EPRs in the consultation room: A discussion of the literature on effects on doctor-patient relationships

In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship.     

A small-scale exploratory study of educator’s perceptions and expectations of summer-born children in the reception classes of three English primary academies and the strategies used to support them

This small-scale interpretative study, carried out in the reception classes of three English primary academies, examined educator perceptions of summer-born children, their expectations of children on entry to reception classes and whether those expectations were age differentiated. It also investigated the support and intervention strategies used for children in reception classes. The findings showed that the children were viewed in terms of a whole cohort and expectations of the children were not age differentiated, raising equity issues. Educators were pressurised by the ‘school readiness’ metanarrative so that although they spoke of a focus on children’s personal, emotional and social development in practice, their focus was on children’s acquisition of literacy and numeracy skills in whole-class activities and intervention groups, resulting in a conforming, instrumentalist pedagogy at odds with their assertions of a play-based curriculum.     

Cross-modality contrast: Exteroceptive context habituation enhances taste neophobia and conditioned taste aversions

The relationship between absolute and relative stimulus novelty was examined within the context of the conditioned taste aversion paradigm in which the relative novelty of the conditioned interoceptive stimulus was manipulated by differential exteroceptive context habituation. Rats received similar isolation histories but either 5 or 30 days of habituation to the test environment prior to treatment. One group was administered lithium chloride following saccharin consumption, a second group was administered isotonic saline following saccharin consumption, and a third group was administered saline after water consumption. The animals habituated for 30 days exhibited greater conditioned avoidance and greater neophobic avoidance of saccharin than did animals habituated for only 5 days. The results are interpreted in terms of a cross-modality stimulus contrast effect which implicates context habituation as an important parameter of both taste neophobia and taste aversion learning.     

Learning to Learn From Data: Benchmarks and Instructional Communities

This article examines the use of interim assessments in elementary schools in the School District of Philadelphia. The article reports on the qualitative component of a multimethod study about the use of interim assessments in Philadelphia. The study used an organizational learning framework to explore how schools can best develop the capacity to utilize the potential benefits of interim assessments. The qualitative analysis draws on data from intensive fieldwork in 10 elementary schools and interviews with district staff and others who worked with the schools, as well as further in-depth case study analysis of 5 schools. This article examines how school leaders and grade groups made sense of data provided through interim assessments and how they were able to use these data to rethink instructional practice. We found substantial evidence that interim assessments have the potential to contribute to instructional coherence and instructional improvement if they are embedded in a robust feedback system. Such feedback systems were not the norm in the schools in our study, and their development requires skill, knowledge, and concerted attention on the part of school leaders.     

The silent politics of educational disadvantage and the National Anti-poverty Strategy

Educational disadvantage is an essentially contested, political concept. At the same time there is a ‘phoney consensus’ surrounding the issue, i.e., policy debates on the topic often fail to reflect this contestation. This lack of awareness of the political context to the debate is evident in relation to the targets and measures set for addressing educational disadvantage. While Lynch has pointed out the political undertones of ‘comparative’ targets and measures, the conservative political position inherent in the ‘outputs-led’ model has not properly been explored. Indeed, the apparently technical and value-free nature of targets and measures has enabled this conservative political perspective to become embedded in public educational policy without debate.     

Integrating Education on Addressing Health Disparities into the Graduate Social Work Curriculum

The purpose of this article is to propose an elective social work course as a means of better preparing social workers entering practice in healthcare to meet the challenges of promoting health and reducing health disparities in minority and underserved communities. Course offerings specifically targeting health or medical social work training vary widely. The additional training provided at places of employment and through continuing education after the master's degree is often inadequate for competently addressing the issues clinicians face in practice.