ObjectivesThe clinical academic trajectory for doctors and dentists is well-established, with research embedded in their career development. Recent years have also seen a burgeoning interest and push for nurses, midwives and allied health professionals (NMAHPs) to pursue a clinical academic career. However, the National Institute for Health Research (NIHR) 10-year review suggested that there may be problems with progression post Master’s degree level for this group, with nurses and midwives receiving less NIHR funding than allied health professionals. This study responds to these concerns, tracking the progression and exploring experiences of NMAHPs in the East Midlands region of England.DesignAn online survey and in-depth interviews were used to capture a wide range of experiences.Participants67 NMAHPs who were pursuing a clinical academic career were surveyed, supplemented by 16 semi-structured in-depth interviews.ResultsThree themes emerged during data analysis: Embarking on a clinical academic career, overcoming barriers and benefits.ConclusionsNMAHPs are motivated to pursue a clinical academic career by a drive to improve services for the benefit of patients and the National Health Service more widely, as well as for personal development and career progression. People working in these roles have opportunities to explore possible solutions to issues that they encounter in their clinical role through academic study. Findings reveal benefits emanating from the individual level through to (inter)national levels, therefore academic study should be encouraged and supported. However, investment is needed to establish more clinical academic roles to enable NMAHPs to continue to use their experience and expertise post-PhD, otherwise the full extent of their value will not be recognised.

Access from the University of Nottingham repository:http://eprints.nottingham.ac.uk/32874/1/A%20new%20normal%20Women%27s %20experiences%20of%20biographical%20disruption%20and%20liminality%20following %20treatment%20for%20early%20stage%20breast%20cancer%20%281%29.pdf The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.

This study explores women's perceptions of social interaction during and after their treatment for early stage breast cancer. An analysis of interviews with 24 women between 6 months and 29 years post-diagnosis reveals that interactions can be influenced by conflicting public discourses surrounding breast cancer. For example, there is the continuing association of cancer with death and the resulting potential for a stigmatised identity. In contrast is the ultra-positive discourse around cancer survivorship, with breast cancer in particular being associated with pink campaigning and a push towards positive thinking. Participants described managing conversations during treatment; sometimes playing down their private suffering and presenting a positive (public) image rather than risk alienating support. After treatment they were encouraged to move on and get back to 'normal'. While other breast cancer patients and survivors were often good sources of support, there was also a danger of assuming that all experiences would be the same. We present data to illustrate that women often present public accounts that are driven by an expectation of positivity and fear of stigmatisation at all stages of breast cancer treatment and beyond.

Background:The trauma of chemotherapy-induced alopecia is well documented.However, less is known about how the stereotypical cancer identity affects social interactions.Objective: The aim of this study is to explore women's experiences of hair loss resulting from breast cancer treatment, from a sociological perspective.Methods: Twenty-four women who had been treated for early-stage breast cancer or ductal carcinoma in situ were interviewed. References to hair (loss) were isolated from their narratives. Results:Findings confirm previous research that hair loss can be traumatic. The stigma attached to both having a cancer patient identity and nonconformity with norms of appearance means that women must decide how much to reveal and to whom. An unexpected finding was that distressing experiences were reported by some women who had not lost their hair. Conclusions:Hair is important to identity; therefore, there are implications for social interactions whether women decide to disguise their hair loss or not. There may also be implications for women who do not lose their hair because they fail to conform to the stereotypical appearance of the bald cancer patient. Future research should consider the role of stereotypes in patient experiences.Implications for Practice: Nurses should provide sufficient information and support to prepare patients for the impact on self-perception and social interactions when facing hair loss. Also, patients should be forewarned about the possible implications of not conforming to the cancer stereotype. In addition, greater education among the wider population about the possible side 2 effects of cancer treatments may prevent women feeling stigmatized while already undergoing a stressful experience. KEYWORDS:Alopecia; Breast cancer; DCIS; Hair loss; Identity; Stigma; Stereotypes IntroductionHair is an important indicator of identity. Hair forms our impression of a person, and can be fashioned to demonstrate religious beliefs or music preferences 1 . Hair is an important part of physical appearance, particularly for women, as it symbolizes health, femininity and attractiveness and influences body image and identity 2 . Consequently, hair loss as a result of chemotherapy treatment for breast cancer can have profound implications for women's mental health and social interactions 3 .Illness-related appearance changes can also change the way that the ill are perceived by other people 4 . In the case of cancer, this is perhaps most obvious when people suffer chemotherapyinduced alopecia. Not all chemotherapy drugs have the same side-effects but those used to treat breast cancer tend to result in total alopecia 5 . Despite the numerous unpleasant side-effects of chemotherapy including vomiting, nausea and tiredness, a previous study found that hair loss was reported to be the most traumatic aspect of the treatment by 46% of respondents 6 . The trauma of chemotherapy-induced alopecia has been well-documented in the psychological literature 7 . It is also a common topic in the medical literature as...

BackgroundThis paper responds to previously published debate in this journal around the use of sociolinguistic methods in communication skills training (CST), which has raised the significant question of how far consultations with simulated patients reflect real clinical encounters. This debate concluded with a suggestion that sociolinguistic methods offer an alternative analytic lens for evaluating CST. We demonstrate here that the utility of sociolinguistic methods in CST is not limited to critique, but also presents an important tool for development and delivery.MethodsFollowing a scoping review of the use of role play and simulated interaction in CST for healthcare professionals, we consider the use of the specific sociolinguistic approach of conversation analysis (CA), which has been applied to the study of health communication in a wide range of settings, as well as to the development of training.DiscussionRole play and simulated interaction have been criticised by both clinicians and sociolinguists for a lack of authenticity as compared to real life interactions. However they contain a number of aspects which healthcare professionals report finding particularly useful: the need to think on one’s feet in real time, as in actual interaction with patients; the ability to receive feedback on the simulation; and the ability to watch and reflect on how others approach the same simulation task in real time. Since sociolinguistic approaches can help to identify inauthenticity in role play and simulation, they can also be used to improve authenticity. Analysis of real-life interactions using sociolinguistic methods, and CA in particular, can identify actual interactional practices that are used by particular patient groups. These practices can then be used to inform the training of actors simulating patients. In addition, the emphasis of CA on talk as joint activity means that proper account can be taken of the way in which simulated interaction is co-constructed between simulator and trainee.SummaryWe suggest that as well as identifying potential weaknesses in current role play and simulation practice, conversation analysis offers the potential to enhance and develop the authenticity of these training methods.