PUBLICATIONS 2010
Human patient simulation manikins and information communication technology use in Australian schools of nursing: A cross sectional survey
Clinical Simulation in Nursing
Arthur, C., Kable, A., & Levett-Jones, T.
Summary
Background: Shortage of suitable quality placements for undergraduate nursing students’ clinical experience has motivated Australian schools of nursing to consider alternatives to traditional clinical placements. Human patient simulation manikins and information communication technologies may have the potential to facilitate the development of nursing students’ clinical competence within a laboratory environment.
Method: A cross-sectional survey of Australian schools of nursing was undertaken to explore the use and types of simulation and information communication technologies and the pedagogical principles underpinning their use.
Results: This report profiles the facilities, staffing, teaching strategies, and underpinning pedagogical principles currently employed. Survey results show substantial variations in simulation and information communication technology resources and teaching strategies in current use.
Conclusion: Additional funding and staff training opportunities will be required to ensure adequate facilities and staffing are available to support quality use of these technologies.
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The preparation of technologically literate graduates for professional practice: A review of the literature
Contemporary Nurse
Bembridge, E., Jeong, S., & Levett-Jones, T.
Summary
The impact of information and communication technology has been felt globally and the healthcare sector is not immune to the changes brought about by the introduction of new technologies. In contemporary clinical practice environments, information and communication technology skills are advantageous, not only to nurses, but also to the patients for whom they care. There is good evidence that these skills, appropriately utilised, can have a significant impact on patient outcomes. This scholarly paper presents the background to a project that explores graduate nurses' experiences of using information and communication technology in clinical contexts. A broad historical overview of the implementation of information and communication technology in higher education and healthcare in Australia is provided before discussing the extent to which the technology skills learnt at university are relevant or transferable to contemporary practice environments. The current levels and use of information and communication technology among new graduate nurses, the apparent dichotomy between technological versus humanised healthcare, and the need for national information and communication technology competency standards are discussed.
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The transferability of information and communication technology skills from university to the workplace: A qualitative descriptive study
Handover - Hunter New England
Nursing Journal
Bembridge, E., Levett-Jones, T., & Jeong, S.
Summary
Aim: This paper presents the findings from a study that explored whether the information and communication technology (ICT) skills nurses acquired at university are relevant and transferable to contemporary practice environments.
Background: Whilst universities have attempted to integrate information and communication technology into nursing curricula it is not known whether the skills developed for educational purposes are relevant or transferable to clinical contexts.
Method: A qualitative descriptive study was used to explore the perspectives of a small group of new graduate nurses working in a regional/semi-metropolitan healthcare facility in New South Wales, Australia. Semi-structured interviews were used and the data thematically analysed.
Results: The themes that emerged from the study are presented in accordance with the conceptual framework and structured under the three headings of pre-transfer, transition and post-transfer. The transferability of information and communication technology skills from university to the workplace is impacted by a range of educational, individual, organisational and contextual factors.
Conclusion: Access to adequate ICT and the necessary training opportunities influences new graduates' work satisfaction and their future employment decisions. The ability to effectively use information and communication technology was viewed as essential to the provision of quality patient care.
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The design and implementation of an Interactive Computerised Decision Support Framework (ICDSF) as a strategy to improve nursing students' clinical reasoning skills
Nurse Education Today
Hoffman, K., Dempsey, J., Levett-Jones, T., Noble, D., Hickey, N., Jeong, S., Hunter, S., & Norton, C.
Summary
This paper describes the conceptual design and testing of an Interactive Computerised Decision Support Framework (ICDSF) which was constructed to enable student nurses to "think like a nurse." The ICDSF was based on a model of clinical reasoning. Teaching student nurses to reason clinically is important as poor clinical reasoning skills can lead to "failure-to rescue" of deteriorating patients. The framework of the ICDSF was based on nursing concepts to encourage deep learning and transferability of knowledge. The principles of active student participation, situated cognition to solve problems, authenticity, and cognitive rehearsal were used to develop the ICDSF. The ICDSF was designed in such a way that students moved through it in a stepwise fashion and were required to achieve competency at each step before proceeding to the next. The quality of the ICDSF was evaluated using a questionairre survey, students' written comments and student assessment measures on a pilot and the ICDSF. Overall students were highly satisfied with the clinical scenarios of the ICDSF and believed they were an interesting and useful way to engage in authentic clinical learning. They also believed the ICDSF was useful in developing cognitive skills such as clinical reasoning, problem-solving and decision-making. Some reported issues were the need for good technical support and the lack of face to face contact when using e-learning. Some students also believed the ICDSF was less useful than actual clinical placements.
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Understanding and enhancing the learning experiences of culturally and linguistically diverse nursing students in an Australian bachelor of nursing program
Nurse Education Today
Handover - Hunter New England Nursing Journal
Jeong, S., Hickey, N., Levett-Jones, T., Pitt, V., Hoffman, K., Norton, C., & Ohr, S.
Summary
The growth in numbers of culturally and linguistically diverse students entering nursing programs in Australia presents challenges for academic and clinical staff, and most importantly the students themselves. In this paper we present the findings from a pilot study designed to explore these issues and to develop strategies to address them. This study used a qualitative explorative approach to gain rich in-depth data. Eleven culturally and linguistically diverse students, three clinical facilitators, and four academic staff participated in focus group interviews. Four major themes emerged: level of English language competence, feelings of isolation, limited opportunities for learning, and inadequate university support. The issues we identified led to a meaningful discussion of the political, financial, social and intercultural context that they are entrapped in. This paper provides educators, clinicians, policy makers and researchers with an insight where and how they commence to break the trap and highlights, the need for further research into the perspectives of Australian students’ who study and socialise with their international peers.
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Effectiveness of Patient Simulation Manikins in Teaching Clinical Reasoning Skills to Undergraduate Nursing Students: A Systematic Review
Clinical Simulation in Nursing
Lapkin, S., Levett-Jones, T., Bellchambers, H., & Fernandez, R.
Summary
Human patient simulation manikins (HPSMs) are being used extensively in the education of health professionals, but their effectiveness in the teaching of clinical reasoning skills to undergraduate nursing students is not clear. The aim of this systematic review is to identify the best available evidence for their effectiveness in this regard. The review included all English-language randomized controlled trials from 1999 to 2009 that assessed the effectiveness of high-fidelity HPSMs in educating undergraduate nursing students. The results indicate that the use of HPSMs improves knowledge acquisition and critical thinking and enhances students’ satisfaction with the learning. There is a lack of unequivocal evidence of the effectiveness of using high-fidelity HPSMs in the teaching of clinical reasoning skills to undergraduate nursing students. Further research is required to ascertain the effectiveness of the use of HPSMs as an educational strategy to improve the clinical reasoning skills of undergraduate nursing students.
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Learning to think like a Nurse
Handover - Hunter New England Nursing Journal
Levett-Jones, T., Sundin, D., Bagnall, M., Hague, K., Schumann, W., Taylor, C., & Wink, J.
Nurses with effective clinical reasoning skills have a positive impact on patient outcomes; conversely, those with poor clinical reasoning skills often fail to detect impending patient deterioration. Errors in clinical judgement and decision making are said to account for more than half of adverse clinical events. For these reasons education must begin at the undergraduate level to develop students' critical thinking and clinical reasoning skills. Clinical reasoning is a learnt skill requiring determination and active engagement in deliberate practice as well as reflection, particularly on activities designed to improve performance. This paper profiles one of the learning approaches currently being used by the School of Nursing and Midwifery, at the University of Newcastle to enhance students' clinical reasoning ability and their preparedness for professional practice.
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The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients
Nurse Education Today
Levett-Jones, T., Hoffman, K., Dempsey, Y., Jeong, S., Noble, D., Norton, C., Roche, J., & Hickey, N.
Acute care settings are characterised by patients with complex health problems who are more likely to be or become seriously ill during their hospital stay. Although warning signs often precede serious adverseevents there is consistent evidence that ‘at risk’ patients are not always identified or managed appropriately.
‘Failure to rescue’, with rescue being the ability to recognise deteriorating patients and to intervene appropriately, is related to poor clinical reasoning skills. These factors provided the impetus for the developmentof an educational model that has the potential to enhance nursing students’ clinical reasoning skills and consequently their ability to manage ‘at risk’ patients. Clinical reasoning is the process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process. Effective clinical reasoning depends upon the nurse’s ability to collect the right cues and to take the right action for the right patient at the right time and for the right reason. This paper provides an overview of aclinical reasoning model and the literature underpinning the ‘five rights’ of clinical reasoning.
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Infant Feeding and Mother-to-Child Transmission of HIV
Handover - Hunter New England Nursing Journal
Raward A., & Harris M.
This article presents information for clinicians in antenatal services about which infant feeding practices are efficacious in preventing mother-to-child transmission (MTCT) of HIV and reducing infant mortality. The findings are derived from a systematic review by The Cochrane Library: Interventions for late postnatal mother-to-child transmission of HIV (Hovarth, Iuppa, Kennedy, Madi, Read & Rutherford, 2009).
Nurses and midwives will find the socio-environmental considerations in this article useful when advising mothers on infant feeding under certain medical circumstances (World Health Organisation (WHO), 2003b). This paper emphasises the need for health professionals to be vigilant in reducing the risk of mother-to-child transmission of HIV and reinforces the WHO messages. Health professionals in Australia should consider other infant and maternal medical conditions that may impede breastfeeding in the local community (WHO, 2009).
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The genesis of the neophyte writers' group
Nurse Education Today
Stone, T., Levett-Jones, T., Harris, M., & Sinclair, P.
This paper profiles the establishment and evaluation of the Neophyte Writers’ Group, run by nurse academics in collaboration with clinical nurses. The growing demand for nurses to write, publish and present their work had inspired the introduction of a series of workshops designed to develop and improve writing and presentation skills, which eventuated in formation of the Neophytes. The group was founded on the basis of Bandura’s theory of self-efficacy (1997), a concept which has been discussed extensively in social psychology literature to explain motivation and learning theory. People with high assurance in their capabilities regard difficult tasks as challenges to be mastered rather than as threats to be avoided (Bandura, 1994). The Neophytes’ group employs a collaborative approach intended to increase and reinforce members’ self-confidence; the underlying philosophy is to promote and enhance writers’ motivation, capacity and self-efficacy in order to achieve future publication goals confidently and independently. Support which engenders these strengths through a program relevant to participants’ needs is likely, as this group found, to increase publication productivity. Additional unexpected outcomes resulted, such as engagement by clinical nurses’ in academic work, and an increase in research higher degree enrolments.
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Complementary therapies in healthcare: Design, implementation and evaluation of an elective course for undergraduate students
Nurse Education in Practice
Van der Riet, P., Francis, L., & Levett-Jones, T.
Complementary therapies are making a significant and cost effective contribution to the health of the community, especially in relation to chronic disease management and prevention of disease. Because of the increased use of complementary therapies, nurses, and other health professionals need to be familiar with specific practices so that they can assist clients to make informed decisions in the use of these therapies. Importantly, with the increased interest in complementary therapies, there is a need to ensure these practices are safe, cause no harm and are used to enhance the well-being of patients. This paper reports on the design, implementation and evaluation of a complementary therapies course and a linked Thai cultural studies tour. The course was implemented at The University of Newcastle for the first time in 2009 with an enrolment of 200 students. It is an elective course for both nursing students and those from other disciplines. In this paper we describe the reasons for the introduction of this course and its value in nursing education. We then provide an overview of the course and report on evaluation results from both the course and the Thai cultural studies tour.
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Outcomes from the trial implementation of a multidisciplinary online learning program in rural mental health emergency care
Education for Health
Hills, D., Robinson, T., Kelly, B., & Heathcote, S.
Abstract
Introduction: Emergency Departments (EDs) are often the first point of contact for people with acute mental health problems. The impact of the Mental Health Emergency Care (MHEC) online learning program on the knowledge and skills development of clinicians and support staff was evaluated, and options for sustainable implementation of the program were proposed.
Methods: Participants were recruited from the four rural health services and the rural areas of one metropolitan health service in New South Wales, Australia. The MHEC course was conducted online over 24 weeks and comprised four sequential modules, each based on a clinical scenario that demonstrated a typical, acute mental health presentation to a general hospital ED. The course was designed to model collaborative practice in mental health emergency care.
Results: Participants were surveyed before and after completing the MHEC course. Statistically significant improvements were detected in participant confidence in managing key mental health problems, perceived self-efficacy in dealing with challenging, aggressive behaviours and confidence in key online learning skills. Participants also reported very positive experiences in relation to the course content and structure, instructor support, multidisciplinary discussion and feedback, and improvements in their knowledge and skills about emergency mental healthcare.
Conclusions: This study provides evidence for the effectiveness and acceptability of an online educational program in developing the capacity of front-line staff to respond effectively to people who present to EDs with acute mental health problems. The positive outcomes and evaluations of the MHEC course provide support for the deployment of online learning programs that address mental health emergency care.
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