Background:The Integrated Palliative care Outcome Scale is a newly developed advancement of the Palliative care Outcome Scale. It assesses patient-reported symptoms and other concerns. Cognitive interviewing is recommended for questionnaire refinement but not adopted widely in palliative care research.Aim:To explore German- and English-speaking patients’ views on the Integrated Palliative care Outcome Scale with a focus on comprehensibility and acceptability, and subsequently refine the questionnaire.Methods:Bi-national (United Kingdom/Germany) cognitive interview study using ‘think aloud’ and verbal probing techniques. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis and pre-defined categories. Results from both countries were collated and discussed. The Integrated Palliative care Outcome Scale was then refined by consensus.Setting/participants:Purposely sampled patients from four palliative care teams in palliative care units, general hospital wards and in the community.Results:A total of 15 German and 10 UK interviews were conducted. Overall, comprehension and acceptability of the Integrated Palliative care Outcome Scale were good. Identified difficulties comprised the following: (1) comprehension problems with specific terms (e.g. ‘mouth problems’) and length of answer options; (2) judgement difficulties, for example, due to the 3-day recall for questions; and (3) layout problems. Combining the results from both countries (e.g. regarding ‘felt good about yourself’) and discussing them from both languages’ perspectives resulted in wider consideration of the items’ meaning, enabling more detailed refinement.Conclusion:Cognitive interviewing proved valuable to increase face and content validity of the questionnaire. The concurrent approach in two languages – to our knowledge the first such approach in palliative care – benefited the refinement. Psychometric validation of the refined Integrated Palliative care Outcome Scale is now underway.

BackgroundThe amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks.MethodsData on trainee doctors’ (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use.ResultsMost frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience.Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making.ConclusionA variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge.By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires dialogue: what Smartphone technology can do is augment, not replace, discussion with their colleagues in the community of practice.

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This article reports on the findings of a study investigating creative risktaking behaviours of the commencing university students enrolled in three units across three disciplines: Interactive and Visual Design, Fashion Design, and Film, Screen and Animation. The study employs an action research methodology in order to help students develop confidence and competence in creative risk‐taking. Upon analysis from relevant literature three key provisions for the study are proposed, being: P1 An open and playful learning environment that encourages sharing and challenging multiple perspectives; P2 An adequate period of time for students to develop and revise creative concepts; and P3 Opportunities to assess their own performance in developing creative risk‐taking capacities. The study draws on the students’ written self‐reflections to identify the key challenges and opportunities in encouraging creative risk‐taking among first year students, which are challenges of collaboration; creative resilience and self‐efficacy; and balancing creativity with technical competency. The article suggests several ways that educators can encourage students to take creative risks within higher education in preparation for careers in the creative industries.

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Climate change, sustainability, diversity, financial probity, gender and governance are profound and complex challenges facing local government today, and are all topics raised by the researchers and practitioners contributing to CJLG Issue 10. Cash-strapped local governments are required to deliver core services ('roads, rates and rubbish' as Heather Zeppel's interviewee said), yet are increasingly required to embrace broad social inclusion and environmental concerns, as our contributors show.

Editorial by Alison Brown.