Preparing nursing students for the future: An innovative approach to clinical education

A clinical education model was developed and implemented by nursing faculty in the Oregon Consortium for Nursing Education undergraduate curriculum to improve clinical learning for preparation of nurses to practice in the 21st century. This clinical education model, developed though collaborative work by nursing practice and education representatives throughout the state, moves away from a “random access opportunity” model of clinical education reliant on “total patient care” experiences to an intentional design of clinical learning activities based on course competencies appropriate to student level. Five elements of the model were proposed: case-based, concept-based, intervention skill-based, focused direct client care and integrative experiences. Different elements are dominant in early, middle and late clinical experiences to best support the developmental level of the student. Expectations for faculty, students and clinical staff were also developed to enhance best practices in clinical learning. Preparation of clinical partners for a change in clinical learning and student accountability are essential for optimal learning. This paper provides an overview of the model with clinical application examples for each element with a particular emphasis on case-based, concept-based and integrative clinical experiences.     

Engaging service users in the development of stroke services: an action research study

Aims and objectives. To develop local stroke services by involving, in a meaningful way, those affected by stroke in identifying and prioritising service development issues. Background. Consideration should be given to including the views of service users in the evaluation and re‐design of services. In stroke, the involvement of patients and carers in the development of services has generally been at a consultative level. There is a need to explore strategies to engage patients and carers more fully with the service development agenda. Design. Action research. Methods. Within the Reflection Phase of this action research study patients’ and carers’ experiences of stroke services were explored by semi‐structured interviews and focus groups. In the Planning and Action Phases, externally facilitated workgroups comprising patients, carers and professionals used a synthesis of the data to identify a range of service development priorities, which informed the development of action plans. Results. Information provision, preparation for transfer of care and the integration of social and leisure activities appear to be priorities for the development of stroke services from the perspective of patients and carers. These findings informed the work of four collaborative workgroups to lead developments in the stroke pathway as follows: stroke prevention and immediate care, early and continuing rehabilitation, transfer of care and long‐term support and information provision. Conclusion. Stroke patients and carers played a key and meaningful part in the identification and prioritisation of service development issues. External facilitation ensured progress with service development and maintaining patient and carer participation. Several pragmatic recommendations for enhancing the local delivery of stroke services were made. Relevance to Clinical Practice. With external facilitation it is possible for stroke service users to take a meaningful role in service developments that moves beyond consultation.     

Professional development in clinical teaching: An action research study

ObjectiveClinical supervisors, who support and assess health students' clinical learning, encounter many challenges. Professional development opportunities for clinical supervisors to overcome the challenges are available but are often designed to meet organisational and tertiary provider administrative needs, rather than the needs of intended target groups.DesignA qualitative action research study was designed to include a group of Australian nursing clinical supervisors in the design and implementation of meaningful professional development activities.ParticipantsTen clinical supervisors, from one organisation, participated in three meetings to explore shared challenges and create solutions to resolve these challenges.ResultsOver a seven-month period in 2018–2019 data revealed clinical supervisors in this study experienced a variety of tensions. Participants prioritised three opposing tensions that were of shared concern; Doing and Thinking; Educator and Clinician and Negotiating and Challenging. Being able to visualise and articulate these tensions helps to empathise with the role complexity that clinical supervisors experience, and this led to the production of solutions which validate and advocate for the role and the values.ConclusionThe group created innovative solutions such as podcasts, posters, banners and flyers to assist them to harmonise the tensions and work more effectively in their role.     

An innovative approach to preparing nursing students for care of the elderly in the home

Nurse educators must prepare future nurses for the increasing number of elderly requiring care in community-based settings. This quasi-experimental study examined the outcomes of a geriatric home care simulation experience for senior community health nursing students (n = 56). The experience included a home care visit to an elderly diabetic client using a high-fidelity human patient simulator as well as a geriatric home safety assessment exercise. Results indicated students were satisfied with the experience and that it had a positive impact on confidence, but no differences were found between groups in terms of learning. Additional analysis using Spearman’s rho found outcomes of satisfaction and self-confidence were significantly correlated (r_s=.378–.605) with simulation design, especially the provision of student support and a challenging problem to solve. Results provide nurse educators with evidence for developing geriatric simulation education experiences for preparing new graduates to care for the increasing number of elderly who desire to age in place.     

An action research approach to the development of a clinical pathway for women requiring Caesarean sections

An action research framework was utilised to introduce a clinical pathway for women undergoing Caesarean section in the Maternity Unit at Westmead Hospital in 1998-1999. This style of research allowed the development of the clinical pathwayfor women having a Caesarean section to be progressively modified to adapt it to suit the needs of the multidisciplinary team and the clinical environment. The clinical pathway itself became a document that facilitated the education of the women, improving their preparation for discharge, aided the orientation and skill development of new staff and improved the continuity of care by enhancing the multidisciplinary approach to the women's care. It also identified the need for continuing staff education throughout the implementation and evaluation phases.     

An innovative approach to providing collaborative education to undergraduate students in the area of child maltreatment

Abstract

Frontline workers in the area of child welfare often enter the field without having taken any specialized coursework in the area of child maltreatment. This article discusses an interdisciplinary certificate program that is specifically designed to teach persons from various academic areas the knowledge and skills necessary to work with children who experience maltreatment. The child advocacy studies certificate program specifically focuses on coursework in the area of child maltreatment and child advocacy to better train future frontline workers in their vital roles. This certificate will decrease underreporting of child abuse cases by mandated reporters by making them more aware of the signs and symptoms of child maltreatment and also give students a greater understanding of how to work with individuals from various fields.     

Integrating clicker technology at nursing conferences: An innovative approach to research data collection

Solecki S, Cornelius F, Draper J, Fisher K. International Journal of Nursing Practice 2010; 16 : 268–273
Integrating clicker technology at nursing conferences: An innovative approach to research data collection A pilot demonstration of integrating an audience response system, that is, ‘clickers’ at a nursing education conference as an engaging tool for using the research process for learning through immediate research results is presented. A convenience sample of nursing conference attendees were surveyed using clicker technology before a panel presentation on the ‘Impaired Health Professional'. The 208 subjects who used the clickers were mostly women (93%) and were nurse educators (81%) with at least 20 years of nursing experience (75%). The ease of data collection, real‐time analysis, the active engagement of both participant and presenter were all findings of this study. The utility of this tool as a stimulus for discussion and learning was also reported. Pilot testing the clicker at an education conference for data collection and educational purposes was an important goal and positive outcome of this study. Researchers and educators are advised on the planning steps required to make this a successful experience.     

Participatory action research: Involving students in parent education

Competition for scarce clinical placements has increased requiring new and innovative models to be developed to meet the growing need. A participatory action research project was used to provide a community nursing clinical experience of involvement in parent education. Nine Hong Kong nursing students self-selected to participate in the project to implement a parenting program called Parenting Young Children in a Digital World. Three project cycles were used: needs identification, skills development and program implementation. Students were fully involved in each cycle's planning, action and reflection phase. Qualitative and quantitative data were collected to inform the project. The overall outcome of the project was the provision of a rich and viable clinical placement experience that created significant learning opportunities for the students and researchers. This paper will explore the student's participation in this PAR project as an innovative clinical practice opportunity.     

An action research on the development of a caring curriculum in Taiwan

The purpose of this study was to plan, develop, implement, and evaluate the effectiveness of the first-year course of a 5-year nursing caring curriculum. An action research method involving participant observation investigated how 18 instructors in a junior college nursing program implemented caring in the course. Data gathered through observation, interviews, and questionnaires were used for evaluation and revision of the course. Results included development of the framework for the caring curriculum and the contents of the first-year course, Introduction to Caring. Course content included the concepts of caring ("love and sincerity," "caring communication," "empathy and respect," "acceptance and trust," and "offering of self"), performance of caring actions ("care of self," "care of family members," and "care of peers"), and caring motivations ("caring reinforcing factors" and "caring restraining factors"). Teaching strategies included role modeling, dialogue, reflection, journaling, and caring groups. Evaluation showed that student caring knowledge, attitudes, and behavior improved after course implementation.     

Nursing intervention research and quality of care: influencing the future of healthcare

BACKGROUND: Improvement of healthcare in the United States is a national priority. Nursing intervention science can contribute substantially to addressing this priority. OBJECTIVES: The aim of this study was to describe strategies needed to maximize the base of nursing intervention science. METHODS: The study involved a review of reports on the state of quality in healthcare and an examination of nurse-led intervention studies funded by the National Institute of Nursing Research aimed at improving healthcare processes and outcomes. RESULTS: Nursing has contributed valuable data regarding the meaning of quality from the perspectives of individuals, families, and communities. Increased efforts are needed to ensure that this science informs ongoing initiatives to define, assess, and improve the quality of healthcare. CONCLUSIONS: Nurse-led intervention research is making significant contributions to the advancement of the science underpinning quality healthcare. However, the message regarding the substantive and unique contributions of this body of work needs to be disseminated more broadly. Future nursing intervention research aimed at improving healthcare quality should consider individual behavior in a broader context, extend the traditional foci of interventions, and be grounded in the sciences of multiple disciplines.     

Online professional development for digitally differentiated nurses: An action research perspective

Professional development opportunities for nurses are increasingly being offered in the online environment and therefore it is imperative that learning designers, nurse educators and healthcare organisations consider how best to support staff to enable Registered Nurses to capitalise on the resources available. Research participants explored educational strategies to support digitally differentiated nurses' engagement with professional development activities in an online environment through a participatory action research project that collected data over a 16 month period through six focus groups before being analysed thematically. The reality of work-based, e-learning while managing clinical workloads can be problematic however specific measures, such as having a quiet space and computer away from the clinical floor, access to professional development resources from anywhere and at any time, can be effective. A ‘one-size-fits-all’ approach to resources offered will not meet the needs of diverse staffing groups whereas heutagogical learning offers tangible benefits to Registered Nurses seeking professional development opportunities in this context. Apparent proficiency with technological skills may not reflect a Registered Nurse's actual ability in this environment and face-to-face support offered regularly, rather than remedially, can be beneficial for some staff. Implementing specific strategies can result in successful transition to the online environment.     

Investment in the future: a 3-level approach for developing the healthcare leaders of tomorrow

Among the numerous challenges facing healthcare leaders is the paucity of well-prepared, effective managers. Cuts in recent years have reduced "bench strength," and the demands of managing in a complex industry are significant. The authors describe a 3-level leadership development program created at the University of Pittsburgh Medical Center to meet this challenge. Leadership gaps, content for each level, and outcomes are discussed.     

Developing culturally sensitive interventions for Vietnamese health issues: An action research approach

This article describes an action research approach to community development in Vietnam. An advisory committee worked with the researchers and identified the stigma of HIV/AIDS as a health issue of importance to it. The advisory committee consisted of representatives from the community. The selected issue was then explored in greater depth by individually interviewing infected persons, their family members, community members, and leaders. At the same time, focus groups were conducted for additional members of each of the above three cohorts. Through open-ended questions, the participants described the impacts of the stigma on their life, the possible causes of the stigma, and the relevant strategies to reduce these causes. Based on the findings, the advisory committee suggested interventions to reduce the stigma. This project demonstrated an effective way in which nurses can work with communities to help them to identify local solutions to their identified health issues.     

Quality of healthcare services provided in disaster shelters: An integrative literature review

BackgroundGlobally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters.ObjectivesTo determine based upon systematic and accurate measurement the scope and quality of health care services rendered in disaster shelters and to describe the health outcomes experienced by shelter residents.MethodsAn integrative review of English-language literature pertaining to the assessment, evaluation, and systematic measurement of healthcare quality and client outcomes in disaster and emergency shelters was undertaken. Articles were identified using a structured search strategy of six databases and indexing services (PubMed, CINAHL, EMBase, Scopus, Web of Science, and Google Scholar).ResultsLimited literature exists pertaining specifically to metrics for quality of health care in acute disaster and emergency shelters, and the literature that does exist is predominately U.S. based. Analysis of the existing evidence suggests that nurse staffing levels and staff preparedness, access to medications/medication management, infection control, referrals, communication, and mental health may be important concepts related to quality of disaster health care services.ConclusionsA small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse.