Hindsight, Foresight, and Shaping the Future of Education - 21st School of Education PGR Conference

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Hindsight, Foresight, and Shaping the Future of Education

21st School of Education PGR Conference

Editors: Sarah Chung, Danielle Diver, Canis Kamran, Jacqui Newsome, Grace Sahota

SCHOOL OF EDUCATION University Of Birmingham, Birmingham, UK

C o n t e n t s

F o r e w o r d b y L a u r a D ' O l i m p i o

A m e s s a g e f r o m t h e c o m m i t t e e

W h e r e h e a l t h a n d e d u c a t i o n m e e t : i n s i g h t s f r o m p r e s e n t i n g a s y s t e m s e x p l o r a t i o n o f t h e p r o c e s s o f e a r l y i n t e r v e n t i o n s t o s u p p o r t c h i l d r e n ' s s p e e c h l a n g u a g e a n d c o m m u n i c a t i o n - J u l i e K e n t 1

“ I t ' s n o t a l w a y s t h e c a s e t h a t s c h o o l s d o n ' t w a n t t o b e i n c l u s i v e , i t ' s h o w l o n g c a n t h e y k e e p i t g o i n g f o r , i t ' s n o t s u s t a i n a b l e ” : T h e r e l a t i o n s h i p b e t w e e n p r i m a r y s c h o o l e x c l u s i o n a n d C o v i d - 1 9 " - M e g a n W h i t e h o u s e 5

A b r i e f a n d h o n e s t h i s t o r y o f f a c e - p a l m i n g : a t t e m p t i n g t o e n s u r e e t h i c a l a n d i n c l u s i v e e d u c a t i o n a l r e s e a r c hH e l e n E v a n s 8

P u p i l V o i c e i n W e l l b e i n g E d u c a t i o n - S a r a n n e M o u l e

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A s s e s s i n g t h e i m p l e m e n t a t i o n o f t h e d e e m e d c o n s e n t l e g i s l a t i o n e d u c a t i o n a n d t r a i n i n g p r o g r a m m e , f o r S p e c i a l i s t N u r s e s - O r g a n D o n a t i o n i n E n g l a n d , t h r o u g h p r o c e s s e v a l u a t i o n - C a t h y M i l l e r 1 4


The School of Education at the University of Birmingham UK boasts approximately 200 postgraduate researchers who work across three departments: the department of teacher education, the department of disability, inclusion and special needs, and the department of education and social justice. Their research is cutting edge, worldleading, and inspiring.

It is a great privilege to hear these early career researchers present their work each year at the annual postgraduate research conference It is even better to see how they support one another in their research and along their PhD journey The questions and dialogue on the day are always encouraging, constructively critical and benefit all in attendance – which includes their supervisors and other members of academic staff as well as PGRs from other universities.

The postgraduate researchers organise the conference themselves and this collection of papers emerges from the 21st School of Education PGR Conference, which took place on Saturday 26th November 2022 Emerging from the covid pandemic and all the difficulties that characterised the period of

2020-2021, this conference was held online in order to support accessibility for as many people as possible It was a celebration of coming together and sharing ideas, while being informed by past experiences

This central idea of looking backwards and looking forwards is reflected in the conference theme, Hindsight, Foresight and Shaping the Future of Education. The keynote speaker was a philosopher of education who had recently completed an ESRC-funded postdoctoral research fellowship with our School, Dr Jane Gatley, who spoke with conviction and enthusiasm about her work as well as her experience as an early-career researcher.

The conference was a great success with 31 presentations and many more people attending and dropping in and out throughout the day There were a few technical glitches on the day (for which zoom was responsible!), but the organisers heroically and effectively provided resolutions and ensured everyone was able to get the most they could from the day.

A big thank you to the conference organising

o r w a r d

committee, who are also the editors of this fine publication: Sarah Chung, Danielle Diver, Canis Kamran, Jacqui Newsome, and Grace Sahota.

I hope these papers give you a small taste of the exciting research being undertaken by PhD students at the University of Birmingham



A m e s s a g e f r o m t h e

c o m m i t t e e

The theme of the 21st School of Education PGR Conference was designed to examine the nature of being a researcher in education. The intention was to explore the balance between being informed by the past whilst looking forward to the future, reflecting on how we can shape education for the better.

We were incredibly lucky to welcome two speakers - Dr Jane Gatley and Dr Holly Prescott Dr Gatley, whose paper, Can working with educational concepts shape the future of education?, explored the contribution of conceptional analysis to educational studies Dr Prescott spoke on Postgraduate career options.

The conference showcased 31 pieces of diverse educational research from a vibrant, inclusive research community, with presentations from those at the beginning of their PGR journey, to those ready to submit.

Whilst there were some 'technical hitches' on the day, this only further demonstrated the collegial nature of the research community, as everyone pulled together, sharing a sense of camaraderie as we worked together to

ensure that everything went to plan as much as possible.

However, the support was more than technical Each session gave the presenters the opportunity to receive feedback, encouragement, and guidance too, leading the conference to become more than simply a platform to share our research

As a committee, we would like to express our thanks to Dr. Laura D'Olimpio for all her support and guidance throughout. We would also like to thank Dr Laura Day Ashley, Dr Lila Kossyvaki, and Dr Tracy Whatmore for chairing several of the sessions Finally, we would like to thank all the presenters for sharing such amazing research, which is truly shaping the future of education.

21st School of Education PGR Conference Committee:

Sarah Chung

Danielle Diver

Canis Kamran

Jacqueline Newsome

Grace Sahota



Within early education, many factors influence the type and availability of support for children's speech, language and communication (SLC) This research took an ecological systems approach to exploring inter-professional working practices between education and health. Themes were drawn from analysis of interviews with Early Years Educators (EYEs), Speech and Language Therapists (SLTs) and parents which considered the systems around the child using Bronfenbrenner’s (1996) ecological systems theory (EST), with particular focus on the exosystem, where policy and local practice determine everyday practice, and the mesosystem where professionals and parents interact

Early Years context

Communication and Language is a prime area in the Early Years Foundation Stage (EYFS) (DfE 2021); an area of learning which underpins all other areas of learning and development. Research and practice evidence show that poor outcomes in SLC have a negative impact on children’s

development by the time they start school and that these disadvantages persist into later life, affecting educational outcomes, employment opportunities and health and wellbeing (Law et al 2013;2017; Beard 2018).

The ecological systems theory

Developmental researchers aim to “describe, explain and optimise human development” (Skinner et al 2019 p2). Bronfenbrenner’s EST (1996) presents a possible theoretical framework to apply to children’s SLC development, providing a holistic perspective on child development, acknowledging the roles, norms and values that shape development. As well as providing a lens through which to explore the context in which communication develops, this perspective also supports examination of the wider context in which Early Years education and Speech and Language Therapy services operate, including the Local Authority (LA) commissioning of SLT services and input into early intervention for SLC at local and national levels. The EST served as a framework for the development of the research into approaches to supporting SLC and helped build a picture of the systems

CONFERENCE PAPERS PAGE 01 W h e r e h e a l t h a n d e d u c a t i o n m e e t : i n s i g h t s f r o m p r e s e n t i n g a s y s t e m s e x p l o r a t i o n o f t h e p r o c e s s o f e a r l y i n t e r v e n t i o n s t o s u p p o r t c h i l d r e n ' s s p e e c h l a n g u a g e a n d c o m m u n i c a t i o n .

Iaround the child in the analysis of data collected from participants using a process of thematic analysis (Braun and Clark 2022).

The exosystem

This relates to events external to the child, including changes to policy and practice approaches A recent systems-based report (PHE 2020) highlights current government interest in the long-term implications of children’s SLC and the importance of a strong universal service for all children; one which aims to prevent future problems “by supporting parents providing effective, inclusive, communication environments in early years settings” (p12-13). However, there are longstanding issues around access to SLT which were highlighted by the Bercow reviews (2008) and 2018 (ICAN 2018).

Key findings related to the exosystem included commissioning of SLT services, training and support for EYEs and access to SLT services via other gatekeepers in the system Professionals observed that universal SLT is no longer commissioned by the LA so children who have early SLC needs are supposed to be supported in the EY setting and parents are signposted to other appropriate agencies. Previous research suggests that the commissioning process for SLT has not produced good evidence of efficiency or service improvement (Davies and Davies, 2012).

Providing training and working through others was identified as a key strategy by SLTs and research supports this (Kent and McDonald 2020). However, mechanisms for supporting EYEs were not always clear Aspects of shared language in assessment were identified and it was evident that

language used around SLC was not shared between professionals

The mesosystem

This is where interactions between those in the child’s environment occur. Mesosystem analysis examines early communication relationships around the child that are mediated between the home, the EY setting and those other system factors which support early SLC. It provides useful insights into health interventions because it allows exploration of both the intrapersonal and the environmental (Eriksson et al 2018) The new EYFS (2021) highlights the mutuality between home and setting, stating that “good parenting and high-quality early learning together provide the foundation children need...” (p 5). However, reviews of the literature around interagency working suggest an epistemic hierarchy of knowledge which judges whose knowledge is of value and influences inter-professional working (Urban, 2008). Notably, parents are not always viewed as credible knowers (Adams et al 2022).

Findings in this area were related to aspects of trust, relationship, communication, access, shared understanding and expectations of professional and parental interaction around children's SLC. Parents discussed how much they valued having their concerns taken seriously. However, there was evidence of an inconsistent process of support which was setting-dependent. Some parents expressed how EYEs were responsive, knowledgeable and trustworthy whereas other parents described miscommunication and limited action being taken in response to their concerns. Lumby (2007) suggests that the views of parents in the education system


hold less relevance than those of teachers despite the role of parents in schooling being viewed as important in policy and wider education ethos. Parents who have their own views on their child’s SLC may not fully trust the perspectives of EYEs or the guidance that they receive.

The dream question

Significant insight came from asking participants the “dream question” in relation to what they would do to improve the system for supporting children’s SLC Key implications for policy and practice included:

The need for improved communication and opportunities for information sharing between professionals and with families. Access to SLT support is complex and the “gatekeeper” role of the Health Visitor adds complexity.

Professionals missed former ways of working, for example, sessions previously delivered in Children's Centres EYEs and SLTs felt settings would benefit from specific training in SLC as it was seen as a specialist skill. Training should be universally available and regularly updated.


The application of the EST to researching early SLC support provided valuable insight into the ways in which those within the child’s system can impact an enabling communication environment in the Early Years setting. In designing and commissioning SLC support, findings imply that LAs need to build an evidence base, particularly involving parents in designing service models.


Adams, SE and Myran, S 2022 Leader-parent relationships in the early childhood education context: An exploration of testimonial and epistemic justice Improving Schools Vol 25, (1), 65–82.

Beard A 2018 Speech, language and communication: a public health issue across the lifecourse. Paediatrics and child health vol:28, (3),126 –131

Bercow, J. (2008) The Bercow Report: A review of services for children and young people (0-19) with speech, language and communication needs. Nottingham: DCSF.

Braun, V and Clark, V. 2022. Thematic analysis: A Practical Guide. UK: SAGE.

Bronfenbrenner, U 1996 The ecology of human development: experiments by nature and design. Cambridge, MA: Harvard University Press

Broomhead, K. 2013. ‘Going the extra mile’: educational practitioners compensating for perceived inadequacies in the parenting of children with behavioural, emotional and social difficulties. Pastoral Care in Education [02643944] vol:31, (4), 309 –320

Davies K and Davies, P. 2012. Tensions in Commissioning: Services for Children's Speech, Language and Communication Needs in One English Region. Journal of health services research & policy Vol 17 (2 suppl), 37-44

IDepartment for Education (2021). Statutory framework for the early years foundation stage Available at: https://www.gov.uk/government/publications/ early-years-foundation-stage-framework--2 [Accessed: 22 January 2023]


Eriksson, M, Ghazinour, M and Hammarström, A 2018 Different uses of Bronfenbrenner’s ecological theory in public mental health research: what is their value for guiding public mental health policy and practice? Soc Theory Health.16:414–433.


ICAN. 2018. Bercow: 10 years on. UK: ICAN.

Kent, J and McDonald, S 2020 What are the experiences of speech and language therapists implementing a staff development approach in early years settings to enhance good communication practices? Child Language

Teaching and Therapy 1–13.

https://journals sagepub com/doi/full/10 1177/0 265659020974426

Law, J Reilly, S and Snow, P 2013 Child speech, language and communication need re‐examined in a public health context: a new direction for the speech and language therapy profession

International Journal of Language & Communication Disorders [1368-2822] vol:48, (5),486 –496.

Law, J. et al 2017. Early Language Development: Needs, provision, and intervention for preschool children from socio-economically disadvantaged backgrounds. A Report for the Education Endowment Foundation. UK: EEF.

Lumby, J. 2007. 'Parent voice: knowledge, values and viewpoint'. Improving schools, 2007, Vol.10 (3), 220-232

Public Health England. 2020. Best start in speech, language and communication: guidance to support local commissioners and service leads UK: PHE.

Urban, M 2008 Dealing with uncertainty: challenges and possibilities for the early childhood profession. European early childhood education research journal, Vol 16 (2), 135-152

Skinner, EA, Kindermann, T and Mashburn, AJ 2019. Lifespan developmental systems. Routledge: UK.


the West Midlands to explore the relationship between the Covid-19 pandemic and school exclusion In doing so, the impact of the pandemic on children’s social and behavioural skill development, as well as their mental health, is considered These issues are explored within the context of a marketised education system and demands to ‘catch-up’ following a return to schooling as ‘normal’

Previous Research

Statistics from the Department for Education (2022) show that in the 2020/21 academic year, there were 5,281 suspensions and 71 permanent exclusions recorded by West Midlands primary schools. Importantly, the figures show that some groups of children are more likely to be excluded from school than others In fact, children from Gypsy Roma and Black Caribbean backgrounds are 2.5 times more likely to be permanently excluded than children from White British backgrounds, children eligible for free school meals (FSM) are 3 times more likely to be permanently excluded than those not eligible and children with Special Educational Needs (SEN) and an Education Health and Care plan are 36

current education system

Research regarding the impact Covid-19 has had on exclusion use is limited Glorney and Roden (2022) raised concerns that mental health associated exclusions may increase due to the additional demand placed upon Child and Adolescent Mental Health Services. Despite this, there was hope that the shared experience of the pandemic may encourage teachers and senior leaders to consider the reasons behind disruptive behaviour rather than immediately resorting to disciplinary measures Furthermore, Daniels, et al (2020) found evidence of permanently excluded children not receiving any education during the first lockdown of the pandemic They also noted that the variation in provision of home learning, due to differing resources at schools, has exacerbated educational disadvantage and it may now be more likely for some children to disengage from education. Such research provides a valuable insight into Covid-19 and school exclusion however, it was conducted in the immediate aftermath of the lockdowns and did not distinguish between different stages of education

CONFERENCE PAPERS PAGE 05 “ I t ' s n o t a l w a y s t h e c a s e t h a t s c h o o l s d o n ' t w a n t t o b e i n c l u s i v e , i t ' s h o w l o n g c a n t h e y k e e p i t g o i n g f o r , i t ' s n o t s u s t a i n a b l e ” : T h e r e l a t i o n s h i p b e t w e e n p r i m a r y s c h o o l e x c l u s i o n a n d C o v i d - 1 9 "

Research Methods

The data presented here was obtained from semistructured interviews with 19 education professionals working in or with primary schools in the West Midlands. Participants worked in a variety of roles including, but not limited to, senior leadership, governance, local authority inclusion teams and education psychology. All interviews were manually transcribed then analysed using reflexive thematic analysis (Braun and Clarke, 2022). Ethical clearance was granted by the University of Birmingham ethics committee

Findings and Discussion

Upon speaking to the education professionals who took part in this research project, it became clear that the Covid-19 lockdowns and subsequent school closures had negatively impacted on children in terms of their social skills and behaviour Interestingly, this appears to have been more acute amongst younger children One school governor explained this to me when discussing how children in his schools are increasingly experiencing ‘dysregulated emotions’ where they are overwhelmed by a social environment that they have not been prepared for,

“The little children who weren't in school in reception and year one haven't learned social and behavioural skills They have been at home with family they haven't learned how to take turns, share, make friends and do all of that stuff and then it makes them sad and then they become dysregulated because they're not coping in a social environment ”

Such sentiments were echoed by an educational psychologist who explained that despite this identified delay in social and emotional development amongst children, demands on schools mean that teaching to the curriculum and ensuring the development of academic knowledge takes priority;

“Especially for this lot who have been through Covid because they have a delay already and then expecting them to be school ready and go to a curriculum that is two years advanced from them is absolutely ridiculous Yet we're not adapting the curriculum, we're saying 'we've got to catch you up', but how do you catch up two years in a month? It just isn't going to happen ”

These issues are compounded by the fact that, despite anecdotal reports of increased levels of need in primary schools post-lockdown, schools have experienced difficulty in obtaining assessments of need for children which has had a subsequent negative impact on their ability to procure additional support with learning and/or mental health. Therefore limiting the ability of schools to include all children within the mainstream classroom. This was explained to me by a Local Authority inclusion officer:

“children who might have been seen during the pandemic just couldn't get seen, learning support services may not have been able to see them, or EPs The Child and Adolescent Mental Health waiting list has gone through the roof since the pandemic so anyone that was waiting to be seen got put back and we're still seeing that backlog now ”

While the issues raised by my research participants do not directly link school exclusion use to the Covid-19 pandemic and lockdowns, it is clear that we need to be aware of the association between the two It is known that children with poor mental health (Tejerina-Arreal, et al., 2020) and those with special educational needs (Black, 2022) are more likely to be excluded from school It is therefore possible that this level of increased need, combined with a lack of access to support and pressure to ‘catch-up’ has the potential to increase the use of exclusion in mainstream primary schools in the long term.


This article has explored the association between Covid-19 and primary school exclusions, focusing


on the impact ‘lockdown’ had on the development of social and behavioural skills and mental health amongst primary school children. It was also noted that despite living through such a disruptive time, little support has been made available to children with schools also expected to have returned to work as ‘normal’, irrespective of the emotional impact of the pandemic This research provides a snapshot into the relationship between the Covid-19 pandemic and school exclusion, it is therefore imperative that future research delves into this issue in more depth in order to ascertain a more accurate picture of how the pandemic has impacted schooling


Black, A (2022) ‘‘But what do the statistics say?’ An overview of permanent school exclusions in England’, Emotional and Behavioural Difficulties, 27:3, 199-219, DOI: 10.1080/13632752.2022.2091895

Braun, V , and Clarke, V (2022) Thematic Analysis: A practical guide. SAGE Publications.

Daniels, H , Thompson, I , Porter, J , Tawell, A , and Emery, H. (2020) School Exclusion: Risks

After Covid-19. Available at: http://www education ox ac uk/wpcontent/uploads/2019/11/Daniels-etal.-2020 School-Exclusion-Risks-after-COVID19 pdf

DfE (2022) ‘Exclusion from maintained schools, academies and pupil referral units in England: Statutory guidance for those with legal responsibilities in relation to exclusion’. Available at:

https://www gov uk/government/publications/ school-exclusion

Glorney, E. and Rhoden, N. (2022) ‘Permanent school exclusions in Surrey: What works to keep children and young people in education?’. Surrey County Council. Available at: https://pure royalholloway ac uk/en/publications /permanent-school-exclusions-in-surrey-whatworks-to-keep-children

Tejerina-Arreal, M , Parker, C , Paget, A , Henley, W., Logan, S., Emond, A. and Ford, T. (2020) ‘Child and adolescent mental health trajectories in relation to exclusion from school from the Avon Longitudinal Study of Parents and Children’. Child Adolescent Mental Health, 25: 217-223. https://doi org/10 1111/camh 12367


voice in their attempts to broaden participation in research and increase student autonomy within student voice practice From my first attempt at creating a student researcher group for my MEd in Special Education (Autism-adults) dissertation, through to the piloting of student researcher training for my MA in Social Research dissertation– there has been lots to learn, and definitely a few face-palm moments.

These are the moments I wish to share; not embarrassed by getting things wrong in my attempt to ensure my research is as ethical and inclusive as possible. I know there are researchers out there who are afraid to try, and so, I share these few face-palms as encouragement to try and then learn from your mistakes

Face-palm moment no 1 – ‘Nothing about us without us’

The first face-palm moment occurred when I was

Having spent my literature review quoting Damian Milton and other autistic scholars and advocates, I felt increasingly uncomfortable writing about how specific features of participants’ autism affected their participation and engagement in my research without discussing it with them first It all seemed too subjective and felt incredibly rude.

Luckily, I was able to swiftly rectify this oversight because one student had returned to college after ‘lockdown’ restrictions had been lifted, and the other was accessible through Microsoft Teams. I created an autism-specific research profile for each participant using admissions data, excerpts from our journal entries, peer comments and my own observations. Further consultation with participants allowed them to add their own insights or remove elements they did not agree with or were not happy to share. Only information contained in these profiles was used

f ) y s e t r
CONFERENCE PAPERS PAGE 08 A b r i e f a n d h o n e s t h i s t o r y o f f a c e - p a l m i n g : a t t e m p t i n g t o e n s u r e e t h i c a l a n d i n c l u s i v e e d u c a t i o n a l r e s e a r c h .

Face-palm moment no. 3 – ‘Call me by my name’

The learning I took from this experience was the importance of building in time with future participants to co-create their own research profiles. The above study informed my first journal article (Evans, 2021).

Face-palm moment no. 2 – ‘Great expectations’

For my Masters in Social Research dissertation study, I wanted to pilot accessible research training which could inform the design of the training phase of my PhD study I was determined to create recruitment materials which truly supported students to give informed consent. The resulting information booklet and consent form utilised an easy-read style and many images As I had created the booklet in PowerPoint, I was able to add audio and email the presentation to participants

I am still pleased with the result and have further developed the format for my PhD recruitment In this information booklet however, I had no images of students doing research to draw from and so used a photograph of an intellectually disabled researcher to illustrate the idea of inclusive research as a potential future opportunity.

During their post-activity interview, however, one participant shared that they had been expecting to meet this researcher and were disappointed not to have met them. As a quick fix, I emailed all participants a YouTube link featuring the researcher talking about his experience doing research

The learning I took from this experience was to remember that, just as there is an expectation for every prop on a stage to be used, each image shown may be expected to hold significance or be taken at face-value Luckily now, I have a wealth of appropriate photographs of students doing research (taken at the pilot) to support realistic expectations in the promotion of, and recruitment for my PhD study.

For the same pilot study, I wished to give participants the option to be named, and only one participant wanted a pseudonym

It was whilst writing up the dissertation, I came across a paper by Rose et al (2019) detailing quality criteria developed specifically for studies using Interpretative Phenomenological Analysis (IPA) which have intellectually disabled participants One point made was that researchers should clearly state the participants’ level of intellectual disability.

To comply, I would need to create and share a table detailing participants’ academic levels and diagnoses, but I had not asked for consent for this aspect and, given that all the participants had by then left college and were not contactable, I really did not feel comfortable sharing their name against this personal information without further consent. The quick fix here was to use pseudonyms for all participants featured in the table

The learning I took from this experience was to be clear, when gaining consent from participants, what personal information need to share with others and to agree the terminology you will use regarding participants’ diagnoses and needs with participants

Concluding thought

If it easy to broaden participation in educational research to meaningfully include intellectually disabled participants, more people would do it


Evans, H. (2021) ‘Quiet voices: using creative research methods to increase participation and the voice of learners often overlooked’, Good Autism Practice, 22(1), pp 13-23

In dissertation

Rose, J , Malik, K , Hirata, E , Roughan, H , Aston, K and Larkin, M (2019) ‘Is it possible to use interpretative phenomenological; analysis in research with people who have intellectual disabilities?’, Journal of Applied Research in Intellectual Disabilities, 32 (5), pp.1007-1017.


Hearing the voices of pupils about their own education acknowledges their right to have their opinions heard and taken into account when adults make decisions which affect them, as stated in article 12 of the United Nations Convention on the Rights of the Child (UN General Assembly, 1989) Schools have been encouraged since the implementation of the Children Act in 1991 to give pupils the opportunity to express their views on aspects of school life and where possible help to make decisions on and take responsibility for a variety of school issues (Children Act, 1989)

Pupil voice should not only be heard, but acted upon. Research evidence suggests that, when consulted, the views and suggestions from pupils about their schooling are generally thoughtful and relevant (e.g. Cooper and McIntyre, 1996) and coincide with the views of their teachers on what is desirable within education (Freeman, 1996). It has also been found that when asked about their thoughts on their education, pupils find this motivating (Freeman, 1996).

Benefits to pupils and even whole school communities of listening to and acting on pupil voice are well documented; over the last thirty years, since the implementation of the Children Act 1989, educators and researchers have explored how best to make pupils feel heard and valued Less well researched is the importance of

pupil voice in wellbeing education Hurry et al (2021) state that there is ‘insufficient research on the role of pupil voice’ in wellbeing education and that taking into account student attitudes could be ‘critical’ for the success of mental health promoting programmes (p. 21).

Though insufficient, existing research suggests that accounting for pupil voice could give opportunity for the improvement of wellbeing provision in schools or for tailoring it to specific needs, in addition to increasing how enjoyable, acceptable and effective wellbeing interventions are (Foulkes and Stapley, 2022) Pupils understand issues faced by their peers and are best placed to suggest what they need from wellbeing education (Checkoway, 2011) Their involvement could also make pupils more invested in any provision (Lind, 2007).

My longitudinal case study explored attitudes of year 7 pupils to their wellbeing provision, and followed them up to year 8 to make comparisons across time Pupils in year 7 received both mindfulness lessons (.b programme) and resilience lessons (Bounce Forward programme). Pupils were interviewed before either set of lessons, between them and after both had been taught. The same pupils were then interviewed in year 8 The interviews were semi-structured, allowing for deviation from pre-determined questions. The pupils were asked questions such

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Ias ‘What do you think of the wellbeing lessons?’ and ‘Do you enjoy them?’ They were also asked to comment on their peers’ engagement with lessons, ‘Do you think everyone in your form enjoys them?’

One issue in pupil voice research, according to Lewis, Florian and Porter (2007) is reporting a ‘collective choir’ (p. 225); giving an overall sense of the opinions of a number of pupils is difficult. To try to do so, however, I used a reflexive thematic analysis. Developing themes meant looking at the data as a whole and drawing out what was pertinent to answering the research questions. This, in most cases, was where pupils had opinions in common about the wellbeing provision, but where one opinion felt particularly meaningful, this would also be drawn into a theme. I hoped to give a sense of the data as a whole through the creation of the themes and as my thematic analysis was reflexive, the themes went through several iterations to ensure best representation

Three themes were developed representing pupil voice on wellbeing education in this case study. The first was Social support for and from others This included sources of social support pupils reported, such as from school, peers and family. The social skills that either enable pupils to provide support or receive it were incorporated here, for example using mindfulness skills to help with friendship issues The majority of the skills discussed were learned in wellbeing lessons. Pupils also spoke regularly about the importance of feeling safe in the classroom and all who referred to this said wellbeing lessons felt like a safe place to speak openly. As this is another form of social support this was included in this theme

The second theme was How pupils cope with challenge Pupils spoke about using both mindfulness and resilience skills to cope with challenge, in addition to other coping techniques which fell into either taught or non-taught skills. They talked about the adversities that they experienced, and also adversities they believed

pupils their age might experience. These were in one of two categories: peer-related or non peerrelated. The third theme developed from pupil interviews was Praise and criticism of wellbeing lessons When discussing wellbeing lessons, pupils discussed the perceived benefits of and problems with the lessons and also their suggested improvements

Hearing the voices of pupils in this study gave them the opportunity to explain where improvements to their wellbeing education could be made. It also gave them the chance to share their positive opinions, including where the skills they have learned have benefitted their lives The overwhelmingly positive feedback received in this study was unexpected, but just as beneficial as the suggested improvements; knowing what to keep as well as what to change will mean that the wellbeing education in this case can go from strength to strength Sharing the results of this study may help other schools, not only by giving an example of what might benefit pupils, but by encouraging them to hear the voices of pupils concerning their wellbeing education ‘Members of any school’s children’s workforce... need to see pupil voice as being integral to the success of their work in improving outcomes for children and young people ‘ (Cheminais, 2013, p. 1). Acknowledging pupil voice allows for an informed, structured and positive approach to wellbeing education.


Bounce Forward (2019) Available at: https://bounceforward com/ (Accessed: 3rd April 2023).

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Checkoway, B (2011) ‘What is youth participation?’, Children and youth services review, 33 (2), pp 340-345


ICheminais, R (2013) Engaging pupil voice to ensure that every child matters: a practical guide Oxford: Routledge. Children Act (1989) Available at:

https://www legislation gov uk/ukpga/1989/41/ contents (Accessed: 5th April 2023)

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Foulkes, L. and Stapley, E. (2022) ‘Want to improve school mental health interventions? Ask young people what they actually think’, Journal of Philosophy of Education, 56 (1), pp. 41-50.

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Lewis, A, Florian, L and Porter, J (2007) ‘Research and pupil voice’, in J. M. Kauffman and D. P. Hallahan (eds.) Handbook of Special Education. Oxford: Routledge, pp 222-232

Lind, C. (2007) ‘The power of adolescent voices: co‐researchers in mental health promotion’, Educational Action Research, 15(3), pp. 371-383.

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The purpose of this paper is to reflect with hindsight and provide an overview of my PhD research, focussing on the complexities of the ethical process, due to the sensitivities around observing end of life discussions, between bereaved families and the Specialist Nurse-Organ Donation

I will begin by explaining the background to the deemed consent (opt-out) legislation for organ donation Due to the worldwide shortage for donor organs for transplantation, many countries have tried to reduce the disparity between the supply and demand of available organs by introducing an “opt-out” system. The Organ Donation (Deemed Consent) Act 2019 was enacted on May 20th, 2020, in England The new consent arrangements, mean that all adults over 18 will be considered potential donors after their death, unless they make a decision that they do not want to be a donor, they have nominated a representative to make a decision on their behalf after death, or are in a safeguarded group

Although the law is in force, families are always involved in discussions before donation can proceed It is the role of the Specialist Nurse in Organ Donation (Specialist Nurse) to discuss end of life options for organ donation with families

To realise the impact of leveraging the legislation, training for Specialist Nurses n300 (covering

England) responsible for securing consent for organ donation, was paramount Organ donation is a rare and precious gift, owing to the fact that whilst there are around 500,000 deaths each year in UK, only 1% of the population, ever die in circumstances on critical care, where donation is possible.

The new law means that in the future when someone dies, if they have not recorded or expressed a decision or nominated a representative, the default position will be that the individuals consent to donate will be ‘deemed’ The change in law means that Specialist Nurses will conduct discussions with donor families in an unfamiliar and unnatural way.

To prepare Specialist Nurses for the implementation of the Act, a specifically designed tri-modular education programme was delivered

Legislation Theory

Practice with professional actors- how the law change affects the organ donation conversation

Consolidation of theory and practical modules

Purpose of the Research

The research evaluates the implementation of a specifically designed educational intervention for

1. 2.
CONFERENCE PAPERS PAGE 14 A s s e s s i n g t h e i m p l e m e n t a t i o n o f t h e d e e m e d c o n s e n t l e g i s l a t i o n e d u c a t i o n a n d t r a i n i n g p r o g r a m m e , f o r S p e c i a l i s t N u r s e s - O r g a n D o n a t i o n i n E n g l a n d , t h r o u g h p r o c e s s e v a l u a t i o n CATHY MILLER – UNIVERSITY OF BIRMINGHAM CXM947@STUDENT.BHAM.AC.UK

the Specialist Nurses covering introduction of the new deemed consent legislation in England


The fundamental principle of scientific inquiry is to conduct ethical and sound research (Kjellström,Ross and Fridlund, 2010). The Health Research Authorities publication: A UK Policy Framework for Health and Social Care Research (HRA and the UK Health Departments, updated 2020)lays out the key principles to guide the conduct of all health and social care research across the UK, detailed below:

Firstly, an application for ethical clearance was made to NHSBT Research Innovation and Novel Technologies Advisory Group (RINTAG) Once written confirmation was received from RINTAG, I submitted an application for ethical approval to the University of Birmingham. In parallel, I completed an application to the Health Research Authority (HRA), via the Integrated Research Application System (IRAS). Once the IRAS application was submitted, it went through the HRA approval focussing on the legal and governance requirements The HRA made recommended an application was also submitted to the Research Ethics Committee (REC), where I was interviewed by experts with the support of my supervisor. Once approved by the REC, my application was reviewed once again by the HRA

The ethics application was to shadow, observe and interview Specialist Nurses in clinical practice, which meant by proxy, I would see patients and/or their families, even though I was not studying them directly

A particularly sensitive area of ethics requiring careful consideration was the researchers’ observations of Specialist Nurses conducting donation conversations with vulnerable participants (bereaved family members); under the new opt-out legislative framework (Cook, 1995; Parkes, 1995; Steeves, Kahn and Ropka, 2001) Due to the personal, emotive, and potentially intrusive nature of the observation, this type of research is classified as ‘sensitive’ (Lee and Renzetti, 1993, pp. 3–12). Assessing the benefits of research, proportionate to avoiding harm (non-maleficence) was an essential role for the researcher and her supervisor requiring ethical and governance committee scrutiny from NHSBT RINTAG, UoB, HRA, REC and NHSBT R&D.

Figure 1 Overview of Desk and Field based research and Regulatory Considerations Figure 2 Key principles to guide the conduct of Health and Social Care Research across the UK Figure 3 Timeline of Ethical Process

Whilst the review and evaluation of the virtual education and training (stage 2 1) proved useful in assessing whether the process implementation plans were followed, it was veneered by comparison and not as rich as the real-life context. The shadow observation afforded a unique perspective not seen elsewhere when evaluating the implementation or impact of deemed consent education and training. So, despite the shadow observation receiving extra ethical scrutiny, this aspect yielded the richest and most beneficial data.

The Specialist Nurse gained permission from the families for the end of life/donation conversation to be observed, without me being present during this discussion. As part of the ethics process, I developed a script for this conversation. All potential donor families were offered a debrief document, after the donation discussion, expressing condolences and thanking them for allowing me to observe the Specialist Nurse undertaking the discussion.

The HRA were satisfied with the additional debrief document, which was routinely offered to each potential donor family, after the consultation. The debrief outlined the types of data collected (sex of the patient, cause of death, number of people present and relationships, approximate age of patient) and assurances that no identifiable data had been collected With regard to the data being collected, I had to clarify to the HRA that I would only collect data that became apparent from the discussion I observed, as I did not have permission to access medical records for research purposes

With the benefit of foresight, I would have started the ethical process during the Designing and Conducting Ethical Research (DCER) module. Even after ethical clearance, I encountered another hurdle, each of the 16 hospital Trusts’s that I may have been called to (in the region under study), required an ethical step to agree to the research being conducted in their hospital Trust, giving a “green light” in terms of “capability and capacity”.

Despite the complexities of the ethical process, I am proud to shape the future of education, as the only person to date, in the UK, to conduct the study of human experience, real time, where the

action was, in the critical care unit.

As spoken by John Whiting, age 80-something, to an undergraduate class when he was a guest lecturer at UC Irvine:

“An observer is under the bed. A participant observer is in it.”


Cook AS. Ethical issues in bereavement research: an overview Death Stud 1995; 19: 103–122

Lee RM and Renzetti CM The problems of researching sensitive topics: an overview and introduction In: Renzetti CM and Lee RM (eds) Researching sensitive topics Newbury Park, CA: Sage, 1993, pp. 3–12.

Parkes CM Guidelines for conducting ethical bereavement research Death Stud 1995; 19: 171–181

Steeves R, Kahn D, Ropka ME, et al. Ethical considerations in research with bereaved families Fam Community Health 2001; 23: 75–83

The Organ Donation Deemed Consent Act (2019) https://www legislation gov uk/ukpga/2019/7/con tents/enacted

Accessed 01.05.2023.


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