Continuing education is perceived here as a process that helps to improve the lives of individuals, to clarify their thoughts and personal reflection on what they are doing and act as engaged citizens in a process of social transformation. In this research, the content of continuing education is mainly based on the experiences of the actors in education and this education must take place in the school where teachers work (Ghaye, Lillyman, 2010).
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It has been emphasized Cordingley (2003): that knowledge is multiple for teachers as part of a research it has been identified in three types: the knowledge of teacher educators (those who teach), the knowledge of a teacher’s students (those who are taught) and knowledge built by members of both groups when interacting during class. The research adds that each individual constructs his knowledge through experiences and teachers construct their professional knowledge so through their daily practice and experiences which they are subjected. Two main perspectives emerge writings on the concept of professional development (Cordingley, 2003):
Developmental Perspective
Professional development is associated with progression in the teaching profession. Particularly, Fessler and Christensen (1992) identify the following stages of progression: initial training, entry into the profession, strengthening skills, enthusiasm, frustration, stability, withdrawal and leaving the profession.
Professionalizing Perspective
Professional development is associated with learning, generally perceived as both process and product. According to Day Antoniou and Kyriakides (2011) professional development is achieved through learning experiences natural conscious and planned. The authors noted a conceptual shift in several writings between the concept of professional development and the training continues. According to them, the training means more interventions can promote the development of teaching and learning.
Professional Development and Learning
The professional learning begins from the beginning of the initial training and continues until the end of the professional career. This learning is a process of professional development. Among health care professional development is linked to successful treatment outcomes and the patient’s experience of care (Frankel, et al, 2011). In education improving teaching skills and developing professionally, the teacher contributes to learning and student success entrusted. Professional development is linked to innovation:
Professional development can bring about changes in the school environment and fosters a culture of innovation among teachers. Currently, changes to concern mainly student learning and ways to promote it. To better adapt their practices to the needs of students, teachers must be innovative and take into account the results of research in teaching (Stanovich, 2000)
Training offered in academia is often too fragmented and training does not adequately consider the social complexity. “In the statistics of a globalized world, is qualifying Often Understood (quantitatively) as efficacy, or efficiency of the educational worker, Malthus is disregarding the professional teacher as a human being who is situated in a local school culture. Consequently, the programs and activities from the materialized Which policies (Such as continuing education) end up Being vertical actions (discontinuous), with little consideration of the real needs of teachers and interest) (Stanovich, 2000). Criticism by teachers on training received to date indicates that:
The course received were too short and no continuity between them (isolated activities);
The course proved sometimes too theoretical and had little to do with daily practice;
The course does not take into account the needs and interests of teachers (topics chosen by the researchers and academic staff);
The course does not take into account the cultural and political progress;
The course does not allow forming a critical opinion (ideas imposed);
The courses were sometimes offered in locations far from the school where teachers work (hard to get there, means having a lot of time and spending money).
The course does not take into account the reality of the school and the various contexts that can meet:
The relationship between universities and teachers is fragile (critical universities that do not prepare enough teachers for the reality of school and critical schools that are not prepared enough students for graduate studies). Some administrative practices rely on quantity rather than quality regarding training. Indeed, in recent years, offering continuing education has increased in various institutions such as universities and professional associations, but it is not always a guarantee of quality.
Role of Reflection in Quality Care
Reflective practice is about care professionals and their work. Reflective practice is about learning from experience. The role of reflection is highly important for the quality of care, without knowledge of different aspects care professionals cannot claim to be capable enough to perform their task to perfection or precision. It is about signifying what care professionals do and why they do it. The series makes an important statement about the kinds of knowledge which care professionals generate through reflection. Reflective practice does not disconnect theory and practice rather it bridges the gaps between values and actions while regarding and operating with evidence. Briefly, reflection is knowledge which is about and for the improvement of self, the team and the context of healthcare (Mamede, et al., 2012).following factor are highlighting the importance of reflection in quality of care (Mamede, et al., 2012):
Reflection is with no apologetic attitude though not exclusively practical in kind.
Reflection is intrinsically domestic and closely associated to the real clinical work framework of the practitioner.
Reflection is created and owned by practitioners themselves.
Reflection is frequently prepared overtly and collaboratively, not confidentially and just individually.
To inquire existing practice reflection can be used hence, to assist the development of a ‘critical’ posture towards healthcare.
Reflection is useful or ‘good enough’ to enable health care professionals to make more sense of their opinion and actions.
To the development of an enquiring posture reflection play a vital role which is a significant constituent in being able to assert that health care professionals are enduring learners. Thus Reflection above all, is appreciative. Reflective practitioners expand their work systematically and rigorously (Mamede, et al., 2012).
Model of Reflection
Miss June, 32 yrs old was admitted in A & E with car accident causing her to lose blood. She was accompanied by her friend and was conscious during her arrival. However, her health deteriorates and doctor suggested giving her unit of blood. Miss June refused to receive a blood transfusion by saying it is against her religion. The mentor tried to convince Miss June to receive a bag of blood, since her health was deteriorating with time. But Miss June refused it. To deal with this ethical dilemma and save her life nursing management should get all the facts of patient besides the above case scenario, these facts include a record of heart rate, her respiratory rate and her blood pressure (BP) (Hupston, Fleur, 2008).
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In the precise cases of the nursing professions, it is advised that the professional to recognize, respect and perform actions that will protect the person’s right to make a decision about their health, cure, and well-being, turning them excused from any kind of unfairness (Gardiner, 2003). It also compels them to execute or contribute to health care without the approval of the patient or their legal envoy, apart from in cases of looming risk of death (Volbrecht, 2002). Hence, any diagnostic, preventive, or therapeutic intervention is required to be voted on the bioethics principles of malfeasance, non-malfeasance, beneficence, and autonomy and it can only be conducted with the permission of involving person, based on sufficient information (American Nurses Association, 2001).
Evaluate Alternative Actions
The need for blood transfusions in this case certainly has created an ethical dilemma for the healthcare team, because this procedure involves the collision of two fundamental rights: the basic right of life and the right of denial due to faith and religious values.
Decision and Test
The nursing management decides to tackle the situation in three steps. In first step with the help of evidence they begin to convince Miss June that blood transfusion for health care purpose particularly in life threatening condition is altogether different from eating blood. Nursing management should make Miss June realize that her original belief about abstaining from the blood intake is right however, it’s not applicable in this scenario. (Migden, Braen, 1998). However, even if the patient is still not convinced it cannot be forced on her to change her belief otherwise. Her care giver quickly moves to the second line of action and propose to her that she can have a transfusion by means of alternative hemotherapies (Hupston, Fleur, 2008). However, if Miss June even refuse to have an infusion of blood transfusion, isolated figurative elements (red blood Cells, leukocytes or platelets) there is an apparent clash between the fundamental right of life and the fundamental right to freedom of belief and conscience. This situation requires health care giver professional to make a decision in favour of the pervasiveness of the Miss June’s dignity as the boundary and bottom for her other rights.
Act and Reflect On the Outcome
When blood transfusion is essential but there is no consensual decision between patient and physician the apparent outcomes are the need of altering the law that forced the health care provider to take a decision that is not in the interest of a patient’s health. Another important outcome reflection is that the critical scenarios like this dilemma in the case of Miss June should be taught in nursing curriculum so that they can prepare themselves for the situations like this. Hospital library should make the evidences prepared to tackle the situation like this which requires some religious knowledge and information to convince the patients and their family.
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