The clinical learning environment itself and support from the mentor are key factors that influence student preparation for registration. Without this level of support, students may be left feeling unprepared to deal with the transition.

Background: An increasing number of the ageing population worldwide is at risk of becoming frail and incapacitated. This has the potential to impact not only on the well-being of individuals but also on the sustainability of healthcare systems.Objective: The aim of this study was to explore the views and experiences of frailty from the perspective of primary care professionals, including nurses, who work directly with older people within the community. Methods:A qualitative approach with a descriptive phenomenological methodology was used, which focused on exploration of primary care professionals' current experiences of early detection and prevention of the onset of frailty. Four multiprofessional focus groups were held with a total of thirty-three primary care professionals who worked with older people as part of their daily role. Participants included district nurses, general practitioners, home care workers, physiotherapists and social workers. Results: Professional views encompassed typical patterns of ageing, loneliness, presence of comorbidity, disability and end of life, with social conditions prevalent in most frailty they encountered. Three main themes emerged: the psychosocial nature of frailty, late detection of frailty and barriers to the feasibility of prevention. Physical frailty was considered a constituent part of ageing, which recognised the presence of a skills gap related to the detection of the early signs of frailty. Present health and social care systems are not designed to prevent frailty, and the competencies required by health and social care professionals are not usually included as part of their training curricula. This may hinder opportunities to intervene to prevent associated decline in ability of older adults. Conclusions: To enhance the early assessment of frailty and the planning of preventive multi-factorial interventions in primary care and community settings, training and effective detection strategies should be incorporated into the role and daily care activities of primary care professionals.

PurposeThe objective of this paper is to investigate how design variables – specifically spatial arrangements and adjacencies (which are termed “place”) – can be best deployed to improve working practices (which are called “process”) in order to help creative organisations to enhance the performance of working groups (i.e. support managerial purpose).Design/methodology/approachObservations of space use over time and questionnaires eliciting participants' opinions on the impact of the new spatial arrangements on working methods were used in two healthcare companies to study the outcomes of pilot projects.FindingsThe managerial objectives in both companies were to create working environments that could be used to stimulate interaction within and between diverse disciplines brought together to develop new healthcare products. Significant benefits were reported, particularly improved accessibility and collaboration within and between working groups – an important conclusion is that no individual design feature was responsible for the changes but rather the weaving together of place and process in pursuit of managerial purpose.Research limitations/implicationsThe interaction of purpose, place and process has led one to conclude that methods dependent on limiting variables and controlling contexts are not appropriate for studying relationships between environment, productivity and user satisfaction. The synoptic, multivariate and interventionist Harvard Business School case study method may be more appropriate.Originality/valueEnvironmental variables are far from being irrelevant to achieving improvements in organisational performance in creative organisations. However, context, purpose and process must also be taken into account.

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