Settler colonisation continues to cause much damage across the globe. It has particularly impacted negatively on Indigenous peoples’ health and wellbeing causing great inequity. Health professional education is a critical vehicle to assist in addressing this; however, non‐Indigenous educators often feel unprepared and lack skill in this regard. In this qualitative study, 20 non‐Indigenous nursing, physiotherapy and occupational therapy educators in Australia were interviewed about their experiences and perspectives of teaching Indigenous health. Findings from the inductive (...) thematic analysis suggest educators require skill development to: identify their discomfort in teaching cultural safety; contextualise the sources of this discomfort and; reflect on how this understanding can improve their teaching. Additionally, educators require professional training to become practitioners of cultural humility and to be facilitators and colearners (rather than experts) of the Aboriginal‐led curriculum. Of relevance to this is educator training in how to decentre non‐Indigenous needs and perspectives. Educators can also renew their teaching practices by understanding what a dominant settler paradigm is, identifying if this is problematically present in their teaching and knowing how to remedy this. Crucial to improved cultural safety teaching is institutional support, which includes Indigenous leadership, institutional commitment, relevant policies, and well‐designed professional development. (shrink)

This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could (...) ‘see’ neither their role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost‐effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice. (shrink)

All nursing courses in the UK include ethics in the curriculum, although there is considerable variation in the content of ethics courses and the teaching methods used to assist the acquisition of ethical reasoning. The effectiveness of ethics courses continues to be disputed, even when the perceptions and needs of students are taken into account in their design. This longitudinal study, carried out in the UK, but with implications for nurse education in other developed countries, explored (...) the ethical understanding of nursing students and changes in their understanding and approaches to practice over their four years of training (1995-1999). The data collection tools were a questionnaire originally piloted prior to the 1995 study, from which the present study developed, and five vignettes describing ethical dilemmas in health care also piloted in 1995. Students’ thinking progressed as they became more mature as individuals and professionals, although this progress was not necessarily in the direction of greater certainty. Suggestions are made to help nurse educators to maximize the effectiveness of ethics courses in transmitting the skills of ethical reasoning. (shrink)

Background:The perceptions of core professional nursing values of men in baccalaureate nursing programs are poorly understood.Objective:The study purpose was to understand and interpret the meaning of core professional nursing values to male baccalaureate nursing students.Research design and context:One-to-one interviews were conducted with male nursing students from a public university in the Midwest, following interpretive phenomenology.Ethical considerations:Measures to protect participants included obtaining Institutional Review Board approval, obtaining signed informed consent, and maintaining confidentiality.Findings:The study revealed (...) five themes and several subthemes under an overarching finding of caring. Acquisition of professional nursing values began prior to the nursing program and continued to varying degrees throughout the program.Discussion:Several implications are offered for nursing education, nursing practice, research, and public policy. These include identification of common values, teaching-learning strategies, inclusive environments, teamwork, and conflict resolution.Conclusion:Caring was revealed using a metaphor of a puzzle. (shrink)

Background There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum. Methods In January 2018, following the successful implementation of a peer-led, (...) grassroots medical ethics curriculum, student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/ MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum. Results The majority of respondents were female, white and mid-20s in age. Almost half of respondents reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. Conclusions The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos. (shrink)

Con el objetivo de diseqar una propuesta de modificacisn al programa de la formacisn de enfermeros y sugerir la inclusisn de temas sobre la discapacidad infantil, que permitan instruir al personal en formacisn, se realizs un estudio descriptivo cualitativo, en dos etapas, en la primera, mediante entrevistas se recogis la opinisn del claustro de profesores de la Licenciatura en Enfermerma de la Universidad de Ciencias Midicas de Camag|ey, en una segunda etapa se aplics el mitodo de Panel de Expertos, en (...) el que participaron diez expertos seleccionados de manera intencional a partir de su prestigio, experiencia y vinculacisn a la docencia, en lo referido al tema. Se analizaron los programas rectores de la carrera de formacisn en Enfermerma. El analisis de los mismos permitis apreciar aspectos tan importantes como el trabajo con la familia del discapacitado, o los procedimientos propios del manejo en el domicilio del discapacitado, los cuales no son objeto de estudio en la carrera. Se diseqs una estrategia curricular teniendo en cuenta los objetivos pedagsgicos a cumplimentar con las modificaciones propuestas. Se impone la necesidad de incluir en los programas de estudios aspectos relacionados con esta compleja tematica. Constituye un reto entonces para la universidad continuar desarrollando estrategias que permitan el desarrollo del proceso docente educativo y garanticen calidad en el egresado. In order to design a modification proposal to the nurses training program and suggest the inclusion of topics on the child disability, enabling to instruct staff in training, a qualitative descriptive study was carried out in two stages. In the first stage, opinions through interviews to the staff of the Nursing Faculty of the University of Medical Sciences of Camag|ey were collected. In the second stage, the method of Experts Panel was applied. Ten experts were chosen intentionally taking into account their prestige, experience and links to teaching in regard to the subject. Guiding programs of the career of nursing training were analyzed. This analysis gave the possibility to appreciate important aspects, such as the work with the family of disabled children, and management procedures in their home, which are not the object of study in the career. A curricular strategy was designed taking into account the educational objectives to be fulfilled with the proposed modifications. It is necessary to include those aspects related to this complex subject in the programs. To continue developing strategies that allow improving the educational teaching process and ensuring the quality of graduated students represents a challenge to the University. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:My Circumcision Decision:A Journey of Inquiry, Courage and DiscoveryLaurie EvansBefore becoming a mother, I was teaching parents to massage their babies and offering trainings for professionals. To promote my work, in 1984, I exhibited at the Whole Life Expo in New York City. When I returned to my booth after a break, I noticed someone had left a pamphlet by Edward Wallerstein, who wrote "Circumcision: An American Health (...) Fallacy." Since I am naturally curious, I read it. Disturbed, I thought of tossing it. But, how could I be teaching a nurturing technique for newborns and avoid this topic? As a Jewish woman, how would I make the decision for my own future sons? Little did I know this one piece of paper would lead me on a path of inquiry that would change my life.One of the presenters at this conference was Dr. Robert Mendelsohn, an Orthodox pediatrician. Although Dr. Mendelsohn realized some parents would allow circumcision for religious reasons, he was honest enough to dispel every medical myth and explain the harm of removing normal functioning tissue. He also described possible complications from removing the foreskin, including infection, hemorrhage, and although rare, death.To learn more, I read whatever I could find on the topic. I attended midwifery and childbirth conferences to promote my work and prepare for when I became pregnant. I decided to ask about circumcision, but the conversations were awkward and I received little helpful information. I found that circumcision was a taboo topic; few people wanted to talk about it. Why? Doctors who perform circumcisions, nurses who recommend it, and parents who consent to it do not want to face the reality of the harm they cause. Instead of facing the pain, they avoid the topic, and the procedure continues. Most men do not want to discuss or think about their own circumcisions. I learned that we need to have compassion during these conversations.A Jewish ritual ceremony (bris) is performed on the eighth day after the boy's birth, and includes circumcision and prayers. At a bris, friends and relatives are invited to observe and celebrate. It is part of my heritage. I tried to talk to my relatives about the information I had found, but everyone refused to discuss it. This avoidance made my decision very difficult. Then, for the first time, I was invited to a bris; I didn't want to attend. However, I had been at the boy's birth, so I decided to go to offer support. During the circumcision, my reaction was intense: I wanted to take the baby and run. I felt like an accomplice. I wanted to grab people by the [End Page E2] shoulders and scream, "How dare you?" I vowed I would never attend another bris, and I made the decision to write publicly instead of anonymously.I still had doubts, because I didn't know one intact adult male. What if I were to have a son, keep him intact, and he developed a complication later in life? I have learned that doctors are not taught non-invasive solutions, so most circumcisions performed after infancy are unnecessary. A Jewish doctor recommended a circumcision for a seventynine year old man who had a persistent rash that would not respond to treatment. Our organization suggested that he apply topical acidophilus. After he followed the recommendation, the rash disappeared, so he canceled the circumcision.In 1985, I became pregnant. Like many women I spoke to, I didn't want to face the circumcision decision, so I prayed for a girl. Our childbirth educator shared about male circumcision, which led to conversations with my husband. These tense interactions ended in an impasse. I wondered how this decision would impact my marriage. I experienced immense relief that my firstborn was a girl. Time was on my side.One day while walking in New York City, I serendipitously crossed paths with my childbirth educator. She was going to the United Nations to oppose female circumcision. I was in my 30s and had a master's degree in teaching. I had studied massage and anatomy. Yet, I had never heard about this tribal ritual. I had... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response 4: The Summer of Our DiscontentCaroline EdwardsI write this response on the eve of another wave of industrial action in the UK in November 2022—the Universities and Colleges Union (UCU) “UCU Rising” campaign, the latest in a series of regular disputes over pay and working conditions, the gender and ethnicities pay gap, and casualisation that has been ongoing since 2018. In 2022’s “summer of discontent,” we’ve seen our (...) rail, maritime and transport workers, airport staff, bus drivers, telecommunications workers, postal workers, nurses, refuse workers, and higher and further education staff engage in ongoing industrial disputes with intractable bosses. Even criminal barristers continue with an indefinite, uninterrupted strike after years of government cuts and chronic underinvestment. Everywhere you look, there is a palpable sense of a country on its knees. It’s nearly 100 years since the last General Strike of 1926 and in the UK it’s looking increasingly likely that we will have another General Strike on our hands soon. In “Two Cheers for Blueprints, or, Negative Reasons for Positive Utopianism” Antonis Balasopoulos contextualizes this within the longer economic durée of the shift from Fordist production to so-called flexible accumulation after 1972, writing in this issue that “the turn of capital to the faster and higher [End Page 554] profits involved in financialization rather than infrastructural and industrial investment, form much of the objective, structural ground for what can only be described as the rapid rise of a dystopian structure of feeling in western societies since the early 1970s.” Antonis’s brilliant summary reminds us of the monumental scale of the challenges facing utopian thought and praxis in our current moment. Make no mistake—the “crisis ordinariness” of everyday life under late capitalism that Lauren Berlant identified in Cruel Optimism (2011) has intensified in the years following the Global Financial Crisis (2007–8), the wave of Occupy protests in 2011, and, more recently, the COVID-19 pandemic (2020–). “For some time now,” as Antonis writes, the utopian goals of “happiness, fulfilment, [and] emancipation... have been out of the question altogether.”It’s hard not to agree with this assessment, given the current chaos of life in the UK. Adam Stock’s roundtable contribution “Funding Utopia: Utopian Studies and the Discourse of Academic Excellence” focuses on the academy’s complicity with the neoliberal financialization of what were previously protected as public goods (education, our health service, transport infrastructure, and so on) over the past three decades. As Adam notes, the rhetoric of “excellence” that has come to dominate all areas of university life—teaching, research, public engagement, and the quantifiable “impact” of university research beyond the academy—is really just another way of using competition to mask the market logic of scarcity. Swingeing cuts to publicly funded research have led to a scarcity of resources in scholarly knowledge production, which is legitimated through the discourse of “excellence” and “prestige.” Only a handful of elite research leaders are granted awards and the value of all research becomes judged by its proximity to this distribution (concentration) of wealth within a small number of institutions. Defending education as a public good has long given way to the desperate, existential struggle for survival at UK universities. Numerous institutions are on the brink of bankruptcy, which was the goal all along for the ideologically driven Office for Students (OfS). Market exit, as they euphemistically term it, proves market efficiency.At my own institution, Birkbeck, University of London, the challenge to utopian thinking is all too violently clear. Birkbeck has a special place in the UK higher education system—a university founded nearly 200 years ago in the Crown and Anchor Tavern on the Strand (it was called the London Mechanics’ Institution back then) to offer education to working-class Londoners that [End Page 555] fitted around their busy working lives. As my colleague Joanna Bourke writes in Birkbeck: 200 Years of Radical Learning for Working People (2022), life expectancy in the poorest parts of London was just twenty-nine years; cholera, typhoid, and typhus were major killers; and illiteracy was widespread. At Birkbeck, we are the only university to teach evening classes and offer the requisite support... (shrink)

Background:Despite their negative consequences, evidence shows that futile medical treatments are still being provided, particularly to terminally ill patients. Uncovering the reasons behind providing such treatments in different religious and sociocultural contexts can create a better understanding of medical futility and help manage it effectively.Research objectives:This study was undertaken to explore Iranian nurses’ and physicians’ perceptions of the reasons behind providing futile medical treatments.Research design:This was a qualitative exploratory study. Study data were gathered through conducting in-depth semi-structured (...) personal interviews and analyzed using the conventional content analysis method.Participants and research context:Twenty-one nurses and nine medical specialists were recruited purposively from four teaching hospitals affiliated to Tehran University of Medical Sciences.Ethical considerations:This study was approved by the Nursing and Midwifery Research Center and the Research Ethics Committee of Tehran University of Medical Sciences. All participants gave informed consent for the research and that their anonymity was preserved.Findings:The main theme of the study was “having an obligation to provide medical treatments despite knowing their futility.” This theme consisted of three main categories including patients’ and family members’ request for continuing life-sustaining treatments, healthcare professionals’ personal motives, and organizational atmosphere and structure.Discussion and conclusion:Different personal and organizational factors contribute to providing futile medical treatments. Promoting the structure and the function of hospital ethics committees, establishing and developing home care facilities, increasing the number of palliative care centers and hospices, and educating healthcare professionals, patients, and family members about the services and the benefits of such centers can facilitate making wise decisions about continuing or discontinuing treatments which have been labeled as futile. (shrink)

Background Previous studies have shown that the rapid transition to emergency remote teaching due to the COVID-19 pandemic was challenging for healthcare teachers in many ways. This sudden change made them face ethical dilemmas that challenged their values and ethical competence. Research aim This study aimed to explore and gain a deeper understanding of the ethical dilemmas healthcare teachers faced during the COVID-19 pandemic. Research design This was an inductive qualitative study using a hermeneutic approach. Semi-structured interviews (...) were conducted and analysed thematically. Participants and research context Healthcare teachers ( n = 20) from eight universities and universities of applied sciences in the Nordic and Baltic countries participated. Ethical considerations This study was based on the research ethics of the Norwegian National Research Ethics Committee for Medicine and Health Sciences and approved by the Norwegian Agency for Shared Services in Education and Research. Findings Healthcare teachers faced several ethical dilemmas due to restrictions during the COVID-19 pandemic. The analysis revealed three main themes: How should I deal with students’ ill-being, and what can I as a teacher do?; What can I demand from myself and my students, what is good teaching?; How do I manage the heavy workload and everyone’s needs, and who gets my time? Conclusions This study highlights the importance of healthcare teachers’ continuous need for pedagogic and didactic education, especially considering new technology and ethical issues. During the pandemic, the ethical consequences of remote teaching became evident. Ethical values and ethical dilemmas should be addressed in healthcare education programmes at different levels, especially in teacher education programmes. In the coming years, remote teaching will grow. Therefore, we need more research on this issue from an ethical perspective on its possible consequences for students and healthcare teachers. (shrink)