Gary Lamph, Alison Elliott, Sue Wheatcroft, Gillian Rayner, Kathryn Gardner, Michael Haslam, Emma Jones, Mick McKeown, Jane Gibbon, Nicola Graham-Kevan and Karen Wright
The aim of this paper is to provide an overview of a novel offender personality disorder (OPD) higher education programme and the research evaluation results collected over a…
Abstract
Purpose
The aim of this paper is to provide an overview of a novel offender personality disorder (OPD) higher education programme and the research evaluation results collected over a three-year period. Data from Phase 1 was collected from a face-to-face mode of delivery, and Phase 2 data collected from the same programme was from an online mode of delivery because of the COVID-19 pandemic.
Design/methodology/approach
In Phase 1, three modules were developed and delivered in a fully face-to-face format before the pandemic in 2019–2020 (n = 52 student participants). In 2020–2021 (n = 66 student participants), training was adapted into a fully online mode of delivery in Phase 2. This mixed-methods study evaluated participant confidence and compassion. Pre-, post- and six-month follow-up questionnaires were completed. Qualitative interviews were conducted across both phases to gain in-depth feedback on this programme (Phase 1: N = 7 students, Phase 2: N = 2 students, N = 5 leaders). Data from Phase 1 (face-to-face) and Phase 2 (online) are synthesised for comparison.
Findings
In Phase 1 (N = 52), confidence in working with people with personality disorder or associated difficulties improved significantly, while compassion did not change. In Phase 2 (N = 66), these results were replicated, with statistically significant improvements in confidence reported. Compassion, however, was reduced in Phase 2 at the six-month follow-up. Results have been integrated and have assisted in shaping the future of modules to meet the learning needs of students.
Research limitations/implications
Further research into the impact of different modes of delivery is important for the future of education in a post-pandemic digitalised society. Comparisons of blended learning approaches were not covered but would be beneficial to explore and evaluate in the future.
Practical implications
This comparison provided informed learning for consideration in the development of non-related educational programmes and, hence, was of use to other educational providers.
Originality/value
This paper provides a comparison of a student-evaluated training programme, thus providing insights into the impact of delivering a relational-focused training programme in both face-to-face and online distance learning delivery modes. From this pedagogic research evaluation, the authors were able to derive unique insights into the outcomes of this programme.
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Gary Lamph, Alison Elliott, Kathryn Gardner, Karen Wright, Emma Jones, Michael Haslam, Nicola Graham-Kevan, Raeesa Jassat, Fiona Jones and Mick McKeown
Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview…
Abstract
Purpose
Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview and the research evaluation results of a regional higher education programme delivered to a range of criminal justice workers used on the OPD pathway.
Design/methodology/approach
Three modules were developed and delivered; these are (1) enhancing understanding (20 students), (2) formulation and therapeutic intervention (20 students) and (3) relationships, teams and environments (17 students). A mixed-methods study evaluated participant confidence and compassion. Pre, post and six-month follow-up questionnaires were completed. Additionally, a series of focus groups were conducted to gain in-depth qualitative feedback with a cross-section of students across the modules (N = 7). Quantitative data was collected and analysed separately due to the three modules all having different content. Qualitative data was analysed, and a synthesis of qualitative findings was reported from data taken across the three modules.
Findings
A total of 52 students participated, drawn from three modules: Module 1 (N = 19); Module 2 (N = 18); Module 3 (N = 15). Confidence in working with people with a personality disorder or associated difficulties improved significantly following completion of any of the modules, whereas compassion did not. Results have been synthesised and have assisted in the future shaping of modules to meet the learning needs of students.
Research limitations/implications
Further evaluation of the effectiveness of educational programmes requires attention, as does the longer-term durability of effect. Further research is required to explore the post-training impact upon practice, and further exploration is required and larger sample sizes to draw definitive conclusions related to compassion.
Practical implications
This unique model of co-production that draws upon the expertise of people with lived experience, occupational frontline and academics is achievable and well received by students and can be reproduced elsewhere.
Social implications
The positive uptake and results of this study indicate a need for expansion of accessible OPD workforce training opportunities across the UK. Further research is required to explore student feedback and comparisons of effectiveness comparing different modes of training delivery, especially in light of the pandemic, which has forced organisations and higher education institutions to develop more digital and distance learning approaches to their portfolios.
Originality/value
This novel research provides an evaluation of the only higher education credit-bearing modules in the UK focussed solely upon the OPD workforce and aligned with the national drive for non-credit bearing awareness level training “knowledge and understanding framework” (KUF).
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Chris Connell, Emma Jones, Michael Haslam, Jayne Firestone, Gill Pope and Christine Thompson
This paper aims to explain how and why the philosophical changes to the pre-registration nursing standards by the UK’s Nursing and Midwifery Council (NMC) have resulted in a…
Abstract
Purpose
This paper aims to explain how and why the philosophical changes to the pre-registration nursing standards by the UK’s Nursing and Midwifery Council (NMC) have resulted in a paradigm shift for mental health nursing.
Design/methodology/approach
This paper critically examines the changes to nursing education standards and offers an analysis of the problems associated with the shift towards a generic nursing syllabus.
Findings
The said shift prioritises physical health intervention, skills, procedures and tasks over the uniqueness of mental health nursing.
Practical implications
This paper argues that mental health nursing skills and qualities such as connection, genuine advocacy and therapeutic-use-of-self have been undervalued and under-represented by the new education standards.
Originality/value
This paper calls on the profession and service users to join the discourse and inform future mental health nursing identity. Ultimately, this paper calls on the NMC to reconsider the underpinning principles of the education standards and allot due consideration to the specific needs of the mental health nursing profession.
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Michael Brian Haslam and Emma S. Jones
The purpose of this paper is to consider the influence of the Emergency Department (ED) target wait time upon the discharge decision in ED, specifically for patients who have…
Abstract
Purpose
The purpose of this paper is to consider the influence of the Emergency Department (ED) target wait time upon the discharge decision in ED, specifically for patients who have self-harmed. Pressures to discharge patients to avoid breaching the 4-h target wait time, potentially increase the risk of adverse responses from clinicians. For the patient who has self-harmed, such interactions may be experienced as invalidating and may result in adverse outcomes.
Design/methodology/approach
Secondary data analysis was applied to the retrospective referral data of a Mental Health Liaison Team (MHLT), collected over a period of 11 months from a single hospital in the North of England. In total, 734 episodes of care were referred to the team from ED, where the primary presentation was recorded as self-harm.
Findings
Over half of patients referred to the MHLT from ED having self-harmed were seen after already breaching the target and the potential for a more restrictive outcome reduced. Of those patients seen within 4 h, the potential for a more restrictive treatment option was increased.
Practical implications
Recommendations to improve the patient journey for those who have self-harmed include mental health triage and treatment in clinical areas outside of the target.
Social implications
This study challenges the concept of the target as being realistic and attainable for patients who have self-harmed.
Originality/value
This exploratory study provides a starting point from which to explore the impact of the target time upon discharge decisions and clinical outcomes specifically for those who have self-harmed.
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Michael Haslam and Keir Harding
This discursive paper considers the use of restrictive practices in mental health inpatient settings and how these are often prioritised over relational approaches, especially…
Abstract
Purpose
This discursive paper considers the use of restrictive practices in mental health inpatient settings and how these are often prioritised over relational approaches, especially where the diagnostic label of personality disorder intersects with risk.
Design/methodology/approach
Key concepts from Orwell’s 1984 are studied for their pertinence to mental health inpatient settings, supporting our argument that restrictive practices arise from dichotomous thinking and externalised fears.
Findings
Drawing upon Orwellian themes of power, social control and digital surveillance from 1984, the authors highlight the role of fear in perpetuating restrictive practices under a guise of benevolent care in mental health inpatient settings, especially for those who are diagnosed with a personality disorder. A lack of preparedness to work with complexity in such environments, coupled with a deficit in self-reflexivity and critical thinking, can exacerbate challenges.
Research limitations/implications
To transcend damaging dichotomies and reduce restrictive practices in inpatient settings, the authors make the argument for the adequate preparation and education of the mental health nurse and authentic, collaborative, user-involved care.
Originality/value
The authors use Orwell’s novel to support a critical discourse around those damaging dichotomies and inherent contradictions that contribute to restrictive practice in contemporary mental health settings and to question whose interests’ these restrictive practices serve.
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This article applies the whistleblowing stages model to whistleblowing journeys as seen in British National Health Service (NHS) Inquiries.
Abstract
Purpose
This article applies the whistleblowing stages model to whistleblowing journeys as seen in British National Health Service (NHS) Inquiries.
Design/methodology/approach
It provides a qualitative analysis of Inquiry Reports since 2001, using Interpretive Content Analysis to allocate material to stages.
Findings
It is found that the Inquiry Reports show a wide variety of reporting mechanisms, but that most persons initially report internally. It seems to confirm recent suggestions that WB is often not a “one off” or simple and linear process, but a protracted process. While the simple stages model may be appropriate for individual “whistle-blowing incident” by a single whistleblower, it needs to be revised for the protracted process of raising concerns in a variety of ways by different people as shown in the Inquiry Reports.
Research limitations/implications
The evidence is confined to the publicly available material that was presented in the Inquiry Reports.
Practical implications
It provides a template to apply to cases of whistleblowing, and provides some baseline material.
Originality/value
This paper is one of the first to explore the whistleblowing stages model using qualitative material to one setting over time.
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Michael Barrett and Yves Gendron
This paper seeks to examine how auditors sought to establish their trustworthiness as trust providers on the internet; a vision which has remained largely unrealized. The…
Abstract
Purpose
This paper seeks to examine how auditors sought to establish their trustworthiness as trust providers on the internet; a vision which has remained largely unrealized. The investigation focuses on the WebTrust assurance project, launched by the North American accounting institutes to reinvigorate the alleged declining market for the expertise of external auditors.
Design/methodology/approach
An in‐depth longitudinal case study drew on a social theory of trust to examine the complexity of relations upon which trustworthiness of professional claims is predicated and investigate how commercialism has influenced the development of WebTrust.
Findings
Analysis illustrates the critical role that experts have in professionalization processes in trusting (or not) their own systems of expertise. Also, face‐to‐face relationships continue to play a key role in establishing the trustworthiness of professionals and their systems of expertise – even in the cyberspace domain.
Practical implications
It is argued that the WebTrust case and other commercialistic ventures sustained in accountancy provide a persuasive argument against the benefits of the free‐market logic in professional domains. Professional associations should be more vigorous in defending professionalism.
Originality/value
The research indicates that élite bodies of the profession, including professional associations, conceived of WebTrust mainly through a commercialistic lens – which is particularly revealing of the mindset that seemed to characterize a number of experienced professional accountants across North America shortly before the collapse of Andersen. The WebTrust saga illustrates how the profession has strayed from its ideals, or myths, of service ethic towards more focused efforts in developing “innovative” services based on a commercialistic logic.
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Russell Mannion, Huw Davies, Martin Powell, John Blenkinsopp, Ross Millar, Jean McHale and Nick Snowden
The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of…
Abstract
Purpose
The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.
Design/methodology/approach
Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.
Findings
The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system). This evolution in thinking about wrongdoing is also visible in public inquiries, as analysis and recommendations increasingly tend to emphasise cultural and systematic issues. Yet, while organisational and systemic factors are undoubtedly important, there is a need to keep in sight the role of individuals, for two key reasons. First, there is growing evidence that a small number of doctors may be disproportionately responsible for large numbers of complaints and concerns. Second, there is a risk that the role of individual professionals in drawing attention to wrongdoing is being neglected.
Originality/value
To the best of the authors’ knowledge this is the first theoretical and empirical study specifically exploring the role of NHS inquiries in holding the medical profession to account for failings in professional practice.
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Jill Manthorpe, Bridget Penhale, Neil Perkins, Lisa Pinkney and Paul Kingston
This article presents an analysis of modernisation as it affects adult protection in England. One of the key policy goals of modernisation has been to improve protection of…
Abstract
This article presents an analysis of modernisation as it affects adult protection in England. One of the key policy goals of modernisation has been to improve protection of service users. The article outlines some areas of good practice that are emerging and draws attention to some of the latent conflicts that are apparent.
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Sonja Gallhofer, Jim Haslam and Steven Cahan
This paper reviews Pacific Accounting Review, 1988–96. Against the background of an historical overview of the journal's development, the paper includes analyses of publications…
Abstract
This paper reviews Pacific Accounting Review, 1988–96. Against the background of an historical overview of the journal's development, the paper includes analyses of publications and citations in the journal. The paper looks forward to the future progress of Pacific Accounting Review.