Qualitative research has been increasingly recognized in recent years as having a distinctive and important contribution to make to health care research. It is capable of being used as a methodologically sufficient approach in its own right, as a precursor to quantitative studies, during or after trials to explain processes and outcomes, and as a means of enhancing the link between evidence and practice. However, qualitative research has been little used as an evidence resource for systematic reviews. We argue that formal synthesis of both qualitative and quantitative forms of research is essential, and we discuss some of the problems that need to be overcome in carrying out such syntheses. These include methodological prejudice, problems in searching for qualitative evidence, and issues in synthesizing qualitative data. We call for progress to be made on the science and methods of including qualitative research in the evidence base of medicine.

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This article considers the emerging method of design experimentation, and its developing use in educational research. It considers the extent to which design experiments are different from other, more established, methods and the extent to which elements of established methods can be adapted for use in conjunction with them. One major issue to be addressed before the metaphors and methods of design experiments can be fully accepted is that they assume the combination of different forms of data from different sources. How this combination takes place is, as yet, unresolved. The article, therefore, looks at similar problems also faced in`new' political arithmetic, research syntheses and ®eld trials to see how lessons learned in these approaches could help in the development of the design ®eld.

The experience of future disorientation was common among participants; however, this was impacted on by a number of factors such as functional impairment and fear of recurrence. Furthermore, future disorientation does not appear to be stable and may ease as patients begin to adjust to the uncertainty of living with colorectal cancer as a chronic illness.

The world of healthcare is changing, and patient needs are changing with it. Traditional doctor-driven models of workforce planning are no longer sustainable in the United Kingdom (UK) healthcare economy, and newer models are needed. In the multiprofessional, multiskilled clinical workforce of the future, the physician associate (PA) has a fundamental role to play as an integrated, frontline, generalist clinician. As of 2016, about 350 PAs were practicing in the UK, with 550 PAs in training and plans to expand rapidly. This report describes the development of the PA profession in the UK from 2002, with projections through 2020, and includes governance, training, and the path to regulation. With rising demands on the healthcare workforce, the PA profession is predicted to positively influence clinical workforce challenges across the UK healthcare economy.

The purpose of this study was to develop an understanding of the experience of a gynaecological cancer diagnosis on women and their family in the year following treatment. The psychological and social consequences of gynaecological cancer and treatment have received little attention in research or practice until recently. Cancer service developments, however, are increasingly looking towards nurses to address the psychosocial needs of patients and families without necessarily having sufficient knowledge of what those needs are. This Grounded Theory study used symbolic interactionism as an interpretive framework. Twenty women were interviewed who were at least 12 months post-surgical treatment for gynaecological cancer. The analysis highlighted the degree of biographical disruption that occurs following illness that can affect both women and partners and a theory of future disorientation was developed. This study advances a conceptualisation of the chronicity of gynaecological cancer survivorship in relation to the challenge of living with the risk of the cancer returning, and how women's approaches to managing that risk affect their perception of the future. Cancer services within primary care must develop skilled professionals and interventions to provide appropriate and timely support for patients following cancer treatment, so that the successful outcome of a cure is not clouded by women having to live for many years with the fear of cancer recurrence.

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Physician associate (PA) education in the United Kingdom has grown substantially since the establishment of 4 PA education programs in the late 2000s. From those 4 programs in 2008, the number of universities educating PAs fell to a nadir of 2 programs in 2012 and then rose to 29 by the end of 2017. Due to program closures, the number of students enrolled in the early years fluctuated substantially. In 2008, 43 students entered PA education; in 2010, only 17 students started PA training, but in 2017, the number of students enrolled in PA programs soared to 853. Early in the course of PA education, programs were only offered in the greater London and West Midlands areas of England. As of 2017, PAs were being educated in all 4 countries of the United Kingdom, although the explosive growth in the number of programs is expected to slow as 2020 nears.