Antoinette McCallin

Postgraduate research supervision: a critical review of current practice

Changes in the funding and delivery of research programmes at the university level have, in recent years, resulted in significant changes to research supervision. This paper critically reviews key influences effecting postgraduate supervision. Analysis draws on literature spanning 2000–2010 to determine the appropriateness of traditional models of postgraduate research curricula and supervision for the New Zealand context. Influences discussed include the research context, faculty issues, supervision pedagogy and models of supervision. Each area is analysed for strengths and challenges and contribution to the knowledge economy. From this review, the authors propose strategies for the development of postgraduate research supervision: faculty development, including supervisor education, and formalised research training for students.

Interprofessional practice: learning how to collaborate.

Abstract Interprofessional practice is a way of practicing that is based on collaboration. We cannot assume that health professionals have either the skills or attributes required for interprofessional practice. They may need to learn how to collaborate. Developing interprofessional practice requires a commitment to engage in shared learning and dialogue. Dialogue has the potential to encourage collegial learning, change thinking, support new working relationships, and improve client care.

Breaking the Silence Integration of Facial Disfigurement After Surgical Treatment for Cancer

Little is known about the psychosocial effects of facial disfigurement. We present the results of a qualitative study following 15 patients who had been surgically treated for head, neck, or eye cancer over the course of their first postoperative year. Taped nurse–patient conversations and individual interviews were analyzed using the grounded theory method. The findings revealed that the main concern of the patients was feeling isolated, which was resolved using a process of interactional integration. Interactional integration begins by breaking the silence to enable the progression from a disfigured person to a person with a disfigurement. The model explains the process of adjustment and demonstrates various elements that could be used in interventions targeting patients who experience psychosocial problems.

Moderated guiding: a grounded theory of nursing practice in end‐of‐life care

AIM The aim of this study was to generate a grounded theory of nursing practice in end-of-life care. BACKGROUND Provision of end-of-life care that meets the needs of the dying person and their family is complex. While symptom control, disease management and psychosocial care are well understood, there is less evidence about how nurses manage everyday practicalities in challenging organisational environments. DESIGN Qualitative using Glasers method of grounded theory. METHODS Data were collected from 30 semi-structured interviews with registered nurses working in end-of-life care in New Zealand. Data were analysed using constant comparative techniques. Theoretical sampling and memo writing furthered theoretical development. RESULTS Nurses used the process of moderated guiding to manage different expectations in end-of-life care. Moderated guiding included checking out, involving and supporting. Guiding was both controlling and non-controlling. Moderation was required, as there were tensions in nursing practice because of patient control issues, resource constraints and the individual nurses emotional investment in the nurse-patient relationship. CONCLUSIONS Moderated guiding raises questions about the challenges nurses face in a health care environment where responsibilities for care have changed. RELEVANCE TO CLINICAL PRACTICE Moderated guiding explains the role nurses have as resource managers in health services where wider social and economic issues impact multiple clinical demands and influence nursing practice.

Restoring: How older adults manage their recovery from hip fracture

AIMS AND OBJECTIVES To generate a substantive theory that explained recovery from hip fracture from the perspective of older adults and find out how they managed it. BACKGROUND Hip fracture is a well-researched phenomenon. The perspective of how older adults recover from hip fracture has been examined least of all. Patients spend less time in hospital following injury and generally recover in their home setting. DESIGN A Glaserian grounded theory approach was used for this study. METHODS Semi-structured interviews (n-21) were conducted with older adults post discharge following hip fracture. Data were collected, analysed and theorised using the grounded theory methodology. RESULTS Older adults recovering from hip fracture were restored back to normal through a process in which they continuously balanced regaining of physical and social functioning against reasserting usual psycho-social behaviours within different contexts. Importantly, the older adults personal recovery process starts within the acute setting once the person regains physical functioning, especially regaining mobility. From this point onwards, older adults will respond to health professionals, instructions and interventions in many ways. The responses will be based on their developmental life stage to enable them to counter the diverse expectations placed on them by health professionals, social networks and their self-beliefs. CONCLUSION Nurses need to understand that older adults will recover in their own way following discharge, often re-interpreting health information to fit their own situations.

Reflections from New Zealand: Facilitating Cultural Change

This chapter discusses how interprofessional learning and collaborative practice were embedded into the curricula of a large, diverse health faculty in New Zealand, and the leadership processes required to facilitate a cultural change.