The priority to ensure patient safety and use resources effectively, demands attention and innovation. Video enhanced reflective practice (VERP) provides training based upon analysis of film clips of one's professional practice to develop practical insight into the processes of communication, so that effective changes can be made to ongoing behaviour and practice.In this case the focus was on multi-disciplinary communication within daily board rounds on an acute medicine and care of the elderly ward.Baseline assessment and post intervention testing of perceptions of change by both full and core team were undertaken to establish the impact of VERP training. In addition pre and post focus group discussion and film analysis supplemented evaluation.The findings support the view that after VERP training of a core team, board rounds were seen as consistently easier to participate in, providing improved focus, were more efficient in goal setting and resulting in better care for patients as well as improved pathways to discharge. This suggests benefits to the communication "culture" of a multidisciplinary team resulting in increased benefits for the wider team.It is concluded that the use of tailored VERP training for personal, professional and team development is relevant, feasible, and worthy of further testing and investigation. ProblemA board round is a process which should improve communication among the multi-disciplinary team (MDT), enhancing team working and providing a more coordinated approach to discharge planning.In our pilot ward, an acute medical and care of the elderly ward, board rounds had been in place for around three years. For the board round all team members are expected to assemble at 11.10 am each morning in front of the white board at the nurses station.This board contains patient details including planned date of discharge, any risk factors to patient safety and input from physiotherapy,occupational therapy or social work. The board rounds are attended by the nurse in charge, consultant, middle grade and junior doctors, junior and senior nurses, social worker, physiotherapist, occupational therapist and ward clerk among others. There follows a twenty minute discussion of the thirty inpatients in the ward with an emphasis on facilitating early and safe discharge. This process requires efficient communication of all and input from different members of the team depending on the case discussed. An inefficient board round process leads to delays in discharging patients. In our pilot ward it was recognised that board rounds were often not as efficient and useful as they could be.Rarely was it possible to contain the discussion to its allocated time of twenty minutes, and there were frequent distractions and often not all staff were present. Some improvement work had already been undertaken as part of a breakthrough series improvement collaborative (OPAC) in NHS Tayside which set out to improve the experience of older people in our acute care hospital wards.Several PDSA (Plan, Do, Study, Act) ...

This study aimed to involve International Baccalaureate (IB) teachers in formative assessment and summative evaluation of a continuing professional development (CPD) programme designed to facilitate a studentcentred, process-focused approach in which the 'Approaches to Learning' (ATL) element of the IB curriculum takes a central role. Given its emphasis on participants' collective perspectives, focus groups were selected as the data collection method. Respondents were twelve teachers with diverse backgrounds and experience, from different school departments, with varying teaching styles, epistemological beliefs and views regarding ATL. This study includes a discussion of the literature with reference to teachers' beliefs, attitudes, values and knowledge, the role these play in teaching practices, the extent to which CPD may be able to influence them, and the elements of CPD which make teachers' development more likely. Findings indicate that formatively assessing teachers' development from CPD, and development itself, are 'messy' processes, as is trying to distinguish between 'student-centred' and 'teacher-centred' teaching in relation to facilitating self-regulated learning. Differences were identified in how experienced teachers, particularly those with Postgraduate Certificate in Education (PGCE) certification and new teachers, particularly those without a PGCE, reacted to CPD and developed in relation to the aims of CPD. However, these issues were mitigated over time by the CPD programme's emphasis on collegiality and its coherence with previous CPD and IB standards for teaching and learning. Students' increasing competence with, and acceptance of, student-centred teaching also made it easier for teachers to develop their practice, illuminating the nature of enculturation as a driver of learning. Importantly, formative assessment helped the researcher to understand the complex and incremental nature of teachers' development as well as gain insights into how CPD contributed to that development. This investigation demonstrates that brief experiences of top down, whole school, 'training model' CPD can, indeed, enhance teachers' student-centredness and facilitate explicit instruction of ATL skills, and illustrates the utility of using focus groups to formatively assess, and summatively evaluate, teachers' CPD.

This investigation set out to explore the self-regulated learning strategies implemented by high-achieving International Baccalaureate (IB) Diploma Programme (DP) students and those with learning difficulties in a context in which teachers were developing their practice to better align with IB philosophy. Specifically, I aimed to determine whether the strategies used by students in the two categories differed and, if so, what accounted for these differences. The sample included four DP students with diagnosed learning difficulties and six high-achieving DP students. Methods included collecting samples of independent work that reflected their strategy use; accompanying written reflections; and semi-structured interviews utilising a combination of stimulated recall and open-ended questions. Results suggest that only slight differences existed in the number and type of strategies used by participants in each category, but there were some important differences in strategy quality. These differences appeared to be related to the epistemic awareness students demonstrated, rather than their categorisation as having learning difficulties or being high-achieving. Although the IB Diploma Programme is widely considered an appropriate secondary programme for high-achieving students, its potential to enhance self-regulated learning suggests this programme may also be an appropriate option for some university-bound students with learning difficulties. As the literature review for this investigation uncovered only one previous study pertaining to IB Diploma Programme students with learning difficulties, this is a significant contribution to knowledge with implications for admissions as well as teaching and learning in IB schools. The investigation also indicates that epistemic awareness may play a more significant role in self-regulated learning than contemporary theories suggest.

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