Hannah Pyman: Hi, everyone. Thank you for joining us today for our second newcomers presents
Hannah Pyman: webinar of this term.
Hannah Pyman: In this webinar we're going to explore various research topics with help from some of our early career researchers.
Hannah Pyman: My name is Hannah Pyman, and I'm the scholarly communications coordinator in the Library at the University of Essex. My colleague Katrine Sundsbo and myself will be managing the webinar today, so if you have any problems or questions, please do just send us a chat message.
Hannah Pyman: We encourage you to ask questions via the Q&A function here on Zoom, while the panelists are presenting or at the end of the presentation, and we will then be asking these questions to our speakers at the end of the webinar.
Hannah Pyman: So with us today. We have Andrew Burton, Lucia Collen, and Vicki-Jo Scott, who all have very interesting and different topics that they're going to speak to us about.
Hannah Pyman: So our first speaker today is Andrew Burton, who is in the second year of his full time PhD research with the LiFTs department, and he's going to talk to us about eco theater and the limits of naturalism. So whenever you're ready, Andrew.
Hannah Pyman: You are muted.
Andrew Burton: Thanks very much, Hannah.
Andrew Burton: That's great. Can you see my screen okay?
Hannah Pyman: Yes, we can.
Hannah Pyman: Excellent.
Andrew Burton: Right so eco theater and the limits of naturalism.
Andrew Burton: As Hannah said I'm a second year PhD research students in LiFts. My thesis is currently called 'theatre and performance in an age of ecological crisis' and this presentation stems from one of my draft chapters which is about naturalism.
Andrew Burton: My central narrative, my central research question, is what is the role and potential of drama in raising environmental awareness in our current age of ecological crisis?
Andrew Burton: And my chief methodology is ecodramaturgy. Theresa J May says that it has a critical lens. Ecodramaturgy examines the role of theater in the face of rising ecological crises, foregrounding the material ecologies represented on stage", which I think is very useful overall definition.
Andrew Burton: People use the term naturalism and sometimes realism actually confusingly, so
Andrew Burton: just to start with a simple definition from OED that naturalism is "a style or method characterized by close adherence to, and representation of, nature or reality."
Andrew Burton: And even those terms of course are contested. Nature itself is a problematic concept. When Timothy Morton in 'ecology without nature'
Andrew Burton: says that "the idea of nature is getting in the way of properly ecological forms of culture, philosophy, politics and art"
Andrew Burton: he's talking about the post-enlightenment tendency to champion human exceptionalism, rather than accepting humans as an integral part of the ecological systems that make up life on Earth.
Andrew Burton: It's that sense that nature is that thing outside of us that thing over there that we can do things to or does things to us.
Andrew Burton: Raymond Williams, the cultural critic says that "naturalism is originally the conscious opposition to supernaturalism and to metaphysical accounts of human actions". And so there's an attempt to describe human actions in exclusively human terms.
Andrew Burton: In 1994 the theater scholar and eco critic Una Chaudhuri published a highly influential paper in this field, it was in the American Journal of Theater.
Andrew Burton: And it was called, 'there must be a lot of fish in that lake'. It was towards theater ecology.
Andrew Burton: And she noted the "disastrous coincidence in the second half of the 19th century between the age of ecology and the birth of naturalism".
Andrew Burton: She explained that "in the theater naturalism... hid its complicity with industrialization's animus against nature by proffering a wholly social account of human life". So naturalism
Andrew Burton: is problematic when dealing with theater plays that deal with ecology, simply because there's such a focus on the human. It's so anthropocentric in that sense.
Andrew Burton: In my research I contend that there is a naturalistic spectrum operating in eco theater writing,
Andrew Burton: and that it moves from closed time, closed place plays at one end of the spectrum, through plays which deploy a more open approach to time and place near the center. And finally, what I call a form of 'disrupted' naturalism at the far end of that spectrum.
Andrew Burton: So looking at the first end of the spectrum, we have plays that unfold within a closed time. That is, there are no time jumps, that what we see on stage corresponds to real time.
Andrew Burton: And closed place. That means it's set in one location, typically an interior.
Andrew Burton: These are pressure cooker playd where the focus is typically on a single moral issue that needs to be resolved urgently, and with no possibility of the that decision being deferred or avoided.
Andrew Burton: Lucy Kirkwood's 2016 play 'the children' typifies this kind of naturalistic play. It adheres closely to what Steve Waters in 'the secret life plays' refers to as "the pure aim of naturalism,
Andrew Burton: epitomized by Emile Zola's aspiration for a play to be 'une tranche de vie', a slice of life, the continuous, unbroken scene, devoid of authorial intervention."
Andrew Burton: 'The children' takes place in real time over the course of one summer evening in one location.
Andrew Burton: Although the lives of the characters have been devastated by a recent disaster at a nuclear power station on the Suffolk coast, modeled on Sizewell B,
Andrew Burton: their concerns are focused squarely on the eponymous children. The emotional intensity of the play is directed inwards, forcing the characters to examine their individual motivations, hopes and fears.
Andrew Burton: Towards the end of the spectrum, I talked about plays that deploy a more open approach to both time and place, and Steve Waters, the contingency plan diptych,
Andrew Burton: exemplifies this perfectly.
Andrew Burton: It was originally performed in 2009 so 11 years ago and this 2020 rewritten version was due to open in February or March,
Andrew Burton: and then transferred to London's Donmar Warehouse, that both the original production and the Donmar transfer are currently on hold because of coronavirus.
Andrew Burton: Anyway, the play shifts between an exposed coast coastal setting in Northwest Norfolk and a cloistered urban setting in Whitehall.
Andrew Burton: And it covers a period of five months between spring and autumn.
Andrew Burton: It's a recognizably contemporary Britain, Boris Johnson is prime minister, Dominic Cummings Is the butt of the joke. And there's even reference made to the coronavirus pandemic itself.
Andrew Burton: And in this latest version of 'the contingency plan', natural forces (in the shape of an imminent storm surge of unprecedented severity),
Andrew Burton: come to the imaginative fore, and they represent a palpable threat both to people's lives and to the country's future political stability.
Andrew Burton: The personal is played out in the northwest liminal zone where the wilderness meets the domestic picturesque and the political is played out in the Whitehall scenes.
Andrew Burton: And at the far end of my spectrum there is what I'm calling disrupted naturalism or fractured naturalism.
Andrew Burton: This is a form of naturalism which auguries from a devastated natural world interrupt and disturb nationalism's conventions by splintering the illusion of mimesis, and the suspension of disbelief
Andrew Burton: upon which which naturalism depends. And a very good example of this is Carol Churchill's 2016 play 'Escaped Alone',
Andrew Burton: in which the more than human world gatecrashers the anthropocentric focus of the drama
Andrew Burton: with devastating impact. The form itself begins to splinter, a visceral demonstration of human impotence in the face of the impending ecological crisis
Andrew Burton: and interestingly reintroducing aspects of supernaturalism and metaphysics that Raymond Williams reminds us that naturalism originally opposed.
Andrew Burton: There are four characters, they sit in a backyard on a summer afternoon. It could be any summer afternoon that kind of a trope of the domestic picturesque again.
Andrew Burton: And their talk appears to be quite superficial even inconsequential, but at regular intervals their conversation is interrupted by monologues revealing apocalyptic visions of ecological disaster from a devastated world.
Andrew Burton: So I think that's sort of rounds up my my current sense, which I'm still developing in this chapter,
Andrew Burton: of the of the naturalistic spectrum and how it operates. And then at the end of my presentation, which I think you will have access to of to today's talk, there are the various references that I've used in here.
So that is the talk. Thank you for listening.
Hannah Pyman: Thank you so much, Andrew, that was really interesting. Thank you for sharing that with us today. And if anyone does have any questions for Andrew please do put them in the Q&A and we'll get back to them after everyone has had a chance to speak.
Hannah Pyman: Okay.
Hannah Pyman: So our next
Hannah Pyman: speaker is Lucia Collen, and she is currently a PhD student in the School of health and social care and is also a qualified nurse and midwife.
Hannah Pyman: So she is going to explain her research on sharing sexual health information. So I'm just going to share my screen and then you tell me whenever you're ready. That will be great.
Lucia Collen: All right, I'm ready. Can you hear me.
Hannah Pyman: Yes, we can hear you. Just let me know when you need me to change slides.
Lucia Collen: As you have already said I am Lucia Collen.
Lucia Collen: I'm from Malawi in the southern part of Africa.
Lucia Collen: And
Lucia Collen: Which is a two hours fifteen minutes flying from Johannesburg, where the 2010 World Cup took place.
Lucia Collen: My
Lucia Collen: title is
Lucia Collen: for my research project, for my PhD, is understanding intergenerational sexual and reproductive health communication in a rural community of Malawi: an ethnographic participatory action research.
Lucia Collen: So, next slide please.
Lucia Collen: My presentation overview. I'll talk about the introduction, rationale, study aims, background, research questions, methods, and conclusion.
Lucia Collen: As I've already said,
Lucia Collen: In Africa we live as a community.
Lucia Collen: In the typical village, you find three generations, which means a grandma a mother and her daughter living side by side.
Lucia Collen: And you also do your oral transmission of information. We love sharing stories.
Lucia Collen: We love talking. Equally, most of the things the young Africans learn is through observation and imitation. For instance, cooking, we learn from our parents how to cook by observing, you don't have recipe books. Equally, sexually mothers for sex education, follows the same trend.
Lucia Collen: The World Health Organization has also recognized the strength
Lucia Collen: of the African culture of relying on communication, oral transmission of information. In encouraging that, we need to conduct your research
Lucia Collen: to see how we can utilize intergenrational communication about sex and how each can influence you, can encourage sexual responsibilities and positive behaviors among
Lucia Collen: young people.
Lucia Collen: And since families and parents are primary agents of sexualisation, we learn basically from our parents and our grandparents, that's why basically this research is all about
Lucia Collen: leaning on how they communicate today share information among these three generations.
Lucia Collen: Daughters, mothers, and grandmothers. Next please.
Lucia Collen: Why did I think of doing this research? So far it has been done in terms of intergenerational recession with LGBT communication in developing countries, such as Malawi. So I thought, theres's a need to get an understanding on the experience in influencing factors on sexual reproductive health
Lucia Collen: communication from the perspective of three generations. Next please.
Lucia Collen: Next,
Lucia Collen: And I also consider the,
Lucia Collen: err,
Lucia Collen: historical background
Lucia Collen: and its influence.
Lucia Collen: Please go back a little bit.
Lucia Collen: Yes, it also considers the broader historical, economic, and socio-political contexts that shape the intergenerational sexual reproductive health communication experiences and sexual behaviours. Nowadays with the coming of technology a lot of things are changing.
Lucia Collen: So I also want to see how things have changed in addition to use of technology and everything else.
Lucia Collen: Next, please.
Lucia Collen: The background to this research. It's based on my personal and professional experience of growing up and living in a rural community of Malawi.
Lucia Collen: As a child, how difficult it is to access sexual reproductive health information.
Lucia Collen: And I thought maybe as I grew up things may have changed. But when I started working I also realized, through a community project on motherhood,
Lucia Collen: which I was conducting soon after my graduation. When I first started employment after my graduation. Then I noted that young people, they still have difficulties to access sexual and reproductive information as well as services.
Lucia Collen: And because they had difficulties in this you continue to have difficulties. As a result, most of them, they have teenage pregnancies,
Lucia Collen: unsafe abortions, as well as child birth complications, because they don't have access to information, as well as access to services. Next, please.
Lucia Collen: However,
Lucia Collen: as I already said little has been done in relation to intergenerational sexual reproductive health communication in developing countries.
Lucia Collen: Research that has been conducted in
Lucia Collen: European and America. I use data from a European study here. There was a study conducted in 10 European countries. The results revealed that there is easy communication
Lucia Collen: between parents and their children. Especially mothers. In contrast, in Sub-Saharan Africa, sex communication on sexual issues,
Lucia Collen: parents and their children they normally don't talk. It's considered to be a taboo topic.
Lucia Collen: And even if they talk
Lucia Collen: parents mostly just give you a warning to their children: "don't do this. Don't have a boyfriend. You're gonna get pregnant." It's not that easy communication as compared to our friends in the global north.
Lucia Collen: Next, please.
Lucia Collen: Traditionally the way of teaching young people in sexual matters is mainly
Lucia Collen: done by extended families, such as grandparents, aunts and uncles.
Lucia Collen: However, the young females prefer to receive information from their parents and relatives, despite the tradition of not
Lucia Collen: talking about these issues.
Lucia Collen: So to achieve my further aims...
Lucia Collen: Next, please.
Lucia Collen: I have some research questions that I went to be tested.
Lucia Collen: How do girls learn about sex, suxuality, and their future roles as women in this community? How do girls, mothers, grandmothers describe their experiences, beliefs and perceptions
Lucia Collen: on girls' sex education which takes place in that community? And how do girls, mothers, grandmothers view the relationship between sexual reproductive health information as well as young people's behavior? I must point out, this is just one of the main objectives of this research. This research is a big research.
Lucia Collen: And it is an ethnographic reproductive research, which has a number of
Lucia Collen: main objectives. So I just picked one in relation to the town that we are given, but it's a bigger project. So this is part of it. Maybe in the near future I'll come and talk about the other
Lucia Collen: parts of the project.
Lucia Collen: So,
Lucia Collen: Next, please.
Lucia Collen: So, as I already commented about, a methodology that I'm going to use since it's an ethnographic research, it will be confucted in two phases. Phase one are collecting data, and the data will be collected using
Lucia Collen: in depth interviews,
Lucia Collen: focus group discussions,
Lucia Collen: as well as observations. And after I've collected the data,
Lucia Collen: after analysis, then I'm going to conduct a hit improvement intervention with the need to be an action as the methodology is talking about.
Lucia Collen: So, so far,
Lucia Collen: I've just updated this protocol to the ethics committee,
Lucia Collen: and waiting for feedback.
Lucia Collen: I'll be leaving soon for field work. Thank you very much for your attention. Questions, comments, I welcome.
Hannah Pyman: Thank you Lucia that was great.
Hannah Pyman: And yeah, as I just mentioned, if you have any questions
Hannah Pyman: please do put them in the Q&A and we'll get to them at the end of all of our presentations.
Hannah Pyman: Okay so final speaker today is Vikki-Jo Scott, who is currently undertaking a PhD in health studies part time alongside her work as a senior lecturer.
Hannah Pyman: As well as returning to clinical practice during the COVID-19 pandemic. So very busy I think this year! So whenever you're ready.
Vikki-Jo Scott: Thank you.
I'm just gonna share my screen.
Vikki-Jo Scott: And
Vikki-Jo Scott: I'm going to do something slightly different in that I pre-recorded my talk to keep it within eight minutes, but also in case of any technical difficulty. So we'll see if that works.
Vikki-Jo Scott: ....
Hannah Pyman: Oh you are muted. I'm not sure if you...
Vikki-Jo Scott: ... systematic literature review
Hannah Pyman: that I was undertaking as part of my PhD studies.
Vikki-Jo Scott: Aas I talk through this presentation, you'll see that I'm focused initially on the left hand side which talks about methodology and
Vikki-Jo Scott: design of the research. I will refer to the PRISMA diagram on the right hand of the screen and I will go through the findings, which are in the center of the screen.
Vikki-Jo Scott: At the top of the presentation, you can see a link to a blog that I've been writing on this subject, and on the right hand side some contact details for me.
Vikki-Jo Scott: And so my research - I started with a question of what research is being conducted in UK setting with regard to the benefits of advanced clinical practice postgraduate training, education, the key stakeholders.
Vikki-Jo Scott: And this is really to answer three main questions for my PhD. So first thing what empirical research is there regarding the benefits that impact postgraduate adults clinical practice training, education. Secondly, whether there was sufficient evidence
Vikki-Jo Scott: to support or refute the claims of potential benefit
Vikki-Jo Scott: to this group of people. And finally to identify what the current gaps in evidence are regarding the benefits and impacts of postgraduate
Vikki-Jo Scott: clinical practice training education. And really that last one will be then leading you on into a research proposal for my PhD.
Vikki-Jo Scott: So, the method was a systematic literature review. I used the accessible databases through the University Library and I snowballed from the reference list in the primary sources that I found.
Vikki-Jo Scott: I focus my research on particular stakeholders. So these are health care professionals who are already advanced practice or potentially could be,
Vikki-Jo Scott: employers of those health professionals, postgraduate training and education providers, such as universities, education commissioners who actually fund these courses,
Vikki-Jo Scott: and then the professional regulatory bodies that oversees healthcare professionals. Firstly it may seem, I did not include in those key stakeholders patients. And yet, of course, they are the most important
Vikki-Jo Scott: part of this. The reason for that is for my initial research I'd already found and large amounts of research that looked particularly at patient outcome measures and patient perceptions on practice such as satisfaction surveys,
Vikki-Jo Scott: so I decided to not have that as a focus within this research as it had already been done. I applied specific inclusion exclusion criteria. So the first thing the UK, and that's because
Vikki-Jo Scott: in 2017 a new framework of advanced clinical practice was published and this referred specifically to the context within England, English settings, and more broadly within the four nations,
Vikki-Jo Scott: which is a specific context that can't be translated necessary globally.
Vikki-Jo Scott: I wanted to look at specifically empirical research only. What I found in initial searches was there was lots of commentary, policy, and authors referring to each other's work that limited on the face of it, empirical research that underpins those policy documents.
Vikki-Jo Scott: Of course, I wanted to focus on advanced clinical practice not clinical practice more generally.
Vikki-Jo Scott: I wanted to look particularly a Masters or postgraduate level only training in education.
Vikki-Jo Scott: And that's because within the advanced clinical practice framework, they refer to that being an expectations that training and education will be at that level.
Vikki-Jo Scott: And I very specifically wanted to exclude things that were measuring clinical effectiveness. So things like waiting times or patient satisfaction because as I said, I knew that evidence was already there.
Vikki-Jo Scott: So you can see on right of the screen, my PRISMA diagram. And I found 885 records for my initial searching, including snowballing, and I applied my
Vikki-Jo Scott: exclusion criteria and ultimately I ended up with 44 studies to review. Not surprisingly, as I said,
Vikki-Jo Scott: picking up on my initial search the largest number that were excluded were because they were not empirical research so they were like policy documents, commentaries, and those kinds of applications rather than primary clinical research themselves.
Vikki-Jo Scott: So what did I find? I found that there's a broad consensus on the definition of advanced clinical practice.
Vikki-Jo Scott: Title, scope of practice, pay, regulation, and the types of training and education vary.
Vikki-Jo Scott: I also found the clinical practice element of the role dominated over leadership research and education. And within the advanced clinical practice framework they say that a defining
Vikki-Jo Scott: description of advanced clinical practice is that it should include those four elements. So it's interesting that clinical practice consistently was noticed as dominating.
Vikki-Jo Scott: I found that the the barriers to effective advanced clinical practice are well known, that these are still commonly in place. So, for example, opposition from doctors or other health professionals to the role or protocols such as being able to prescribe medications which may limit their practice.
Vikki-Jo Scott: Even though I wasn't looking for it I did find reference within the papers to the clinical effectiveness of advanced clinical
Vikki-Jo Scott: practice being tested in specific contexts. And this had been shown to be at least equivalent to other professions' existing services.
Vikki-Jo Scott: There was evidence if particular education methodologies being used and being effective for the development of advanced clinical practitioners, such as coaching or gamification methodologies in training
Vikki-Jo Scott: sessions.
Vikki-Jo Scott: I also found that the descriptions referred to two different types of roles within advanced clinical practice.
Vikki-Jo Scott: So, one being substitution roles where you're replacing existing health professionals, usually a junior doctor. So you're taking on tasks that used to be done by a junior doctor or could be done by a junior doctor.
Vikki-Jo Scott: Or supplementation roles were these were new services that may provide a value added, something new, something additional to the standard service, or provided some coordination across different types of services. And that was a supplementation role.
Vikki-Jo Scott: And and what was also interesting was that depending on whether it's a substitution or supplementation role that may affect the speed of cost effectiveness of the role.
Vikki-Jo Scott: And finally, I found that there is limited in empirical evidence of personal positive impact for health professionals, for example, in terms of career development, autonomy, staff retention, or job satisfaction. And that's really where our research is going to take us next. Thank you.
Vikki-Jo Scott: Yes. So that was my presentation in terms of References
Vikki-Jo Scott: just to let you know if you go onto the blog post and I've given a number of references to the key documents with it within that blog.
Vikki-Jo Scott: So they are my references. Thank you very much.
Hannah Pyman: That's great. Thank you so much. That was great. And yeah, just to say I will be circulating
Hannah Pyman: the slides after the session so you will be able to go on to that QR code and find the references and find that blog post. And I'll circulate the other two presentations as well afterwards.
Hannah Pyman: Okay. So that was all three of our speakers today. We did have a fourth speaker originally and but we're down to three so we probably will finish slightly earlier.
Hannah Pyman: However, we've now got plenty of time for questions. So I'm going to hand over to Kat now who's going to take the lead on the questions.
Hannah Pyman: And if anyone thinks of any other questions they'd like to ask during please do feel free to put them in the Q&A.
Hannah Pyman: And for the panelists, if you think of any questions for each other, as panelists I don't think you can use the Q&A function
Hannah Pyman: so feel free to either unmute and ask questions directly, or you can add it to the chat as well. Whichever you prefer, if you have any questions for each other.
Hannah Pyman: I'll hand over to Kat now.
Katrine Sundsbo: Thank you. Yeah, we...
Katrine Sundsbo: Excuse me.
Katrine Sundsbo: We have some questions already. And I've got a first question for Andrew.
Katrine Sundsbo: So do you think the intensity of this year is going to bring more theater close to reality to allow people to demonstrate the effects of the pandemic through theater, or do you think there may be more of a demand for escapism?
Andrew Burton: That's a really interesting question. I mean, I think this year has brought into question the very nature of the very fabric of the theater experience, you know, as a
Andrew Burton: form in which strangers come together and typically huddled quite closely together, typically in a darkened space,
Andrew Burton: usually without much ventilation actually in the west which is everything coronavirus, you know, wants us to do. I guess to spread itself. So in that sense, that I think the very nature of experience
Andrew Burton: has obviously I think that's going to be, you know, not replicated for some time to come. And I'm, I'm guessing, I don't know what healthcare professionals feel,
Andrew Burton: if Vikki has a view on this, but I, I certainly feel that most of 2021 is going to be just a gradual playing out and it might be 2022 when things start to resemble something like normal. But I think on a deeper level, the question is a good one because I think
Andrew Burton: our need to tell stories communally is ever stronger, and I think that
Andrew Burton: it will take a while for us to process, what's happened. I think when it happened quite immediately, I think it will take some years.
Andrew Burton: Just in the same way that after the attacks in 911 you know the the the narratives, the dramatic narratives and the fictive narratives,
Andrew Burton: took several years really to play through and they're still playing through. I think we're looking maybe a decade ahead to see how that changes. But yeah, certainly. I mean the thing about theatre and theatre form is
Andrew Burton: it's never really itself under threat, it would, because it will constantly move. And I think it will morph in ways we can't quite yet imagine.
Katrine Sundsbo: Great, thank you very, very interesting. Next question here for Lucia. So you mentioned that young females in Sub Saharan Africa
Katrine Sundsbo: prefer to receive information from their extended families, if there's a reluctance from family members to deliver information and this way, do you think their preferences will have to change?
Lucia Collen: I don't think the preferences have to change because from the presentation as well I have communicated that traditionally the value
Lucia Collen: extended families, mainly grannies, uncles, and aunties see their role
Lucia Collen: meant its most of the terms of the parents, mother, and daughter.
Lucia Collen: But now with the
Lucia Collen: main issues have been in, for example, urbanization, people moving away, you're in the city with your Mum.
Lucia Collen: And the technology in Africa is not as good as here.
Lucia Collen: The only things we have is each other. So eventually, whether they want it or not they'll be forced.
Lucia Collen: For example, in this pandemic, they cannot travel home for 20 kilometers with their daughter because she has hit puberty. She needs to be told how to look after herself.
Lucia Collen: The mother can't go to the hospital, necessarily, because of the COVID, so she has no choice if she has to. So eventually I'm seeing that it's going to evolve.
Lucia Collen: The situation, their circumstances, we just force them to start opening up.
Lucia Collen: And I want to see if it has already started or not.
Lucia Collen: And also hear from them.
Lucia Collen: You are not comfortable, but the young ones they want to learn from you. So how are we going to motivate them? So basically this is project is all about that, seeing how things have evolved, are they the same, are they evolving or not, that kind of stuff.
Thank you.
Katrine Sundsbo: Great, thank you for this. If you can hear some noise in the background it will be building going on here.
Katrine Sundsbo: Next question is for what Vikki-Jo. So with shortages in healthcare staff and budget cuts, do you think substitution roles are more likely to increase?
Vikki-Jo Scott: Yes.
Vikki-Jo Scott: I think, I think there's a real disconnect between
Vikki-Jo Scott: the advanced clinical practice community. There was a national conference recently where they were very clearly saying "oh no way we're not substitution role we're something new. We are adding value we're
Vikki-Jo Scott: taking on our own autonomy in our own space" and yet time and time again, the research talks about the fact that so many, the reality of advanced clinical practice practitioners, is that they're having to negotiate all the time with people that hold power in their organization in terms of
Vikki-Jo Scott: giving, handing on tasks for them to do. So there's been an awful lot of talk about a lack of enough doctors and that's why nurses are taking on
Vikki-Jo Scott: doctors' roles but now you've got the problem that there's not enough. Not now. There always has been, but even more so.
Vikki-Jo Scott: You have not enough nurses. So there's about 100,000 vacant posts in the NHS at the moment and one in, they say between one and five or one in eight of those are nurses, so vacant posts in terms of nursing.
Vikki-Jo Scott: Now the hope is, and this is in the people plan for the NHS, that by offering the advanced clinical practice role, you might retain some nurses within the NHS by giving them
Vikki-Jo Scott: something else to stretch themselves, something else move into, but part of where my research is leading me to is
Vikki-Jo Scott: you know,
Vikki-Jo Scott: whether that is enough to actually retain people within their role, and the reality is, do we need lots and lots of advanced clinical practitioners and doctors?
Vikki-Jo Scott: Or do we need a whole range of professionals? And the reality is we need a whole range! We need occupational therapists, physical therapists, newly qualified nurses, middle
Vikki-Jo Scott: career development nurses, and if you've not got the supply line coming in, you might, you know, have these very advanced people but actually they will
Vikki-Jo Scott: become disheartened and disillusioned and eventually leave the NHS, especially if they're not given that autonomy that is being promised.
Vikki-Jo Scott: By saying that you can move into an advanced clinical practice role, you won't just be a mini Dr. You'll be able to develop the role yourself.
Vikki-Jo Scott: So I think it very much depends on whether the rhetoric of advanced clinical practice is realized and people are allowed to take on that full range of
Vikki-Jo Scott: role in terms of clinical practice leadership education and research, or whether they are continuing to be pushed into just taking on the tasks that the doctors don't want to do anymore, or that there's not enough doctors to do anymore.
Vikki-Jo Scott: And if it's if the latter than I can't see this really taking off and and saving the NHS, which is what they're saying it might help to do.
Katrine Sundsbo: Thank you.
Katrine Sundsbo: Yeah, concerning but very interesting.
Katrine Sundsbo: I've got one question for Andrew. Do you think that having a naturalistic approach to characters like in the plays by Carol Churchill and Lucy Kirkwood makes the events that are happening offstage seem more real than if playwrights tried to show them on stage with the scenery?
Andrew Burton: That's a really good question, really interesting. Kind of goes to the, I think my question is very incisive actually, because it goes to the heart of the power of what you don't see.
Andrew Burton: You know the power of what's omitted in a way. And I think even the Greek dramatists knew this, you know, the ancient Greek dramatists noted, you get more power by not showing something so
Andrew Burton: there are various instances and a number of great plays where awful events happened, but they're described by a messenger or by a chorus.
Andrew Burton: And they kind of gain agency by that. And you could say that in filmic terms Hitchcock was doing much the same, you know,
Andrew Burton: gaining power by omission in a way. And yes, I think that's absolutely right. I mean, I think if you were trying to show those things on stage and trying to represent them,
Andrew Burton: this way is not a great medium really for various militude, film and TV are much, much better at that. But theatre is much better at
Andrew Burton: expressionistic or impressionistic writing where you create worlds and imagine worlds and and so in both of those instances with with Carol Churchill plays and Lucy Kirkland's 'the children',
Andrew Burton: that we're taken into that imagined world, but then our brain starts to work overtime on what might be going on outside. I mean, in the case of Lucy Kirkwood's play
Andrew Burton: it's a recent nuclear devastating nuclear incident on the south coast. Now my research into this has shown me that back in 2007 there was actually a near miss at Sizewell in January.
Andrew Burton: And it was not very well documented. But essentially, the cooling system had an error. And it was only because someone went into check his laundry that was trying to dry
Andrew Burton: that they overrode the systems that have malfunctioned. And there could have been a major release of cesium 135 into the atmosphere. It would have been absolutely devastating for
Andrew Burton: most of Europe, not just East Anglia in Britain. So I think thinking about those sort of things and they have more power by being off stage.
Andrew Burton: You have a good question.
Katrine Sundsbo: Thank you, kind of, I guess, maybe as a bit of a follow up to that question. So plays are often like a way of commenting on very political situations, you mentioned like Boris Johnson and coronavirus was included in that 2020 adaptation
Katrine Sundsbo: of that play you mentioned. What do you think is the most powerful tool of commenting on kind of like the naturalistic approach that you mentioned?
Katrine Sundsbo: What is the most powerful way of doing this o you think?
Andrew Burton: The most.. sorry I don't quite understand the question. The most powerful way of?
Katrine Sundsbo: So for kind of commenting on the political situation of things. So the naturalistic eco
Katrine Sundsbo: situation... you mentioned techniques like
Katrine Sundsbo: kind of time, for example. So if it's closed in time or. So what do you think is the most powerful way of commenting on that using plays?
Andrew Burton: Absolutely, and
Andrew Burton: I think it's it's really to do with the
Andrew Burton: intensely personalizing the issue, I think, really. So if you're dealing with politics as Steve Waters does in 'the contingency plan',
Andrew Burton: People don't really want to go to the theater, you know, to be engaged with drama, just to learn about politics or or what what might happen. They can do that on Prime Minister's Questions or
Andrew Burton: many other forums, and I think what people engage with with drama and theatre is to see how those issues play out on a personal plane, in a personal sphere. So the there's a couple in
Andrew Burton: Northwest Norfolk, who are living off grid in one of the plays in 'the contingency plan'. They've been doing that since the 70s late 70s, which was around the time the Gaia theory
Andrew Burton: was first published by James Lovelock and that whole kind of Whole Earth Catalog movement towards self sufficiency and their idealism is undercut by moral failing. He was a glaciologist and he failed to accurately publish data that showed
Andrew Burton: sea melt rates in Antarctica. So decades later, that's all coming back to kind of haunt him. So, both in the scientific environmental sphere and in the other play
Andrew Burton: in the political sphere in Whitehall all of those issues played through deeply interpersonal. And the same is true in Lucy Kirkwood 'the children' actually.
Andrew Burton: Although it's a nuclear incident that's at the heart of what's happened outside, actually, she uses a triangle relationship where they all three characters used to work 35 years ago at this nuclear power plant.
Andrew Burton: But after the after the accident, after the incident, one of them comes back to try to persuade the other two to help with a clear up
Andrew Burton: so that they can help the eponymous children and the younger people working there to have their lives. So it becomes a moral question, it becomes in a way
Andrew Burton: because the children was published in 2016 and in a way, it was premiered in November of that year,
Andrew Burton: six months after the Brexit vote. It's almost 10 years of austerity, you know. And in a way, it's a comment on what we've left future generations. What that baby boomer generation has left.
Andrew Burton: So it's sort of, it's almost using that as an analogy really for a wider issue that isn't just to do with a nuclear incident.
Andrew Burton: And but again whether those issues are on moralistic ones or whether they're to do with climate change or politics, it is always filtered through the personal and the interpersonal.
Great, thank you.
Katrine Sundsbo: Got
Katrine Sundsbo: a question for Lucia.
Katrine Sundsbo: So it's interesting you mentioned you're looking at the three different generations. And we've had another 'Newcomers Presents' where
Katrine Sundsbo: they were looking at three different generations and and I understand that you've not come to the interview stage yet, but do you
Katrine Sundsbo: think there'll be any difficulty in talking to the three different generation? Is there any differences in how they will open up to you in terms of talking about sexual and reproductive health?
Katrine Sundsbo: You still with us Lucia?
Lucia Collen: Three methods of collecting data.
Lucia Collen: Observations, interviews, and the focus group discussions.
Lucia Collen: With the young ones, the girls, I'll use the in depth interviews.
Lucia Collen: You know, sit the two of us and talk.
Lucia Collen: With the mothers
Lucia Collen: I'll also use the in depth interviews. With the third category, remember I said it's a bigger research study, with the third category I'm going tobuse focus group discussions. Only we have a traditional
Lucia Collen: associated concerns and we have the religious associated concerns. So for the traditional
Lucia Collen: sexuality councillors
Lucia Collen: I'm going to have a focus group discussions.
Lucia Collen: And there is for the religious also a focus group discussions.
Lucia Collen: And the girls normally in Africa, they learn about sexual issues sometimes they have initiation camps. So I'm going to observe
Lucia Collen: how
Lucia Collen: the cultural practices in the communication, how it's done in that one day. So it will be an eight hours observation of simply sitting there and learning how they, tell the girls
Lucia Collen: there issues, only hygiene as well as how to avoid pregnancies and other sexual issues. So I'll be there to observe. So in that role my position will be different. When I'm observing because I grew up in this community, but then
Lucia Collen: I wasn't as part of the community so it's inside-outside approach.
Lucia Collen: For the observation I'll be like the girls, I'll be learning from these
Lucia Collen: councillors, how they're doing it. So like I'll be part of it, not being initiated but observing, because I'm also noticing because I don't know the issues they discuss. So I'll be observing and learning what they are doing and documenting and taking notes.
Lucia Collen: For the interviews, you know, I take charge. Where I have
Lucia Collen: an interview guide, which I'm going to use to at least guide the discussion. And for the focus group discussions I don't have an interview guide but just two questions.
Lucia Collen: The rest, because I'll be like a facilitator, I'll leave the rest for them to add what they think is important because these are the ones where the community has trusted with the responsibility, they know it better than me.
Lucia Collen: So I'll be learning from them. I'll just set the ball rolling, then see how they're going to react.
Lucia Collen: And the recorded conversation with them. I'm going to use voice recording for both the interviews and the
Lucia Collen: focus group discussions. While for the observations, then I'll be taking notes because for eight hours you cannot record.
Lucia Collen: So my position is going to change. Because I'm I belong to the same culture, though I'm different from them, I don't think they do have difficulties
Lucia Collen: opening up. For the older ones, they'll think "she's our daughter". Then the they'll be treating me as their daughter. For the younger ones they'll think "she's our peer", "she's our older sister" so we can talk about it fully. So it will be that kind of situation.
Lucia Collen: Sao I think I'll have problems because I'm in public health
Lucia Collen: my day to day role is going out into the communities
Lucia Collen: collecting data about the issues that are not okay. Then after collecting data I sit back and give feedback. Then with the community will look at
Lucia Collen: some of the issues which we can deal with as a community in the according to their privileges. So if they pick something that is within their reach, maybe just need a bit of education then because I'm a nurse,
Lucia Collen: I know about your, for example, if they want something to talk about how to prevent pregnancy and how it happens when somebody is pregnant because I'm also a midwife I'll be able to communicate to them exactly how it's done.
Lucia Collen: So I don't think I'm going to have problems because I have prior knowledge to the community, because that's what I do every day. Before I came here I was actually working in the community teaching at the University home taking students out in the community. So I'm sure I'll be okay. Yes.
Katrine Sundsbo: Okay. Thank you, That's very fascinating to learn more about your methodology and how you're planning to conduct it. Andrew, you've got a question?
Andrew Burton: Yeah, I was just wondering from Lucia, actually it's a fascinating, fascinating research project, and I wish you well with the field work.
Andrew Burton: I was just wondering whether you are expecting to find or how you plan to deal with issues of female genital mutilation?
Andrew Burton: Whether that's expected to crop up in the interviews that you conduct or in the in the field work generally, and whether you have a, you know, what impact that might have on the general sort of sexual health issues?
Lucia Collen: All right, thank you very much for your question
Lucia Collen: Andrew.
Lucia Collen: In Malawi, you don't have female genital mutilations they have been in Ethiopia and Somalia.
Lucia Collen: Those countries but however we have refugees from Ethiopia and Somalia, where genital mutilation takes place. But for us in Malawi.
Lucia Collen: as a country, we don't have genital mutilations. They just take into the session, the ceremonies they are just simply told, for example, after puberty,
Lucia Collen: how to look after themselves, when they're menstrating, what there is that they need to do. Then we prepare them for marriage. But you don't have the genital mutilation, so
Lucia Collen: I'm not expecting to have issues with dealing with that. If we do have that it's confined to the central region closer to the capital city.
Lucia Collen: In my research I'm going to do the southern part of Malawi. Where we don't have these refugees, because that camp is closer to
Lucia Collen: the central region is the capital city of Milawi. So, and these ones it will be the indigenous people from that community who have grown up in that community. So normally, in the rural areas,
Lucia Collen: if there are any foreigners normally they don't go there because they see less of the opportunities for business and everything else. And now the population of Malawi 84% they live in the rural areas.
Lucia Collen: Where like for example this community, they don't have even access to a tarmac road.
Lucia Collen: In between, like, the town where I grew up into this community there's a big river so basically you have to
Lucia Collen: cross the river and go to that community.
Lucia Collen: There are no buses, there are no cars so nobody would want to go in there because there is opportunity for business or for a better livelihood. So the issue of genital mutilation
Lucia Collen: will not pop up in this case. Thank you.
Katrine Sundsbo: Thank you.
Andrew Burton: Thanks very much Lucia. I think I was thinking of Somalia as being very widespread but that was good to know about Malawai, thank you.
Katrine Sundsbo: Got one question for Vikki-Jo.
Katrine Sundsbo: So you mentioned that advanced clinical practice for postgrads. You mentioned that you found out the training varied quite a lot, that there was lots of differences. And why do you think or, yeah, why do you think there was differences? Are there any reasons why there was so many differences?
Vikki-Jo Scott: It
Vikki-Jo Scott: often comes from how these roles have developed. So again, right from the beginning, some of have evolved as a cast off tasks from doctors
Vikki-Jo Scott: and so the training may well go beyond the job provided within the medical model. So doctors teaching by the bedside, telling them how they want them to do certain tasks. And whereas if it's come through more of
Vikki-Jo Scott: a more evolved development of thinking about a new service they're going to add and this isn't just for one particular profession. So ACPs aren't just nurses, they can be occupational therapists, physios,
Vikki-Jo Scott: so that may involve a different kind of training. And it's only in 2017 that there was a nationally agreed definition for advanced clinical practice,
Vikki-Jo Scott: Where a number of different bodies got together and agreed on what it means. And within that that's where they said
Vikki-Jo Scott: it should be masters level. So what we're now seeing as a scramble for everybody to to get a masters qualification and ye,t you know a bit like
Vikki-Jo Scott: Nursing, people have got into that role by a number of different routes. So you've got advanced clinical practitioners that have been working in that role for a very long time and don't have the masters. They were incredibly experienced but don't have a masters.
Vikki-Jo Scott: And you have people that are just embarking on that career development and have a master's so it's it's varied.
Vikki-Jo Scott: There's been a big call for regulation about the title and the role and but actually
Vikki-Jo Scott: it's more about consistency than it is about regulation because all of them are healthcare professionals that are already regulated and there are a number of bodies that set themselves up potentially as
Vikki-Jo Scott: trying to be gatekeepers to that role but they tend to be niche. They tend to be quite specialized and there's one body at the moment that are trying to be the one
Vikki-Jo Scott: organization that covers all advanced clinical practitioners, but so far they haven't had agreement from the other bodies as to, you know, if you train with one body, will it be recognized by the other?
Vikki-Jo Scott: So this has created a situation where there's all sorts of different routes and different types of training that have been involved. And again, I think it comes back to that, you know, whilst there's now this national definition that ACP should be clinical practice leadership education and research,
Vikki-Jo Scott: if the role develops out of a doctor wanting to pass on tasks then actually it dominates one clinical practice and so the training won't involve things around leadership education or research and
Vikki-Jo Scott: there's certainly evidence that these people have been barred from being involved in those aspects of the work.
Vikki-Jo Scott: And we've seen this in the coronavirus on SAGE in a that nurses were excluded from those discussions. We've seen it again in the last day or so,
Vikki-Jo Scott: where it's talked about the administration of vaccines, and time and time again it's all "well, GPs will be administering it", no, they won't. It will be nurses
Vikki-Jo Scott: giving those injections. So, you know, having a place at the table to influence at that level is being barred and so that then also influences the types of training, that are available.
Katrine Sundsbo: Thank you. Very interesting to get a nice view into how it works.
Katrine Sundsbo: Right. I think we're running out of time now, and I just want to thank all the presenters for coming in and talking about your research, it has been really fascinating
Katrine Sundsbo: to hear about your work and to be able to ask questions and get very inside information into three very different topics.
Katrine Sundsbo: So yeah, thank you for, for joining us.
Lucia Collen: Thank you.
Hannah Pyman: Thanks, everyone. It's been great. Thanks for your time and for all of the questions. It's been a really great discussion. So thank you very much.