Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Child Care Health Dev. 2020 Jul;46(4):522-529. doi: 10.1111/cch.12766. Epub 2020 Mar 24.
Many children start school with additional health and developmental needs (AHDN), yet how best to support these children for optimal outcomes in the school setting is a complex challenge. This study aims to determine the views of education experts on what differentiates the most effective primary schools.
Qualitative interviews were conducted with nine senior leaders across the education system responsible for managing or improving practice across a range of schools or school regions in Victoria. Using a positive deviance approach, which investigates strategies already implemented in organizations achieving desired outcomes, the semi-structured interviews aimed to elicit instances of perceived good practice that already exists within the school system. Interviews were analysed using inductive content analysis.
All education experts reported high variability across schools and suggested a number of factors differentiating those that were most effective at supporting children with AHDN. They included the presence of strong teacher support by the school leadership team; explicit and documented processes to guide the practice of teachers and ensure consistency at a whole school level; inclusive relationships and environments; participation and knowledge sharing between medical, allied health and other stakeholders in the care team; and an evidenced-based approach to allocating resources to programmes and strategies.
This exploration of instances of good practice can generate novel insights into a complex problem. Current findings suggest a number of potential opportunities for enhancing practice that can be tested in future research. Improving outcomes for this vulnerable and significant group of children will require collaboration across health and education.
许多孩子在开始上学时都有额外的健康和发育需求（AHDN），但如何最好地支持这些孩子在学校环境中取得最佳效果是一个复杂的挑战。本研究旨在确定教育专家对区分最有效小学的看法。
对维多利亚州教育系统中的 9 名高级领导进行了定性访谈，这些领导负责管理或改进一系列学校或学校区域的实践。采用积极偏差方法，该方法调查已经在组织中实施的策略，以实现预期结果，半结构化访谈旨在引出学校系统中已经存在的良好实践实例。使用归纳内容分析对访谈进行分析。
所有教育专家都报告说学校之间存在很大的差异，并提出了一些区分那些在支持有 AHDN 的儿童方面最有效的学校的因素。其中包括学校领导团队对教师的大力支持；明确和记录的指导教师实践并确保全校一致性的流程；包容性的关系和环境；医疗、联合健康和其他利益相关者在护理团队中的参与和知识共享；以及基于证据的方法来为方案和策略分配资源。
对良好实践实例的探索可以为复杂问题提供新的见解。目前的研究结果表明，有许多潜在的机会可以提高实践水平，可以在未来的研究中进行测试。要改善这一弱势群体儿童的成果，需要在卫生和教育部门之间开展合作。
