Objective To identify factors affecting the decision of pregnant women to withhold their consent to Design A qualitative, cross-sectional, retrospective study using semi-structured interviews with Setting Patients' homes.Participants Eighteen women who had been invited previously to participate in a clinical trial in pregnancy, but who had declined. ResultsThe invitation to participate in a clinical trial when pregnant has different implications for different women, and the meanings they ascribe to the invitation to participate will affect the likelihood of them participating. Apregnant woman may feel the pressure of conflicting duties: a protective duty to the fetus and to be a 'good citizen' when asked to participate in research. The sharing of information during the recruitment phase has a crucial bearing on how the invitation will be received. The design of the trial, the type and style of information available, the manner in which it is conveyed, the timing and process of the invitation and by whom it is made all affect the likelihood of a woman agreeing to take part.By asking for the contribution of these women, this study identified factors that can influence the chances of an individual entering a trial or not. Contextualising and personalising risk is important in the consent process as recruiting women when pregnant can be difficult and hinder research. From these comments recommendations for future research involving pregnant women participate in a clinical trial. thematic content analysis. Conclusionhave been drawn up.

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This paper reports the first stage in the development of a tool, the Six Staffordshire Teaching Styles Questionnaire, designed to raise awareness in teachers about their teaching style. Effective teachers are adaptable and flexible in providing variety in their teaching activities, aiming to match their manipulation of the teaching and learning environment to the needs of the learner, but teachers should also know what type of activities they are most effective at delivering. Just as mismatched learning styles can cause dysfunctional learning situations, one of the causes of stress in teachers can be an incongruency between the type of activities they believe are effective, or feel they are good at carrying out, and external expectations of “good teaching”.

Introduction Clinicians are being asked to play a major role leading the NHS. While much is written on about clinical leadership, little research in the medical literature has examined perceptions of the term or mapped the perceived attributes required for success. Objective To capture the views of senior UK healthcare leaders regarding their perception of the term `clinical leadership' and the cultural backdrop in which it is being espoused. Setting UK Healthcare sector Participants Senior UK Healthcare leaders Methods Twenty senior healthcare leaders including a former Health Minister, NHS Executives, NHS Strategic Health Authority, PCT and Acute Trust chief executives and medical directors, Medical Deans and other key actors in the UK medical leadership arena were interviewed between 2010 and 2011 using a semi-structured interview technique. Using grounded theory, themes were identified and subsequently analysed in an attempt to answer the broad questions posed. Main outcome measures Not applicable for a qualitative research project Results A number of themes emerged from this qualitative study. First, there was evidence of changing attitudes among doctors, particularly trainees, towards becoming involved in clinical leadership. However, there was unease over the ambiguity of the term ‘clinical leadership’ and the implications for the future. There was, however, broad agreement as to the perceived attributes and skills required for success in healthcare leadership. Conclusions Clinical leadership is often perceived to be doctor centric and ‘Healthcare Leadership’ may be a more inclusive term. An understanding of the historical medico-political context of the leadership debate is required by all healthcare leaders to fully understand the challenges of changing healthcare culture. Whilst the broad attributes deemed essential for success as a healthcare leaders are not new, significant effort and investment, including a physical Healthcare Academy, are required to best utilise and harmonise the breadth of leadership talent in the NHS.