Commentary: Global leadership in transcultural nursing practice, education and research

It is amazing what some women and men dare to do with their ideas in many places in the world. Creative thinking and actions are what the world needs most. Transcultural nursing has been an example of these attributes. While taking new actions may be troublesome to some people, yet new actions and new ideas can lead to a wealth of new knowledge and new ways to serve people. Transcultural nurses have taken such actions and are transforming nursing and health care in many places in the world.     

Initiating research with doubly vulnerable populations

Some research questions can only be answered by members of a vulnerable group. Frequently members of these groups are doubly vulnerable as they experience more than one factor that diminishes their autonomy. Initiating research with doubly vulnerable persons presents unique and often difficult challenges. Because of these challenges, many researchers purposefully exclude doubly vulnerable groups from research endeavours. Thus, the health care needs and concerns of individuals considered doubly vulnerable are often not addressed in the scientific literature. This article presents two challenges frequently encountered when initiating research with doubly vulnerable populations: resolving pre-investigation issues and gaining access to vulnerable populations. Ethically sound strategies for confronting these challenges are discussed. Researchers' experiences with doubly vulnerable populations are also incorporated. Only when doubly vulnerable groups receive the appropriate research attention are the standards of their care and their quality of life enhanced.     

An alternative model for postdoctoral education of nurses engaged in research with potentially vulnerable populations

Post-doctoral education has become a necessity for new nursing doctoral graduates. However, post-doctoral positions are limited and nurse scientists may face barriers that make non-traditional programs necessary. This study describes the outcomes of the Summer Nursing Research Institute (SNRI), an alternative post-doctoral educational program, reports formative perceptions of SNRI participants, and illustrates the efficacy and limitations of the model with selected summative research related outcomes. Participants between 1997 and 2006 were asked to evaluate the experience while attending the Institute (formative evaluation) and an overall summative evaluation was also conducted. Evaluations indicate that participants gained knowledge, skills, and networking abilities in terms of conducting research with vulnerable populations. A program like the SNRI can be successful in widening the research pipeline, in imparting knowledge, and in fostering positive attitudes as well as in improving research skills.     

An emerging view of mastery, excellence, and leadership in occupational therapy practice.

The recent focus on clinical reasoning in occupational therapy, specifically on how therapists solve complex problems, has stimulated interest in how master clinicians think in practice. By gaining insight into how clinicians think and what they think about when they identify and solve problems, we may be able to identify clinical reasoning patterns and processes that occupational therapy students and novice therapists need to experience in order to progress in their practice or to emerge as leaders in their field. Observation of the way in which clinical masters and leaders view challenges and solve problems as manifested in their clinical reasoning may provide new and potential therapists with clues as to how to best bone their skills and knowledge for future success in practice. This paper describes a study that examined the relationship of mastery, excellence, and leadership in occupational therapy. Ten master clinicians were interviewed to determine the characteristics of their mastery and excellence in practice and to explore the degree to which they engaged in leadership behavior. The findings revealed that mastery, excellence, and leadership are independent of one another but that some characteristics are common to all of these phenomenas.     

Developing leadership skills in clinical practice and management

Throughout the UK, increasing responsibility is being placed on clinical nurses to play a leadership role within healthcare settings. Recognising the challenges, Nursing Standard is once again collaborating with the Royal College of Nursing and its corporate partner, Smith and Nephew, in launching the fifth Clinical Practice and Management Awards. Editor in Chief Linda Thomas explains the awards and the benefits nurses can gain from taking part.     

Friends of nursing: a community of caring to promote excellence in nursing practice, education, and research

More than 25 years ago, the name "Friends of Nursing" was adopted by an academic, community Magnet(?) hospital to signify a model for community support of nursing. From inception, the intent was to recruit philanthropic dollars to promote recognition of and excellence in nursing practice, education, and research. Although philanthropy in health care settings is common, what is unique about this program is the long-standing, dedicated conceptual framework for nursing philanthropy and the very significant number of philanthropic dollars from literally thousands of donors to support a diverse range of activities to affect and advance the professional excellence of nurses and the quality of patient care. This model has been successfully replicated within a wide variety of other health care organizations and nursing services throughout the United States and abroad.     

Today's challenge, tomorrow's excellence: the practice of evidence-based education

Nurse educators are being challenged to maintain quality in light of increasing numbers of students, declining numbers of experienced faculty, societal mandates, and rapid changes in health care. The scholarship underlying the practice of nursing education, or evidence-based education, must continue to be explored through the design, testing, and refinement of education strategies from nursing and other disciplines. The involvement of every educator in this process will help create institutional valuing that serves to retain inquisitive and reflective educators in academic settings, while expanding evidence-based education in nursing. This article describes a literature review of the scholarship of nursing education practice and suggests approaches to generate a dynamic explosion of growth in nursing education to inform our students, promote optimal client health outcomes, and challenge each of us to reach higher levels of excellence in the practice of nursing education.     

Promoting an egalitarian approach to research with vulnerable populations of women

Title.  Promoting an egalitarian approach to research with vulnerable populations of women
Aim.  This paper is a presentation of issues that arise when conducting research with women from vulnerable populations.
Background.  Conducting research with ethnic minority populations has accentuated the challenges inherent in research, particularly when the populations participating are considered 'vulnerable' due to additional variables such as low levels of income.
Data sources.  The paper is based on the experiences of three authors using feminist methods in separate but similar research trajectories that include (a) low-income women in the Southern African country of Malawi, (b) women diagnosed with schizophrenia in the United States of America, and (c) rural, indigenous Aymara women of the highlands of Peru. The data forming the basis of this paper were collected over 3- to 6-month periods between 2005 and 2006.
Discussion.  We examine the impact of the researcher's power on the research process. Our research provides examples that illuminate the limitations of informed consent in research with vulnerable populations of women. We offer critical questions about and recommendations for nursing and other health care researchers, both in the third world and the western world, regarding appropriate research methods with vulnerable populations: methods that acknowledge the oppressive realities of the participants, methods that deliberately avoid further marginalization of participants, and methods that have the potential to improve the life situations of the women who participate in our research.
Conclusion.  These examples show the need for new methods to ensure that participants in research understand their role and the benefits they may expect to receive from research.     

Accessing vulnerable research populations: an experience with gatekeepers of ethical approval

Accessing vulnerable populations for research purposes can be difficult, as participants must be sheltered from research that might be insensitive, intrusive, and potentially distressing. People diagnosed with a life-limiting condition may be vulnerable, and involving such people in research samples may be fraught with difficulties. Nevertheless, it is important that these vulnerable populations participate in health and social-care research so that their requirements and opinions can be learnt. This paper describes an experience of proceeding through an ethical approval process for a proposed qualitative research study into the preferred place of death of a group of potentially vulnerable hospice patients. Research of this nature had never been undertaken at the hospice before, and the researchers expected to encounter a degree and variety of gatekeeping when seeking access to this sensitive population.     

Developing a theory of nursing: the relation of theory to practice, education and research

The relevant literature is reviewed and it is held that the relationships between nursing theory, practice, education and research are close and reciprocal relationships. Each is related to the other but it is argued that the hub of the relationships is nursing practice as nursing is a practice discipline.
This paper is based on an address delivered on 10 July 1976 at the annual conference of the Association of Integrated and Degree Courses in Nursing held at the University of Hull, England.     

Evidence-based practice: the importance of education and leadership

johansson b., fogelberg-dahm m. & wadensten b . (2010) Journal of Nursing Management 18 , 70–77
Evidence-based practice: the importance of education and leadership
Aim  To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors.
Background  Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance.
Method  All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire.
Results  The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities.
Conclusions  The present study highlights the value of education in research methods and the importance of supportive leadership.
Implications for nursing management  Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.     

Developing leadership in nursing: the impact of education and training

This is the second of two articles on developing leadership in nursing; this article explores the role and impact of training and education on nursing leadership. Nursing leadership education has been identified as much needed, and can be provided by universities (at Masters, diploma and certificate levels), healthcare organizations or hospitals. Research demonstrates that where leadership has been effectively taught and integrated into nursing, it has a positive impact on nurses' leadership skills and practice. It is suggested that healthcare organizations continue to develop and support leadership training, while also seeking ways of maintaining and promoting leadership development in practice.