• Digital-based self-management interventions for people with osteoarthritis: Systematic review with meta-analysis

      Safari, Reza; Jackson, Jessica; Sheffield, David; University of Derby (JMIR Publications Inc., 2020-06)
      Osteoarthritis (OA) is not curable but the symptoms can be managed through Self-management programmes. Due to the growing burden of arthritis to the health system, and the need to ensure high quality integrated services, delivering Self-management programmes through digital technologies could be an economic and effective community-based model of care. To analyze the effectiveness of digital-based self-management programs on patient outcomes in people with OA. Seven online databases and three grey literature databases were searched for randomized controlled trials (RCT) assessing digital-based structured self-management programs (D-SMP) on self-reported outcomes including pain, function, disability, and health-related quality of life in people with OA. Two reviewers independently screened the search results and reference list of identified papers and related reviews. Data about the intervention components and delivery, and behavioral change techniques were extracted. Meta-analysis, risk of bias sensitivity analysis and subgroup analysis were performed where appropriate. The GRADE approach was used to assess the quality of evidence. Eight studies were eligible including 2687 people with OA. Self-management programs were delivered via telephone plus audio/video, internet or mobile app. D-SMP compared to Treatment As Usual control group resulted in a significant, homogeneous, moderate reduction in pain (SMD -0.28, 95% CI -0.38 to -0.18) and improvement in physical function (-0.26 95% CI -0.35 to -0.16) at post-treatment. The D-SMP effect reduced slightly at 12 months follow-up but remained significant and moderate. Using the GRADE approach, the quality of evidence was rated as ‘moderate’. D-SMPs may result in a moderate improvement in pain symptoms and function in people with OA delivered. Further research is required to confirm the findings of the review and assess the effects of D-SMPs on other health-related outcomes. Clinical Trial: PROSPERO: CRD42018089322
    • Disclosure and sickle cell disorder: a mixed methods study of the young person with sickle cell at school.

      Dyson, Simon M.; Atkin, Karl; Culley, Lorraine A.; Dyson, Sue E.; Evans, Hala; Rowley, Dave T. (Elsevier, 2010)
      Sickle cell is a leading genetic condition, both globally and in England. Little research has been conducted into the experiences of young people with sickle cell at school. A mixed methods study (May 2007–September 2008) based on 569 questionnaires and 40 taped interviews with young people living with sickle cell disorder (SCD) in England found that students with SCD are faced with a dilemma as to whether or not to disclose their sickle cell to teachers and pupils: the latent and hidden characteristics of their symptoms make it possible, in Goffmanesque terms, to “pass”. However the variable and unpredictable course of sickle cell is a reminder of Goffman’s notion of being “discreditable”. We found that teacher or pupil knowledge that a young person has sickle cell is not statistically associated with reported better treatment of young people with SCD at school. Analysis of interviews suggests most young people favour disclosing their sickle cell status (on the basis that teachers will then know what actions to take in the face of bouts of illness and in terms of making allowances for illness or school absences). A minority disagreed because disclosure was felt to attract unwarranted attention or disabling attitudes. Attitudes to disclosing to peers were more varied: either for or against disclosure to peers, or ambivalent in that they felt a tension between acknowledging the reality of their sickle cell, and not wanting it to be a central part of their identity. Some health promotion advice appears to assume that teacher and/or peer awareness is the key to improving school experience for young people with SCD, but this is not borne out by this study. Rather a change in wider school environments is required such that young people with SCD are supported irrespective of whether they themselves foreground or play down their disabled identity.
    • Domestic violence and suicide attempt among married women: A case‐control study

      Rahmani, F; Salmasi, S; Rahmani, F; Bird, J; ASghari, E; Robai, N; Asghari Jafarabadi, M; Gholizadeh, L; University of Derby (Wiley, 2019-04-23)
      The aim of this study was to investigate the impact of domestic violence‐related factors on suicide attempt in married women. Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women. A retrospective case‐control design was adopted. Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of XXX, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide. The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence‐related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, simple and multivariate logistic regression analysis were used to analyze the data. Odd ratios (OR) of domestic violence related factors were compared between the groups. We used STROBE checklist as an EQUATOR in this study. The mean age of participants in the case and control groups was 28.4 years and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08‐326. 63, p<0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54‐118.67, p<0.001), jealousy of husband (OR 23.46, 95%CI 11.63‐47.30, p<0.001), and previous attempts to divorce (OR 16.55, 95%CI 5.91‐46.31, p<0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father‐in‐law (p<0.001). To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals. Recognizing risk, assessment and referral of victims of domestic violence should be an integral part of health care systems.
    • Education and young people with sickle cell disorder: a knowledge review.

      Abuateya, Hala; Atkin, Karl; Culley, Lorraine A.; Dyson, Sue E.; Dyson, Simon M. (Radcliffe Publishing, 2008-06)
      Sickle cell disorders (SCD) are a group of chronic inherited blood conditions. The majority of studies on SCD have a clinical focus and deal with how those living with SCD 'manage' what is constructed as a given: the 'condition' of SCD. Consequently, many studies present the psychological impact, referring uncritically to what are termed 'coping strategies'. Current debates on SCD and other chronic conditions rarely engage with the broader social context. In part response to this, our paper presents a critical review of the literature on SCD, young people and education. The paper evaluates literature that touches on education and SCD, before concluding with a broad discussion of future research and policy priorities. Throughout, we reflect on how the process of constructing a knowledge base from available literature is problematic. We specifically discuss how current research presents a skewed picture of the experience of SCD, which is of limited value to those responsible for education policy and practice. The paper concludes that research should move beyond describing the basic health needs of people with SCD by including the social context of their lives. Existing literature on the individual educational experiences of young people living with SCD is, however, either dated or limited by being based on conceptual argument rather than empirical data. Consequently, there is a need for well-designed studies to establish the best way to meet the educational needs of young people with SCD, reflecting not only their health needs in school, but the whole context of living with SCD, including interaction with disabling or racist structures. Furthermore, this holistic approach could contribute to a wider understanding of the educational needs of young people from minority ethnic backgrounds and of young people living with chronic illnesses.
    • Effect of exercise interventions on perceived fatigue in people with multiple sclerosis: synthesis of meta-analytic reviews

      Safari, Reza; Van der Linden, Marietta L.; Mercer, Tom H.; University of Derby; Queen Margaret University; Centre for Health & Social Care Research, College of Health & Social Care, University of Derby, Derby, DE22 1GB, UK; Centre for Health & Social Care Research, College of Health & Social Care, University of Derby, Derby, DE22 1GB, UK; Centre for Health & Social Care Research, College of Health & Social Care, University of Derby, Derby, DE22 1GB, UK (Future Medicine, 2017-06-20)
      Although exercise training has been advocated as a nonpharmacological treatment for multiple sclerosis (MS) related fatigue, no consensus exists regarding its effectiveness. To address this, we collated meta-analytic reviews that explored the effectiveness of exercise training for the treatment of MS-related fatigue. We searched five online databases for relevant reviews, published since 2005, and identified 172 records. Five reviews were retained for systematic extraction of information and evidence quality analysis. Although our review synthesis indicated that exercise training interventions have a moderate effect on fatigue reduction in people with MS, no clear insight was obtained regarding the relative effectiveness of specific types or modes of exercise intervention. Moreover, Grading of Recommendation Assessment, Development and Evaluation revealed that the overall quality of evidence emanating from these five reviews was ‘very low’.
    • The effectiveness of intrapartum ultrasonography in assessing cervical dilatation, head station and position: A systematic review and meta-analysis

      Wiafe, Yaw Amo; Whitehead, Bill; Venables, Heather; Nakua, Emmanuel Kweku; University of Derby (2016-10-06)
    • Engaging Leaders: The challenge of inspiring collective commitment in universities

      Gentle, Paul; Forman, Dawn; University of Derby (Routledge, 2014)
      Addressing the question of how leadership can work most successfully in universities, Engaging Leaders strengthens the sense of shared professional knowledge and capability amongst leaders in higher education. Presenting a narrative of change which not only spells out why universities need to work differently, this book also takes the reader through clear practical steps which any practising leader can take in order to build a collaborative professional culture which supports and challenges all members of an academic community.
    • Envy's pathology: Historical contexts.

      Minou, Lina; Independent Researcher (F1000Research, 2017-05-23)
      This article is concerned with the physicality of envy primarily in early -modern, but also in eighteenth-century health contexts. The discussion brings together descriptions of the effects of envy on the body of the envier, mainly from works of physiology and health preservation, but also from literary and spiritual writings. These depictions of envy are studied beyond their symbolism and with a view to establish whether they are meaningful according to the medical theories of the time in which they occur. The discussion begins by acknowledging the status of envy as a 'disease' and looks to the specific ways in which the discourse of envy conveys this sense. I find that in the early modern discourse envy is always pathological, that is, it is experienced as disease and signifies disease in general and several diseases in particular. Moreover, envy is uniquely placed to convey pathology on account of its being connected to inherently pathogenic elements of the humoural theory. Specifically, envy is physiologically connected to melancholy, and the way it is presented comes close to attributes assigned to black bile. In addition, envy realizes pathology, the occurrence of disease in the body, by impairing the vital process of digestion and thus depriving the person from proper nourishment and sustenance. The analysis further considers how this impairment of the body fits with the physiological manifestation of envy as 'corrosion' and 'consumption'. Finding commonalities with other maladies mediated by these physiological signs the article concludes by considering the function of pathology in the conception of early modern envy.
    • Evaluating an interprofessional disease state and medication management review model

      Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery; University of Derby (Taylor and Francis, 2013-11-18)
      There is lack of literature data reporting an incorporation of medication management reviews in students’ interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students’ attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.
    • Evaluating clinical placements in Saudi Arabia with the CLES+T scale

      Anthony, Denis; Al-Anazi, Norah; Alosaimi, Dalyal; Pandaan, Isabelita; Dyson, Sue E.; University of Derby (Elsevier, 2019-07-09)
      The clinical learning environment and supervision (CLES) tool has been enhanced with an additional sub-scale for measuring the quality of nurse teacher’s involvement to form the CLES+T scale. It has been widely used in many countries to evaluate clinical placements. Here we report data from Saudi Arabia. The CLES+T was employed to measure satisfaction among student nurses concerning their clinical learning environment. Linear regression was used to determine relationships of various variables to the outcomes of total CLES+T score and those of its subscales. Students were generally satisfied with their placements. For female students the number of visits of the nurse tutor was positively associated with most subscales and with the total score. For males, who had fewer visits of nurse tutor, there was no such association. Nurse tutor visits are positive in terms of clinical placement evaluation by female student nurses. Saudi nursing students are generally similar to students in other international studies in terms of their appraisal of clinical placements.
    • An exploratory study to identify risk factors for the development of capecitabine-induced Palmar Plantar Erythrodysesthesia (PPE)

      Law, Annie; Dyson, Sue E.; Anthony, Denis; De Montfort University; University Hospitals of Leicester NHS Trust; UK; Middlesex University; UK; University of Leeds; UK (Wiley., 2015-02-20)
      AIMS: To identify pre-treatment risk factors for the development of Palmar Plantar Erythrodysesthesia in participants receiving capecitabine monotherapy. Specifically the hypothesis that avoidance of activities that cause friction and pressure cause Palmar Plantar Erythrodysesthesia was tested. BACKGROUND: Previous literature showed contradictory evidence on the subject of predictors of chemotherapy-induced Palmar Plantar Erythrodysesthesia. There is a lack of empirical evidence to support the theory that Palmar Plantar Erythrodysesthesia is caused by damage to the microcapillaries due to everyday activities that cause friction or pressure to the hands or feet. DESIGN: Prospective epidemiological study of risk factors. METHODS: Prospective data collection. All patients prior to commencing capecitabine monotherapy between 11 June 2009-31 December 2010, were offered recruitment into the study and followed up for six cycles of treatment (n = 174). Data were collected during semi-structured interviews, from participants' diaries, physical examination of the hands and feet and review of notes. Data relating to activities that cause friction, pressure or heat were collected. Data were analysed using bivariate (chi-square and independent groups Student's t) tests where each independent variable was analysed against Palmar Plantar Erythrodysesthesia. RESULTS: The only variables that were associated with an increased risk of Palmar Plantar Erythrodysesthesia were a tendency to have warm hands and pre-existing inflammatory disease. CONCLUSIONS: This study gives no support for the hypothesis that avoidance of activities that cause friction and pressure cause Palmar Plantar Erythrodysesthesia.
    • Exploring factors having an impact on attitudes and motivations towards volunteering in the undergraduate nursing student population − A comparative study of the UK and Ghana

      Dyson, Sue E.; Korsah, K.A.; Liu, L.Q.; O’Driscoll, M.; van den Akker, O.B.A; University of Derby; University of Ghana; Middlesex University (Elsevier, 2021-04-10)
      This study explores attitudes and motivations towards volunteering in nursing students in Ghana compared with nursing students in the United Kingdom (UK). Ghana traditionally follows a western model of nurse education, with students studying programmes commensurate in theory and practice, making Ghana a suitable location for a comparative study. We explored similarities and differences in attitudes and motivation towards volunteering to challenge and inform our common place practice towards nursing pedagogy. Ghanaian students displayed positive attitudes towards volunteering, although these did not translate into increased motivation to volunteer while at university. Students reported financial constraints as reasons for not volunteering as did UK students, although Ghanaian students used available resources for daily living expenses, whereas UK students prioritised available resources to pay down student debt. Structured volunteering was absent from both Ghanaian and UK nursing programmes, despite its potential to increase the variety of social groups or situations to which students are exposed, to increase self-confidence and to encourage greater reflection on practice through doing. Structural challenges within countries may provide a better explanation of variation in student motivation towards volunteering, than cross-cultural variation in attitudes towards volunteering between countries.
    • Exploring public perspectives of e-professionalism in nursing

      Jackson, Jessica; University of Derby (RCN Publishing Ltd., 2019-12-02)
      Background E-professionalism is a term used to describe the behaviours of healthcare professionals, including nurses, in the online environment. While a range of professional guidance on the use of online social media platforms is available, there has been little research into the perspectives of patients and the public more generally on nurses’ e-professionalism. Aim To explain what, how and why the public make decisions about the acceptability of nurses’ online behaviours and e-professionalism, and to make recommendations for nurses on managing the information they share online. Method This was a mixed-method critical realist study. Participants in a survey (n=53) and two focus groups (n=8) discussed and rated the acceptability of five vignettes related to nurses’ online behaviours based on real-life examples. Findings The participants generally thought that nurses are entitled to have a personal life and freedom of speech and to promote causes they believe to be important, even if these were not aligned with their own beliefs. Participants unanimously considered the use of profane language against any individuals or groups to be unacceptable. Conclusion The public make decisions on the acceptability of nurses’ online behaviours based on a range of complex factors, including social and individual values, attitudes and beliefs, as well as their intent and consequences. Recommendations for nurses on how to manage the information they share online include: using separate platforms for personal, educational and professional purposes; using functions that control who can ‘tag’ and share their posts; and ensuring any information they share that relates to healthcare or nursing practice is up to date and evidence based.
    • Exploring the long-term influence of the family nurse partnership on the lives of young mothers

      Woodward, Amelia; Ward, Derek; Jackson, Jessica; University of Derby (Oxford University Press, 2017-10-20)
      Background The Family Nurse Partnership (FNP) is an intensive nurse led home-visiting programme for first-time mothers under 19 years old and their babies, run by the English Government. This small qualitative study is part of a larger study which examined the key outcomes of the programme in one UK location. Few studies have explored the experiences of young mothers after graduating from the FNP. The aim of this study was to explore mother’s own experiences of the programme and particularly how the FNP programme has had an impact upon parents and their children post-graduation from the programme. Methods Data was collected using face to face, semi-structured interviews with a purposeful sample of 12 mothers who had graduated from the FNP programme. Mothers were asked about their experience of the programme and their subsequent life-course. The interviews were recorded and then transcribed verbatim. Analysis of the data was conducted using a constant comparative approach. Results The mothers who had participated in the FNP program were very positive about their experiences and talked about the continued impact the programme has had on their lives. Themes emerging from the data included the importance of the supportive nature of the relationship with the family nurse and how participating in the FNP had increased their self-confidence and has empowered them to make positive changes in their lives. Conclusions The interviews found that mothers valued the intervention and it had a long-term impact on the mothers. In addition ways in which the FNP intervention has influenced the lives of clients and their families, that are not routinely measured by the programme were identified. Researchers are now working with the programme providers to support its development of a more flexible intervention model of parenting support so that the beneficial effects of the programme can reach more vulnerable parents. Key messages: •Mothers value the FNP intervention and continue to benefit from the programme after it has finished •Further development and evolution of the model is being undertaken which aims to reach more parents and should be researched.
    • Exploring the potential role of coaching skills.

      de Witt, Julie T; University of Derby (2018-07-04)
      Part of our role is to develop and inspire the leaders of the future; so they will go onto deliver high quality healthcare services for all of us. However, inspiring leaders of the future is not as simple as including in a curriculum. Various reports examining the failures within the UK NHS seem to emphasize this unfortunately (Francis, 2012: Keogh, 2012: Morecambe Bay, 2015). Addressing intrinsic motivation is key in embedding the concept of leadership into our graduates, as future clinical leaders within the NHS. This is also where a coaching approach in both personal tutoring and in the class setting (team coaching) can work. Using a coaching approach we may begin to tap into that area below the waterline and encourage the student to reach their own solution; one which addresses their inherent motivation. In this invited talk I will outline some of those strategies and why you should consider building some of them into your practice.
    • The eye of the beholder

      Bird, Jamie; University of Derby (Routledge, 2019-07-30)
      This chapter addresses issues that arose from being a male researcher and art therapist conducting arts-based research with women who had experienced domestic violence and abuse. Engaging in such research required that I critically engage with issues of gender within the context of conducting research. Through the lens of one particular vignette taken from a larger study, this paper will engage with broader ideas about gender and the conducting of arts-based research and art therapy. Whilst this chapter will have relevance for those men engaged in research or art therapy that involves aspects of domestic violence and abuse, it will also have relevance to those who are interested in wider discussions to be had about the influence of gender upon relationships within therapy and research. This has always been a topic worthy of sustained investigation, but the contemporary emergence within public discourse about abuses of male privilege within various professions make this an especially important subject to attend to. Drawing upon the work of Sandra Harding (1998, 2004), Jeff Hearn (1998) and Ann Murphy (2012), I will explore how feminist standpoint theory and reflexivity helped to manage, and make sense of, the concerns and anxieties that arose whilst conducting research into violence against women. Anxieties about research becoming therapy merged with anxieties about being a male researcher working with women who had experienced domestic violence and abuse. Whilst this chapter does not aim to outline in depth what an arts-based research methodology looks like within the context of studying domestic violence and abuse, it begins by describing the methodology in enough detail to provide a context within which the nature of the research process can be appreciated. The findings of the research are presented in sufficient detail to allow the overall findings of the research to be understood. There then follows examples of words and images produced by one woman, who used her participation as a way of ensuring that she was seen clearly by myself and by other research participants. This aspect of wanting to be seen became an embodiment of the need to acknowledge my own standpoint and reflexive position as a male researcher. Evaluative comments about participation made by other women are used to show how vulnerability was a feature of taking part in this research for both participants and for me. The concept of vulnerability is examined with reference made to ideas about imagination and empathy from the perspective of feminist philosophy, which in turn helps to shape a discussion about the place of gender within research, art therapy, and the boundary between them. In keeping with the principles of feminist standpoint theory and strong objectivity, as set forth by Harding (1998), this chapter is written from a first-person perspective.
    • Fatigue interventions in long term, physical health conditions: a scoping review of systematic reviews.

      Hulme, Katrin; Safari, Reza; Thomas, Sarah; Mercer, Tom; White, Claire; Van der Linden, Marietta; Moss-Morris, Rona; University of Derby; King’s College London; Staffordshire University; et al. (PLOS, 2018-10-12)
      Fatigue is prominent across many long term physical health conditions. This scoping review aimed to map the fatigue intervention literature, to ascertain if certain interventions may be effective across conditions, and if novel interventions tested in specific long term conditions may be promising for other conditions.
    • A feasibility study of a novel work-focused relational group CBT treatment programme for moderate to severe recurrent depression

      Walker, Nicola; Vernon-Smith, Madeleine; Townend, Michael; Teesside University; Leeds and York Partnership NHS Foundation Trust; University of Derby (Emerald, 2021-09-02)
      No current psychotherapeutic intervention is designed to enhance job retention in employees with moderate-severe recurrent depression. We hypothesized that interdisciplinary, work-focused psychotherapy would have the triple benefits of alleviating depression, improving interpersonal difficulties, and enhancing job retention. To test the feasibility of a new Work-focused Relational Group-CBT Treatment Programme for moderate-severe depression. The new programme was based on a theoretical integration of occupational stress, psychological, social/interpersonal, and bio-medical theories and consisted of (i) 1:1 psychotherapist sessions; (ii) a work-focused, twelve-week group CBT programme; and (iii) optional 1:1 sessions with an occupational therapist. Depression, coping/self-efficacy, health-related quality of life (HRQoL), interpersonal difficulty, and work/social functioning outcomes were assessed before and after group therapy using validated instruments. Intervention delivery, therapeutic alliance, client satisfaction, and programme cost were assessed. While there was no statistically significant change in HAM-D depression scores after therapy (n=5; p=0.313), there was a significant decrease in BDI-II depression scores after therapy (n=8; -20.0 median change, p=0.016; 6/8 responses, 7/8 minimal clinically important differences, 2 remissions). There were significant reductions in clinically relevant psychological distress, coping self-efficacy, HRQoL, and interpersonal difficulties after therapy. All clients in work at the start of therapy remained in work at the end of therapy. The intervention was safe, had 100% retention, and clients were satisfied with their treatment. The Work-focused Relational Group-CBT Treatment Programme showed promising immediate positive outcomes in terms of depressive symptoms, interpersonal difficulties, and job retention that warrant further exploration in a longer-term definitive study.
    • Florence Nightingale (1820–1910) – what does history say about her feminism?

      Hogan, Susan; University of Derby (Informa UK Limited, 2020-11-28)
      Is Florence Nightingale becoming unfashionable? The UK’s largest union UNISON voted to drop the use of Nightingale’s image for their union as she was considered to be unrepresentative of modern nursing. One of those backing the motion is on record as saying, ‘All over Eastern Europe, statues of Lenin are being taken off their pedestals, dismantled and pulled off to be cut up.… It is in the same vein that we must enter the new Millennium, start to exorcise the myth of Florence Nightingale’. This paper will discuss modern attitudes to Nightingale in terms of her feminism (not a term she used of herself) and survey scholarly articles that address Nightingale in relation to the position of women. It ends with reflections on the iconography of notable women.
    • Governance options for effective interprofessional education: Exposing the gap between education and healthcare services

      O’Keefe, Maree; Forman, Dawn; Moran, Monica; Steketee, Carole; The University of Adelaide, Australia; University of Derby; The University of Western, Australia; The University of Notre Dame Australia (Informa UK Limited, 2020-07-24)
      The increase in interprofessional models of collaborative practice and identification of health services as interprofessional organisations, sits somewhat awkwardly with traditional governance systems for both health services and educational institutions. Whereas health services have a primary focus on assuring competence and safety for health care practice, educational institutions have a primary focus on assuring academic standards within specific qualifications. Bridging the gap between these two systems with a workable option has proven challenging, especially in relation to interprofessional education (IPE). Given the need to ensure ‘work ready’ graduates within a more interprofessional and collaborative workforce, it is important to review the quality assurance governance models that are in place and to consider which of these existing governance systems, if either, is the more appropriate model for enabling and supporting IPE. This paper describes current issues in relation to governance for quality assurance, summarises the current state of research in the field and discusses potential governance options moving forward. Given that existing governance models are not meeting the challenges of IPE, there is a need to achieve greater alignment between the academic and health service governing systems.