1. Teachers as health promoters: A longitudinal study of the impact of pre- service teacher training in health education Dr Jenny Byrne, Dr Karen Pickett, Willeke Rietdijk, Dr Jonathan Shepherd, Prof Paul Roderick, Prof Marcus Grace University of Southampton, UK Health Wellness & Society Conference Madrid, 3 rd - 4 th September 2015 This research was funded by the Leverhulme Trust

2. Context of Health Education in England Science teachers deliver specific aspects of health including sex education, drug and alcohol education National curriculum changes put a strong focus on high quality subject teaching with much less emphasis on broader aspects of pupil health and wellbeing (DfE, 2010) All teachers have a wider pastoral care role (including health and wellbeing) for pupils - PSHE PSHE remains a non-statutory requirement despite recommendations to the contrary (Formby, 2011; DfE, 2013) Delivery of PSHE at schools’ own discretion and results in high variability of health education between schools Therefore Pre-service teacher education programmes are hesitant to include health education within their curricula and health training provided during school placements is variable

3. Background and context Teachers (especially science teachers) play a key role in promoting children and young people’s health and wellbeing (Tang et al., 2010; WHO, 1993) Therefore training in health as part of pre-service teacher education is important But ◦ training is variable in England (Dewhirst et al., 2014) ◦ little is known about the impact of such training on teachers’ knowledge, skills, confidence and attitudes towards promoting health in school, especially the long- term (Shepherd et al., 2013)

4. The Southampton Health Education Training Model Developed by a multidisciplinary team of experts at Southampton Education School and the Faculty of Medicine at the University of Southampton and external agencies Aims to: ◦ address a gap identified in the pre-service teacher training programme ◦ raise awareness of the importance of PSHE/health and wellbeing education ◦ increase knowledge, skills and confidence to teach PSHE/health and wellbeing education Delivered annually to all postgraduate pre-service teachers since 2009-2010 (Speller et al., 2010; Byrne et al., 2012, Dewhirst, Byrne & Speller, 2014) Based on a philosophy of critical reflection and a socio- constructive view of the learning process

5. Elements of the programme Annual Health Day taking place early in the programme: ◦ lectures ◦ range of interactive workshops (some choice to meet individual needs) ◦ interactive exhibition (wide range of organisations) Compulsory follow-up school-based tasks Reflections on own learning Non-compulsory completion of a health portfolio to be considered for the PSHE Association’s Chartered Teacher Certificate

6. Project aims To explore the impact of the innovative training at Southampton on the knowledge, skills, confidence and attitudes of pre-service (PSTs), newly qualified (NQTs) and early career (ECTs) teachers to engage in teaching and promoting health and well-being in schools To explore the facilitators and barriers that influence the promotion of health and well-being during training and early career development

7. Methodology Initial questionnaire distributed online + follow-up hardcopy to: ◦ Trainee teachers at the end of their pre-service course (2013-14 cohort) ◦ Newly qualified teachers (2012-13 cohort) in their first year post qualifying ◦ Newly qualified teachers (2011-12 cohort) in their second year post qualifying Interviews with pre-service teachers Second questionnaire distributed 12 months later to establish a possible long-term effect Interviews with newly qualified teachers (all three cohorts) to explore the questionnaire findings further

8. Project Schedule PST End of course Intake year 2013-14 (Cohort a) NQT 1 st year teaching Intake year 2012-13 (Cohort b) ECT 2 nd year teaching Intake year 2011-12 (Cohort c) ECT 3 rd year teaching Survey: April 2014 Interviews: May – July 2014 Phase 1 (online Questionnaire to all cohorts + interviews of pre-service teachers only Cohort a ) Pre-service (Cohort a) NQT (Cohort b) ECT (Cohort c) December - March 2014 Phase 2 (online questionnaire) NQT (Cohort a) ECT (Cohort b) ECT (Cohort c) March -July 2015Phase 3 ( interviews) NQT (Cohort a) ECT (Cohort b) ECT (Cohort c)

9. Questionnaire items Perceived usefulness of various aspects of the pre-service health education programme, generally and in helping to gain confidence to teach health education and deal with pupils’ health and wellbeing issues Perceived impact of the pre-service health education programme on knowledge and skill in teaching various health education topics and dealing with a range of pupils’ health and wellbeing issues Skill/knowledge/confidence had increased, decreased or remained the same since starting training (for pre-service teachers) or since qualifying (for qualified teachers) Attitudes towards promoting health and wellbeing Perceived barriers and facilitators in teaching PSHE education or managing pupils’ health and well-being.

10. Respondent demographics and cohort characteristics Gender of respondents MaleFemale Total Count47112159 %29.6%70.4%100.0% Number of teachers per respondent cohort During which year did you complete your teacher training course at Southampton? Primary or Secondary course Total PrimarySecondary 2013-2014 (I'm a trainee teacher)664210865.8% 2012-2013 (I am a NQT and have been qualified for less than 12 months) 162036 34.2% 2011-2012 (I have completed my NQT and am in my 2nd year post- training) 71320 Total89 (54%) 75 (46%) 164100% CohortNo. questionnaires sent No. questionnaires returned Response rate PSTs33410832% NQTs3343611% ECTs346206% TOTAL101416416%

12. Differences between PSTs and ISTs

18. Changes in level of skills, knowledge and confidence in teaching, and dealing with, health and wellbeing issues since starting the course or qualifying

19. Facilitators and barriers to teaching and managing pupils’ health and wellbeing

20. Facilitators ‘other’ to teaching PSHE or managing pupils’ health and wellbeing Personal life experience, lifestyle and self-directed research (NQTSEC) Previous experience as parent, and working in a school as cover supervisor for 10 years (PSTSEC) Subject Specialism (PSTSEC) Previous experience of dealing with similar issues (NQTGTS)

21. Attitudes towards promoting pupil health and wellbeing (whole cohort)

22. Phase 1 selected emerging interview themes Themes Value/purpose of PSHE Relevance Competing priorities Boundaries Need for practical experience and strategies

23. Value of PSHE Seen as important Training helped raise awareness of importance Kids need to know about these things PSHE delivery in school needs to change – not currently achieving much “at my second placement […] they did have a talk about sex education[…] a one-off talk from a nurse […] one of the nurses asked […]: where are the ovaries? And one of the boys said: They are in the legs. And this is coming from a seventeen-year- old […]. So at what point was he going to learn if he hadn’t had this education from this nurse.” “if it [PSHE] is going to carry on the way that it is [in schools], then there is no importance to it because they’re not achieving very much. But if it’s going to be done properly then yeah, it is hugely important.”

24. Competing priorities PSHE not always a priority in placement schools PSHE sometimes treated as less important than other issues in school “the tutor group I followed at [*name] was a bit more kind of … you were supposed to do a certain topic from […inaudible] the SEAL, PSHE thing. Um, and you’re supposed to do one every week and they were a bit blasé about it frankly. The tutor groups were supposed to [do] the same one every week, but it always wasn’t happening, or something else would get in the way, like let’s do their options for the Year 9 group”

25. Relevance Perceived relevance of training to teachers’ practice in school Perceived relevance of training to individual needs – training needed depends on individuals’ characteristics and personal and professional background “And so I remember talking about this, er, talking to these people about young carers [at Health Day exhibition], because I have a few young carers within my er, classes, and er, it was really interesting to talk about them and to discuss with one young carer that was there” “[for portfolio] you had to have a discussion with the PSHE lady at the school […] the school organised that for us, for half an hour chat, just telling us how they taught it and stuff. But [sigh], I guess it gives you hindsight into how a school runs with their PSHE – it’s different in every school, so it’s, you know, it’s great if you’re going end up teaching in that school, but actually I’m not”

26. Boundaries Having to be careful what you say to pupils when teaching PSHE or dealing with health and well-being issues Not knowing where the boundaries lie More training needed about where the boundaries lie “SRE, because we’re a faith school it’s, it’s very tricky, so we don’t really talk about it, much. And when we do we have to be very careful, and um, and I know some parents don’t want their, er, their children to be, to take part er, in PSHE lessons because of that.” “If I was to teach it I would like to go into some more training. I don’t … I haven’t… I am perfectly confident, but things like what to say when, how to deal with a certain situation, I’d like a little more training with that.” “Through my experience that I’ve had so far I feel more confident. But in terms of, I would act this way, or would react this way to this situation, I don’t know. I still feel like there are boundaries that I don’t quite know how to cross. Does that make sense?”

27. Need for practical experience and strategies Need more training in pedagogy of PSHE and practical strategies for teaching and dealing with health and well- being issues Good to have had practical experience on school placement More practical experience needed on course “I can see why some people feel nervous going into PSHE teaching if they hadn’t been given the techniques on how to teach it. So I don't think this course has addressed that; I don't think we’ve learnt any new techniques on how to deal with those kind of situations.” “I honestly, sort of, think the best way to learn how to teach PSHE is to teach it. And maybe that should become a more fundamental part of the course”

28. Conclusion Training appears to have a long term impact on ◦ Confidence ◦ Skills and knowledge ◦ Attitudes School environment and support are key facilitators in promoting health and wellbeing(training year and thereafter) Small sample therefore caution in interpretation of results

29. Thank you

30. Contacts J.Byrne@soton.ac.uk K.T.Pickett@soton.ac.uk W.Rietdijk@soton.ac.uk

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