Objectives To test the feasibility of professional patients as a tool for sexual health service evaluation. Professional patients are paid to use services specifically for audit or evaluation purposes without disclosing their identity as evaluators.Methods Professional patients visited five large sexual health departments used by 3000 clients per week in two inner London Boroughs with very high rates of sexual ill health. They recorded their experience on a structured evaluation form. Semi-structured telephone interviews were completed with seven service providers to document their experience of the programme.Results Recruitment and training for professional patients is described. Forty professional patients made 105 visits during two rounds of visits 9 months apart. After 47% (round 1) and 62% (round 2) of visits, the professional patients felt that they would recommend the service to a friend. The professional patients provided detailed and specific feedback on all aspects of service provision. This information was highly valued by service providers who reported few objections from staff to the visits. A small number of examples of very poor care were documented.Conclusions Professional patients are a useful tool for sexual health service evaluation. They provide high quality feedback because they are both ÔexpertsÕ on sexual health service provision and users of sexual health services. This method of evaluation raises ethical issues about the acceptability of deception as part of the evaluation process, the right of staff to anonymity and to refuse to be visited. Professional patient programmes provide an opportunity for regular cycles of user feedback to monitor quality improvement.

Drawing on Language Awareness (LA) approaches developed for francophone classrooms and a sociocultural theoretical perspective on language and learning that posits the genesis of new knowledge construction is situated in social interactions and shaped by socio-historical context, we conducted a small-scale case study of the implementation of LA activities in elementary school. Fieldwork practices included observing and videotaping classroom interactions among French Immersion students in Vancouver and students from the mainstream francophone programme and classes d'accueil in Montreal, individual and focus group interviews with students, and collecting relevant documents for context descriptiori. In this paper, our analysis of data demonstrates how LA activities enabled teachers to engage students in focused discussions about language diversity and fostered the emergence of a community of learners who had access to a repertoire of languages that expanded beyond official languages. We examine how collaborative LA activities encouraged students to draw on collective language resources to approach languages unknown by the majority. We argue that valuing and sharing knowledge of diverse languages in classroom discussions fostered the discursive co-construction of new knowledge about the evolution of languages, relationships between languages, as well as a critical stance on the relative status of languages.

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