Analysing Different Teaching Syllabus

Analysing Different Teaching Syllabus In the domain of language teaching, many teaching syllabuses have emerged which can be classified according to their goals. Examples are the grammatical or structural syllabus which focuses on teaching grammar; the lexical syllabus of which the goal is to teach students lexis and the orthography of the target language; the situational syllabus which is concerned with teaching language related to certain situations; the topic-based syllabus, which has as its goal the teaching of specific topics, for example, geographical topics such as global warming. There is also the skills-based syllabus which takes into account the four skills of language learning, namely, listening, speaking, reading and writing; the task-based syllabus, in which the task is the key to acquiring language and the integrated syllabus, which attempts to integrate all types of syllabus into one syllabus. This kind of syllabus is central to the Headway series of books. The focus of the teaching syllabuses in schools and colleges used to be on the grammar of the target language. Priority was given to structural categories, such as word class, and to mastering these categories. It was noted, however, that learners using the structural syllabus lacked the ability to communicate fluently in the target language, because they had little practice in expressing themselves communicatively, even though they had mastered the grammar. They were able only to memorise the structural categories and never engaged in communicating with others. This problem, therefore, could be solved only by producing a new syllabus which could meet learners needs and improve their communicative ability. As a result, a notional-functional syllabus emerged, with new goals and procedures. This paper examines the notional- functional syllabus. In the first part, a brief section seeks to define the word syllabus, followed by a section about the general meaning of a notional-functional syllabus. The second part considers the approach taken in this kind of syllabus and discusses it. The third part focuses on an important aspect in the notional-functional syllabus, namely, needs analysis. The fourth part highlights the strengths and weaknesses of this syllabus. The fifth part shows how the notional-functional syllabus has been influenced by theories of language and learning. The final part, attempts to describe the teaching situation best suited to this type of syllabus and some of its most important aspects. The Notional- functional syllabus: Before we embark on describing and discussing the notional-functional syllabus, we should provide a definition for the word syllabus. What is a syllabus? It is noteworthy that many writers such as, (Brumfit: 1984; Nunan: 1988; Richards: 2001) have sought to define this word. For example, a syllabus is defined as: a specification of the content of a course of instruction which lists what will be taught and tested (Richards: 2001:2). It is defined also by Nunan (1988:159) as: a specification of what is to be taught in language and the order in which it is to be taught. Furthermore, it can merely lay down what is to be taught, or attempt the harder task of organizing what is to be learnt (Brumfit: 1984). Accordingly, it is noted that they agree that a syllabus should be a specified by a plan which leads teaching aims. White (1988) agrees with Nunan (1988), in addition, that a syllabus may include such aspects as, structure, functions, topics, skills and situations. The choice of priority among these aspects will specify the type of syllabus. 1.2. What is a notional-functional syllabus? The first appearance of this type of syllabus was in the 1970s, when sociolinguists and language philosophers first tried to reflect the functional aspects of language in the teaching syllabuses (Nunan: 1988). It is worthy mentioning the the notional- functional syllabus is based on two important aspects, namely, a conceptual or notional aspect and a functional aspect. The first, takes into consideration concepts such as, cause and effect, time, movement and space. The second describes and classifies the intentions behind language use. In fact, neither of these aspects was new for language teaching. They always been of much concern in the language teaching field, yet what was new was the adoption of notional-functional categories as principles in syllabus organisation. As a result, the great stress on grammatical considerations was relaxed, because the communicative categories were taken into account (White, 1988). It is, however, worth mentioning that the Threshold syllabus (Van Ek: 1975) and the Waystage syllabus (Van Ek and Alexander: 1977) are prototypes of notional-functional syllabuses prepared by the Council of Europe. The content of these syllabuses includes notions such as those mentioned above and functions such as are found at the Threshold level ( Ek and Trim: 1990), ( see, Appendix:1). D.A.Wilkins (1976) was the keenest advocate of the notional- functional syllabus. He notes that this type of syllabus should encompass three categories of meaning: first, semantico- grammatical meaning , in which grammatical form is taught by semantics, such as, time, which consists of point of time, duration and relations; second, modal meaning, in which there is a concern with the nature of the speakers attitudes, such as, the scale of certainty, including: conjecture, doubt, conviction and disbelief; and third, the communicative function, in which speakers are expected to provide communicate infor mation, such as, requests and complaints (Wilkins: 1976). The approach applied in the Notional- functional syllabus: It is important to note that there is a contention among such writers in the language teaching domain as, (Wilkins: 1976; Nunan: 1988; Richards: 2001). This contention is about whether the approach taken in a notional- functional syllabus is analytic or synthetic. In fact, Wilkins (1976) is the first writer who has paid attention to the difference between synthetic and analytic approaches in teaching syllabuses (Nunan: 1988). The distinction lies in the fact that the strategy of language teaching in a synthetic approach relies on the process of acquiring language through a gradual accumulation of language parts. These different parts are taught separately until the complete linguistic structure is built up. In contrast, with the analytic approach linguistic control of the learning environment is not important, because language components are not viewed as building blocks. In other words, they are not gradually accumulated. Furthermore, the important forms of language are isolated fro m the contrasting context in which they probably occur. Therefore, the focus of learning is significant aspects of the language structure (Wilkins: 1976). Wilkins goes on to propose that a notional-functional syllabus maybe considered an example of the analytic approach to language teaching. This is because it entails no compulsory exposure to grammar, although we will probably be able to separate particular forms from their language environment in order to learn the grammatical system adequately (ibid, p 19). It emerges that (Nunan: 1988; Richards: 2001) disagree with Wilkinss view that the approach of a notional- functional syllabus is analytic; they consider it synthetic. The reason is that the functional-notional syllabus was an attempt to replace the structural syllabus, yet ultimately, it remained similar to the latter, because, the type of exercise and the content which learners need to master is altogether similar to those of the structural syllabus ,although, the units in the notional-functional syllabus have functional labels(Nunan: 1988). Moreover, it is noted that the notional -functional syllabuses continued to be the same as the structural syllabuses, because they failed to get rid of the need for linguistic control and gradually forms accumulated (Richards: 2001). It is, therefore, agreed with the views of Nunan and Richards, because functional-notional syllabuses are not different enough from structural syllabuses. For example, in structural syllabuses learners have to lear n the different verb tenses gradually. In notional- functional syllabuses, they have to create sentences according to the type of function in a sequence way. Hence, the approach tends to be synthetic rather than analytic. Needs analysis: This term refers to a set of procedures used to collect information about learners and their communications tasks which might help in syllabus design. The question why learners need to learn the target language is not solely the concern of needs analysis. Syllabus planners, however, will need information about such aspect as, the social expectations placed on learners and the possibility of resources to help implement the syllabus. Syllabus designers, therefore, use two different types of needs analysis. The first is learner analysis and the second, task analysis. Learner analysis is concerned with the learners purpose in learning the language and with many other questions through which a great deal of information can be amassed through, for example, data collection forms (Nunan,1988). In needs analysis a syllabus plan is derived from the specifications which syllabus planners or teachers derive from determining the sort of language required. This specifies the ends which the learner s desire (White: 1988). White seems to have considered a needs analysis similar to a blue print for a house build since, in order to drew up plan, an architect needs to look at another house to collect information about the design. The architect, therefore, is similar to a syllabus planner or teacher (ibid, p83). Wilkins, on the other hand, drew attention in notional-functional syllabuses to the learners needs. He proposed that the categories to apply in syllabus should be relevant to the particular population of learners (Wilkins: 1981:84). Consequently, notional-functional syllabuses are based on the learners needs, which are known through needs analysis, for example, from interviews asking learners what they require to learn (see, Appendix: 2). Strengths and weaknesses of the notional-functional syllabus: One of the positive aspects which characterises the notional-functional syllabus is the focus on communicative factors as a starting point in a syllabus plan. For example, in this syllabus, there is a concern for the linguistic elements which learners need in order to communicate. Furthermore, the grammatical and situational factors, on the one hand, are not neglected in this syllabus, because communicative competence will be produced and learners will be motivated by the use of language. On the other hand, all types of language functions could be covered in functional notional syllabuses not solely the typical language functions that might emerge in certain situations (Wilkins, 1976). It is worth clarifying the difference here between grammatical competence and communicative competence. According to Richards (2006), grammatical competence involves a concentration on the sentence as a unit of analysis and the ability of language learners to analyse the form of the sentence in order to create their own sentences in the target language. Communicative competence, however, means a state in which learners can use the language in meaningful communication. Another positive aspect of a notional-functional syllabus according to Widdowson, is the improvement which it represented over grammatical syllabuses, because this syllabus allows an authentic and communicative use of language in the context in which the forms are presented (Widdowson: 1978). However, Finocchiaro and Brumfit (1983) praise the syllabus for giving the communicative purposes of students highest priority. Moreover, adopting a functional-notional syllabus in the language teaching domain provides distinct benefits: First, no compulsory exposure to language grammar; second, the provision of concrete learning tasks; third, the chance for teachers to be guided by some principles of psycholinguistics, sociolinguistics and educational theory; fourth, the insistence on the need for language learners to have a real purpose in speaking. Fifth, the widespread progress of target language courses is provided by this kind of syllabus. Sixth, modular and flexible courses could be improved by this syllabus. Moreover, listening and reading activities which are also called receptive activities are provided in this. Furthermore, the communicative abilities of learners will be motivating due to the basic communicative functions which existing in this syllabus (ibid, p36). Hence, we could see that notional-functional syllabus takes into account the importance of communicative activities in language teaching. As Littlewood (1981) indicates, the purposes of communicative activities are, first, to give whole-task practice, whereby students in the target language classroom get practice in completing a whole task with its varied communicative activities. Second, they improve motivation, in that the important target for is to communicate with others; consequently if they recognise that their classroom can serve this target their motivation to learn seems to give them close attention. Moreover, they can create a context which supports learning, because communicative activities encourage positive relationships between learners and their teacher. As a result, these relationships contribute to a propitious learning environment. But, despite its positive aspects, this type of syllabus still has some limitations. One of these limitations is the difficulties which syllabus designers have with respect to grading and selection, because a notional-functional syllabus has much concern for communicative factors. To illustrate, grading is the process of arranging the content of a syllabus from easy to difficult (Nunan, 1988). The items, which should be included in this syllabus, are not chosen on linguistic basis only, but also on the communicative purposes with which learners embark on a course (ibid, p37). Furthermore, because in a functional framework syllabus planners have no empirical evidence to build their selection of exponents and structures, it is thought that their selection is based merely on intuition (White, 1988). In an attempt, however, to solve the problem of grading and selection in the notional-functional syllabus, hybrid syllabuses emerged. These syllabuses combine the structural and notional cat egories in one syllabus, yet even these models of syllabuses have proved problematic, because, as White indicates, there have not been enough evaluate them (ibid, p82). Another shortcoming, with this type of syllabus is that there is no compatibility between function and form, because, in order to decide which function is being explained, we need to know about the context. For instance, in the following sentences: We are thinking of going to see the new Woody Allan film tonight. How about going to see the new Woody Allan film tonight. (White, 1988:76). In these examples, there is confusion whether they should be seen as forms of invitation or function ways of making a suggestion (ibid, 77). Moreover, Widdowson in his critique the notional-functional syllabus notes that the methodology of dress rehearsal results in the activities which aim to produce authentic communication in the classroom. This methodology may enable learners only to convey the items learned in the situations which they can rehearse, but not in new situations (Widdowson: 1987). The notional-functional syllabus also lacks a rigorous use of needs analysis. According to Richards (2001), the term needs is not identified clearly because needs may identified on the basis of intuition and the interests of the syllabus planners. Therefore, the criteria for this term in the syllabus are not clear-cut. Hence, from the limitations of notional-functional syllabus discussed above, it could be seen, that such a syllabus tends to be product- based syllabus, which focusing on what language is learnt rather than process-based syllabus which focuses on how language is learnt. The consequence is that the list of items which a notional-functional syllabus offers is presented to be learnt, yet how they will be learnt is not specified. The influence of language theories and learning on the notional-functional syllabus: Theoretical views of language teaching varied in their ideas. Fore example, there is the structural view in which language is considered a structural system connected with elements for the coding of meaning. This view is considered traditional in language teaching. The functional view, therefore, came as a reaction to it, on the one hand, and an attempt to improve it, on the other hand. Language in the functional view is considered a means of conveying functional meaning (Richards and Rodgers: 1986). Nunan (1988), however, draws attention to the way in which the communicative view was integrated by syllabus designers in the 1970s and at that time attracted a great deal of concern. This view, which is allied to the functional view, asserts that the communicative and semantic dimensions of language are as important as the grammatical characteristics of language. Thus, the content of language teaching is specified and organized by its communicative and semantic dimensions through meanin g and function categories instead of, structure and grammar elements (Richards and Rodgers, 1986). As a result, the notional syllabuses adopted by Wilkins in 1976 came as an attempt to apply this view of language in teaching syllabuses. Hence, the notional syllabuses comprised not solely grammar elements and lexis, yet also specification of the notions, topic and concepts which learners require in communication (ibid, p17). It is noted, moreover, that the functional view tends to be with views such as Hallidays view (1970) which believes that: linguistics à ¢Ã¢â€š ¬Ã‚ ¦ is concerned with the description of speech acts or texts, since only through the study of language in use are all the functions of language and therefore, all components of meaning, brought into focus ( Halliday:1970:145). Hence, it seems clear that the notional-functional syllabus is heavily influenced by functional and communicative views of language. It is important to note, however, that the notional-functional syllabuses are influenced not only by theories of language, yet also theories of learning. Because, as Richards and Rodgers (1986) observe, the models of structural, functional and interactional approaches in language teaching are considered incomplete in themselves, because they provide only theoretical frameworks for teaching language. Thus, they need educational theories of language learning in order to be complete. According to Richards and Rodgers, there are two types of learning theories, namely, process-oriented theories and condition-oriented theories. The first, is built on the processes of learning namely, habit formation, induction, inferencing, hypothesis testing and generalization (ibid, p18). The second concentrates on language learning from the perspective of human nature and the physical context. Therefore, it is should be noted that communicative meaning comes under the umbrella of condition-oriented theo ries, because, learners need to learn how they can transfer their communicative meaning through language. They could do it through a notional approach to language teaching, because the basis of this approach comes from the belief that what learners need in the domain of language is significantly more important than language mastery as unapplied system (Wilkins, 1976). As a result, it could be seen that a notional-functional syllabus relies heavily on the functional view of language and condition-oriented theories of learning. As Wilkins (1981) emphasizes, what links the notional approach with the communicative language teaching movement is the knowledge of language learning in which the communicative purposes have a great deal of concern. The teaching situation best suited to the notional-functional syllabus: Since, the focus of a notional-functional syllabus is on the development of communicative competence such as language learners need for communication in the target language, Furthermore, this kind of syllabus provides for the teaching of every day language in the world beyond the classroom. It could, therefore, be argued that the notional-functional syllabus is suitable for English for Specific Purpose (ESP) or short English courses. Such as, courses in Business English taught in an oil company. Courses of this kind would be suitable for those who want to visit an English speaking country for a business trip or holiday, where they will need to interact in different situations. This syllabus benefits those who want basic communicative functions, for instance, greeting, asking for directions, or expressing feelings. As Wilkins (1976:71) indicates, actual language courses à ¢Ã¢â€š ¬Ã‚ ¦ regarded by some learners as complete in themselves but by others à ¢Ã¢â€š ¬Ã‚ ¦ a basis for further learning. I would argue that a notional syllabus is à ¢Ã¢â€š ¬Ã‚ ¦can meet defined communication needs while at the same time it is constructing a more widely based linguistic competence. It is, however, important to note that there are some aspects which should be taken into account in the teaching situation suited to the notional-functional syllabus, including the following: 6.1. Language level: Linguistic proficiency among language learners is classified into levels, such as, beginner, elementary, pre intermediate, intermediate, upper intermediate and advanced. It could be, therefore, argued that notional-functional syllabus seems to be suitable for intermediate or advanced learners rather than beginners. The reason is that learners in the early stages attempt to concentrate on vocabulary learning before learning how to express themselves communicatively through functional meanings. Accordingly, it is thought that this syllabus seems to be un suitable for beginners, because intermediate or advanced learners already possess the core vocabulary, however, their focus will be on producing sentences communicatively. Thus, it seems more appropriate for them. 6.2. Class size: It could be argued that since a functional-notional syllabus focuses on learners needs, as Wilkins(1976) indicates, in his notional syllabuses that the categories which need to be applied in this kind of syllabus should be individual to a particular group of learners. It is thought, therefore, that large classes which are composed of dissimilar learners are not suitable for the functional-notional syllabus. This type of syllabus needs a specific group of learners, for instance, when it comes to English for Specific Purpose (ESP) courses. In them are particular groups, such as, Business English learners, engineering English learners or medical English learners. These groups of learners will be suitable for this kind of syllabus. 6.3. Assessment: Since, the goal of a notional-functional syllabus is to improve the communicative language ability of learners, in other words, their ability to use language in their communications. There seems, therefore, to be no need for formal assessment. The reason is that the assessment will focus on the way in which learners can achieve this ability through expressing concepts such as, possibility or affirmation. For instance, in the case of business English courses, the assessment is based on the learners performance in communicative language with customers; that is, how well they can communicate with their customers for instance, in making requests or offering business. Conclusion: Syllabuses in the language teaching domain have varied in their goals and procedures. The traditional ones are structural or grammatical, with a focus on finding ways of learning the grammar of the target language. But this syllabus neglects ways of acquiring competence in communicative language. Hence, as can be seen in the above, the notional-functional syllabus emerged as a way for learners to improve their communicative abilities which would be motivated through its basic communicative functions. It all depends on what we use language to do. Furthermore, we can conclude that the notional-functional syllabus is based on the learners needs, which are discovered through a needs analysis strategy. This syllabus has two main aspects: functions which deal with such the communicative abilities as, requesting, grading, arguing and expressing feelings and notions related, for example, to space, location, time and quantity. It is noted, however, that the main in designing this kind of syll abus comprise: first, the situations in which learners will use the target language, broken down into the place, the time and people who engaged in these situations; second, the topics which are found in every day communication, such as, asking for directions, offering help or shopping. Admittedly, the notional-functional syllabus possesses negative as well as positive aspects. Some of the positive aspects are its focus on communicative factors as a starting point and in its high motivating power, because it enables learners to express their ideas and feelings more easily. Moreover, all types of function could be covered in functional- notional syllabuses, not solely the typical language functions which might emerge in certain situations. It is noted, however, that some of the negative aspects which are highlighted in the present paper are the difficulties in selecting and grading, the functions and forms and there lack of compatibility between function and form, because, in order t o decide which function is being explained, we need to know about the context. Furthermore, needs analysis strategy is not identified clearly, because the identification of learns needs only on the basis of intuition on the part of syllabus planners. We could see, however, that the notional-functional syllabus has been influenced heavily by functional and communicative views of language and condition-oriented theories of learning. Finally, we can conclude that, although this kind of syllabus has some limitations, it is widely used in many countries, because it is effective for learners with special purposes, such as, learners of ESP ( English for specific purposes).

Somewhere to call home :: essays research papers fc

Somewhere to call home The Middle of Somewhere stresses the important facts of racism and equal rights among human beings. This interesting and compelling story is about an African family who fought the government for what they believed was right. In the times of segregation, the white people pushed around the blacks. It was the few blacks that chose to stand up for themselves and fight back for what they believed in. â€Å"The middle of somewhere†. If spoken aloud, it makes you think. This must be a place where you call home. Somewhere where you feel safe and where everything around you is comfortable. In the novel, Rebecca and her family always talk about Pofadderkloof. Pofadderkloof is the place where the whites want to move all the black people of the village in order to replace the area with a white suburb. They tell the black people that in Pofadderkloof the houses will be larger and will have a running tap. Also, they will have two bedrooms and a stove. Rebecca’s family was the only family to know that they were telling all lies just to get them to move. When Rebecca’s best friend, Noni and her family move to Pofadderkloof, she is hurt to the point of crying everyday. When a member of Noni’s family actually notices that everything that was told to them were all lies, she goes back to the village on foot for about two days to tell everyone. She refers to Pofadderkloof as â€Å"the middle of nowhere†, because of the one-bedroom houses and miles of dry plain with no markets or available jobs. Pretty soon, the whole village comes together and forms a c ommittee to help each other for what is right. They don’t want to go to the middle of nowhere. There want to stay home in the village, in the middle of somewhere. In the middle of somewhere is home; that’s where everything feels right. The village was the home to many, but it was a key part in Rebecca’s family’s life. To Rebecca, home was everything to her. She loved going home after school to play hopscotch, or jumping rope in front of her house with her friends near the beautiful jacaranda tree. When she heard that bulldozers were coming to tear her house down, she was terrified. She couldn’t sleep at night. It was all she could think about.

Life of Ludwig van Beethoven Essay -- Ludwig van Beethoven Composers M

Life of Ludwig van Beethoven Ludwig van Beethoven, also known as â€Å" The General of Musicians,† was born on December 16, 1770. However, this date is not exact because it is believed that Beethoven’s father lied about his son’s age in order to portray him as an infant prodigy. As a result, Beethoven is convinced he was born on December 16, 1772 at the Rheingasse home, which belonged to the Fischers, who were close friends of the family (Orga 8). Johann van and Maria Magdalena Beethoven bore five children of which three survived. Ludwig van Beethoven was the first child to survive, probably making him the most cherished especially in his father’s eyes. The other two surviving siblings were Casper and Nikolaus. They were said to have played extremely important roles in Beethoven’s life. Johann van said to be a lesser man than his father Ludwig Louis van Beethoven, who was a trained musician and later appointed Kapellmeister. Many believed he could not compare to his dad because he did not have a high-ranking job, instead his income was based on giving piano, singing, and violin lessons to the public (Kerman 354). Johann wanted his first son to be great, especially in the music field, so he pushed him to learn the piano and violin at a very early age. For instance, Beethoven had his first public appearance at the age of eight on March 26, 1778. He performed at a concert with one of his father’s other pupils. His performance consisted of concertos and trios on the keyboard. Beethoven continued to play at concerts, as well as taking music lessons with instructors other than his father. When visiting the Fischer Family one day Johann proclaimed, â€Å"My son Ludwig is my only comfort now in life. He is improving in his music to such an extent that he is admired by everyone. I foresee that in time he will be a great man in the world† (Orga 29). During this time he also attended elementary school in Bonn, but he did not exceed grade school. Beethoven learned all he could by age ten and from then on he lived off his wits and curiosity (Orga 28). In 1779, Beethoven met his first very important teacher at Bonn by the name of Christian Neefe. Neefe automatically saw Beethoven’s talent and had a strong liking to him from the beginning. Moreover, when he took a short leave of absence from Bonn, he appointed Beethoven, at only eleven years o... ... His funeral was held on the 29th of March and about 15,000 guests attended his burial. The surrounding schools were closed that day in respect of the composer. Also, out of respect the choir sang the Miserere in an arrangement from one of his Equali for trombones. Following the singing, about 200 horse carriages accompanied the coffin on its final journey (Orga 8). To conclude, Beethoven was know as â€Å"The General of Musicians,† â€Å"The Young Genius,† and the most admired composer in the history of western music. His musical ability, his passion, and his harsh losses all helped to contribute to his undying success as a great pianist and composer. Even today his works are still studied and listened to around the world. Works Cited Kerman, Joseph. The New Grove Dictionary of Music and Musicians. Ed. Stanley Sadie. 20 Vols. London: MacMillan Pub. Ltd., 1980. 2: 354-60. Grout, Donald Jay. A History of Western Music. 3rd ed. New York: Cornell UP, 1981. Marek, George R. Beethoven: Biography of a Genius. New York: Funk and Wagnall’s Publishing Company, 1969. Orga, Ates. Beethoven: The Illustrated Lives of the Great Composers. London: Omnibus Press, 1983.

Newborn Exam

The government initiatives to reduce junior doctors’ hours within the NHS Plan (DH 2000) have increased the call for midwives to expand their traditional role and take on some of the tasks that in the past have mainly been carried out by junior doctors (Kings Fund 2011). Having been working within the community setting as a midwife for the past three years I was interested in extending my role in order to provide more holistic care for my caseload of clients and their babies.Holistic care for mothers, babies and their families is highly recommended within the midwifery profession and is known to provide an improved experience for women (Changing Childbirth (DOH 1993a) NMC 2012, NICE 2006). The Newborn and Infant Physical Examination (NIPE) is one element of the UK National Screening programme and is offered to all parents for their baby within 72 hours of birth and then repeated again at 6 weeks of age, usually by their GP.This role is one of the tasks that has been highlighte d where midwives can expand their role (Marshall & Raynor 2010). The trust where I work has recently introduced community clinics where parents can take their baby in order to have the newborn examination performed, therefore allowing early discharge home from the unit enabling early family bonding. With this in mind I commenced the Newborn and Infant Physical Examination course.Screening has been used within the NHS for many decades and is a process that enables the health professional to highlight healthy members of the population that could potentially have a health related problem (UK National Screening Committee 2008). The NIPE is a head to toe examination that will enable a practitioner to detect in an apparently healthy baby any abnormality that can then be referred onto the appropriate professional for further investigation.This can then improve the newborns future health by providing early intervention and prevention of further complications (DOH 2009). It particularly focu ses on the eye, heart, hips and testes in the male infant. The importance of these particular areas is of great significance to the baby’s future health. An undetected congenital cataract may lead to the child being blind in that eye. A missed heart defect may not be diagnosed until the parents present with a very unwell or even dead infant.If developmental dysplasia of the hip is not treated early enough following birth it could lead to several episodes of major surgery or even disability in the future. Bilateral undescended testes can lead to problems with future fertility. There are many issues surrounding the NIPE that are argued about within the literature Green and Oddie (2008) question whether the NIPE provides the population with and improvement to overall health or if it just gives the parents reassurance that could in the future be proved wrong, due to the NIPE being a screening tool and not a diagnostic test.Within the content of this essay I will be critically ana lysing the NIPE and some issues around this topic focusing particularly on the examination of the hips. Since being a midwife, and a mother, I have always found this part of the examination most difficult to watch someone perform as it appears to be uncomfortable for the baby. Therefore on commencing the course I have been aware of the discomfort it appears to give the newborn and also the distress this could in turn cause for the parents.I will also be looking into the issues regarding which professional is best qualified to be performing the examination and also if there are any benefits or risks as to the place that it is undertaken. When I am performing the examination I will mainly be alone in the community setting either at a children’s centre or within the home environment, so therefore it is imperative that I am aware of any limitations this may present for the baby, parents or me.As previously mentioned there is a growing trend within many obstetric units for midwive s to carry out the NIPE examination. Within the trust that I am based midwifery led clinics are held on the post natal ward and also within the community for the sole purpose of performing the newborn examination. Bloomfield et al (2003) discussed where the examination should take place and found differing opinions. The benefits of being in hospital were noted to be that medical back up was available and it was more convenient for further immediate referral process.Community examinations were thought to be more likely to enable the parents to ask questions and mention concerns due to the relaxed environment. Following the Maternity Matters report (DOH 2007) advocating that women should have a greater choice for place of birth the home birth rate has increased and is continuing to do so. It is therefore ideal for community based NIPE facilities so that women do not have to attend hospital at all following a home birth.On reflection the examinations that I have witnessed and performed unfortunately seem to have been a way to speed up the postnatal discharge procedure therefore freeing up beds within the unit and not due to providing a more continuous midwifery led experience for the parents and baby as Hutcherson (2010) found. The ideal situation would be to perform the examination on the newborn belonging to the mother you have seen through antenatal care and will be caring for post natally therefore providing continuous care for your personal caseload of clients, as discussed by Baston & Durward (2010).The patient satisfaction and overall job satisfaction in this case scenario would be high for all involved but unfortunately I feel in practice will be a rare occurrence. Eventually I believe that in our trust when there are enough trained midwives within each geographical area the possibility of a midwife performing newborn examinations on babies within the teams’ caseload is possible. This far from being the ideal scenario is the closest it will probabl y get to the holistic care sought after by myself and many other midwives.The EMREN (Evaluation of Midwife Role extension in the routine Examination of the Newborn) study carried out by Townsend et al (2004) looked into aspects of the NIPE one of them being whether a midwife was as capable as a senior house officer when carrying out the NIPE and discovered not only that this was the case but that the mothers satisfaction level may be increased if a midwife performed the NIPE and that also money may be saved by the NHS.Having observed SHO’s, appropriately trained midwives and advanced neonatal practitioners (ANP) performing the NIPE I felt that the midwives and ANP’s communicated far more effectively with both the baby and parents therefore better fulfilling the communication aspect of the competency’s indicated by the UK National Screening Committee (2008). They also provided more detailed information on parenting and public health issues during the examinations which should be an integral part of the NIPE (Baston & Durward 2010).There has been much interest recently into whether pulse oximetry should be part of the newborn screening for congenital heart defects. The UK National Screening Committee is at the present time looking into whether this should be included within the NIPE as part of the screening for congenital heart defects in the newborn. It has been recommended in recent studies and has found to increase the detection rate of congenital heart defects (Ewer et al 2011, Chang 2009). Within our trust I have seen this performed on three ewborns following their NIPE, due to nasal flaring, slight cyanosis and a raised respiratory rate, all have proved to be within the normal range. The saturation monitors are present in the units’ clinic rooms where newborn examinations are performed but the community midwives working in children’s centres or at home do not have access to a monitor. Therefore this could be cause for con cern for parents of babies that are being examined in the community. This then presents the ethical dilemma that newborns are being offered a different aspect within the NIPE depending on where it is carried out.Powell et al (2013) found that parents were happy about having the pulse oximetry screening carried out on their newborn but questions need to be asked if they would prefer to not have it done in favour of the NIPE being performed more conveniently within the community. Ewer (2012) discusses the benefits of introducing pulse oximetry monitoring but without any mention of community based NIPE, or newborns that were born in the home environment. Another concern that I have witnessed and am aware of is not having access to all the antenatal notes of the mother within a community setting.On two occasions the mother has been discharged without the appropriate paper work or has not brought it to the clinic appointment. Obviously within the unit the antenatal and labour notes are e asily accessible, within the community if the mother hasn’t the appropriate information then the parents word must be taken. Having all information relating to the antenatal and interpartum periods is an essential part of the midwives role when performing the NIPE. The practitioner must be aware of antenatal and interpartum occurrences to be able to fulfil the competence set by the UK National Screening Committee (2008).When first undertaking the NIPE’s I found the examination of the hips the hardest part of the procedure, mainly because the baby would quite often cry and struggle a little and this would cause the parents to be distressed and concerned. I also, in the past, as a midwife and mother observing this procedure felt uncomfortable. Having now done a larger amount of these examinations and reading and understanding the relevant literature find them easier to perform. Screening for developmental dysplasia of the hip is based n the fact that if not picked up in the newborn could create the need for major surgical procedures in later life also with a poorer future outcome, Dezateux & Rosendahl (2007). Developmental dysplasia of the hip used to be widely known as congenital dislocation of the hip but has been renamed since the 1990’s. The factors behind this change are that it is now recognised that the condition is not always ‘congenital’ and rarely ‘dislocated’ and more likely to be ‘displaced’, Bracken et al (2012).The definition of developmental dysplasia of the hip is very obscure as there are varying degrees and it quite often develops after birth, overall it describes a disorder where the hip joint is unstable and occasionally dislocated. The hip joint consists of the femoral head, the rounded end of the bone which sits within the cartilage of the socket joint known as the acetabulum. There are thought to be different factors as to why the hip joint becomes unstable. At around seven weeks gestation hip formation has already begun, problems can start to occur then.If the femoral head is wrongly positioned from the start it could result in the formation of a too shallow socket. During pregnancy the hip joint can be affected by external and internal forces, for example oligohydramnios, lack of foetal movement due to foetal conditions, breech presentation (Hurley 2009, McDonald & Jenkins 2008). The incidence of developmental dysplasia of the hip varies in the literature, at birth it is thought to be 1-20 in 1000 but the majority of these stabilize without any treatment within the first few weeks of life, bringing the incidence down to 1-2 in 1000 (Campion & Benson 2007).The incidence is higher in female babies, it is believed due to the female newborn being more susceptible to the maternal hormones therefore the joints are more relaxed, Hurley 2009. It is also more prevalent if a sibling or parent has had developmental dysplasia of the hip, McCarthy et al (2005) and McDo nald & Jenkins. Other factors mentioned by McDonald & Jenkins (2008) include first born infants, multiple gestation and occurring in the left hip more frequently than the right.