A review of nursing and midwifery education research in the Republic of Ireland

This literature review aims to (a) provide a summary of the research conducted in the Irish nurse/midwifery education field, (b) identify key recommendations from the research reviewed and (c) examine the policy, theory and methodological implications of the research conducted. The electronic databases of CINAHL (EBSCO host 1982-2006) and PubMed (1950-2006) were searched for the relevant literature. Sixty-one studies satisfied the criteria for inclusion which were based on; quality of research design, sampling, data analysis, scientific merit, and authorship (registered nurse/midwife who conducted research in the Republic of Ireland). Findings demonstrated diversity in relation to aims, methods and results highlighting a need to formulate a collaborative research agenda in nurse and midwifery education.     

我国助产教育的现状与发展

助产工作是衡量国家卫生保健发展的重要内容,一直受到各级卫生行政部门的重视。我国的助产教育开始于20世纪20年代,目前从属于护理专业,教育体系仍比较落后,而且国际上助产专业范围已从单纯助产操作发展到围孕期、围生期保健和整体护理等临床应用领域,甚至还要扩展到围婚期及婚前领域,所以就更突显了我国需要进行高级助产士专业教育和培训的必要性。因此,有必要整合助产相关领域的各种现有资源,推进和带动现代中国助产的全面发展,为进一步推动全国范围内的助产工作发挥示范和带头作用。     

Research priorities for nursing and midwifery in Southern Ireland

AIM: To identify research priorities for nursing and midwifery in the Southern Health Board area in Ireland for the immediate and long term. METHOD: Ten focus groups were conducted over a 2-month period with 70 nurses and midwives working in clinical, managerial and educational roles participating. Based on focus group findings and a literature review a multi-item Likert type questionnaire was constructed and administered to 520 nurses and midwives (response rate 95%n=494). RESULTS: Research priorities were identified as: (1) impact of staff shortages on retention of RNs/RM's (80%); (2) quality of life of chronically ill patients (76%); (3) stress and bullying in the workplace (76%); (4) assessment and management of pain (75%); (5) skill mix and staff burnout (73%); (6) cardio-pulmonary resuscitation decision making (72%); (7) coordination of care between hospital and primary care settings (69%); (8) medication errors (67%); and (9) promoting healthy lifestyles (64%). Respondents also indicated that these priorities warranted immediate attention. Implications for practice include the need for: (1) emphasis on quality pain control; (2) recognition and exploration of the ethical issues relating to resuscitation; and (3) management of the context within which clinical care is given.     

Madagascar nursing needs assessment: education and development of the profession

Purpose: To address how Madagascar is improving nursing education and the profession to strengthen their nursing workforce. Background: The sub‐Saharan Africa nursing workforce shortage is more than 600 000. Madagascar measures among affected countries. Nursing in Madagascar with reference to the Malagasy Lutheran Church Health Department (SALFA) is examined in this paper. The Malagasy Lutheran Nursing School (SEFAM) was established in 1956 to prepare nurses and midwives. The school recently relocated to better meet SALFA goals to increase nurses in the system and improve nursing education. A US nursing faculty and the SEFAM director proposed to conduct programme assessment to ensure that nursing and midwifery education meet health, social and community needs in Madagascar. Data source/methods: An in‐depth needs assessment of the school programme, facilities and resources occurred. Site visits and informal interviews were held. Field study visits to nursing schools and health‐care facilities in Kenya and Tanzania assisted the authors in learning how nursing developed in those countries. Data analysis included comparison of the authors' comprehensive notes for congruity and accuracy. Outcomes: Strategies are needed to support and maintain quality education, improve quality and quantity of nursing care services in hospitals and dispensaries, and improve conditions for nurses and other health‐care workers. Compared with Madagascar, Kenya and Tanzania have more well‐developed systems of nursing education and professional development. Limitations: There were limited written sources for some information but methods, such as verbal accounts, compensated for this limitation. Implications/conclusions: Implications include advantages, disadvantages, facilitators and barriers to nursing educational and professional development in Madagascar. Development of nursing education, regulation and the profession will continue with support from key stakeholders. Kenya and Tanzania can serve as role models for Madagascar nurses. Countries with similar nursing education and professional development issues can be informed by lessons learned in this project.     

An international exploration of blended learning use in pre-registration nursing and midwifery education

AimTo explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy.BackgroundThe global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere.DesignCross-sectional, sequential, mixed methods studyParticipants/settingsNursing/nurse education leaders from across International Council of Nurses regionsMethodsExploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants’ knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes.ResultsParticipants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation.ConclusionsBlended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact.Tweetable abstractBlended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.     

Sustaining and growing the rural nursing and midwifery workforce: understanding the issues and isolating directions for the future

Nurses and midwives represent the largest group of health professionals in the Australian health care system. In rural environments nurses and midwives make up a greater proportion of the health workforce than in urban settings, which makes their role in service provision even more significant. The role and scope of these nurses and midwives' practice is by necessity more generalist than specialist, which results in disciplinary strengths and weaknesses. As generalist health professionals they work in diverse settings such as public hospitals, multi-purpose services, community health, aged care and in non-government and private for profit and no-profit organisations including general practices. Their scope of practice covers prevention, intervention and rehabilitation and is lifespan inclusive. Rural nurses and midwives are older than their metropolitan based counterparts, work part-time and traditionally have limited access to professional development often due to ineffective locum relief programs. Workplace inflexibility, access to acceptable housing and partner employment are factors cited as inhibitors to growing this workforces. The future of the rural nursing and midwifery workforce will only be secured if Government invests to a greater degree in both education and training and the development of a nationally agreed remuneration scale that allows for part-time work.     

Views on evidence from nursing and midwifery opinion leaders

National registration standards in Australia require nurses and midwives to be educationally prepared to use an evidence-based framework for their practice. These standards assume a shared professional understanding of evidence and, an agreed approach towards educational preparation for evidence implementation. In this study, a qualitative phenomenographic approach is used to explore the ways in which nursing opinion leaders understand ‘evidence’ within the context of evidence-based practice (EBP). Semi-structured in-depth interviews were conducted with 23 nursing and midwifery opinion leaders across the state of New South Wales, Australia. The findings suggest that views of evidence are deeply imbedded within individual clinical, contextual and professional experiences, and are highly variable. Establishing basic consensus on the meaning of evidence for the nursing and midwifery context is fundamental to the successful educational preparation of nurses and midwives for EBP. It is proposed that future evaluations of EBP education in nursing and midwifery examine the assumptions on which such programs are based as individual variation may be a significant factor in both defining and measuring the success of educational interventions for evidence implementation.     

The relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education: An integrative review

AimThis integrative review aims to explore the relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education.BackgroundResearch in higher education has shown that feedback practices can lead to students’ developing evaluative judgement; thought critical for performance improvement and life-long learning. While literature in nursing and midwifery education has not yet employed the term ‘evaluative judgement’ explicitly, there might be similar concepts and practices that seek to develop students’ judgement of performance that sustain learning beyond the immediate task.DesignAn integrative review of the nursing and midwifery feedback literature.MethodsIn February 2020, six online databases (CINAHL, ProQuest, Scopus, ERIC, PsycINFO, Ovid MEDLINE) were systematically searched for literature published between January 1989-February 2020. Synonyms for feedback and evaluative judgement were used to inform our search. This review included a rigorous team-based, five-stage approach: (1) identifying the problem; (2) conducting the search; (3) evaluating the data; (4) analysing the data; and (5) presenting the integrative review.ResultsA total of 1408 studies were initially retrieved with 543 duplicates. 865 abstracts were screened using eligibility criteria, resulting in the exclusion of 835 studies. Thirty full-text studies were appraised for quality. Eighteen studies with diverse methodologies achieved a medium-high quality score for inclusion in data analysis. Conceptions of feedback and evaluative judgement were identified in all studies; despite none using the term 'evaluative judgement' explicitly. Thematic analysis of the studies resulted in seven themes: conceptions of feedback, purposes of feedback, sources of feedback, modes of feedback, conceptions of evaluative judgement, purposes of evaluative judgement and relationships between feedback and evaluative judgement.ConclusionsWhile our findings supported contemporary higher education research, the feedback-evaluative judgement relationship is novel in nursing education. We encourage educators to design feedback activities privileging students’ active engagement through dialogic feedback, reflection and self-assessment, to develop their evaluative judgement of practice.     

Government chief nursing officers: a study of the key issues they face and the knowledge and skills required by their roles

The first Government Chief Nursing Officer (CNO) position was created in New Zealand over a century ago. Over the ensuing decades, the roles of these national nurse leaders have evolved and become a focal point for global nursing and midwifery development. Despite the important actual and potential roles of CNOs, very little work has been done to systematically study the key issues that they face and the skill sets needed to address them. Now, in the face of global cost-driven health reform, the position of CNO is even more important than ever. This paper describes the only global systematic study of CNOs conducted since the beginning of health reform and lays a substantive foundation for the development of these key leaders and their positions. In addition, the research reported provides important groundwork for future studies and enhancement of the global literature relating to national nursing and midwifery leadership.     

A mixed-method evaluation of a New Zealand based midwifery education development unit

The Midwifery Development Education Service was established in the Birthing Unit at Middlemore Hospital in South Auckland New Zealand in 2007. The service is unique in the New Zealand midwifery context for the way it operates as a collaboration between the education and health provider to optimise the clinical learning experience of student midwives. This paper reports on the evaluation of the Midwifery Development Education Service that was undertaken in 2015. The evaluation captured the views and experience of students and midwives who had been involved with, or had worked alongside, the service. A mixed-method approach was adopted for the evaluation study, comprising of an anonymous on-line survey, qualitative interviews and focus group discussion. Considerable satisfaction with the service was identified. This article draws attention to participants’ perceptions of the service as supporting student midwives; the significance of quality time in the provision of the clinical midwifery education; the situating of the service at a unique vantage point (overseeing the needs of the university and the hospital) and its impact upon the learning culture of education within the unit. A potential tension is also identified between the provision of a supportive learning environment and the assessment of student performance.     

助产专业基础护理学课程教学中存在的问题与对策

针对助产专业基础护理课程教学中存在的问题进行分析,并采取相应的措施。通过调整教学内容,改进教学方法,提高基础护理的专业针对性;采用小组分散见习和三阶段临床实习,保证临床教学质量;辅以多方位社会实践等手段,达到基础护理教学特色化,人才培养专科化的教育目标。     

Increasing the use of experimental methods in nursing and midwifery education research

AimTo consider how more use could be made of experimental research in nursing and midwifery education.BackgroundMuch use has been made in nursing and midwifery educational research of pre- and post-, within-subjects research. While this has its place and has been a valuable design for testing educational interventions, there has been a distinct lack of more rigorous experimental designs.DesignDiscussion paper to consider the use of experimental designs in nursing and midwifery education research.MethodsA review of within-subjects designs, between-subjects designs and new approaches to experimental research such as pragmatic designs, non-inferiority designs and the framework offered by complex interventions.ResultsRecommendations for implementing experimental designs in nursing and midwifery education research have been drawn.ConclusionsWithin-subjects designs have dominated experimental research in nursing and midwifery education. While suitable for preliminary studies, they should be augmented by more rigorous designs based on between-subjects designs. These do not have to be strictly randomised controlled trials and there are many reasons why these are hard to implement in nursing and midwifery education research. However, a range of alternatives is available.     

本科助产专业标准化病人的培训及应用

目的 探讨本科助产专业助产技能考核中标准化病人的培训方法及实施效果.方法 根据纳入标准在护理专业高年级中招募16名学生,按照《标准化病人参与医学教育最佳实践标准》的原则进行培训和质量评价,并将标准化病人应用于客观结构化临床考核中.结果 标准化病人模拟质量总得分为(81.60±9.59)分,模拟态度维度均分为(4.85±0.31)分,模拟能力维度均分为(4.15±0.68)分,遵守问答规则维度均分为(4.17±0.71)分.结论 标准化病人在本科助产专业助产技能考核中的培训及应用得到考生认可,具有可行性,为助产技能教学改革提供参考依据.     

Delineating advanced practice nursing in New Zealand: a national survey

Background

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning.

Aims

To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles.

Method

Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one‐way ANOVA and post hoc between group comparisons.

Results

Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain‐specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership.

Conclusions

Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles.

Implications for nursing policy

By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence‐based nursing workforce planning and policy development.     

助产方向护理本科生心路历程的扎根理论研究

目的 探索助产方向护理本科生学习过程中的心路历程,为助产本科教学工作提供参考.方法 对17名助产方向护理本科生进行半结构式访谈,应用扎根理论方法,通过不断比较、三级编码和撰写备忘录对获得的资料进行分析.结果 助产方向护理本科生心路历程经历初识憧憬期、学习探索期、成长蜕变期和理性抉择期,内在动因、专业认识、专业情感、应对...