by J. Biggs and C. Tang, Maidenhead, England,
Open University Press, 2007, 360 pp., £29.99, ISBN-13: 978-0-335-22126-4

Teaching for quality learning at university

http://eta.health.usf.edu/publichealth/HSC4211_HBS/readings/socialEnvironment_MacNeil.pdf

Social Environment and Physical activity: A review of concepts and evidence

Primary health care

https://openaccess.city.ac.uk/360/2/interventions_to_improve_hand_hygiene_compliance_in_patient_2011.pdf

Interventions to improve hand hygiene compliance in patient care

Background Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health.

/pdf/the-breadth-of-primary-care-a-systematic-literature-review-3sqx3e8ssr.pdf

The breadth of primary care: a systematic literature review of its core dimensions.

Social capital is widely considered to influence health. It is usually defined as a list of components such as social networks, social participation, trust and reciprocity. It is trust and reciprocity that are the subjects of this article. The presumed relationship of each with health is rarely explained in social capital studies. Trust is usually treated simplistically, both conceptually and in relation to measurement, while reciprocity is misunderstood, under-theorized and rarely measured. Pathways from trust and reciprocity to better health may be by way of reduced stress. Clarification and valid measures are needed to progress studies of social capital and health.

Social Capital and Health Starting to Make Sense of the Role of Generalized Trust and Reciprocity

Background: In England, there are particularly pressing problems concerning access to adequate primary care services. Consequently, innovative ways of delivering primary care have been introduced to facilitate and broaden access. Aims: The aim of this study was to review the evidence of seven recent innovations in service provision to improve access or equity in access to primary care, by performing a systematic review of the literature. Design of study: Systematic review. Setting: Primary care in the United Kingdom (UK). Method: Seven electronic databases were searched and key journals were hand-searched. Unpublished and ‘grey’ literature were sought via the Internet and through professional contacts. Intervention studies addressing one of seven recent innovations and conducted in the UK during the last 20 years were included. Two researchers independently assessed the quality of papers. Results: Thirty studies (32 papers and two reports) were identified overall. Variation in study design and outcome measures made comparisons difficult. However, there was some evidence to suggest that access is improved by changing the ways in which primary care is delivered. First-wave personal medical services pilots facilitated improvements in access to primary care in previously under-served areas and/or populations. Walk-in centres and NHS Direct have provided additional access to primary care for white middle-class patients; there is some evidence suggesting that these innovations have increased access inequalities. There is some evidence that telephone consultations with GPs or nurses can safely substitute face-to-face consultations, although it is not clear that this reduces the number of face-to-face consultations over time. Nurse practitioners and community pharmacists can manage common conditions without the patient consulting a general practitioner. Conclusion: The evidence is insufficient to make clear recommendations regarding ways to improve access to primary care. In the future, it is important that, as new initiatives are planned, well-designed evaluations are commissioned simultaneously.

Systematic review of recent innovations in service provision to improve access to primary care

Background: With 360° appraisals integral to professional life, learning how to give constructive feedback is an essential generic skill.Aim: To use a formative objective structured clinical examination (OSCE) for skills acquisition and development in giving feedback, whilst facilitating awareness of the importance of communication skills in clinical practice.Methods: Medical and nursing students took part in a formative OSCE. Using actors as simulated patients, a three-station OSCE circuit was repeated three times so that students could rotate through the roles as ‘candidate’, ‘examiner’ and ‘observer’. As ‘candidates’, they received immediate feedback on their consultation from the ‘examiner’/‘observer’. The events were evaluated using a questionnaire and focus groups.Results: Students immensely valued this learning event for considering expectations for a performance (91–100%). Concerns around giving peers feedback were acknowledged, and they were divided on preference for feedback from peers or tutors...

https://www.tandfonline.com/doi/pdf/10.3109/0142159X.2011.542522

Peer feedback as an aid to learning – What do we want? Feedback. When do we want it? Now!

Documentary analysis has been widely used in the comparative analysis of health care policy implementation in England. However, the value of the method is rarely debated, and the process whereby it is carried out rarely described in detail, or justified. Documentary analysis has obvious appeal. Documents may be the only source of data at an early stage of a policy innovation. They also present none of the problems (practical, ethical, interactive) of human subjects of research, and can provide a useful supplement to data collected from human subjects by other means. However, official documents are likely to be partial or superficial, representing aspirations rather than realities. The scope for analysis is therefore limited. Analysis may also tend to be positivist in philosophy, taking at face value the ‘apparent’ meanings of texts. It will be argued in this article, however, that a more interpretative analysis is also possible, when implied assumptions or underlying ideologies are identified and discusse...

Comparative analysis of health policy implementation

This paper explores some of the experiences of older people living in residential settings (sheltered, very sheltered housing and residential care), in the context of theories of participation, consumerism and citizenship. It draws on material from personal interviews undertaken with over 100 older people in England and Wales, and also from discussions with staff. Two-thirds of respondents were aged over 85. A significant minority of residents expressed some concerns about the routines of life, such as meals and social contact. Staff expectations of social participation were often unrealistic : for many residents, social contact was more a matter of adjustment than of friendship. Residents did not participate in deciding how the residential settings where they lived should be organised and managed, except for helping with simple domestic tasks. There is a need to change both attitudes and practice to enable older people to participate more fully in these settings.

Stephen Abbott

Papers

Social Capital and Health Starting to Make Sense of the Role of Generalized Trust and Reciprocity

Systematic review of recent innovations in service provision to improve access to primary care

Peer feedback as an aid to learning – What do we want? Feedback. When do we want it? Now!

Comparative analysis of health policy implementation

Social and democratic participation in residential settings for older people: realities and aspirations