Practice of Leadership in Children's Centres

Just back from meeting with a group of very dynamic Children's Centre leaders - a clearly committed group who are seeking accreditation and recognition of their workplace learning. Their Action Learning Set is very well developed and advanced and it would be very rewarding to work with this cohort. The group are keen to develop their knowledge, particularly in leadership. While theories of leadership can be gleaned from texts, it is the practice of leadership which enables the creation and acquisition of knowledge. This is exactly what this group have in abundance.

Failing to adhere to ethics ends professional career

The guardian article reveals the story ...

Andrew Wakefield, the doctor at the centre of the MMR row, has been struck off for serious professional misconduct. Photograph: Anthony Devlin/PA He was not at the General Medical Council (GMC) hearing to receive the verdict on his role in a public health debacle which saw vaccination of young children against measles, mumps and rubella plummet.

The GMC said he acted in a way that was dishonest, misleading and irresponsible while carrying out research into a possible link between the measles, mumps and rubella (MMR) vaccine, bowel disease and autism.

He had "abused his position of trust" and "brought the medical profession into disrepute" in studies he carried out on children.

The GMC said there had been "multiple separate instances of serious professional misconduct".

One of Wakefield's colleagues at the time at the Royal Free hospital in London, John Walker-Smith, 73 and now retired, was found guilty of serious professional misconduct and struck off. Another, Simon Murch, was found not guilty. Wakefield had already been discredited after a series of research projects failed to find any link between the triple MMR vaccine and autism, although a number of families continue to support him, even claiming to have been victimised for working with him.

He said today in an interview with BBC Radio 4's Today programme before the verdict that he and colleagues had listened and responded to "concerns of parents about their very sick children" and had acted "appropriately in the children's best interests to determine what the nature of their problem was".

Months after his research was published, the government withdrew single vaccines for measles, mumps and rubella, which parents could have opted for instead of the triple jab.

"When I made the recommendation to single vaccines they were available in the UK," he said from New York. "It is the government that is to blame for the resurgence of measles."

Wakefield said he had never opposed vaccination or claimed to have proof that MMR was linked to autism.

"I never made the claim at the time, nor do I still make the claim that MMR is a cause of autism," he said.

"You are conflating the two things. You are conflating the link with autism with the overall review of the vaccine."

In a statement after the verdict, he claimed that efforts to "discredit and silence me through the GMC process" had provided a screen to shield the government from exposure over the the MMR vaccine "scandal".

Wakefield had been found guilty in January of acting dishonestly and irresponsibly for carrying out unnecessarily invasive tests on children. He was said to have abused his position of trust, although his dishonesty had not led to personal financial gain.

He and the other doctors published a paper in the Lancet medical journal in February 1998 suggesting the measles virus might be linked to inflammatory bowel disease and play a role in autism.

The paper, based on just eight case studies, conceded that no definite link had been found but Wakefield, at a press conference, said he believed that instead of the triple MMR, children should be given doses in single jabs, preferably a year apart.

The GMC panel in January found Wakefield had conducted the trial unethically, including subjecting 11 children to invasive tests, such as lumbar punctures and colonoscopies they did not need, and without proper approval.

In February 1998, the same month the Lancet paper was published, he applied for ethical permission to run a trial of a new potential measles vaccine and set up a company called Immunospecifics Biotechnologies which would produce and sell it. The father of one of the children he had seen with developmental problems and bowel disease would be the managing director.

Wakefield tried the new vaccine on the child without mentioning it in medical notes or telling the child's GP. He was also found to have unethically arranged for his son's friends to have blood samples taken from them during his birthday party – for which he paid them £5 each.

The GMC panel chairman, Surendra Kumar, said: "In causing blood samples to be taken from children at a birthday party, he callously disregarded the pain and distress young children might suffer and behaved in a way which brought the profession into disrepute."

Wakefield hit on his theory after seeing children with bowel disease who had developmental problems. The third step in the hypothesis was the timing of the MMR vaccine: the first shot is given at around 13 months, about the age when autistic spectrum disorders start to be noticed.

In February, the 53-year-old left his role at a Texan clinic, The Thoughtful House Centre for Children, which he founded to study developmental disorders.

Kumar said Murch's involvement was more limited than that of Wakefield and Walker-Smith. He should have ensured there was appropriate ethical approval for research on the children, but ended the lumbar punctures after being unable to draw any clear inference that the children were suffering from a serious neurological disorder.

"The panel concluded Prof Murch acted in good faith, albeit it has found he was in error," said Kumar. "His actions, although comparable to professional misconduct in respect of undertaking procedures which were not clinically indicated, were mitigated by the fact he was under a false impression that they were clinically indicated."

Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said: "Measles, mumps and rubella vaccines have all been shown to be safe and UK families are fortunate to have free access to these which is not true of many parts of the world. The false suggestion of a link between autism and the MMR vaccine has done untold damage to the UK vaccination programme."

The Department of Health said: "The safety of MMR has been endorsed through numerous studies in many countries.

"Thankfully, more parents are having their children vaccinated with MMR and they see it as being as safe as other childhood vaccines."

Isabella Thomas, 53, from Somerset, insisted that her two sons Michael, 18, and Terry, 16, received "fantastic" treatment at the Royal Free hospital under Wakefield.

"They were normal, then they started to deteriorate neurologically and medically. They were in the most horrendous pain you could think of. I went from doctor to doctor trying to find out what was wrong. I was only too pleased to be part of the study because we needed to find out what was wrong with the boys."

Thomas said that, as controversy erupted surrounding the research, the family was blacklisted.

"When I went to my doctor he said: 'I don't want politics being brought into this surgery'. I said: 'My son is ill, it's not about politics.'"

Allison Edwards, chairwoman of the campaign group Cry Shame which supported Wakefield, said: "This is to issue a warning to doctors not to dissent. No children were harmed in the clinical tests, they were trying to look at the problems and treat them, and the children improved. How do you get charged with doing your job?"

Two Men and some Tweets

Two men in a meeting. Having a discussion. One has his Blueberry in hand and takes it up from time to use it. The other notices but presumes his actions are ok. It later traspires that the account of the meeting as deduced by the first man is actually being braodcast on Twitter.

These two men are in the news at the moment. The man with the Blackberry is Derek Simpson leader of UNITE union who are in dispute with BA (The world's favourite airline). The other is Willie Walsh, CEO of the airline.


"I was shocked and angry when I found out that Derek was doing that. Sending out his version of events to the wider audience, that really did undermine my confidence in his desire to resolve this situation. It is a really serious issue," Walsh said.



Simpson reported, "I am not afraid of saying what is really going on .....".



How clear cut are the ethics?

Was there full and informed consent to tweet? Well clearly not, or else Mr Walsh would not have been so annoyed. But is that unethical? Have BA dealt ethically with their employees? Do the employees have a right to know what top management are communicating to their union leader. On the other hand, should information be released during the course of negotiations as opposed to at the end? This is a fine example of how ethics can be unclear unless the full information and knowledge is to hand. And the entire process of negotiation does involve withholding of information / knowledge as a bargaining tool. Other aspects to consider ethically are ....

Was any harm done to participants at the meeting?
Was any harm done to parties outside the meeting?
Shareholders?
Workers?

Idenities, multimodality and knowledge

Identities was a recurrent theme at the one day conference on the Ph.D in the multimodal age yesterday in the British Library yesterday. Katherine Hayles' work on the posthuman condition was alluded to by Lesley Gourlay.

This is expressed as the cognosphere which hosts a dispersed sense of self (Hayles 1999) and where distributed identities co-exist. Another theme explored was the continuing existence of the artefact of the Ph.D as a collation of linear text following a conventional format. The evolution of the modal approach is starkly illustrated when two BBC sites are compared. Gunter Kress Professor of Semiotics at the Institute of Education showed how modal the BBC children's site is compared to the more linear structure of the main site.

The discussion suggested that change is in the air with professional practice at doctoral level deserving of consideration of acceptance of alternative formats as a key notion. Resistance will be challenging in that examiners in following a rigorous convention, submitted their Ph.Ds in that format. Ergo, so should everyone else. The social shift from citizen to consumer could, however, counter academic intransigence. Individual self interest is stronger now and this development is in parallel with the deep social changes where pillars in other spheres have been weakened if not yet quite crumbled as has happened in the Church and Parliament. Surely this affront on the academy's pillars will be afforded new weight from the Tory / Liberal alliance. A new format Ph.D would see the individual telling the academy "I can choose" in a world where user generated content as facilitated by Web 2.0 technology is the norm. Is the brave new world on its way? Academics are able to accommodate the change, but are they willing?

Forging identity and learning in Professional Practice

Knowledge acquisition and learning have shifted from the explorations in Artificial Intelligence and neural networks to how technology has adapted to living in the world, asking who we are, how we learn and construct knowledge. Etienne Wenger (he who coined the phrase – Communities of Practice with Lave) had some big questions to ask at the Mediating Boundaries conference organsied by Jisc Advance on 12th May in London. His big question is how technology interacts in the social world. As a snail on garden path leaves a silver trail indicating his presence so our meanderings in the digital habitat reveals something of our identity. The issue of our identity or multiple identities in reconfiguring the landscape we inhabit is another idea which preoccupies him. There are four facets to our occupation of the digital habitat:

Fabric of connectivity which encapsulates our virtual presence
Modes of engagement which mirrors self expression
Active Medium indicates social/informational computing
Redefined geography opens the possibilities of multi-membership

We place ourselves at the centre of the digital landscape and we manage these connections with a multiplicity of thick (closer) and thin (less close) relationships. Wenger posed the question of social learning spaces. Where do we come to know both a practice and identity? Is it on a technologically facilitated network or at a real workshop? Where is there a genuine social learning space?

Accountability and responsibility are two certainties for individuals in organizations. And Wenger identifies two discourses which are at odds here. The vertical line which reflects grade and scale and is expressed in Policy. The horizontal line embraces tacit peer contact and is not always positive.

The implications of this for professional practice are profound. From an identity perspective we have to consider the various relationships we have and how where we visit impacts on and shapes our identity. Presumed in this identity is what we know and how we learned what we know. In promoting a learning citizenship Wenger advocates moving from curriculum oriented view to an identity oriented view. This means shifting our practice from what we are going to teach to managing who we are. Becoming good at something is preferable to not succeeding and the production of portfolios and establishing areas of excellence is central to placing individuals at the centre of a learning landscape as opposed to standing alongside it. The digital habitat is a series of nodes and network links and as connected professionals we have to both locate ourselves on the landscape and forge an identity.

Submission Guidance

The following should all be submitted as your whole assignment. This is taken from the Guidance Notes for the Module which you were sent back in February. The suggested word counts are included. Make sure that your assignment is professionally presented with a clear and helpful layout / structure e.g. Title Page & Table of Contents

SECTION 1

Learning Diary (Blog entries 5 x 200 words) 1000 words
Critical Commentary on learning in this module (Blog) 500 words

SECTION 2

Glossary

Influences on Worker / Researcher

Critique of Research Tool (e.g. Questionnaire)

SECTION 3

3 Project Proposal 2500 words
3 Ethical Issues relating to Project Proposal 500 words
3 Ethics Release Form Form completed by you

SECTION 4

4 Proposal & Rationale for your Award Title 500 words
4 Learning Agreement Cover Sheet Form completed and countersigned (Ignore Parts 1,2,3,4)

Separately Module Feedback Questionnaire (send to Avni) Form to complete