Ann Wakefield

Learning together: clinical skills teaching for medical and nursing students

Objective  To evaluate the feasibility and effectiveness of shared learning of clinical skills for medical and nursing students at the University of Manchester.

Facilitating reproductive choices: the impact of health services on the experiences of young women with breast cancer

Objective: Chemotherapy and hormone treatments carry significant implications on the fertility of young women with breast cancer. Increasingly, nulliparous women experience fertility dilemmas due to rising survival rates and pregnancy delay. This qualitative study investigated womens responses to being told that treatments affected their fertility and how their interactions with health services impacted on their experiences.

Mapping the introduction of Assistant Practitioner roles in Acute NHS (Hospital) Trusts in England

AIMS This mapping study describes current or planned introduction of assistant practitioner roles in English National Health Service Acute Hospital Trusts. BACKGROUND In the last decade there has been a growth in nursing support workforce numbers and their scope of practice. An important United Kingdom support worker development is the Assistant Practitioner role. METHOD A national census was carried out (April 2007) via an emailed questionnaire to Directors of Nursing. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis. RESULTS Eighty-five per cent (143/168) of Directors of Nursing, from all 10 English Strategic Health Authorities, responded. Forty-six per cent (n = 66) of Trusts had introduced assistant practitioners and 22% (n = 31) were planning to implement the role before 2009. There is wide variation in assistant practitioner numbers across and between Strategic Health Authorities, Trusts and clinical areas. Resistance to the role existed in 32% (n = 46) of Trusts. Reasons for resistance included no perceived need for the role, lack of evidence of effectiveness, financial constraints and professional and patient safety concerns. IMPLICATIONS FOR NURSING MANAGEMENT These findings, which contribute to the international evidence-base on health care support workers roles, provide nurse managers with numbers of assistant practitioners and their deployment. This is useful for Nurse Managers making workforce decisions.

Breaking bad news: qualitative evaluation of an interprofessional learning opportunity

This paper analyses the effects of bringing together a small group of nursing and medical students to learn the skills needed to break bad news to patients. It outlines the qualitative and quantitative methods used, to provide the reader with a comprehensive account of the teaching, learning and research strategies drawn on during the study. The paper examines the evaluation phase, as this aspect is of greatest import if such initiatives are to flourish. The facet of the study analysed in detail concerns the students’ responses to the open-ended qualitative questionnaires. In coding the data, three researchers independently highlighted a series of themes associated with the benefits and hazards of nursing and medical students learning and working together. Finally, the paper closes by arguing that trust and mutual respect are vital ingredients if collaborative working is to become part of the medical and nursing curriculum.

Challenges and opportunities associated with the introduction of assistant practitioners supporting the work of registered nurses in NHS acute hospital trusts in England

Objectives To understand the challenges and opportunities associated with the introduction of assistant practitioner (AP) roles supporting the work of ward-based registered nurses (RNs) in National Health Service (NHS) acute hospital trusts in England. Methods Three case studies of NHS acute hospital trusts. This paper presents qualitative findings, drawing on documentary data sources and data generated through interviews and focus group discussions. Results Introduction of APs into ward-based nursing teams has been variable, and often driven by external pressures rather than perceived organizational need. This, along with little national guidance, has created some confusion about the role, but at the same time has permitted flexible role development through ‘negotiated compromise’ at local level. While there are various areas of potential improvement in policy and practice, APs are generally perceived to have the potential to make a valuable contribution to patient care. Conclusions Findings from this study will help policy-makers, organizations and practitioners understand factors that enable and/or inhibit the integration of new assistant roles within existing occupational structures to develop innovative services and enhance patient care. These factors are important when considering how care will be delivered to maximize the skills of the entire nursing workforce.

Team working but no blurring thank you! The importance of team work as part of a teaching ward experience

This article examines the theme of teamwork emergent from qualitative data amassed during a small-scale research project. The study was intended to establish whether it was feasible to introduce an educational teaching ward within the medical and nursing undergraduate curriculum. The study took place on a general medical ward at one of the hospital sites linked to the University of Manchester. During the project, students were encouraged to work as teams to share their knowledge and skills related to practice. From the recorded interview data and facilitator/researcher reflective diary notes, it soon became apparent that despite enjoying the opportunity to engage in collaborative working and learning, the students felt that there could be too much sharing. For this reason, the students made it very clear that interprofessional education was not the panacea, given that it could result in professionals losing their distinct identity. Moreover, the students felt that as each profession has a different role, different job and different agenda, a large proportion of the teaching should remain discipline specific. Hence, the article closes by considering why a blurring of the professional boundaries was not perceived to be a wholly positive educational outcome by the students.

Promoting interdisciplinarity through educational initiative: a qualitative evaluation

This paper describes a multi-professional teaching innovation that took place at The University of Manchester during October 2001. Ideas for the project were first established in December 2000 when a multi-professional team of educationalists began exploring ways in which three disparate student groups could be brought together as part of an integrated learning activity (). For this reason, a problem-based learning scenario was developed to encourage nursing, midwifery, and medical students to share their previous knowledge and principles of care. In addition, the students were also asked to identify the type(s) of information they felt should be included in a user guide for new parents regarding the uncomplicated labour and puerperium. In total 10-second year nursing, 17-third year midwifery and 13-fourth year medical students volunteered to take part. These were subsequently divided into five integrated problem-based learning groups each supported by two teachers reflecting similar multi-professional backgrounds. In this paper, the discussion will explore a series of themes identified as being of major import by students and tutors during the qualitative phase of the study namely:

Methodological aspects in the assessment of safety culture in the hospital setting: A review of the literature

A thematic literature review was undertaken to identify methodological aspects in the assessment of safety culture and critically examine how these have been addressed in hospital-based studies of safety culture, for the period 1999-2012. The literature search included an electronic database search (BNI, CINAHL, EMBASE, MEDLINE and PsycINFO), access to websites of organizations dedicated to the enhancement of patient safety, and a manual search of reference lists of the papers included. The analysis of the 43 records included in the review revealed that discussion regarding the measurement of safety culture in the hospital setting revolves around three methodological areas, namely: research approaches; survey tools for data collection; and levels of data aggregation. To advance these discussions, robust research is needed to clarify what dimensions belong to the core of safety culture and what the main sources of safety culture variability are. Studies using a mixed methods approach to assess safety culture would be useful, since they permit the in-depth research necessary to depict the multiple components of this construct.

The changing ‘shape’ of the nursing station

Abstract The Nursing Station is a puzzling structure fulfilling a variety of roles throughout the day. At times, it resembles a communal market place with staff standing around chatting. Yet, once a shift commences, regulatory characteristics emerge to control a person’s entry and exit from the ward, by ensuring that they have an authentic reason for being there. This paper juxtaposes the role of the Nursing Station with Strauss et al.’s (1964) notion of shape. In this way, is intended to examine in detail how the Nursing Station can influence the normal and natural flow of work within a ward.