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As the result of an apparent misinterpretation of the United States Pharmacopeia (USP) Chapter 797 Standards for Pharmaceutical Compounding 1 by the Association for Professionals in Infection Control and Epidemiology (APIC), 2 the Joint Commission, without scientific evidence, is requiring that intravenous (IV) solution bags must be spiked no sooner than 1 hour before being connected to a patient to avoid contamination. Recent studies have shown no growth in normal saline (NS) over a 4-hour period 3 and in lactated Ringer's (LR) over an 8-hour period 4 after spiking. Unfortunately, these short time intervals could not be used to support our longstanding hospital policy, which had permitted 24 hours of storage before discard or use. In addition, we wanted to extend the observation period to 9 days to maximize the probability of detecting even low-level microbial contamination. Finally, we wanted to verify that our protocol was sufficiently sensitive to detect a low level of contamination (0.1 CFU/mL) because previous studies have demonstrated that low levels of contamination can be difficult to detect. 5

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Purpose\ud – The purpose of this paper is to investigate the role of creative activity and storytelling in assisting development of students’ reflective ability and critical thinking.\ud \ud Design/methodology/approach\ud – Eight biomedical science students undertaking year-long work-based placements took part in this action research study. A coding scheme was designed to assess students’ reflections initially and at each stage of the study. Intervention activities involved students using mood boards, images and storytelling to assist development of creative learning spaces with a thematic approach employed to analyse both personal and collective reflections. Post-intervention evaluation considered possible long-term impact on students’ reflective ability.\ud \ud Findings\ud – Students’ pre-intervention reports showed little reflection focusing mainly on competence demonstration and descriptive situation summaries. During the intervention workshops, all students demonstrated both identification of self as a practitioner and a critically reflective approach. However, this was not maintained long term as initial post-intervention reports tended to revert to a more descriptive style of writing suggesting longer-term support is required.\ud \ud Research limitations/implications\ud – The importance of further research into the long-term usefulness of creative collaborative learning spaces in work-based programmes is suggested.\ud \ud Originality/value\ud – This is the first study investigating the approach to supporting critical reflection during work placement in biomedical scientists. It is suggested that the current competence-based training programme provides limited opportunities for developing and embedding critical reflection. Where opportunities are provided, such as creative learning spaces, students’ critical reflection was greatly enhanced. However, it appears essential that this approach is maintained throughout training as critically reflective skills developed during collaborative learning have limited transferability to subsequent reflective report writing

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Purpose The role of higher education institutions in enhancing capability development of the healthcare professionals workforce has resulted in work-based learning becoming an essential component of awards linked to professional registration. The purpose of this paper is to explore how key stakeholders (academics, workplace tutors and students) on a programme leading to registration as a Biomedical Scientist (BMS) position themselves in their role and the subsequent impact of this upon delivery of pre-registration training and the development of professional capability. Design/methodology/approach Constructivist grounded theory methodology and a mixed-methods approach were drawn upon for the study. Findings Findings expose the challenges of a positivist focus and assumptions around workplace learning and professional development presenting a barrier to developing professional capability. In addressing this barrier, two strategies of “doing the portfolio” and “gaining BMS currency” are adopted. The registration portfolio has become an objective reductionist measure of learning, reflecting the positivist typology of practice in this profession. Practical implications To ensure that students are supported to develop not only technical skills but also professional capability there is a need for a paradigm shift from a positivist episteme to one that embraces both the positivist and socio-cultural paradigms, viewing them as complimentary and parallel. Originality/value The study provides a novel insight into how stakeholders interact with the pressures of internal and external influences and the impact this has upon behaviours and strategies adopted. The theoretical understanding proposed has a range of implications for practice and for the development of practitioner capability through pre-registration training and beyond.

This study investigated the role of 'flipping', the practice-based pathology laboratory and classroom to support the development of trainee pathologist practitioners' in the field of gynaecological cytopathology, addressing development of their knowledge and practical application in the clinical setting. Content-rich courses traditionally involve lecture led delivery which restricts tutors from adopting approaches that support greater student engagement in the topic area and application of knowledge to practice. We investigated the role of 'flipping', the practice-based pathology laboratory and classroom where 'virtual lectures' were accessed outside of 'class time' allowing more time for students to engage in active learning under the supervision of a consultant histopathologist. 'Flipping' was used to support two gynaecological cytopathology training courses with cohorts of eight trainee pathologists on the first course and six on the second. Lectures were made available to the trainees to watch before attending the workshops. The workshops consisted of group activities and individual practical exercises allowing trainees to review and report on patient practice cases with the support of their peers and tutors. Focus group sessions were held after each course, allowing trainee pathologists to reflect on their experiences. Discussions were transcribed and thematic analysis was used to capture key themes discussed by the trainees. Trainees' identified that 'flipping' provided them with more time during face-to-face sessions, enabling a greater depth of questioning and engagement with the consultant histopathologists. Having already watched the lectures, trainees were able to attend the sessions having identified areas in which they needed additional support and development. Trainee pathologists reported they had more time to concentrate on developing their skills and practise under the guidance of the consultant histopathologists so developing their capability in gynaecological cytopathology. The role of alternative methods of delivery such as 'flipping' is suggested for short courses designed to support practitioner capability and continued professional development.

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