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The wellbeing of students in higher education generally, and law students, in particular, has become an area of increasing concern in recent years. Despite the growing interest in the area, empirical work on the wellbeing of distance learning law students remains sparse. This paper builds on previous studies around wellbeing in higher education, especially in relation to law schools, by reporting on the findings of a series of focus groups conducted with distance learning law students at The Open University. Its aim was to explore participants’ perceptions of how studying law had impacted their wellbeing. Its findings indicate that participants viewed the online distance-learning nature of their studies as having the most significant impact on their wellbeing, generating a range of practical and psycho-social implications. Although issues specific to the law as a discipline were raised, it appeared to be the mode of delivery, not the subject content, that was of primary relevance. This exploratory study is particularly salient at this time when law schools across the globe have been forced to perform an ‘online pivot’, with many now also considering expanding their long-term online offerings. The paper concludes by considering the ways in which the results of this study could usefully inform future wellbeing initiatives within online legal education.

As a student, growing up and attending schools in Canada, I found that my racial and cultural identity and experiences were often ignored, questioned, trivialized and/or inferiorized by most of my teachers. Presently, as a teacher, I have born witness to the same type of behaviours within schools albeit, in more covert ways. Such continual oppressive practices prompted this study of how students of South Asian descent describe their educational experiences in K-12 Canadian classrooms. I conducted a qualitative study that was informed by Auto-ethnographic and Critical Ethnographic methods. I used semi-structured interviews to investigate both positive and negative experiences as well as the ways in which participants believed their racial identity may or may not have factored into their schooling. Data was examined using a thematic analysis approach. The themes that emerged were then analzyed through Critical Race Theory, Whiteness Theory, and Anti-racism education lenses. The findings uncovered oppressive practices that contribute to the disaffection of students as well as inclusive practices that lead to validation and engagement. It is hoped that the findings of this study will allow educators to analyze ways in which teacher behaviours and educational institutions perpetuate or combat racism and build or limit the empowerment of their students.

Background: Dementia training for Brazilian GPs is underdeveloped. We investigated knowledge and attitudes to dementia management amongst Brazilian GPs and compared these with previous UK findings to inform future decisions about how training is structured.Methods: 115 Brazilian GPs were asked to complete a Portuguese translation of a questionnaire previously used in the UK. This comprised a 14-item multiple-choice knowledge quiz, and a 5-point Likert-scale questionnaire assessing attitudes across 10 dementia management domains. Exploratory factorial analysis was conducted for attitudes.Results: Attitudes towards dementia demonstrated the same underlying factor structure, “heartsink” and “heartfelt” factors, in Brazil as in previous UK studies, explaining 61.6% of variance in responses. Knowledge scores were negatively correlated with both heartfelt and heartsink factors.Conclusions: Greater knowledge about dementia was associated with some pessimism about dementia care. The similarity in the structure of attitudes towards dementia management between Brazilian and UK GPs provides a starting point for shared educational approaches targeting attitudes.

Context: Mental ill-health affects an estimated one-in-four people over a lifetime, but members of the public can struggle to know how to help someone in need. We therefore felt it was important to create an interactive educational tool focused on mental health literacy. We developed a bespoke educational tool, called A Support Net, and evaluated its uptake in a real-world context. \ud \ud Methods: We captured data including: total learners; completion rates; learner country; and time spent using A Support Net. \ud \ud Intervention: A Support Net uses immersive video-based vignettes demonstrating realistic case studies of someone struggling with mental health problems, and learners are encouraged to reflect on how to support that person. Learners are introduced to four different scenarios and are tasked with making decisions around supporting that person, with the aim of making a positive difference (visually displayed with a ‘your impact’ scale). \ud \ud Results: To date there have been 8,814 users. The most frequently used vignette (‘Lily’) was accessed by 2,848 learners and had a completion rate of 62%. Most learners are from the UK, and 86% used the tool on their PC (average amount of time spent = 11 minutes). \ud \ud Conclusions: Overall engagement, evidenced by total learner numbers, has been encouraging which could indicate that the use of video vignettes was an engaging intervention strategy. However the completion rates for all four scenarios are low. For future interactive tools of this kind we plan to include a small number of evaluation items to measure possible improvements in mental health literacy.

Background: Studies have sought to determine the possible precursors to medical students’ and doctors’ positive or negative attitudes towards older patients by examining associations with a variety of demographic, educational/training, and job/career factors. A review is now needed to explore the quality of these studies and to synthesize findings.\ud \ud Methods: A systematic review on the worldwide English language literature was conducted. Ten databases were explored (including Medline, PsychInfo and Science Direct) from database inception to December 2015 using a systematic search strategy. Quality was assessed and reported.\ud \ud Results: The search identified 2332 articles; 37 studies met the eligibility criteria. Students’ year in medical school, doctors’ years of practice or seniority, participants’ age and ethnicity did not appear to demonstrate relationships with (positive or negative) attitudes towards older patients. Ten studies reported that female medical students and/or doctors reported significantly more positive attitudes towards older patients than their male counterparts, although 18 studies found no differences. No studies reported more positive attitudes scores for males than females. Interest in working in older patient settings and reporting a high level of intrinsic motivation for choosing medicine as a career were both associated with positive attitudes towards older patients. Eight of 11 studies found more positive attitudes were reported by those who demonstrated higher levels of knowledge about ageing but this apparent relationship is questioned here due to methodological issues identified in the quality assessment stage pertaining to the knowledge measures employed. Reliability and validity of the attitude measures, that were employed, were examined.\ud \ud Conclusions: This article has identified factors associated with medical students’ and doctors’ positive attitudes towards older patients, as well as factors which have been extensively studied but failed to demonstrate meaningful relationships with attitudes. This is the first study to identify that the relationship between attitudes and knowledge about ageing may be a methodological artefact. Future research can build on the relationships identified here and should employ appropriate measures of attitudes with demonstrated reliability and validity.

Background Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. Methods We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians’ scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014. Results The top three problems were incomplete reconciliation of medication during patient ‘hand-overs’, inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score. Conclusions Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method, and merits further exploration with a view to becoming a part of a routine preventative patient safety monitoring mechanism. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0552-6) contains supplementary material, which is available to authorized users.

Objective: To identify patient safety monitoring strategies in primary care. Design: Open-ended questionnaire survey. Participants: A total of 113 healthcare professionals returned the survey from a group of 500 who were invited to participate achieving a response rate of 22.6%. Setting: North-West London, United Kingdom. Method: A paper-based and equivalent online survey was developed and subjected to multiple stages of piloting. Respondents were asked to suggest strategies for monitoring patient safety in primary care. These monitoring suggestions were then subjected to a content frequency analysis which was conducted by two researchers. Main Outcome measures: Respondent-derived monitoring strategies. Results: In total, respondents offered 188 suggestions for monitoring patient safety in primary care. The content analysis revealed that these could be condensed into 24 different future monitoring strategies with varying levels of support. Most commonly, respondents supported the suggestion that patient safety can only be monitored effectively in primary care with greater levels of staffing or with additional resources. Conclusion: Approximately one-third of all responses were recommendations for strategies which addressed monitoring of the individual in the clinical practice environment (e.g. GP, practice nurse) to improve safety. There was a clear need for more staff and resource set aside to allow and encourage safety monitoring. Respondents recommended the dissemination of specific information for monitoring patient safety such as distributing the lessons of significant event audits amongst GP practices to enable shared learning.