Michelle Powell

OBJECTIVES: Interprofessional education is recognized for its potential for collaboration and teamwork, reflecting clinical practice; however, existing literature for simulation-based interprofessional education does not include Physician Associate (PA) students. This initiative aimed to explore the students? perception of interprofessional clinical simulation for PA students and allied health professional (AHP) students as part of our program development.
METHODS: A high-fidelity simulation session was designed and conducted for volunteering students from the PA, paramedic science, and physiotherapy courses. We used a mixed-method electronic questionnaire consisting of 15 statements rated on a numerical rating scale (0-5) and four open-ended questions with unlimited free-text responses to explore student perceptions. Inductive thematic analysis was used for qualitative analysis. The session design was underpinned by Allport?s (intergroup) contact hypothesis with an emphasis on mutual intergroup differentiation.
RESULTS: Forty-six students participated in the simulation teaching, with 48% (n=22) providing feedback. Overall student perception was mainly positive toward the interprofessional simulation; however, some barriers to learning were recognized. Based on the evaluation of our initiative and existing literature, we propose 5 top tips to promote an effective learning experience for students. (1) Understand the importance of interprofessional collaboration. (2) Establish clear roles. (3) Plan the scenarios in advance. (4) Maintain equal status between groups. (5) Provide clear instructions and expectations.
CONCLUSION: To our knowledge, this is the first study of high-fidelity interprofessional simulation involving PA and AHP students. We successfully explored student perception which highlighted aspects that can impact learning. This pilot study demonstrated that interprofessional simulation is a feasible and acceptable form of learning for our students and highlighted how to improve future interprofessional simulation teaching sessions.

This article outlines the development of the assistant practitioner role within a primary care setting and the experiences of 5 trainee assistant practitioners undertaking a foundation degree in health and social care delivered by the University of Bolton. The article will examine the changes in staff skill mix within general practice, and how the assistant practitioner role aims to contribute to the efficacy of services, improve patient access, and continuity of care. Furthermore, it will explore how it is offering career progression for healthcare assistants, in line with the Skills for Health (2015) skills escalator. A focus group methodology was used to gather the views of the trainee assistant practitioners at the end of their university programme and about to enter their new role. They were asked to reflect on the benefits of their learning and competency development, considering how their role has changed and will change in the future.

Palliative and end-of-life care must be a multidisciplinary approach and can be delivered in a range of settings. As the population ages, many older people who need palliative and end-of-life care may receive this care in a nursing home. The place a person spends their last few days varies, with most people wishing to die at home, whether that be living and dying in their own home or in a nursing or residential home (Age UK, 2010; Munday et al, 2007).
The final article in this series of 4, with the 3 former looking at hospice care, hospice at home and day care (Brown and Smith, 2012a, b, c), will explore the role of the assistant practitioner (AP) in this environment. It will look at the way in which services are responsive to an ageing population and the issues of ageing, also the importance of creating a workforce that can meet this need.
Furthermore, consideration will be given to the importance of good-quality care at the end of a person's life within a nursing home setting. Legal and ethical issues will also be examined. There will also be examination of the course that has been developed around end-of-life Care, and comments from a student about her experience.

It is important that the mental wellbeing of the healthcare workforce is attended to by managers. While many research workers have looked at issues of occupational stress and burnout, fewer have considered the mental wellbeing of staff. In this paper, we report on the findings from a larger survey of mental wellbeing, compassion fatigue and burnout in health and social care professionals.
Here we focus on the findings for assistant practitioners (APs). Some 45 APs took part in our questionnaire survey. They were all completing their foundation degree at the University of Bolton. The group were all quite experienced and most worked full-time. The average score on the Warwick Edinburgh Mental Wellbeing Scale for our group was 22.96, which is significantly below the average for the general population in the North West of England of 27.70. Only 3 out of 45 APs had ‘high wellbeing’, while 7 out of 45 had ‘low wellbeing’. Scores for trust were also quite low. Burnout was more of a problem than compassion fatigue for this group of practitioners, with the highest score on the item: ‘I have frequently felt weak, tired or rundown as a result of my work.’ While this was only a small study, and as such needs to be treated with some caution, it does reinforce the need to think about the wellbeing of the workforce and the necessity for managers to provide support for APs in their roles.