Journal articles on the topic 'Reflective Practice (RP)'

The purpose of this study was to determine professional evaluators’ perceptions of reflective practice (RP) and the extent and manner in which they engage in RP behaviors. Nineteen evaluators with 10 or more years of experience in the evaluation field were interviewed to explore our understanding and practice of RP in evaluation. Findings suggest that RP is a process of self and contextual awareness, involving thinking and questioning, and individual and group meaning-making, focused on facilitating growth in the form of learning and improvement. The roles of individual and collaborative reflection as well as reflection in- and on-action are also discussed. Findings support a call for the further refinement of our understanding of RP in evaluation practice. Evaluators seeking to be better reflective practitioners should be competent in skills such as facilitation and interpersonal skills, as well as budget needed time for RP in evaluation accordingly.

AbstractThis paper provides a critical review of reflective practice (RP), drawing attention to particular problems with its representation, as well as proposing a more evidence-based and data-led approach to RP. Our central argument is that RP in the fields of applied linguistics, TESOL and education has achieved a status of orthodoxy without a corresponding data-led description of its value, processes and outcomes. Our concern is that RP is described in ways that are elusive, general, and vague and which may not be particularly helpful for practitioners. This is largely due to the lack of concrete, data-led and linguistic detail of RP in practice and to its institutional nature, lack of specificity, and reliance on written forms. It is also the case that, despite a small number of exceptions (e.g. Korthagen and Wubbels 1995; Walsh 2011), reflective practice is not operationalized in systematic ways.This paper argues that applied linguistics needs to champion a description of RP's processes and impact by drawing on data-led accounts of reflective practice across a range of contexts. Too many RP accounts rely on general summaries and so are neither critical, transparent, nor usable by other practitioners. A key aspect of developing a more critical approach is the need to move beyond rosy summaries of the outcomes of RP towards accounts of how RP gets done. Where possible we need to share examples of ‘reflection in action’ so that its nature and value can be better understood. We propose here that RP needs to be rebalanced, away from a reliance on written forms and taking more account of spoken, collaborative forms of reflection; in sum, we argue for a more dialogic, data-led and collaborative approach to reflective practice.

The McGill University Health Centre Reflective Practice Program, which began in 2003, provides a theory and structure for reflection and is the basis of an ongoing professional development program for nurses in leadership positions. It is designed to improve their knowledge and skills, and to provide support to nurse leaders who are continually facing difficult interpersonal situations involving staff, patients, families and the interdisciplinary team. It is based on a well-developed theoretical framework, a theory-of-action approach to reflective practice (RP). This approach is described in some detail, together with the training program for RP facilitators. This RP program involves regular monthly small group meetings to discuss challenging interpersonal situations. To date, 37 facilitators have been trained and currently about 120 nurses are participating regularly in RP groups. To illustrate this approach a detailed example of a typical RP session is presented, together with some illustrative feedback data collected over several years. We conclude with recommendations for implementing this type of RP program and describe how our theoretical approach has spread beyond the nursing department and has been introduced to some students and faculty in the School of Nursing and to interprofessional staff in one of the clinical groupings.

AbstractThis article evaluates the use of reflective practice (RP) tools by focusing on the main critiques on RP. In the literature, RP has often been criticised for its design-related problems, RP’s being directed by problem identification purposes rather than empirical data, and RP practitioners’ loss of contact with their discourse communities due to the undue emphasis on practical knowledge. Therefore, this article suggests methodological and data triangulation of RP tools as well as highlighting the community of inquiry framework to overcome the aforementioned problems While doing this, the authors reflect on their own RPs, both of which were conducted at a refugee centre in Philadelphia, USA. In this examination, the critical role of reflective tools is highlighted.

Reflective practice (RP) and reflective journal writing (RJW) are considered the most important ways to enhance students’ learning progress. During the pandemic, offline learning has replaced online learning to keep students safe and healthy. This research solely examined reflective practice during online learning, which is significant as online education is less effective and students carry the full study load. However, this study’s core purpose was to determine international graduate students’ perceptions regarding RP and RJW during online learning in the pandemic period. It also investigated whether student engagement in RP enhances their critical reflection and learning progress. The mixed-method (QUAN-QUAL) approach was utilized in this study. The sample consisted of 123 international graduate students who were enrolled in various disciplines and majors in China and at least attended two consecutive semesters (24 weeks) online. The survey questionnaire was based on 28 items to collect the quantitative data. The questionnaire was categorized into four variables: self-education, learning progress, critical reflection, and engagement. While semi-structured interviews were conducted with 5 participants for qualitative data collection, the quantitative results indicated that all of the statements received good ranks and could be used to study how reflective journals helped students improve their self-education, critical reflection, writing skills, learning progress, and engagement. In addition, the results revealed a statistically significant beneficial association between engagement, self-education, critical reflection, and learning progress. Qualitative findings corroborated the quantitative results that participation in RP and RJW boosted students’ critical thinking skills and facilitated their learning and development. Based on the results, this study concluded that RP or RJW enhance success ratios as well as critical reflection, which is effective not only in learning but also in professional and practical settings.

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was a qualitative study based on the methodology of phenomenology. All penultimate year medical students at University College London Medical School (n=361) were approached for this study and altogether thirteen participants were recruited, with data collected through two focus group discussions. Thematic analysis was used to generate the coding framework. Results: Five key themes emerged around student attitudes to RP, which were grouped into three domains: ‘value of RP’, ‘barriers to engagement’, and ‘strategies for enabling RP’. ‘Value of RP’ centred on the themes of humanising medicine and developing empathy, developing professionalism and RP as a tool for sense-making. ‘Barriers to engagement’ centred on the purpose and tokenism of RP and in the third domain, ‘strategies for enabling RP’, the theme of student agency in RP emerged strongly. Conclusion: Overall, the value of RP was not fully appreciated until students began their clinical placements. Potential strategies identified by participants for optimising engagement included student co-design and positioning RP within a broader pastoral role early in the undergraduate curriculum.

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was a qualitative study based on the methodology of phenomenology. All penultimate year medical students at University College London Medical School (n=361) were approached for this study and altogether thirteen participants were recruited, with data collected through two focus group discussions. Thematic analysis was used to generate the coding framework. Results: Five key themes emerged around student attitudes to RP, which were grouped into three domains: ‘value of RP’, ‘barriers to engagement’, and ‘strategies for enabling RP’. ‘Value of RP’ centred on the themes of humanising medicine and developing empathy, developing professionalism and RP as a tool for sense-making. ‘Barriers to engagement’ centred on the purpose and tokenism of RP and in the third domain, ‘strategies for enabling RP’, the theme of student agency in RP emerged strongly. Conclusion: Overall, the value of RP was not fully appreciated until students began their clinical placements. Potential strategies identified by participants for optimising engagement included student co-design and positioning RP within a broader pastoral role early in the undergraduate curriculum.

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was a qualitative study based on the methodology of phenomenology. All penultimate year medical students at University College London Medical School (n=361) were approached for this study and altogether thirteen participants were recruited, with data collected through two focus group discussions. Thematic analysis was used to generate the coding framework. Results: Five key themes emerged around student attitudes to RP, which were grouped into three domains: ‘value of RP’, ‘barriers to engagement’, and ‘strategies for enabling RP’. ‘Value of RP’ centred on the themes of humanising medicine and developing empathy, developing professionalism and RP as a tool for sense-making. ‘Barriers to engagement’ centred on the purpose and tokenism of RP and in the third domain, ‘strategies for enabling RP’, the theme of student agency in RP emerged strongly. Conclusion: Overall, the value of RP was not fully appreciated until students began their clinical placements. Potential strategies identified by participants for optimising engagement included student co-design and positioning RP within a broader pastoral role early in the undergraduate curriculum.

Some historical and current trends in reflective practice (RP), artificial intelligence (AI), and engineering design (ED) are presented and compared. Human artistry, context, and connectionist approaches to knowledge are the common threads highlighted. ED is considered to be a type of RP and AI a part of RP. This is supported by an analysis of the transformation processes involved in each. AI and systems are presented as approaches for the formalization of RP at the technical and conceptual levels, respectively. Interconnectedness in a hierarchical fashion and purposeful process loops are defined as the key ingredients of a systems approach. AI techniques that could support a range of ED categories (case-based reasoning, decomposition, and transformation) are identified, as are the wider RP approaches that subsume those categories. The ED, AI, and RP categories are identified as spanning from routine to creative, connectionist to cognitivist, and intuitive to deliberate, respectively.

Reflective practice (RP) is widely used in various professional education fields and is a central part of teacher education. Through reflection, they may make some adjustments or changes in order to improve their practice and become a better teacher. However, in RP the focus is often individual rather than collaborative and there is a lack of evidence-based accounts, which reduces the effect of reflection to a certain degree and similarly in China. Therefore, it is important to have a collaborative and evidence-based reflection scheme that fits a specific teaching environment in order to improve teaching and develop teachers.

This article deals with the notion of reflective practice (RP) and how it may contribute to the professional development in teacher education programs especially for pre-service teachers and in-service teachers within the context of Indonesia. It aims to explore and explain the stance and features of RP and how it can serve to help both pre-service and in-service teachers improve their teaching quality and develop their teaching professionalism, especially those involved in English language teaching (ELT). This article examines the feasibility of this concept to be applied in Indonesian pedagogical contexts. Being widely accepted as an empowering teaching mode practice in most parts of the world, this RP plays a central role in triggering teachers' professional development, leading the teachers to be self-learning, autonomous learning, self-evaluating, and problem-solving-oriented practitioners. The research method used in this article is library research, through which the standpoint and characteristics of RP are explored and disclosed, and RP's potential can be maximized systematically. This library research method is realized based on the five research problems posed in this article. The same data on RP were extracted from research articles and textbooks on RP. The main findings suggest such aspects as the conceptualization of RP, defining features of RP practitioners, benefits teachers can gain from RP, and potential contributions of RP for both pre-service and in-service teachers' teaching competence and continual professional development. Hence, this RP article potentially provides a meaningful paradigm for language teachers and enriches their pedagogical repertoire. Thus, this article brings about two important notes. First, it theoretically portrays how RP can meaningfully affect the efficacy of ELT practice in Indonesia. Secondly, it fundamentally sets out RP conceptualization as the basis for professional teaching practice through continuous learning and development. That is, learning to develop through a critical self-evaluation of teachers' teaching practice

The present study delivers the twelfth grade students’ experiences who implement reflective practice as a technique to learn critical thinking skills when joining the class discussion. However, their perceptions on the above activity have to be a fundamental issue for the success of learning. This descriptive qualitative case study took place at SMA N 2 Masbagik of East Lombok. It aimed to describe and explain students’ reflective practice implementation, their critical thinking manifestations, and their perceptions of the reflective practice implementation to learn critical thinking skills in class discussions. Taken from field notes observation and video recordings revealed three stages of reflection process considered by the students when implementing the reflective practice. It consisted of stating positive behaviour, ideas, and feelings (first stage), returning to experience, attending to feelings, and reevaluating experiences/events/phenomena (second stage), and making conclusion or commitment (third stage). They also showed three ways in expressing critical thinking as proposed by Halpern (2003). It consists of verbal reasoning, arguments, and making decision. Furthermore, the data from open-ended questionnaire and interview revealed the domination of positive perceptions. Through this study, the writer opens the idea to give suggestion that this activity should based on clear instructions and theoretical background to meet the teaching and learning goal.

Since 2003, a university healthcare centre in Quebec (Canada) has offered its nursing leaders access to a long-term professional development program focusing on skills in Reflective Practice (RP). This program is based on teaching nursing leaders to interpret and reframe difficult, emotionally-charged situations they encounter on a regular basis, so they can improve their interpersonal interactions with their colleagues, patients, and patients’ families. This article describes the results of a qualitative study conducted in 2018 with 18 nursing leaders who participated for at least three years in the RP program. Participants were asked to describe their understanding of the RP approach, key learnings from the program, and parts of the training they found most valuable. They were also asked to define or share the program’s impact on their professional practice and leadership skills. It was found that the participants view RP as a useful tool for understanding and improving their interactions with others, and that it had led to concrete improvements in their interpersonal and leadership skills. Several of the positive changes described by participants are rarely described in other studies about the use of RP as a professional development tool in a clinical nursing setting. The results suggest that when nurse leaders have participated for several years in an RP program, they experience different benefits than front-line staff with less long-term participation.

AbstractDuring the course of pre- and in-service teacher education programmes, reflection can happen in a number of ways, for example: reflective journals, personal stories and pair/group co-operative discussions, professional development portfolios, and blogs and electronic portfolios. The aim of this paper is to examine various technologies such as online chat, discussion forums and blogs, in terms of their suitability and affordances as reflective media. It begins by examining positional survey data gathered from student teachers (STs) who have used these social media over a period of time. Following this it focuses on one of the desired outcomes of Reflective Practice (RP), the construction of teacher identity as part of the process of becoming a professional. The construction of identity through the mediational tool of language used across these modes is examined through a corpus linguistics lens. Collections of language produced around RP activities are analysed as a corpus in quantitative and qualitative ways. These complementary sources of data in a mixed-methods approach provide some insights into the technologies and their potential in a Language Teacher Education (LTE) context. To this end, our findings suggest that blogs, in particular, foster narration, RP and the expression of identities, while chat and forums promote emotional and affective engagement, all of which can be useful to STs at the initial and continuing stages of their career.

Reflective practice (RP) is an avenue to becoming an effective teacher. Collaborative dialogue on teaching practice increases critical engagement with RP and provides peer-support opportunities (Mann & Walsh, 2017). In this paper we describe how our use of collaborative RP sessions impacted our sense of teacher efficacy. Two classes of Japanese university students selected, practised, and performed three short extracts from movies. We aimed to develop pronunciation, fluency, and enjoyment and engagement with English. In three teaching cycles, we engaged in collaborative dialogue sessions to reflect on teaching, discussing achievement of class goals and planned changes. RP sessions were audio recorded, transcribed, and qualitatively analysed for themes of teacher efficacy. We believe that reflecting and sharing our teaching practices led to an increased sense of our own capacity to effect positive teaching outcomes. Additionally, our response to negative teaching outcomes suggested increased confidence in our ability to adapt our teaching practice in response. 省察的実践（RP）は、能力のある教師になるための手段である。教育実践に関して協働的な対話をすることで、省察的実践への取り組みが高まりピアサポートの機会が作られる（Mann & Walsh, 2017）。本稿では、協働的な省察的実践のセッションが教師効力感にどのような影響を与えるか考察する。2クラスの英語を学習している日本人大学生は３つの映画の抜粋を選び、練習し演じた。教師は発音、流暢さ、楽しさ、英語を使うことへの取り組みを重視するよう心がけた。３つの実践で、教師は協働的な対話に参加し、クラス目標の到達や変更すべき点について話し合いながら授業について振り返った。セッションを録音し、書き起こし、教師効力感に関して質的分析を行った。自分の教育実践を振り返り共有することで、プラスの教育効果を与える能力が向上する感覚につながることが明らかになった。また、マイナスの教育効果に対し自分の教育実践を受けとめる能力に自信を持てるようになった。

IntroductionEquipping our medical students with as many tools as possible to cope with the challenges that they will inevitably face has never been more important than it is today.ObjectivesThe aim of this study was to examine the effectiveness of a reflective practice (RP) group for medical students, particularly with adaptation to COVID-19 and transition to video.MethodsA pilot programme of RP for 3rd year medical students commencing their clinical placement was run by the Sligo Medical Academy, NUIG in Ireland between January – April 2020. This group for nine students was initially run face-to-face but pivoted to an online group in March 2020 with the COVID-19 pandemic. Data was collected through one-to-one interviews with all student participants and the facilitator (n=10). Interviews were recorded and transcribed. Data were analysed using thematic content analysis.ResultsOur analysis identified four main discussion themes: transition to clinical environment, gender in the workplace, building professional identity and family and support systems. The students who continued the RP group over zoom during the COVID-19 pandemic particularly identified with the theme of support systems and solidarity. The smooth transition to zoom and its effectiveness in a time of social distancing were discussed. Identified challenges related primarily to timing of the RP group, particularly after a full day of placements or time differences for international students overseas.ConclusionsReflective practice programmes are not routinely offered to medical students in Ireland currently and this study gives recommendations on implementing and improving experiences of undergraduate training based on RP.DisclosureNo significant relationships.

The development of information technology (IT) has made a lot of positive changes in language teaching approaches and made significant innovations in educational quality. In learning a language generally and specific skills in particular, it is essential for learners to reflect on what they experienced. Through reflection, teachers and students are able not only to look back to the past happenings, but also to make some necessary changes. Thanks to the support from technology devices, reflective practice (RP) in teaching and learning has become more convenient, especially in smart education environment. This paper is aimed at investigating the evaluation and perception of students on the effects and challenges of using information technology to enhance communication skills and Reflection Practice in teaching and learning English speaking skills and recommending some technology-assisted teaching strategies. In order to examine this, a set of questionnaires, interviews and reflection journals were administered to 80 English major students at Hanoi Law University and six teachers who have taught English speaking skill. The findings showed that using technology-driven teaching approach in RP helped learners achieve more benefits for learning English speaking.

This service evaluation aimed to explore ward staff’s experiences of attending a reflective practice (RP) group within an inpatient neuro-rehabilitation setting. Thirteen staff members completed a bespoke questionnaire and three staff members engaged in semi-structured interviews. Findings suggested that the group was a good use of participant’s time, felt a safe space, and was a good space to discuss team dynamics. There were mixed findings regarding whether the group improved staff’s confidence or their understanding of patient’s behaviour. Thematic analysis revealed four core themes, including ‘organisational pressures’ which impacted the RP group; ‘group practicalities’; ‘benefits and improvements’; and the ‘safe space’ of the group. Future evaluations would benefit from using a validated questionnaire and measures of burnout to explore the wider impact of RP.

Reflective practitioner teachers should critically review their own work and introduce innovations that should improve everyday educational practice. For this reason, the focus of the research is on the personal and professional empowerment of reflective practitioner teachers during the SARS-CoV2 pandemic. 355 teachers from the Republic of Serbia participated. The empirical research used descriptive methods and techniques of scaling and surveying with an instrument specially constructed for the needs of this research - Questionnaire with assessment scale (RP-COV-19). The results show that the most common form of empowerment is attending online seminars, while teachers rarely attended online classes of colleagues from the school where they work and colleagues from other schools. Teachers' perceptions on the use of the Internet in the aspect of personal and professional empowerment are very positive. Teachers generally rate their training and engagement during the pandemic with the highest marks (four and five), while there were no negative marks at all. Reflexivity accompanied by personal and professional empowerment must be given priority by teachers, because in today's process of education, reflective practitioners are considered successful teachers. Keywords: teacher reflective practitioner, professional empowerment, the Covid-19 pandemic, empirical research, improvement of educational practice.

To learn a lesson well, we need to hear, see, ask questions about it, and discuss it with others. Not only that, teachers need to "do it", that is to describe something in their own way, to show their example, to try to practice their skills and to do tasks that demand the knowledge they have gained. Problems to be studied in this research are: Does using STAD cooperative model can improve the learning result of mathematics? Steps taken in using the STAD cooperative model. The place of study is the place used in conducting research to obtain the desired data. This research took place at SD Negeri 08 Koto Berapak, Bayang District. The time of study is the time of the research or when the research is held. This study was conducted in the academic year 2017. The subjects of the study were the students of the second grade of SD Negeri 08 Koto Berapak, Bayang District, in the year of 2017 on the subject of mathematics. This research uses Classroom Action Research (PTK). According to the PGSM Project Trainers Team, the TOD is a reflective form of study by actors undertaken to enhance the rational stability of their actions in performing their duties, deepening their understanding of the actions, and improving the conditions under which the learning practices are conducted (in Mukhlis, 2000: 3). Meanwhile, according to Mukhlis (2000: 5) PTK is a form of review that is systematic reflective by the actors to improve the learning conditions undertaken. The main purpose of PTK is to improve / improve the learning pratek on an ongoing basis, while the purpose of inclusion is to grow a culture of research among teachers That is a set of plans and arrangements about classroom learning activities, as well as assessment of learning outcomes. It is a learning tool used as teacher's guidance in teaching and composed for each round. Each RP contains basic competencies, indicators of achievement of learning outcomes, specific learning objectives, and teaching and learning activities. The results of data analysis and discussion can show some of the progress achieved during learning either through classical learning, cooperative STAD model, playing quiz, or learning outcomes. So the results of this class action research can be drawn conclusions as follows: 1. Learning STAD cooperative model can encourage students to learn about math more excited, improve learning process, and learning outcomes. 2. Playing quiz can encourage students to learn about math to be more passionate, improve learning process, and learning outcomes. Some other findings obtained are the emergence of student creativity in making questions and answers, the number of questions posed by students, the responsibility of completing the task, the loss of boredom, even students prefer to complete the task rather than rest.

SummarySchool is a complex system, inseparable from the specific context of here and now. Each day involves immersing in the course of particular events which are the result of multiple interactions at school. Time is what binds all the events taking place at school, and the category of time makes multi-level and multi-aspect analysis of school reality possible. The aim of the article is to reflect on the author’s own practice of phenomenographic studies of daily school time, to show the doubts occurring as part of the studies and to present the decisions taken. The text is the analysis of key elements of planning the studies, carrying them out and analyzing the results.

Art. 116 of the Constitution of the Republic of Poland provides that a state of war and the conclusion of peace are declared by the Sejm acting in the name of the Republic of Poland. These two notions, having no constitutional definition, come under the rubric of established notions, i.e. concepts whose meaning derives from doctrinal findings and provisions of law, as well as from constitutional principles and values. The Sejm’s power to declare a state of war and, consequently, declare the conclusion of peace is part of Polish system-of-governance traditions. The parliament’s power to declare war actually characterizes most of the democratic systems, even if it could be argued that waiving this prerogative in practice characterizes it as well, reflecting the preponderance of the executive power in the domain of foreign policy. The wording of Art. 116 rules out an invasive war, also in the form of a war of prevention or a preventive self-defence. The Sejm may adopt the relevant resolution only in case of armed aggression against the territory of the Republic of Poland, or if international treaties impose an obligation of common defence against aggression, i.e. as a consequence of an act of aggression. Being of key importance for the constitutional regulation of war and peace, this constraint is commensurate with international law, which the Republic of Poland is required to respect pursuant to Art. 9 of the Constitution, and is also commensurate with the Preamble to the Constitution. In a democracy, acts of war – as an important government prerogative – may only be conducted pursuant to the relevant constitutional provisions which define the conditions that must be met for such acts to be legitimate. The conduct of a war, after all, does not warrant the suspension of the Constitution. A democratic state ruled by law must not conduct a war otherwise than on the basis, and within the constraints, of law – if it is to retain its constitutional identity. For the use of armed forces abroad to be commensurate with the Constitution, such use must not represent an act of aggression, nor can it represent any acts violating the principles of the United Nations Charter. If past experience is to be a guide, democratic constitutions are not capable of preventing anti-democratic changes in the system of governance, nor are they capable of preventing wars. War represents a failure of the Constitution, by destroying its foundation, the belief in inalienable and inherent dignity of the person.

The Society of Automotive Engineers (SAE) Recommended Practice (RP) J2954 (November 2017) was recently published to standardize the wireless power transfer (WPT) technology to recharge the battery of an electric vehicle (EV). The SAE J2954 RP establishes criteria for interoperability, electromagnetic compatibility (EMC), electromagnetic field (EMF) safety, etc. The aim of this study was to predict the magnetic field behavior inside and outside an EV during wireless charging using the design criteria of SAE RP J2954. Analyzing the worst case configurations of WPT coils and EV bodyshell by a sophisticated software tool based on the finite element method (FEM) that takes into account the field reflection and refraction of the metal EV bodyshell, it is possible to numerically assess the magnetic field levels in the environment. The investigation was performed considering the worst case configuration—a small city car with a Class 2 WPT system of 7.7 kVA with WPT coils with maximum admissible ground clearance and offset. The results showed that the reference level (RL) of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) guidelines in terms of magnetic flux density was exceeded under and beside the EV. To mitigate the magnetic field, the currents flowing through the WPT coils were varied using the inductor-capacitor-capacitor (LCC) compensation instead of the traditional series-series (SS) compensation. The corresponding calculated field was compliant with the 2010 ICNIRP RL and presented a limited exceedance of the 1998 ICNIRP RL. Finally, the influence of the body width on the magnetic field behavior adopting maximum offset was investigated, demonstrating that the magnetic field emission in the environment increased as the ground clearance increased and as the body width decreased.

BackgroundWe draw on the work of established scholars in the field of reflective practice who highlight its importance as a key cognitive skill for professionals to hold. While the substantive effect of engaging in reflective practice is emphasised in the literature, apparently coaches only spend a limited time learning about and engaging with it.ObjectivesThis study was conducted in two parts: Part 1 examined coaches’ knowledge of reflective practice and ascertained their perceived lack of value and use of reflective practice within their coaching. In response to the unexpected findings in Part 1, in Part 2, we instituted an educational intervention to further these participant coaches’ knowledge of Reflective Practice (RP) and facilitate its integration into their coaching practice.DesignThe present study utilised a mixed method design with semi-structured interviews being conducted in Part 1. A coach development reflective programme inspired by Stimulated Recall approach was implemented in Part 2.ParticipantsTwelve high level coaches were interviewed about their reflective practices in Part 1. In Part 2, the same coaches agreed to participate in the educational intervention for the duration of the project.ResultsFindings from Part 1 revealed an interesting paradox: coaches demonstrated a lack of appreciation for reflective practice yet recounted the positive influence that specific events and individuals had on their practice. In Part 2, to fully develop RP with the present cohort, an educational intervention was conducted. While watching videos of their own practice, coaches initially required lots of prompts from the lead interviewer to facilitate a deep and meaningful discussion of their practice. During the latter stages of the intervention, however, participants were less dependent on questions and prompts.ConclusionIn part 1, the coaches in this study did employ reflection, although they did not label it as such. The qualitative evidence we have gathered enables us to suggest that it is the combination of how to reflect, and against what criteria that makes RP a powerful tool to develop expertise which it has the potential to be. Importantly, however, additional coach education input is necessary for these benefits to be fully realised.

This study tackles the lack of collective models to analyze teaching practices by employing a bottom-up and collaborative approach for engaging in Reflective Practice (RP) for English as a Foreign Language (EFL) teachers in a Mexican context. The Collective Accompaniment Model (CAM; Guillemette, 2014) served to develop reflection with peers at the same hierarchical level, allowing for reflection to evolve over time. The research question was “What are the contributions of other colleagues’ interactions to support reflective practice via collective accompaniment with EFL teachers in Mexico”? The methodology employed during the inquiry was action research (AR) with nine EFL teachers who had graduated or were in the last year of the BA TESOL degree in a public university in Guanajuato in Mexico. Data collection instruments such as verbal and written accounts of reflection were employed via the CAM, and data were analyzed using inductive and deductive coding. The findings show that the CAM provided a dialogic venue strengthening the reflective process. Each participant analyzed individual aspects of their professional practice through sharing experiences, creating a sense of togetherness, and belonging. This study calls for dialogic ways to carry out RP with EFL teachers in Mexico to adjust EFL teaching practices.

AbstractAdaptive expertise (AE) and reflective practice (RP), two influential and resonant theories of professional expertise and practice in their own right, may further benefit health professions education if carefully combined. The current societal and systemic context is primed for both AE and RP. Both bodies of work position practitioners as agentive, learning continually and thoughtfully throughout their careers, particularly in order to manage unprecedented situations well. Similar on the surface, the roots and practices of AE and RP diverge at key junctures and we will focus on RP’s movement toward critically reflective practice. The roots of AE and RP, and how they relate to or diverge from present-day applications matter because in health professions education, as in all education, paradigmatic mixing should be undertaken purposefully. This paper will explore the need for AE and RP, their shared commitments, distinctive histories, pedagogical possibilities both individually and combined, and next steps for maximizing their potential to positively impact the field. We argue that this exploration is urgently needed because both AE and RP hold much promise for improving health care and yet employing them optimally—whether alone or together—requires understanding and intent. We build an interprofessional education case situated in long-term care, throughout the paper, to demonstrate the potential that AE and RP might offer to health professions education individually and combined. This exploration comes just in time. Within the realities of uncertain practice emphasized by the pandemic, practitioners were also called to act in response to complex and urgent social movements. A combined AE and RP approach, with focus on critically reflective practice in particular, would potentially prepare professionals to respond effectively, compassionately, and equitably to future health and social crises and challenges.

The significance of reflective practice (RP) has been widely recognized in both general education and language education. The past years have witnessed an exponential growth of studies in examining how technology can be utilized to promote teachers’ RP and video-based RP has been extensively reported as a powerful tool for teacher learning in many educational contexts. While existing literature has documented the potential benefits that student teachers may reap from video-based RP, there is a lack of attention to the complex interplay between the process of their RP and the contextual factors in their situated learning environment. This article reports on a study which aims to promote video-based RP among student teachers in a pre-service language teacher education course in Hong Kong. Drawing on data from post-course interviews with and the videoed reflection of six student teachers, the study uncovered the complex and dynamic process of the student teachers’ video-based RP. This article offers practical implications for language teachers, teacher educators and school leaders on how to promote RP in second language teacher education.

INTRODUCTION: Different approaches have been endeavoured by medical educationists to produce high[1]standard graduates from medical school, including collaborative group discussions and reflective practice (RP) assignments. The current study aimed to evaluate the outcome of teacher-led whole batch discussion following RP tasks given to the students. The overall teaching approach is referred to as “Reflection-based whole-batch discussion (RWD)”. MATERIALS AND METHODS: One hundred twenty-two medical students who attended the haematology course at the University Sultan Zainal Abidin were recruited into this study over 2 academic years. The first batch of students (n=61) was unexposed to the RWD intervention (RWD-unexposed) while the second batch from the following academic year (n=61) was exposed (RWD-exposed) to the intervention. Students adhered to the guidelines given by the instructor pertaining to the reflective practice (RP) before the sessions. A weekly RWD session was conducted where the instructor-led a dually interactive forum to discuss students’ mistakes and misunderstandings as reflected within their write-ups. Exam results from both RWD-exposed and the RWD[1]unexposed students were compared using the student t-test. RESULTS: The mean scores of students’ results were significantly higher among RWD-exposed students compared to RWD-unexposed students in their essay questions and objective structured practical exam questions (p<0.01). However, RWD-exposed students scored significantly lower than the RWD-unexposed < 0.01). However, RWD-exposed students scored significantly lower than the RWD-unexposed student's group in multiple true and false (MTF) questions. CONCLUSION: Implementing RWD is a promising teaching strategy in improving the academic achievement of medical students especially in answering essay questions. MTF questions format may be an incompetent tool for evaluating the impacts of new teaching strategies and therefore medical educationists recommended efficient alternative assessment tools such as OBA and EMQ for the sake of curriculum development in medical institutes.

VSP uses browser-based virtual environments to simulate life-like and challenging clinical scenarios. They are an innovative and creative way to develop proficiency capabilities of healthcare professionals as an adjunct to their studies and practice placement. Evidence suggests that a simulated environment can better equip nursing and allied health professional students for practice [1–3]. The concept of VSP may have been brought forward by the COVID-19 pandemic but was inevitable with the increasing access to technology-enhanced learning and the emerging evidence of its benefit. This VSP was a collaboration between UK simulationists and Indonesian academics with a two-month deadline. Work was completed online using videoconferencing and translation services, the evaluation (with ethical approval) was completed using a JISC online survey in March 2022. The Indonesia VSP consists of four patient scenarios, one scenario from each of the fields of children and young people, adult, mental health and learning disability nursing and is set within the emergency department and is aimed at learners in their final year of a nursing programme in Indonesia. The Indonesia VSP scenarios were designed in line with the UK Nursing and Midwifery Council (NMC) proficiencies and the Indonesian equivalents and were designed based on clinical scenarios that are not commonly seen in clinical practice or may be particularly challenging to enhance learners’ skills and build their confidence with managing such situations. The VSP was designed for 10 hours of learning and was made available to adult nursing students from 37 Poltekkes across the Indonesian continent. The VSP project was delivered on time with the evaluation from the pilot group being overwhelmingly positive with 82% of respondents being satisfied with the quality of VSP (response rate of 30% n=51/171) The key themes identified were: ‘real-life patient scenarios based on holistic and patient-centered care’ and the VSP enabling learners to use ‘critical thinking skills and relate the content to previous knowledge’ gained on their course so far. VSP is a meaningful way of enhancing exposure to experiences that are not guaranteed for all learners leading to greater equity of experience. The reflective and blended nature of the VSP leads to a better understanding of difficult topics. The VSP platform enables knowledge transfer that allows our team to take our in-house digital innovations to a global platform to support the training of the future nursing workforce of Indonesia. 1. Akselbo I, Olufsen V, Ingebrigtsen O, Aune I. Simulation as a learning method in public health nurse education. Public Health Nurs. 2019;36(2):226–232. 2. Bogossian FE, Cant RP, Ballard EL, Cooper SJ, Levett‐Jones TL, McKenna LG, Ng LC, Seaton PC. Locating ‘gold standard’ evidence for simulation as a substitute for clinical practice in prelicensure health professional education: a systematic review. J Clin Nurs. 2019;28(21–22):3759–3775. 3. Mills BW, Carter OB, Rudd CJ, Ross NP, Claxton LA. 2015. Clinical placement before or after simulated learning environments? A naturalistic study of clinical skills acquisition among early-stage paramedicine students. Simul Healthc. 2015;10(5):263–269.

Abstract Background/Aims Severe Raynaud’s phenomenon (RP) can lead to digital ulcers (DU), ischaemia, infection and gangrene. In 2015, NHS England published a commissioning policy enabling the use of bosentan for digital ulceration in SSc in patients refractory to intravenous 6-8 weekly prostanoid in combination with sildenafil following standard therapy (including calcium channel blockers (CCB), ACE inhibitors, losartan and fluoxetine). Bosentan is licensed to prevent new DUs in SSc. Specialist MDT ratification and Blueteq registration is required. RCTs showed bosentan reduced the formation of new DU by 30-50% in at risk individuals. It is a well-tolerated drug. It is now off-patent so its cost has reduced from £22,000 to £650 per year. Aim To audit current departmental practice in patients receiving prostanoid (epoprostenol) for severe RP from any cause and check adherence to the patient pathway for treatment escalation prior to prostanoid therapy. To determine approximate costs of alternative therapeutic approaches. Methods We retrospectively audited patients attending our day unit for epoprostenol infusions over a 12-month period between 2018 and 2019. Using our centre’s admissions database and electronic patient records, we identified which oral medications patients were currently co-prescribed or had previously trialled. Using pharmacy data and tariff costings, we calculated the cost of epoprostenol infusions and oral medications with blood monitoring. Results Between 2018 and 2019, 73 patients attended for epoprostenol infusions: 31 SSc, 25 RP, 17 other diagnoses (mixed/undifferentiated CTD, SLE, vasculitis). The mean number of epoprostenol infusions per patient per year was 5.92 days (range 1-25). The percentage of patients who had first been trialled on the following medications include: CCB 77.4%, ACEi/ARB 41.1%, fluoxetine 9.59%, sildenafil 87.1% and tadalafil 25.8%. In the SSc group 22.6% had also trialled bosentan. Only 2 SSc patients (6.45%) had trialled all of the drugs on the pathway prior to prostanoid reflecting the relative lack of efficacy of some first line therapies. The departmental tariff per prostanoid infusion is £450, resulting in an estimated average annual cost of £2700 per patient. The annual cost of supplying bosentan 125mg twice daily plus blood monitoring for the first year is approximately £1350. Conclusion Epoprostenol is used in our unit for patients with severe RP from a range of conditions. Sildenafil and CCB have been trialled in the majority of our patients prior to escalation. Only a minority of patients have received bosentan according to current guidelines and licensing. Given the reduction in cost, combined with the importance of avoiding hospital admissions with COVID-19, we would suggest that bosentan could be used earlier in the treatment pathway for a broader range of indications. NHSE is revising the SSc commissioning policy. Disclosure A. Young: None. B. Griffiths: None. J. Vila: None.

Purpose Complex repairable systems (CRSs) are generally modeled by stochastic processes called “point processes.” These are generally summed up in the nonhomogeneous Poisson process (NHPP) and the renewal process (RP), which represent the minimum and maximum repair, respectively. However, the industrial environment affects systems in some way. This is why the main objective of this work is to model the CRS with a concept reflecting the real state of the system by incorporating an indicator in the form of covariate. This type of model, known as the proportional intensity model (PIM), will be analyzed with simulated failure data to understand the behavior of the failure process, and then it will be tested for real data from a petroleum company to evaluate the effectiveness of corrective actions carried out. Design/methodology/approach To solve the partial repair modeling problem, the PIM was used by introducing, on the basis of the NHPP model, a multiplicative scaling factor, which reflects the degree of efficiency after each maintenance action. Several values of this multiplicative factor will be considered to generate data. Then, based on the reliability and maintenance history of 12-year pump's operation obtained from the SONATRACH Company (south industrial center (CIS), Hassi Messaoud, Algeria), the performance of the PIM will be judged and compared with the model of NHPP and RP in order to demonstrate its flexibility in modeling CRS. Using the maximum likelihood approach and relying on the Matlab software, the best fitting model should have the largest likelihood value. Findings The use of the PIM allows a better understanding of the physical situation of the system by allowing easy modeling to apply in practice. This is expressed by the value which, in this case, represents an improvement in the behavior of the system provided by a good quality of the corrective maintenance performed. This result is based on the hypothesis that modeling with the PIM can provide more clarification on the behavior of the system. It can indicate the effectiveness of the maintenance crew and guide managers to confirm or revise their maintenance policy. Originality/value The work intends to reflect the real situation in which the system operates. The originality of the work is to allow the consideration of covariates influencing the behavior of the system during its lifetime. The authors focused on modeling the degree of repair after each corrective maintenance performed on an oil pump. Since PIM does not require a specific reliability distribution to apply it, it allows a wide range of applications in the various industrial environments. Given the importance of this study, the PIM can be generalized for more covariates and working conditions.

Photo by National Cancer Institute on Unsplash ABSTRACT The COVID-19 pandemic has brought about the advent of many new telehealth technologies as providers have been forced to shift their practice from the clinic to the cloud. Perhaps, none of these fields has been as widely advertised and expanded as telemental health. While many have lauded this change, it is important to question whether this method of practice is truly beneficial for patients, and further whether it benefits all patients. This paper critically examines the current structure of telemental health interventions and compares them to more traditional in-person interactions, reflecting on the unique benefits and challenges of each method, and ultimately concluding that telemental health is the wrong modality for certain patients and modalities. INTRODUCTION As the e-health revolution rapidly progresses, scientists, healthcare professionals, and technology experts are attempting to determine which areas of medical practice will best adapt to changing dynamics. Two key professions that are ripe for this kind of disruption are psychiatry and psychology. The American Psychiatric Association, along with its partners in the American Telemedicine Association, states that “telemental health in the form of interactive videoconferencing has become a critical tool in the delivery of mental health care. It has demonstrated its ability to increase access and quality of care, and, in some settings, to do so more effectively than treatment delivered in-person.”[1] This claim, though appearing bombastic, is also reflected, though with more nuance, by the American Psychological Association. For its part, the American Psychological Association states that “the expanding role of technology and the continuous development of new technologies that may be useful in the practice of psychology present unique opportunities, considerations, and challenges to practice.”[2] Thus, the point of this paper will be to examine whether the rapidly expanding system of telemental health is ethical based on its adherence to accepted standards of care, privacy concerns, and concerns about the boundaries of the patient-provider relationship. l. Standard of Care Concerns One of the most considerable objections to the broader implementation of telemental health services is the speculation that it is less effective than in-person treatment. It would follow that a system that is broadly implemented would not only fail to be beneficent, but it would also fail to be non-maleficent. Providers would be knowingly providing an ineffective treatment. Some may argue that such a system would also violate the principle of justice. It would create an unequal system of care in which those patients who could afford to see their therapist in person would benefit more than those who could not. However, data from a wide variety of sources at first glance, would seem to contradict these fears.[3] A review of the literature regarding the implementation of telemental health in geriatric patients, for example, showed that telemental health was as good as in-patient psychiatric care in several areas, including the diagnosis of dementia, nursing home consultations, and in conducting psychotherapy for geriatric patients and their caregivers.[4] On the other end of the age spectrum, a review of nineteen randomized controlled trials and one clinical trial demonstrated high comparative effectiveness between telemental health interventions in children and adolescents.[5] Hailey et al. found that telemental health interventions were effective in over half of the 65 studies reviewed. These studies encompassed a diverse and wide-ranging number of psychiatric disciplines, including child psychiatry, post-traumatic stress disorder, dementia, cognitive decline, smoking cessation, and eating disorders. Methods included phone- and web-based interventions.[6] Indeed, the data is not just limited to outpatient settings. For example, Reinhardt et al. conducted a literature review of studies about telemental health visits for psychiatric emergencies and crises. They found that no studies reported a significant statistical difference in diagnosis or disposition among psychiatric patients who presented to the Emergency Department. In addition, their review demonstrated a reduction in length of stay, reduction in time to care, and decreased costs among these patients. The authors also reviewed literature pertaining to crisis response teams and patients with severe mental illness. Both studies demonstrated that telemental health visits for these patients were similar, if not better, than face-to-face visits. In addition, both patients and practitioners showed high satisfaction with these services.[7] Thus, the implementation of telemental health is limited to out-patient settings and could feasibly be implemented in the in-patient and emergency settings. There is, however, one particularly glaring gap in telemental health services: group therapy. Perhaps the most famous example of group therapy is Alcoholics Anonymous, but group therapy has expanded to include many different modalities. Group therapy is a common intervention for many mental illnesses and can be incredibly effective in treating diseases ranging from PTSD to borderline personality disorder.[8] In a pilot study comparing a video teleconference based Dialectical Behavioral Therapy (DBT) group to an in-person DBT group, Lopez et al. found that while patients had similar levels of cohesion with the facilitator, participants in the video teleconference group saw less group cohesion than their peers in the in-person group. Further, while many patients in the video teleconference group believed that the convenience offset the adverse effects, many also wished for an in-person group. Attendance was also significantly higher in the video teleconference group.[9] Thus, while the video teleconference group did report some positives, some significant differences raise ethical questions. How well does a group do without cohesion? For example, if a person needing to be consoled breaks down and cries in front of the group, the in-person response may be different from the video conference. In the in-person group, other group members may place a gentle hand on the shoulder of the grieving person or maybe even hug them. The group facilitator or group members in the video conference group could say the same words of consolation as those in the in-person group. However, there still seems to be some missing action. The idea of physical touch, in this way, can mean a lot more than just a small action. Van Wynsberghe and Gastmans argue that this kind of deprivation may lead to feelings of depersonalization.[10] And, to an extent, their supposition is supported by the data presented by Lopez et.al. The low level of group cohesion in the video conference group could suggest that other group members seem unimportant to the participants. They are simply things on a screen, not real people. Dr. Thomas Insel, former National Institute of Mental Health Director writes that while technology may hold the key to improving mental health on the population level, there is a human-sized piece of the puzzle missing from these interventions. The solution, he asserts, lies somewhere in the integration of these two types of experiences, one that he terms “high-tech and high-touch.”[11] The lack of touch and physical presence is an obstacle for both patients and providers. At best this may lead to a slightly poorer provider-patient relationship and at worst may result in poorer quality care. ll. Privacy & Confidentiality Concerns Privacy and confidentiality are among the most serious concerns for practitioners and patients, made more complex by the advent of e-health. Major news outlets provide plenty of examples of breaches of confidentiality of people’s electronic records. Even significant systems, often thought to be secure, used to facilitate direct contact between people in the wake of COVID-19, like Zoom, have been breached. Not too long ago, "Zoom Bombing” was a national phenomenon, appearing in online classrooms, often sharing explicit or politically motivated content. Psychiatric patients are susceptible to issues surrounding privacy and confidentiality, and they may even come from communities that ostracize and stigmatize mental illness. These concerns must be taken seriously. Of course, both the American Psychiatric Association and the American Psychological Association address privacy concerns. Both organizations note in their guidelines that relevant HIPAA regulations apply to telehealth and doctors must use apps and videoconferencing tools with the highest levels of security.[12] Interestingly, the American Psychiatric Association takes these instructions one step further. It requires providers to be in a private room during telehealth videoconferences or calls and that people seeking care also have a private space so that any conversations are not overheard. This not only prevents violations of privacy but reassures the therapeutic relationship between provider and patient.[13] While providers can take these steps to ensure their patients’ privacy, an internet connection may not guarantee privacy. Many privacy issues are more easily mitigated in a clinical space. For example, walls and doors can be soundproofed, or white noise can be played in the waiting room to ensure that therapeutic conversations are not overheard. And while the American Psychiatric Association asks providers to mitigate these risks as they would in their respective clinics, there is another layer to online privacy. Providers should be concerned about telecommunications providers, how they collect information, and what types of information they collect.[14] If, for example, the patient must navigate to the practitioner’s webpage to enter into the therapy portal, that information might be tracked and used to generate personalized ads for the patient. If a person suffering from severe paranoia started receiving ads for psychiatric medication, they may react negatively to the invasion of privacy. That type of targeted advertising could even exacerbate a mental health condition. The scandals surrounding the National Security Administration (NSA) in recent years have added another layer of complexity to the issue of privacy. Whistleblowers like Edward Snowden, revealed that the government was collecting metadata from text messages, videos, and social media. Government surveillance is an added risk of mental health videoconferencing.[15] The government would not be bound by the rules that require privacy with few exceptions like the Tarasoff law, which could require disclosure to stop a violent act as a clinical care provider. The government might judge someone a risk-based on ill-gotten surveillance data, wrongly add a person to a watch list, or engage in further surveillance of a patient whom non-clinicians working in government assess to be a potential danger. Protection from government surveillance is a fundamental ethical endeavor. Yet government as a collector of data without a warrant or with easily attained FISA and other warrants is problematic. Scenarios may seem far-fetched but are within the realm of possibility. Secondly, the provider must envision how this might hinder care. For example, patients aware of the possibility of government surveillance may be reluctant to show up to online meetings if they show up at all. Perhaps they are so sensitive to these issues that they stop checking with their therapist altogether. It is easy to see how a person who has schizophrenia and shows signs of paranoia may avoid telehealth for fear of being tracked. Of course, one could also have privacy concerns about a therapist’s office. Perhaps patients are nervous about being seen in the office or parking lot. They might worry about being overheard. These concerns, however, can be mitigated fairly simply, for example, patients could find anonymous means of transportation and practitioners can soundproof their offices. Thus, in both the office and the videoconference, concerns can be mitigated easily and tangibly, but not eliminated entirely. Mental health providers should use the highest quality communication services with end-to-end encryption to bolster online privacy. lll. Boundary Issues and Professionalism The boundaries here are philosophical, not physical. Both the American Psychiatric Association and the American Psychological Association work to ensure that the patient-professional boundaries are kept as close to normal as possible. Both organizations expect practitioners to maintain the highest levels of professionalism when dealing with patients using telemental health services.[16] Practitioners are responsible for enforcing boundaries through informing their patients about appropriate behavior so that patients are discouraged from calling at inappropriate times absent an emergency. Videoconferencing systems and multi-layered protections like passwords and gatekeeping would prevent patients from logging into another patient’s appointment. These boundaries exist for a good reason. A 2017 report demonstrated that there is an escalating shortage of psychiatrists.[17] Nearly 1 in 5 people in the US has a mental health condition.[18] Mental health providers are nearly overwhelmed, therefore inappropriate, frequent, and unnecessary contact adds another level of complexity to treating patients. Mental health providers need to be stewards of the resource they provide. They must concentrate on the patient they are with. They also must guard themselves against burnout, because dealing with patients too often, even though technology allows for it, will lead to them being less effective for the rest of their patients. While these professional boundaries must be policed carefully, practitioners should also be careful of having boundaries that are too high. Thus, providers must balance between too much intimacy and too little.[19] Presence and physical touch have symbolic meaning. Being with a person reaffirms their personhood, and both provider and patient can feel that. Humans are relational beings, and a physical relationship often comforts people. It may also legitimize and reinforce the patient through sensation and perception. There may be something inherently missing from the practice of telemental health, as exemplified by the group members’ inability to console others in group therapy sessions over teleconference.[20] The screen may also be an agent of depersonalization. It may make the patient’s complaints seem less real. Or perhaps the patient may feel as though they are not being heard. Although the evidence of telemedicine’s successes above may seem to contradict this, none of the studies that extoll the benefits of telemental health have follow-up periods greater than one year. And while many studies show that patients are highly satisfied with telemental health, measurements of satisfaction are not standardized. It remains unclear whether patients benefit enough from their telemental sessions or whether they require more regular sessions to stay as satisfied as they were with in-person mental health care. Perhaps as time goes on, patients become more frustrated with telemental health. The research must answer these questions, but currently, it does not sufficiently address metaphysical arguments against telemental health. CONCLUSION Privacy is a key practical issue that remains. Although providers try to combat issues of privacy by using high-level conferencing software, which has end-to-end encryption,[21] surveillance and breaches may occur. While not suitable for all kinds of patients, telemental health services prove to be effective for groups of people that otherwise may not have been able to receive care over the past two years. There are some settings, such as group therapies, that are best suited for in-person meetings. Although online sessions encourage individuals to show up regularly, their downsides are not yet known. There is incredible power in the idea of presence, and humans are inherently relational beings. For some, a lack of contact is unwelcomed and makes therapy less satisfying. Opportunities to use in-person clinical care remain a priority for some patients, and healthcare providers should further investigate prioritizing in-person care for those who want it. Telemental health could be beneficial for emergencies, natural disasters, vulnerable groups, or when patients cannot get to their provider's office. However, for now, telemental health should not take a leading role in providing mental health treatment. - [1] Chiauzzi E, Clayton A, Huh-Yoo J. Videoconferencing-Based Telemental Health: Important Questions for the COVID-19 Era from Clinical and Patient-Centered Perspectives. JMIR Ment Health, 2020. doi:10.2196/24021 [2] Joint Task Force for the Development of Telepsychology Guidelines for Psychologists. Guidelines for the practice of telepsychology. American Psychologist, 2020. 791–800. doi.org/10.1037/a0035001 [3] Gentry MT, Lapid MI, Rummans TA. Geriatric Telepsychiatry: Systematic Review and Policy Considerations. Am J Geriatr Psychiatry. 2019 doi: 10.1016/j.jagp.2018.10.009; Campbell R, O'Gorman J, Cernovsky ZZ. Reactions of Psychiatric Patients to Telepsychiatry. Ment Illn. 2015;7(2):6101, 2015. doi:10.4081/mi.2015.6101; Malhotra S, Chakrabarti S, Shah R. Telepsychiatry: Promise, potential, and challenges. Indian J Psychiatry, 2013. doi: 10.4103/0019-5545.105499; Reinhardt I, Gouzoulis-Mayfrank E, Zielasek J. Use of Telepsychiatry in Emergency and Crisis Intervention: Current Evidence. Curr Psychiatry Rep, 2019. doi: 10.1007/s11920-019-1054-8 [4] Gentry, Lapid, and Rummans, Geriatric Telepsychiatry [5] Abuwalla, Zach & Clark, Maureen & Burke, Brendan & Tannenbaum, Viktorya & Patel, Sarvanand & Mitacek, Ryan & Gladstone, Tracy & Voorhees, Benjamin. Long-term Telemental health prevention interventions for youth: A rapid review, 2017. Internet Interventions. Doi.11. 10.1016/j.invent.2017.11.006. [6]Hailey D, Roine R, Ohinmaa A. The effectiveness of telemental health applications: a review, 2008. Can J Psychiatry. doi:10.1177/070674370805301109. [7] Reinhardt, Gouzoulis-Mayfrank, and Zielasek, Use of Telepsychiatry in Emergency and Crisis Intervention [8] Kealy, David & Piper, William & Ogrodniczuk, John & Joyce, Anthony & Weideman, Rene. Individual goal achievement in group psychotherapy: The roles of psychological mindedness and group process in interpretive and supportive therapy for complicated grief, 2018. Clinical Psychology & Psychotherapy. doi:10.1002/cpp.2346. Schwartze D, Barkowski S, Strauss B, Knaevelsrud C, Rosendahl J. Efficacy of group psychotherapy for posttraumatic stress disorder: Systematic review and meta-analysis of randomized controlled trials. Psychother Res, 2019. doi: 10.1080/10503307.2017.1405168; Wetzelaer P, Farrell J, Evers SM, Jacob GA, Lee CW, Brand O, van Breukelen G, Fassbinder E, Fretwell H, Harper RP, Lavender A, Lockwood G, Malogiannis IA, Schweiger U, Startup H, Stevenson T, Zarbock G, Arntz A. Design of an international multicentre RCT on group schema therapy for borderline personality disorder. BMC Psychiatry, 2014. doi: 10.1186/s12888-014-0319-3 [9] Lopez, Amy et al. “Therapeutic groups via video teleconferencing and the impact on group cohesion.” mHealth, 2020. doi:10.21037/mhealth.2019.11.04 [10] Van Wynsberghe A, Gastmans C. Telepsychiatry and the meaning of in-person contact: a preliminary ethical appraisal. Med Health Care Philos, 2009. doi: 10.1007/s11019-009-9214-y. [11]Thomas Insel, “Tech Can Help Solve Our Mental Health Crisis. But We Can’t Forget The Human Element.,” Substack newsletter, Big Technology (blog), January 27, 2022, https://bigtechnology.substack.com/p/tech-can-help-solve-our-mental-health. [12] Armstrong, C. M., Ciulla, R. P., Edwards-Stewart, A., Hoyt, T., & Bush, N. Best practices of mobile health in clinical care: The development and evaluation of a competency-based provider training program, 2018. Professional Psychology: Research and Practice. doi.org/10.1037/pro0000194 [13] Armstrong, C. M., Ciulla, R. P., Edwards-Stewart, A., Hoyt, T., & Bush, N. Best practices of mobile health in clinical care: The development and evaluation of a competency-based provider training program [14] Sabin JE, Skimming K. A framework of ethics for telepsychiatry practice. Int Rev Psychiatry, 2015. doi:10.3109/09540261.2015.1094034 [15] Lustgarten, S. D., & Colbow, A. J. Ethical concerns for telemental health therapy amidst governmental surveillance, 2017. American Psychologist. doi.org/10.1037/a0040321 [16] Armstrong, C. M., Ciulla, R. P., Edwards-Stewart, A., Hoyt, T., & Bush, N. Best practices of mobile health in clinical care: The development and evaluation of a competency-based provider training program [17] Merritt Hawkins. An Overview of the Salaries, Bonuses, and Other Incentives Customarily Used to Recruit Physicians, Physician Assistants and Nurse Practitioners, 2018. http://physicianresourcecenter.com/wp-content/uploads/2018/09/Merritt-Hawkins-2018-Review-of-Physician-and-Advanced-Practitioner-Incentives.pdf [18] Bose, J., Hedden, S., Lipari, R., Park-Lee, E. Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health, 2015. https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf [19] Sabin and Skimming. A Framework of Ethics for Telepsychiatry Practice [20] Van Wynsberghe and Gastmans, Telepsychiatry and the Meaning of In-Person Contact [21] Lustgarten and Colbow, Ethical Concerns for Telemental Health Therapy amidst Governmental Surveillance