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Advanced Journal of Professional Practice
Number of Followers: 29  Open Access journalISSN (Online) 2059-3198 Published by U of Kent  [4 journals]
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- Being ‘accommodated’ is not the same as ‘belonging’: Achieving an
EDI milestone.
Authors: Claire L. Parkin, Kate Dart
PubDate: 2023-02-01
DOI: 10.22024/UniKent/03/ajpp.1053
Issue No: Vol. 3, No. 2 (2023)
- The use of assisted robotics in promoting movement at the elbow joint.
Authors: Alfie Wain, Zuvarnan Theivendram
Pages: 27 - 27
Abstract: The use of assistive robotics in healthcare is a relatively new concept which has been growing over the 21st century. The clinical use of an assistive robot in a rehabilitative context is to support the movement of a person with a degree of motor impairment (Reinkensmeyer, 2021). Evidence from Malik et al. (2016) and Lo et al. (2017) suggests the use of assistive robotics in rehabilitation and physiotherapy improves outcomes for a wide variety of patients, such as post stroke patients (Figure 1) or patients with neurological disorders, such as cerebral palsy.
PubDate: 2023-02-01
DOI: 10.22024/UniKent/03/ajpp.1142
Issue No: Vol. 3, No. 2 (2023)
- Assisted robotic arm for patient with cerebral palsy.
Authors: Karen Lin, Benjamin Yip
Pages: 28 - 28
Abstract: Many diseases can affect the motility of an individual, such as Parkinson’s disease and cerebral palsy (CP). This project focuses on creating a prototype for a wearable assistive device which aims to provide support to patients who have been affected by a chronic illness influencing their mobility. We will be focusing on the medical, mechanical, and biopsychosocial aspects in designing our wearable assistive device to cater to the patients’ needs.
PubDate: 2023-02-01
DOI: 10.22024/UniKent/03/ajpp.1141
Issue No: Vol. 3, No. 2 (2023)
- Exploring how the level of ethnic diversity and segregation in Faculty of
Medicine, Health Sciences, and Pharmacy courses affects the size of the
Ethnicity Attainment Gap.
Authors: Oyinkansola Bello, Yvonne Mbaki, Marie Kokolski, Susan Anderson
Pages: 32 - 32
Abstract: Background:Research shows multifaceted / poorly understood causes of the Ethnicity Attainment Gap (EAG) between White & Black, Asian, and Minority Ethnic (BAME) students within the UK. Mclean's (2013) study on EAG found it grows throughout the course due to university factors. This paper investigates the Powell Diversity Rationale Hypothesis — whether ethnic diversity and segregation in The Faculty of Medicine, Health Science and Pharmacy (TFMHSP) courses affect the EAG. Method:Ethical approval gained; a survey was distributed to 1000+ students. In categories concerning belonging, discrimination and ethnic segregation, data analysis revealed significant discrepancies between BAME/White students' responses. Using Kivlighan’s Diversity Index, an objective measure of ethnic diversity determined the most (Medical Physiology and Therapeutics (MPT)) and least (Biology) diverse courses, both were compared using established themes and perceived attainment. Findings:Responses were representative of the ethnicity split of the 2018 cohort (63.46% White and 35.58% BAME). BAME MPT/Biology students had no significant differences in their perceived grades compared to White students and both reported no ethnic representation in university leadership e.g., academic staff. Other areas where BAME student experience was poorer concerned facing discrimination/harassment. A 2021 redistribution of the survey revealed that Covid-19 may influence the EAG, but only short-term changes were observed. Conclusions:Ethnic diversity does not reduce EAG based on perceived attainment. Recommendations for further research to identify/address the reasons of the EAG include employing real grades/focus groups. These aim to improve the university environment & build well-rounded healthcare professionals.
PubDate: 2023-03-20
DOI: 10.22024/UniKent/03/ajpp.1157
Issue No: Vol. 3, No. 2 (2023)
- The role of the multi-professional consultant practitioner in supporting
workforce transformation in the UK
Authors: Kim Manley, Robert Crouch, Renee Ward, Esther Clift, Carolyn Jackson, Jane Christie, Helen Williams, Beverley Harden
Pages: 1 - 26
Abstract: There is an urgent need to transform health and social care to take a whole systems approach to meet health and social care need and address health inequalities in partnership with citizens and communities to focus on what matters to them. Pivotal to this is transformation of the healthcare workforce to develop the capabilities required and offer career progression and development opportunities to attract and retain staff. The contribution that multi professional consultant practice roles can make as system leaders to this challenge is highlighted across the five domains of multi-professional consultant level practice: 1) strategic and enabling leadership; 2) learning, developing, improving practices; 3) embedded research and inclusive evaluation; plus 4) process consultancy combined with 5) the credibility of professional expertise. The interdependence of these domains is a crucial part of the role, and its inbuilt flexibility is an asset which enables changing priorities and community needs to be addressed in partnership with people. The multi-professional skillset also contributes to developing effective cultures of learning at every level of the health and care system. This feature enables change to be embedded sustainably through drawing on and valuing the contribution of all and developing good places to work – instrumental in both workforce retention and innovation. Multi-professional consultant practice roles are an invaluable resource that needs to be at the forefront of system transformation ARTICLES AJPP 3 Vol 3, No2 (2022) and recognised as catalytic for achieving strategic priorities by commissioners. This paper provides three consultant level practice case studies in pharmacy, nursing, and allied health practice to illustrate impact and outcomes on population health priorities. There is an urgent need to invest in workforce education and development if the future vision for people centred integrated health and social care is to be realised and sustained in the longer term. This requires investment in commissioning consultant practitioner roles as systems leaders and creating attractive career progression and development frameworks for practitioners to progress from enhanced to advanced to consultant practitioner level roles.
PubDate: 2022-12-08
DOI: 10.22024/UniKent/03/ajpp.1057
Issue No: Vol. 3, No. 2 (2022)
- Reporting the inequalities in the access to medical school depending on
applicant’s self-perception: Medical Schools Council’s Report.
Authors: Yasmin Biston, Trisha Greenhalgh
Pages: 29 - 29
Abstract: The socio-economic inequalities associated with access to medical school are highlighted in the Medical School Council’s (MSC) report where there is a significant gap between the number of medical school applicants who come from disadvantaged areas and the number of medical school applicants from advantaged backgrounds1. Reports highlight that this inequality is driven by the perception young people from low socio-economic backgrounds have of themselves2. The MSC report uses the Multiple Deprivation Index to assess the deprivation of an area which illustrates individuals from deprived areas on average make up 4.8% of medical school applicants annually1. Data collected from The Medical Student Personal Beliefs Questionnaire highlight the different attitudes displayed in students from affluent areas and non-affluent areas. Overall, students from disadvantaged areas believe that medicine is not accessible to them. Differently, the students from higher socio-economic backgrounds believed that medicine is something that they can see themselves fulfilling. Less affluent students believe that having a higher social class and receiving superior education would provide them with an edge in the admissions process2. Individuals from disadvantaged backgrounds perceive themselves as not worthy to practise medicine. Surely, with more doctors being established from lower socio-economic backgrounds there will be more doctors representative of the patients they serve. Therefore, for the morale of university applicants and the future of medicine, schools need to help further break down the stereotype that medical school is only accessible if you come from a background of wealth and a family line of doctors.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1154
Issue No: Vol. 3, No. 2 (2022)
- Effects of gender on participation in different sized groups.
Authors: Berivan A Arikan, Susan Anderson, Yvonne Mbaki, Marie Kokolski
Pages: 30 - 30
Abstract: Background:Universities incorporate the use of small and large group teaching. Assessing how comfortable different genders feel participating in both can give an insight into differences in participation and student experience. This project assessed if there is a relationship between student gender and comfort participating in different sized groups. Method:Responses from the BAME Attainment Gap Survey distributed in the Faculty of Medicine and Health Sciences in a UK University were used. Nonparametric and multiple comparisons tests compared how comfortable different groups of students were participating in different sized groups. This included between males and females, groups of courses with different gender proportions, and students in different gender stereotyped courses such as medicine and nursing. Further questions from the questionnaire were also compared within these groups. Findings:Findings suggest all males feel significantly more comfortable than females participating in both sized groups, particularly large groups. Being in a gender stereotyped course only affected female comfort in participation. There were some correlations between increasing the proportion of females and comfort in participating. Finally, there were limited correlations between student experience and comfort in participating. Conclusions:This study provides evidence suggesting that gender does have an impact on how comfortable students are participating in class. Large group teaching may cause a greater inequality of engagement between students than small groups, however this may be affected by the nature of the course, and proportions of females. These results may have implications on how institutions use different sized teaching groups, and admissions.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1155
Issue No: Vol. 3, No. 2 (2022)
- Equality: an evaluation of the experience of LGBTQ+ healthcare students at
university.
Authors: Rhian Pembridge, Susan Anderson, Yvonne Mbaki, Marie Kokolski
Pages: 31 - 31
Abstract: Background:Evaluate lesbian, gay, bisexual, transgender, non-heterosexual, non-cisgender (LGBTQ+) and cisgender/heterosexual (CisHet) healthcare students’ experiences of social inclusion, mental health and wellbeing, staff support, discrimination, and diversity at university between 2018 and 2021. Method:Statistical analysis using non-parametric (Mann-Whitney, Kruskal-Wallis, Dunn’s multiple comparison test) and parametric (unpaired t-test) analyses on LGBTQ+ and CisHet students’ responses to two questionnaires; Questionnaire A to students in the faculty of medicine and healthcare science in 2018, and Questionnaire B to medical students in 2021. Findings:LGBTQ+ and CisHet students similarly felt welcome, however, LGBTQ+ students agreed significantly more than CisHet students that their sexual orientation influenced their sense of belonging, and they experienced or witnessed significantly more discrimination than CisHet students. In 2021, both groups felt less supported by their tutors, with LGBTQ+ students feeling more supported by their friends. LGBTQ+ students disagreed significantly more than CisHet students that there was sufficient LGBTQ+-diversity amongst staff and students and agreed less that the university encouraged LGBTQ+ diversity in staff. From 2018 to 2021, both groups’ awareness of equality, diversity and inclusion policies increased, they found maintaining their wellbeing more difficult, and they felt similarly neutral regarding the diversity of resources. Conclusions:While both groups’ experiences were similar in many aspects, LGBTQ+ healthcare students had different experiences of inclusion, representation and discrimination than CisHet students. Recommendations included improving LGBTQ+ representation amongst staff and in the curriculum, increase signposting for wellbeing services, and make reporting of discrimination and harassment easier.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1156
Issue No: Vol. 3, No. 2 (2022)
- Optimising communication with Ddeaf patients during the COVID-19 pandemic:
A case study.
Authors: Eleanor Duck
Pages: 33 - 33
Abstract: Background: Deafness is defined as severe hearing loss resulting in little to no auditory perception. D/deaf individuals may use multiple methods of non-verbal communication e.g., lip-reading, sign-language, reading/writing. During the COVID-19 pandemic public health measures such as use of personal protective equipment (PPE) and strict hospital visiting policies limiting signing interpreter access, disproportionately affected the D/deaf
community’s ability to communicate and thus engage with healthcare professionals.
Case Study: A 76-year-old female with a background of bilateral hip osteoarthritis and low mood was admitted to a community hospital for rehabilitation following a fall. She was congenitally deaf and communicated by British Sign Language (BSL), reading/writing and lip reading. On the 9th day of admission, she became symptomatic of COVID-19 infection with cough, fever, tachypnoea, and she tested positive on PCR. According to infection control protocol she was required to isolate for 10 days. During this time the patient reported worsening mood and struggled to engage with rehabilitation exercises without her regular BSL interpreter to assist with instructions.
Discussion: As per the Equality Act 2010 the NHS has a duty to make reasonable adjustments to enable communication between D/deaf patients and healthcare professionals. However, almost 90% of D/deaf people report being worried about how they will communicate if hospitalised with COVID-19. The current evidence on the impact of COVID-19 on D/deaf people and strategies to improve in-hospital communication was
explored.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1158
Issue No: Vol. 3, No. 2 (2022)
- Governmentality of Obesity A thematic content analysis of grey literature
from Public Health England.
Authors: Rachil Emmanouel
Pages: 34 - 34
Abstract: Background: The failure to meet World Health Organisation (WHO) targets calling for the reversal of rising obesity rates worldwide has been attributed by critics to the “lifestyle drift”, which is “the tendency for policy to start off recognising the need for action on upstream social determinants of health inequalities only to drift downstream to focus largely on individual lifestyle factors”. The framing of obesity as predominantly a consequence of population dietary habits and physical inactivity has served to create “social silences” around macro-level factors and structural inequalities which shape health and health choices, whilst also promoting a moralistic and victim-blaming discourse around obesity. In the UK and other OECD countries, the ‘biomedical individualism’ of health promotion has been tied to the political imperative of neoliberalism, which favours individual responsibility for health.
Method: This research used qualitative thematic content analysis to determine how obesity is framed in Public Health England (PHE) grey literature and the nature of interventions advocated for in UK policy. Findings: It finds that PHE focuses predominantly on behaviour change strategies whilst largely ignoring more complex determinants of obesity. Direct PHE health messaging, digital technologies, medical monitoring and school intervention are identified as “technologies of government” designed to fashion health conscious and self-governing consumers.
Conclusions: The absence of discussions around political economy and structural inequalities mediating health behaviours, serves to stigmatise and pathologise the ‘lifestyle choices’ of more vulnerable populations. The construction of obesity as a wider economic burden on society further exacerbates this.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1159
Issue No: Vol. 3, No. 2 (2022)
- International medical schools have insufficient training addressing LGBTQ+
health needs.
Authors: Michael Fu, Tangming Zou, Raksha Aiyappan, Xinyu Ye, Simisola Onanuga, Angela Tan, Ana Baptista, Sue Smith
Pages: 35 - 35
Abstract: Background: The LGBTQ+ community constitutes a significant proportion of society with unique health needs. However, healthcare services and doctors often inadequately address their needs, with insufficient training proposed as a major contributory factor. This international observational study aimed to investigate the level of training in LGBTQ+ medicine during medical school.
Method: Following validation with LGBTQ+ organisations, a survey was created to assess medical students’ knowledge, sources of understanding, and areas for improvement for LGBTQ+ health issues in the curricula. The survey consisted of multiple-choice and Likertscale questions. Following a pilot, the online survey was disseminated at two medical schools in London and Singapore.
Findings: 330 respondents completed the survey, with comparable absolute numbers from both universities. At least one-third of respondents were unclear on terminologies such as ‘out-of-the-closet’ and ‘men who have sex with men’. Additionally, respondents lacked knowledge of clinical topics such as conversion therapy. 84.2% of respondents expressed inadequacy in learning about LGBTQ+ medicine at university, with only 27.9% of respondents indicating they learnt general LGBTQ+ issues from medical curricula. Sexual health (90.9%) was well-learnt at medical schools, whilst many other topics such as genderaffirming care were not learnt (56.7%).
Conclusions: This study highlights the lack of training surrounding LGBTQ+ medicine that medical schools provide for students, with much information gathered from outside sources. Medical school curricula should be reviewed to better incorporate important issues surrounding LGBTQ+ medicine. This would better equip the next generation of doctors to address the LGBTQ+ community’s health needs.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1160
Issue No: Vol. 3, No. 2 (2022)
- “Most of the professors were Men” - a qualitative study of female
medical students’ perceptions of careers in academic medicine.
Authors: Bethany Sinclair, Andrea Agnel, Kirstie Haywood, Sophie Rees
Pages: 36 - 36
Abstract: Background: Women remain underrepresented in academic medicine, particularly at higher grades. A gender-based disparity in attitudes towards academic medicine has been described in qualified clinicians but not explored in student populations. To explore the perspectives of female graduate entry medical (GEM) students with regards to future careers in academic medicine.
Method: A qualitative study using focus groups, facilitated by two female undergraduate medical students. A semi-structured topic guide was developed with a primary focus was on gender. However, the influence of intersecting characteristics was also explored.
Findings: Twenty-seven female students from years 2 to 4 of a single GEM school in the West Midlands participated in five focus groups (mean duration 47.2 mins; range 36-59 mins). Thematic analysis revealed seven themes: work-life balance, impact on clinical career progression, personal preferences, GEM specific concerns, role models, imposter syndrome, culture of academia. GEM-specific concerns of financial issues and the influence of previous experience were highlighted. The presence of imposter syndrome, routed in a lack of knowledge about careers, lack of self-confidence and feelings of not belonging was an important recurrent theme.
Conclusions: Access to relevant and timely information, support, opportunities, and concordant mentors are essential requirements from the first year of medical school. Fear of discrimination and bias must be addressed across the academic journey. Future exploration of the impact of ethnicity, LGBTQ+ and disability on academic medicine careers is required.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1161
Issue No: Vol. 3, No. 2 (2022)
- Is there a difference in clinical skills gained between healthcare
professionals of high- and low and middle-income countries with online
simulation-based learning'
Authors: Tamzin Ogiliev, Kashish Malhotra, Anisah Ali, Vina Soran, Dengyi Zhou, Eka Melson, Meri Davitadze, Punith Kempegowda
Pages: 37 - 37
Abstract: Background: Healthcare professionals in low- and middle-income countries (LMICs) compared with those in high-income countries (HICs) face unequal clinical learning opportunities, caused by barriers such as cost, time, and accessibility. Simulation via Instant Messaging - Birmingham Advance (SIMBA) overcomes these barriers, acting as a free virtual simulation-based model which supports clinicians’ professional development. The study compared the impact of SIMBA in LMICs and HICs.
Method: Sixteen SIMBA sessions were conducted between May 2020 and October 2021. Participants solved anonymised real-life clinical scenarios by interacting with moderators over WhatsApp. Participants completed pre- and post- SIMBA surveys; responses were grouped into HICs and LMICs using the 2022 World Bank Report. Participants’ performance, perceptions, and improvements in core competencies were compared using the Chi-square test. Thematic analysis of open-ended questions was also performed.
Findings: 462 participants (29.7% from LMICs, n137) completed both the pre- and postSIMBA surveys. Participants from HICs showed better knowledge on patient management (p=.01), whereas participants from LMICs reported higher improvement in professionalism (p=.02). Both groups reported similar gains in patient care (p=.28), systems-based practice (p=.052), practice-based learning (p=.15), communication skills (p=.22), application to practice (p=.266), engagement (p=.197), and overall quality of the session (p=.101). In thematic analysis, strengths of SIMBA included providing individualised, structured, and engaging sessions.
Conclusions: Healthcare professionals from both LMICs and HICs improved in their competencies, illustrating that SIMBA produces equivalent teaching experiences. Furthermore, SIMBA’s virtual nature enables international accessibility and potential for global scalability. This model could steer future standardised education policy development in LMICs.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1162
Issue No: Vol. 3, No. 2 (2022)
- Embedding accessibility in research support and scholarly communication
systems and processes: A Reflective Case Study.
Authors: Josie Caplehorne, Rosalyn Bass, Helen Cooper, Suzanne Duffy, Liam Green-Hughes
Pages: 38 - 61
Abstract: In the context of the Public Sector Bodies (Websites and Mobile Applications) Accessibility Regulations (2018) this reflective case study examines the improvements we are making to accessibility across our research systems. We share our methodologies and break down the steps we are taking to embed inclusive practices. We explore how these steps went and what we have learnt from the process. We are committed to future digital content accessibility in research and scholarly communication at the [Organisation name] and this project shows how it can be achieved using existing resources and be applied to other situations.
PubDate: 2022-12-20
DOI: 10.22024/UniKent/03/ajpp.1047
Issue No: Vol. 3, No. 2 (2022)
