTRACT FROM AUTHOR]

Infant and young child feeding (IYCF) practices are influenced by many context‐ specific factors related to local food systems as well as social and cultural practices. Understanding these local contextual perspectives is essential for designing effective programs and policies. This paper uses focused ethnographic study methods to examine challenges experienced by mothers related to IYCF in two counties in Kenya, a country with considerable heterogeneity in agriculture, food systems, and cultures. A two‐phase qualitative study was undertaken in each of Kilifi County and West Pokot County, entailing interviews and rating activities with mothers, health workers, and vendors. Interviews were audio‐recorded, transcribed, translated into English, coded, and analysed by topic. Results show low levels of dietary diversity in both counties; in West Pokot, the level of adequate meal frequency is also low. Core foods in young child diets included maize porridge and family foods such as ugali (stiff maize porridge), vegetables, beans, fish, and plantains. Food safety, acceptability, and acquisition ease were the main drivers of food choice. Mothers generally felt that all core foods fed to young children are healthy and safe, but there was more variability regarding child acceptance, acquisition ease, cost, and convenience. Common barriers to feeding nutrient‐dense foods to children included child illness, economic constraints, and limited knowledge of modification strategies, skills, or tools to make the foods suitable for young children. Potential actions to address these barriers include sharing information on child‐appropriate recipes; raising awareness on local, affordable nutrient‐dense foods; and improving WASH practices to reduce illness frequency. [ABSTRACT FROM AUTHOR]