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Professional practice in the care of young people should include effective communication, a policy of inclusion and active assessment of competence.

Journal of Advanced Nursing 47(2), 153-164 Developing Lecturer Practitioner roles using action research Background. Lecturer Practitioner roles are well established in the United Kingdom. The national literature demonstrates that these staff are valuable to National Health Service trusts and universities however, their roles are busy and demanding, with conflicting expectations from the two employers. In addition, their role in addressing the theory-practice gap -a major reason for their establishment -is at best unclear. Although a number of qualitative studies have explored the topic, there have been no systematic attempts to develop the role or to quantify the effects on postholders.Aim. This paper reports a study that aimed to develop aspects of Lecturer Practitioners' work roles, examine the effects of this on individuals at one English university, and to quantify Lecturer Practitioners' occupational stress and burnout. Methods. A flexible, 'spiral' action research framework and 'collaborative group approach' were used, with mixed methods of data collection. Data were collected through focus groups, meetings and participant feedback, and participants' reflective diaries. A questionnaire using previously validated psychological attitude rating scales was also used to measure occupational stress and burnout, the extent to which the project influenced these, and the influence of Lecturer Practitioners' experience and qualifications. Six null hypotheses were constructed to measure these ideas. Findings from qualitative and quantitative perspectives were triangulated to give depth to the analysis. Findings. Five themes emerged from the focus groups: personal motivation, workload pressures, role clarity, preparation and support, and gains from the role. Specific policies and documentation were developed as a result of this initial project planning work. The findings from the questionnaire indicated that Lecturer Practitioners were no more stressed or burnt out than comparable workers. Synthesis of findings indicated, broadly speaking, that these LPs were 'thriving rather than just surviving'. Conclusion. Action research was an effective methodology for uncovering new knowledge, and bringing about organizational change in this project.

Students undertaking educational preparation for advanced practice roles see themselves as innovators, specifically aiming to develop and improve aspects of service provision. Education for advanced practice roles should not be undertaken lightly, but can equip students with various skills, particularly regarding clinical assessment, and these skills should underpin practitioners' autonomy.

This article discusses the communication issues arising from one of the themes identified in a phenomenological study exploring young people’s perceptions of their involvement in healthcare decisions affecting management of their care (Kelsey et al, 2007). Communications were described in terms of ‘satisfactory’ and ‘poor’ experiences. Satisfactory experiences included being spoken to directly and asked to provide information, appropriate modification of technical language, good listening skills and demonstrating empathy. Poor experiences included inadequate non verbal communication, power imbalances, exclusion from conversation and judgemental attitudes. These experiences are depicted utilising extracts from the young people’s interviews and discussed in relation to current literature on adolescent developmental and communication theory. Implications for future practice are identified.