Chronic obstructive pulmonary disease (COPD) is one of the most deadly and costly chronic diseases in the world characterized by many breathing problems. The management of COPD and the prevention of exacerbations are a priority goals to improve the quality of life in patients affected by this illness. In addition, it is also crucial to improve the patients’ adherence to care which, in turn, depends on their knowledge and understanding of some factors such as the prescribed medical treatment, changes (...) in dailylife, and the process of breathing. In turn, the adherence to care leads to greater autonomy for the patient who is thus able to better manage his illness. Here we presented the application of the Model IARA in patients affected by COPD in order to achieve their autonomy in illness management which, in turn, leads to a better quality of life. IARA is an intervention program which improve the awareness and knowledge of patients with respect to both the disease and symptoms through health education. Moreover, through IARA the patients are encouraged to become more actively involved in COPD care process, also regarding drug therapy adherence. Using St. George's Respiratory Questionnaire combined with qualitative analysis, we demonstrated that IARA could be considered a useful approach in COPD management. (shrink)

There has been a focus on policies relating to early years education and care across the developed world and particularly in Europe. In the UK, there has been a raft of policy changes alongside increased investment. However, this paper argues that these changes may not be sufficient to meet EU objectives in terms of quality or the government's policy goals of high quality, affordable and accessible early years education and care. There are major issues that appear to militate (...) against achieving these goals; these relate to the levels of government funding and to the regulatory context. There are also divergences between the providers in terms of their own objectives and underlying values which mean that quality may be variable and access to certain types of providers restricted. These factors appear to militate against the delivery of universal provision of high quality early years education and care. (shrink)

BackgroundWeChat is the main social platform in China, characterized by its versatility and ease of communication. This study aimed to explore the effect of a WeChat-platform-based education and care program on relieving anxiety, depression, and post-traumatic stress disorder in parents of pediatric and adolescent patients with osteosarcoma.MethodsIn total, 48 patients and 86 parents were enrolled in this randomized, controlled study and then assigned to the WBEC program and the usual education and care program for 6 months as a (...) 1:1 ratio.ResultsParents in the WBEC group had lower Hospital Anxiety and Depression Scale for anxiety scores at M3 and M6 when compared to the UEC group, while anxiety rate was only decreased at M3 in the WBEC group. Meanwhile, parental HADS for depression scores were reduced at M3 and M6 in the WBEC group when compared with the UEC group; while depression rate remained the same. Parental Impact of Event Scale-Revised scores were slightly reduced among the WBEC group at M6 when compared with the UEC group [12.0 : 10.0–20.8] vs. 15.0 ], but not statistically significant.ConclusionWeChat-platform-based education and care is considered a feasible intervention to reduce anxiety and depression in parents of pediatric and adolescent patients with osteosarcoma, while also providing mild relief from PTSD. (shrink)

The public funding of early years education and care in England has been transformed. Historically, local councils had the main responsibility for decisions regarding nursery education and child day care, but in 1996 the Conservative government introduced a nursery education voucher scheme. Parents of four-year-olds could exchange the voucher for three terms of part-time ‘preschool provision’ in a state maintained nursery or primary school, or in a private, voluntary or independent (PVI) provider of child day care; in (...) 1998, the Labour government replaced the voucher with an entitlement to free part-time ‘early education’. The entitlement was expanded progressively and in 2017 the Conservative government introduced 30 h per week free ‘childcare’ for some children, together with an Early Years National Funding Formula. Funding goals and policy have shifted over time, underpinned by the idea of ‘a level playing field’ between providers in maintained and PVI sectors. However, there is no statutory requirement for PVI settings to employ qualified teachers, militating against a genuine ‘level playing field’ and the integration of education and care. (shrink)

The Routledge Handbook of Philosophies and Theories of Early Childhood Education and Carebrings together leading writers in the field to provide a much-needed, authoritative guide to the major philosophies and theories which have shaped approaches to Early Childhood Education and Care. Providing a detailed overview of key concepts, debates and practical challenges, the handbook combines theoretical acumen with specific examples to show how philosophies and theories have evolved over the centuries and their impact on policy and society. It examines (...) the ways in which societies define and make sense of childhood and the factors that influence the development of philosophies about young children and their learning. The collection offers an insight into the key theorists and considers how the economics and politics of their time and personal ideology influenced their ideas about childhood. It looks at curricula and provision which have proved inspirational and how these have impacted on policy and practice in different parts of the world. The handbook also explores alternative and perhaps less familiar philosophies and ideas about babies and young children, their place in society and the ways in which it might be appropriate to educate them Bringing together specially commissioned pieces by a range of international authors, this handbook will enable academics, research students, practitioners and policy-makers to reflect on their own understandings and approaches, as well as the assumptions made in their own and other societies. (shrink)

Early childhood education and care settings in England and the people who work in them constitute an important sphere of influence, shaping young children's characters and values. But the values and dispositions expected of the early years workforce are missing from statutory policy documentation despite its clear requirement that practitioners will espouse and promote particular 'universal' values in their work. The expectations for young children's achievement by the age of five also reveal a complex approach combining a structuralist and (...) postmodern duality of individualistic and collectivist values. These present challenges and dilemmas for the sector. (shrink)

Families have a right to privacy, but we know little about how the public–private boundary is negotiated at the micro level in educational settings. Adopting ethnomethodology, the paper examines how talk about the home situation was occasioned and managed in ten parent–teacher conferences in early childhood education and care (ECEC), with a special focus on the ECEC teacher’s strategies for eliciting family information. The paper demonstrates a continuum of interactional practices which, in various degrees, make parents accountable for (...) providing family information. The analysis shows that parents both volunteer and provide the pursued information, thus actively orienting to the norm of visibility in child rearing. However, although both parties orient to questioning and fishing as business as usual, the parents’ accounts sometimes had an excusing quality or they adopted a reserved communication style, suggesting a certain ambivalence as well. The paper outlines different ways of understanding the present partnership ideal in parent–teacher teacher cooperation with implications for the negotiation of privacy. The paper also addresses training, which can contribute to staff and student reflections on the management of the public–private boundary. (shrink)

This paper explores legislative provision and pre-school education policy in England over the course of the twentieth century. The paper argues that there has been a significant ideational shift over this period, from a policy focus on nursery education for poor children to universal early childhood education. Not only have ideas changed but provision and funding have changed. Although there have been major revisions to legislative provision, there are elements of continuity as regards the institutions delivering early childhood education, particularly (...) maintained nursery schools and nursery classes, but with layering of private-for-profit and not-for-profit institutions to ‘fill the gap’ in provision. At the same time, the central state has taken increasing control of publicly funded early childhood education through legislative provision. (shrink)

With places at nursery school promised for every child above the age of four, this book raises the stakes by looking at the quality of what is provided, and how that compares to what should be provided. Beyond Quality In Early Childhood Education and Care challenges received wisdom and the tendency to reduce philosophical issues of value to purely technical issues of measurement and management. In its place, it offers alternative ways of understanding early childhood, early childhood institutions and (...) pedagogical work. The book places issues of early childhood into a global context and relates them to writers from many fields. Drawing on work with aboriginal peoples in Canada, on the experience of Reggio-Emilia in Italy and on a project in Stockholm inspired by Reggio, the book considers the implications of these alternative ways of understanding, for practice and a reconceptualization of early childhood education and care. (shrink)

We need to examine the role of "Angel Teachers" and make the case that they are now needed to take a primary role in the schools intervention efforts. This book will explore how they arrive at this role, their skills, how they help kids and how they avoid becoming saviors, self-promoters, and in the helping process for their own self-esteem.

With an estimated 12.1% of children aged 2–5 years already obese, prevention efforts must target our youngest children. One of the best places to reach young children for such efforts is the early care and education setting. More than 11 million U.S. children spend an average of 30 hours per week in ECE facilities. Increased attention at the national, state, and community level on the ECE setting for early obesity prevention efforts has sparked a range of innovative efforts. To (...) assist these efforts, CDC developed a technical assistance and training framework – the Spectrum of Opportunities for Obesity Prevention in the ECE setting – which also served as the organizing framework for the Weight of the Nation ECE track. Participants highlighted their efforts at national, state, and local levels pursuing opportunities on the Spectrum, the standards and best practices that had been the emphasis of their efforts, and common steps for developing, implementing, and evaluating initiatives. Strong leadership and collaboration among a broad group of stakeholders; systematic assessment of needs, opportunities and resources; funding sources; and training and professional development were reported to be integral for successful implementation of standards and best practices, and sustainability. (shrink)

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected (...) by ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

This paper applies crip theory (McRuer, 2006, 2018) as well as other key conceptual tools from disabled childhood studies (Runswick-Cole et al., 2018) and disability studies in education (Cousik & Maconochie, 2017) as a tactic intended to question and resist the story of overcoming as it manifests itself within the discourses and practices of self-regulation in early learning classrooms. This paper offers a brief overview of the range of self-regulation strategies enacted within educational settings in Ontario, Canada, that purport (...) to support young children in overcoming themselves on their way to normalcy. This paper also engages in crip theory as a strategy to both question and disrupt the taken for granted assumption that self-regulation entails a return towards or a sustaining of the efficient and productive neoliberal individual in school systems. Finally, this paper considers how we might not only invite but embrace the disruptions that occur when embodied differences refuse to be overcome by demands to self-regulate. Ultimately, a key aim of this paper is to resist how discourses and practices of self-regulation in Early Childhood Education and Care (ECEC) establish the overcoming narrative as a means to cure, fix or exclude embodied differences while contemplating the vibrant possibilities embedded within learning with and from disabled childhoods. (shrink)

Professionalism and Leadership in Early Childhood Education and Care explores the tension between what early years practitioners are expected to achieve, and the level of expertise and understanding required to underpin this. It examines the impact of recent policies on the agency of individual practitioners, and the culture and ethos of their settings, and questions the driving factors behind reforms to curriculum and practice and where this locates practitioners and their provision. Bringing together the latest research and ideas on (...) professionalism and leadership, the book explores how professional status is understood and acquired and what makes this problematic in ECEC. It explores the impact of different leadership approaches, what needs to be challenged and sets out how the workforce might assert its own identity and values and continue to advocate for the needs of young children. Including case studies to illustrate the lived experiences of individual practitioners as they worked towards becoming graduate professionals, this will be valuable reading for early years professionals engaged in undergraduate and postgraduate study and those researching policy development and professional identity within ECEC. (shrink)

National early childhood education and care (ECEC) systems have been shaped by external influences and have taken different forms in developed countries than in post-colonial countries. This study systematically compares and examines the autonomous elements in national ECEC systems and the countervailing homogenisation process in Slovakia and Indonesia -two countries located in a different hemisphere with different historical, cultural, and political backgrounds. The study shows new rhetoric triggering different tendencies. In Slovakia, the “competency” and “standards” turn led to steps (...) to increase ECEC institutions’ autonomy and give them greater power to create tailor-made education programmes. While in Indonesia, the turn went in the opposite direction, reinforcing curriculum centralisation and increasing its regulatory functions regarding ECEC. This shift towards the same discourse, terminology and concepts does not automatically trigger processes that lead to a significant similarity and the convergence between ECEC systems due to their specific historical, cultural, and political contexts. (shrink)

What this book is about -- Theoretical perspectives : modernity and postmodernity, power and ethics -- Constructing early childhood institution : what do we think it is? -- Constructing the early childhood institution : what do we think they are for? -- Beyond the discourse of quality to the discourse of meaning making -- The stockholm project : constructing a pedagogy that speaks in the voice of the child, the pedagogue and the parent -- Pedagogical documentation : a practice for (...) reflection and democracy -- Minority directions in the majority world : threats and possibilities. (shrink)

In 2000, the Millennium Development Goals set out targets aimed at creating a safer, more prosperous, and more equitable world. If these goals were to be achieved, children’s lives would indeed be transformed. In this collection, achievements against these targets are identified, with each contributor examining the progress made in early years provision in Australia, China, England, Greece, the Netherlands, Portugal, South Africa, and Sweden. They highlight the priorities and agendas of their respective governments, and focus on the trends and (...) issues which are particularly relevant to each situation, thereby revealing the social and educational inequalities that persist across countries. A common theme running through this volume concerns the political tensions that arise when governments and educators hold fundamentally different views about the nature and purpose of early years education and the needs of children and families. It is clear that although the past two decades have seen many changes in attitude towards the importance of the early years of life; politically, economically, and environmentally, much still remains to be done if the Millennium Development Goals for young children and their families are to be fully met. Despite this, this volume demonstrates that those who work in this area continue to experience a deep concern for the well-being of young children, which transcends cultures, frontiers, and political and sectarian divides. This book was originally published as a special issue of the _International Journal of Early Years Education. _. (shrink)

European states differ tremendously in the extent to which their national education systems administer preschool programs, and whether or not these services can serve as day care for working parents. This article traces contemporary policy differences in three countries—France, Sweden, and Germany—to the effects of nineteenth-century conflicts between religious and secular forces over education. Intense, clerical-anticlerical conflict in France led to the incorporation of preschools into the national education system. In Sweden and Germany, the more accommodating relationship between church (...) and state assured that no such incorporation took place. These decisions had lasting consequences for the nature and extensiveness of child care services for preschool-aged children. (shrink)

What is at the basis of moral action? An altruism acquired by the application of rule and principle? Or, as Noddings asserts, caring and the memory of being cared for? With numerous examples to supplement her rich theoretical discussion, Noddings builds a compelling philosophical argument for an ethics based on natural caring, as in the care of a mother for her child. The ethical behavior that grows out of natural caring, and has as its core care-filled receptivity to (...) those involved in any moral situation, leaves behind the rigidity of rule and principle to focus on what is particular and unique in human relations. Noddings's discussion is wide-ranging, as she considers whether organizations, which operate at a remove from the caring relationship, can truly be called ethical. She discusses the extent to which we may truly care for plants, animals, or ideas. Finally, she proposes a realignment of education to encourage and reward not just rationality and trained intelligence, but also enhanced sensitivity in moral matters. (shrink)

This study refers to the discursive transformation in perceptions of preschool age children generated by central European Union policy on early childhood education and care. This policy is representative of the pervasion of contemporary entrepreneurial culture and curricula within preschool education. At the same time, the field is also starting to become subordinated to the neoliberal trend of economising the social. This study highlights the fact that, within discourses on the child, these trends are encouraging a particular conception of (...) childhood and of developmental theories. This conception is also enabling entrepreneurial logic to be applied to the preschool education sector via the use of theoretical tools. Consequently, children are being shaped into so-called knowledge-workers, or gold-collar workers, as they are referred to in current employment discourse. Even authorised preschool education documents (e.g. NAEYS’s Developmentally Appropriate Practice etc.) are responding to this transformation by introducing a new type of normality into this sphere, as can be seen in the Slovak state education programme for preschool education. (shrink)

Schools self-identify as caring communities and teach young children to be caring for each other. But schools also teach other contradictory and competing messages, such as individualism and self-reliance, rationalist concepts of justice and meritocracy, and other neoliberal approaches to life and community. Furthermore, while endorsements of care are commonly found in educational institutions, caring is not always (or even often) practiced or regarded as a major aim in schools, in contrast with human capital approaches to youth development. (...) This essay examines how schools do and don’t care. At its core is the rearticulation of care ethics in education, and what caring means within the contemporary field. Over time, enthusiasm for care ethics has peaked and waned. It begins with a brief explanation of what caring is within the field of care ethics, before it considers how caring is ideally involved in education. In this case, discourses of care ethics and caring in education can be coopted against the writings of care ethicists to complement positive psychology, socially conservative character education and civic education, and individualistic and neoliberal approaches to education. As a result, schools can appear to care, but do so in highly distorted ways. These distortions, I argue, do not reveal fundamental limitations or flaws within care ethics approaches to care. Instead, they demand a reconsideration and rearticulation of care ethics in the contemporary education landscape: a context which has changed considerably since debates and articulations of care ethics in the 1980s. (shrink)

In this short essay I express my own deep sympathy with Nel Noddings’s ethic of care and applaud her stubborn resistance in Happiness and Education to what John Dewey would have called false dualisms, such as those between intelligence and emotion, theory and practice, or vocation and academic studies.However, I question whether the sort of caring relation she depicts so beautifully in this and many other books is sufficiently robust to alone carry the weight of the moral life that (...) she supports, and whether her suspicion of community, while sounding important cautions, does not leave us with an ethical vision that is too thin to deliver the sort of education she prescribes. To this end, I argue that she judges Victor Frankl’s conception of freedom too harshly and his response to human suffering with an uncharacteristic lack of charity. Following well-known communitarian arguments of MichaelWalzer and CharlesTaylor I suggest that some account of a situated human agent who can choose freely to enter into relation is necessary to sustain the role of caring in education that has been Noddings most significant philosophical contribution. (shrink)

Illustrating the tensions and possibilities that the notion of the ethic of care as a democratic and citizenship issue may have in discourses of citizenship education in western states is the focus of this article. I first consider some theoretical debates on the definition of an ethic of care, especially in relation to issues of justice and (im)partiality. Then, I discuss the reconceptualization of care on the basis of two related but distinct themes: the reconciliation of justice (...) and care, and the rethinking of citizenship. Following this, I lay out some implications for citizenship education and answer the question of what learning and teaching for/about a reconceptualized ethic of care can contribute to changing current perceptions of and actions towards immigrants, refugees and asylum seekers. (shrink)

In this paper I examine and elaborate on Asha Bhandary’s conception of autonomy, and take up the question of what education for autonomy, thus understood, might require. I argue that educating for autonomy requires educators to impart, to students, an interlocking set of dialogical or relational skills that center responsiveness to the perspectives of others, and that these skills significantly overlap with the skills required for basic education in care.

Returning to the origins of education, Becoming Pedagogue explores its role in today's society by reuniting philosophy with pedagogy. It investigates the aesthetics, ethics and politics of childhood, education and what a teacher really does, enabling educators to define and perform their profession as per its historical and intellectual roots. Reflecting on the practice, science and knowledge-tradition of pedagogy as well as abstract and formalist discourse at all levels, Olsson's work evokes real and free aspects of educational experiences and (...) events. Through a close reading of French philosopher Henri Bergson's major works, historical and contemporary pedagogical resources as well as the pedagogy developed in the early childhood centres in Reggio Emilia, Italy, it develops a critical-cum-creative methodology that both analyses the present educational situation as well as creates new pedagogical alternatives. Using brand new perspectives as well as practical examples of what teachers do, Becoming Pedagogue will provide students, educators and researchers tools for critiquing simplified ideas of what a teacher is as well as giving them inspiration to experiment with alternative ways of teaching. (shrink)

In this article, we critique two theoretical positions that analyze the place of emotions in education: the psychological strand and the cultural feminist strand. First of all, it is shown how a social control of emotions in education is reflected in the combination of psychological and cultural feminist discourses that function to govern one’s self effectively and efficiently. These discourses perpetuate an assumed divide between the rational and the emotional, and reinforce the existing power hierarchies and the status quo of (...) stereotypes about the role of emotion in education. Then we use the Foucauldian notions of parrhesia and care of the self to suggest alternative ways of thinking about emotions in education. Instead of campaigning for one side or the other of the rational/emotional divide, we suggest that it may be more interesting and fruitful to examine the particular ways discourses of emotion in education construct their own brand of parrhesia. (shrink)

Nurses make an important contribution to the organisation and coordination of patient care but receive little formal educational preparation for this work. This paper builds on Allen's care trajectory management framework to specify evidence‐based and theoretically informed competencies for this component of the nursing role and proposes how these might be incorporated into nursing curricula. This is necessary so that at the point of registration nurses have the expertise to realise their potential as both providersandorganisers of patient (...) care and are better able to articulate and develop this aspect of nursing practice. (shrink)

Because health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well‐being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling (...) its service goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well‐being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work. (shrink)

Adolescence is a valuable phase of life, not just because it is the phase of learning in school and preparing for a working life. During the COVID-19 pandemic it became clear that the rights, experiences, and lifeworlds of adolescents are considered less important than the needs of school, work, and productivity. However, there is an ethical claim for people to have a good adolescence, and this means that the losses of social contact, experiences, time, and space demanded of adolescents, in (...) order to protect older and vulnerable groups during the COVID-19 pandemic, should be taken seriously. A distinctive quality of adolescence is that it cannot be repeated, nor can these experiences be replicated as adults. First experiences of independence, friendship, love, informality, recklessness, and youthful exuberance are intrinsically valuable and cannot be substituted for later in life. It is therefore not surprising that adolescents have sought and found their own spaces during the pandemic, some of them forbidden, because lock downs and closed social spaces have relegated them to the confines of their childhood bedrooms. In this paper, I explore an ethic of a good adolescence, which was impacted on by the COVID-19 pandemic, and consider what can be learned from this situation. Adolescents are to be taken seriously, their experiences are no less valuable than those of adults, and the losses they have suffered for the benefit of others should be honored. As far as possible, young people should be supported to have a voice in public discourse and in finding spaces to be adolescents. (shrink)

Background and purpose Educators’ ethical competence is of crucial importance for developing students’ ethical thinking. Previous studies describe educators’ ethical codes and principles. This article aims to widen the understanding of health- and social care educators’ ethical competence in relation to core values and ethos. Theoretical background and key concepts The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. Methods Data material was collected from nine educational units for healthcare (...) and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. Ethical considerations The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. Findings The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. Conclusion Educators’ personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators’ training regarding ethical competence. (shrink)

The authors draw on their extensive early years experience to provide a comprehensive and up-to-date review of the key issues in the field of early childhood care and education. In this fully updated and revised new edition, rewritten to include the new Early Years Foundation Stage, students will find that this text now meets the needs of students on Foundation degrees, Early Childhood Degrees and the new Early Years Professional qualification. Topics covered in this essential textbook include: an overview (...) of the principles of effective practice discussions on equal opportunities and children's rights an update of the latest development theories relating to brain development and how children learn and the difficulties children may face in their learning investigations into what working with parents really means consideration of the different early years systems in operation summaries of key management issues and useful information on how to address them comparison with European perspectives on early years care and education the importance of play in children's early learning. Readers of this second edition will also find the expansion of existing chapters in order to include topics such as inclusion, transitions, child protection in relation to the internet and partnerships with parents. The book covers the whole age range from birth to eight years with a special section on the birth to three years age group. Each chapter is fully referenced and has case studies or reflective practice boxes within the text. Informative and engaging, the book challenges the reader to think about how underlying theory may be reflected in practice. It will be essential reading for all students who are studying for early childhood qualifications at levels four, five and six. (shrink)

In considering the challenges medical educators face in addressing the needs of today's health-care system, it is instructive to review the challenges Abraham Flexner (1910) was called upon to address at the turn of the last century. As Flexner surveyed the state of U.S. medical schools 100 years ago, he found a legacy system of medical education that was failing to prepare 20th-century physicians to meet the evolving needs and expectations of patients. That legacy system was based largely on (...) an outmoded apprenticeship model of education, was failing to incorporate the rapidly developing natural sciences, and to make matters worse, was devoid of external scrutiny and uniform standards by which medical schools .. (shrink)

Two of our greatest educational theorists, John Dewey and Nel Noddings, have been reluctant to admit that some students are simply more talented than others. This was no doubt due to their feeling that such an admission was inconsistent with democratic concern for everyone. But there really is such a thing as superior talent; and the present book explains how that admission is compatible with our ideals of caring. Traditionalists confident that some disciplines are more important than others haven’t (...) worried that that way of putting things threatens to make those who are excluded feel quite bad about themselves. But an ethics of care can show us how to make these differences much less hurtful and more morally acceptable than anything that has been proposed by traditionalists. So the present book offers a middle way between the denial of the reality of superior talents and an insensitive insistence on that reality. It argues that care ethics gives us a way to do this, and it bases that claim largely on the promise of such an ethics for moral education in schools and in homes. It is argued on psychological grounds that caring can only take place on the basis of empathy for others, and the book shows in great detail how empathy can be encouraged or develop in school and home contexts. Other approaches to moral education—like Kantian cognitive-developmentalism and Aristotelian character education—can’t account for moral _motivation_ in the way that an emphasis on the development of empathy allows. And in the end, it is only students educated via care ethics who will be sensitive to one another in a way that largely undercuts the negative psychological impact of educational institutions and practices that acknowledge the greater talents or creativity that some students have. (shrink)

This study explores child health care nurses’ pedagogical knowledge when supporting parents in their parenthood using various teaching practices, that is how to organise and process the content during parent education groups in primary health care. The aim is to identify teaching practices used by child health care nurses and to analyse such practices with regard to Aristotle's three forms of knowledge to comprehensively examine child health care nurses’ use of knowledge in practice. A qualitative methodological (...) design alongside the analysis of video‐recordings was used. The results showed that child health care nurses used four teaching practices: lecturing, demonstration, conversation and supervision. Their use of episteme was prominent, but they also seemed to master techne in combination with episteme during the first three teaching practices. During the conversation teaching practice, the child health nurses rarely succeeded. Consequently, they missed opportunities to identify mothers’ expressed concerns and to act in the best interests of both the mothers and their infants by the use of phronesis. In health care, however, theoretical episteme is superordinate to productive knowledge or phronesis, which also became evident in this study. Nevertheless, more interactive pedagogical practices are needed if more use of phronesis is to become a reality in parent education groups. (shrink)

This article argues that environmental considerations fall within the scope of medical bioethics, and there are implications specific to medical education. It endorses the need to expand the scope and epistemology of contemporary medical bioethics discourse by including themes related to environmental considerations. Our discussion begins by providing a brief history of environmental bioethics. It then offers a critique of three specific health and environmental issues, namely technology, toxics, and consumption, and discusses how these issues are key to articulating moral (...) considerations of human health and subsequently medicine and its teaching. Lastly, it explores criticisms of including environmental issues into the bioethical debate before providing suggestions of how environmental ethics can be included into the medical curriculum. This article concludes by suggesting theoretical possibilities for environmentally inclusive bioethics, such as reorienting bioethical discussions to its original environmental advocacy and supporting environmental bioethics as a competency in medical education. (shrink)

Although it uncovers a tragic conflict between caring and aspects of contemporary schooling, this book offers hope for teachers.

Background: Nursing Ethics has featured several discussions on what good care comprises and how to achieve good care practices. We should “nurse” ethics by continuously reflecting on the way we “do” ethics, which is what care ethicists have been doing over the past few decades and continue to do so. Ethics is not limited to nursing but extends to all caring professions. In 2011, Elin Martinsen argued in this journal that care should be included as a (...) core concept in medical ethical terminology because of “the harm to which patients may be exposed owing to a lack of care in the clinical encounter,” specifically between doctors and patients. However, Martinsen leaves the didactical challenges arising from such a venture open for further enquiry. Objectives: In this article, we explore the challenges arising from implementing care-ethical insights into medical education. Research design: Medical education in the Netherlands is investigated through a “care-ethical lens”. This means exploring the possibility of enriching medical education with care-ethical insights, while at the same time discovering possible challenges emerging from such an undertaking. Participants and research context: This paper has been written from the academic context of a master in care ethics and policy. Ethical considerations We have tried to be fair and respectful to the authors discussed and take a neutral stance towards the findings portrayed. Findings: Several challenges are identified, which we narrow down to two types: didactical and non-didactical. Discussion and conclusion: In order to overcome these challenges, we must not underestimate the possible resistance to a paradigm shift. Our efforts should mainly target the learning that takes place in the clinical phases of medical training and should be accompanied by the creation of awareness in healthcare practice. (shrink)