Bernie Garrett

High-fidelity patient simulation: considerations for effective learning.

ABSTRACT This article explores a case of the implementation of high‐fidelity simulation (HFS) in an undergraduate preregistration nursing program in a Canadian school of nursing. A small practice collaborative project to develop reusable simulation resources for team‐based simulations is described, using HFS technology. Considerations for effective learning resulting from faculty and student evaluations of the project are discussed. Students identified positive learning experiences and indicated that real‐time patient status changes proved valuable to them. Also, using these techniques offered a safe environment for improving competence. The use of reflective debriefing appeared to be a focal area for learning that requires emphasis in the planning of HFS experiences. This template, team‐focused learning approach also appeared to offer a cost‐efficient strategy for HFS.

Evaluation of an eportfolio for the assessment of clinical competence in a baccalaureate nursing program

This paper reports a study undertaken to evaluate the implementation of an electronic portfolio (eportfolio) tool for the assessment of clinical competence in a Bachelor of Science in Nursing program. Baccalaureate nursing programs increasingly use information and communications technologies to support student learning, assess and record progress. Portfolio based practice assessment and electronic portfolios represent growing trends to enhance learning via student reflection and self-identification of further learning needs. Using an action-research process, a mixed-methods evaluation strategy explored the efficacy of the eportfolio in its second year of use. Website tracking analytics and descriptive statistics were used to explore trends in eportfolio usage. Instructor and student surveys and focus groups were carried out at the end of the second year. Instructors valued the eportfolios convenience, improved transparency, an improved ability to track student progress, enhanced theory-practice links, and the competency based assessment framework. Students valued accessibility and convenience, but expressed concerns over assessment data openness and processes for standardization. Both groups felt that the eportfolio navigation required simplification. Electronic portfolios represent a technological evolution from paper-based clinical assessment systems. Although there appear to be many student and instructor advantages in using eportfolios, to maximize successful implementation, clinical teachers require additional training in this new pedagogic approach. Strategies to assist an institutional culture shift towards more transparent assessment processes may also need consideration.

Implementing high-fidelity simulation in Canada: Reflections on 3 years of practice

This paper explores our experiences in implementing and using high-fidelity simulation (HFS) over the last three years, in the context of the results of the Canadian Association of Schools of Nursing (CASN) health 2006 simulation survey, which explored the use of simulation across Canada in professional health education. Considerations for the practical implementation of simulation based on evaluations at the University of British Columbia School of Nursing are discussed. The rapid increase in the uptake of simulation-based education in Canada is due in large part to the belief that these techniques offer a safe environment for learners to improve competence. Students and teachers have identified positive learning experiences with high-fidelity simulation, particularly with respect to complex patient care scenarios, multidisciplinary team scenarios, student team work (i.e., team-based learning), and reflective debriefing. Despite these benefits there have been significant resource implications from adopting these technologies. The use of team-based learning and reflective debriefing appeared to be a focal area for emphasis in the planning of clinical simulation experiences. A team focused learning approach may also offer a more cost-efficient strategy for clinical simulation.

Using social media to promote international student partnerships

This paper describes a project to establish and evaluate online study partnerships, using social networking applications, between final year Canadian nursing students at the University of British Columbia (UBC) and second year undergraduate science education students at the University of Plymouth (UoP) in the UK. The project took place between 2009 and 2010 and evaluated the use of social networking applications with international interdisciplinary partnerships between Canadian and UK students. A multi-method evaluation strategy incorporating questionnaires, online focus groups and web analytics was used to explore the value of social media to promote the exchange of ideas and discussion of scientific philosophy in different contexts, between students working in disciplines with differing philosophical perspectives principally modern/post-modern, quantitative/qualitative, empirical/theoretical. This project resulted in a very successful collaborative partnership between UK and Canadian students.

Ways of knowing: realism, non‐realism, nominalism and a typology revisited with a counter perspective for nursing science

In this paper, we reconsider the context of Barbara Carpers alternative ways of knowing, a prominent discourse in modern nursing theory in North America. We explore this relative to the concepts of realism, non-realism and nominalism, and investigate the philosophical divisions behind the original typology, particularly in relationship to modern scientific enquiry. We examine forms of knowledge relative to realist and nominalist positions and make an argument ad absurdum against relativistic interpretations of knowledge using the example of Borges Chinese Emporium of Benevolent Knowledge. We propose a contentious postpositivist practical classification for nursing knowledge that demonstrates and supports the idea that knowledge has both individual and subjective components. This classification supports the practical application of nursing knowledge within the paradigm of realist postpositivist science.

Augmented reality m-learning to enhance nursing skills acquisition in the clinical skills laboratory

Purpose – This paper aims to report on a pilot research project designed to explore if new mobile augmented reality (AR) technologies have the potential to enhance the learning of clinical skills in the lab. Design/methodology/approach – An exploratory action-research-based pilot study was undertaken to explore an initial proof-of-concept design in using AR resources to supplement clinical skills lab teaching. A convenience non-probability sample of 72 undergraduate nursing students tested these resources during lab sessions, and participated in post-exposure surveys and focus groups to help evaluate them. This pilot design aimed to test logistics and gather information prior to further developmental work. Findings – Key similarities emerged between the survey and focus group findings regarding the technical issues and support for student learning. Students clearly expressed a comfort with the technology, and both students and faculty identified the ability to access resources to support self-directed lea...

New sophistry: self-deception in the nursing academy

In this essay, I advance an argument against the expansion and acceptance of postmodern metaphysical antirealist ideologies in the development of nursing theory in North America. I suggest mystical theoretical explanations of care, the rejection of empirical epistemology, and a return to divinity in nursing represent an intellectual dead end, as these ideas do little to help resolve real-world health issues and also negate the need for the academic discrimination of bad ideas. I examine some of the philosophical foundations of nursing theory and deconstruct some of the more preternatural theories that have become established as the dominant conventional wisdom in the academy. It is argued that this can be characterized as a form of self-deception, and overall has had a negative impact on advancement of the nursing profession and public health care. Reasons behind the widespread acceptance of these irrational theoretical stances in nursing and the ongoing support for mystical therapeutic interventions are explored.

Changing the game; some thoughts on future healthcare demands, technology, nursing and interprofessional education

This editorial discusses the conclusions of a number of high-profile reports on the future of healthcare provision, and healthcare professional education. The need for the realignment of service provision, regulation, interdisciplinary healthcare and supporting education is discussed in the context of rapid technological and social change.

Prostate Cancer Support Groups Canada-Based Specialists’ Perspectives

To understand prostate cancer (PCa) specialists’ views about prostate cancer support groups (PCSGs), a volunteer sample of Canada-based PCa specialists (n = 150), including urologists (n = 100), radiation oncologists (n = 40), and medical oncologists (n = 10) were surveyed. The 56-item questionnaire used in this study included six sets of attitudinal items to measure prostate cancer specialists’ beliefs about positive and negative influences of PCSGs, reasons for attending PCSGs, the attributes of effective PCSGs, and the value of face-to-face and web-based PCSGs. In addition, an open-ended question was included to invite additional input from participants. Results showed that PCSGs were positively valued, particularly for information sharing, education and psychosocial support. Inclusivity, privacy, and accessibility were identified as potential barriers, and recommendations were made for better marketing PCSGs to increase engagement. Findings suggest prostate cancer specialists highly valued the role and potential benefits of face-to-face PCSGs. Information provision and an educational role were perceived as key benefits. Some concerns were expressed about the ability of web-based PCSGs to effectively engage and educate men who experience prostate cancer.

Employing an experimental approach to evaluate the impact of an intelligent agent

This paper explores a different approach to evaluating the merits of specific technical components of computer based learning applications. A traditional double blind experimental study was implemented in a new context. A computer based Clinical Decision Simulator (CDS) system was designed and implemented incorporating an intelligent agent. This was compared to an otherwise identical system with no agent, and a group of students not using CBL systems. The results suggested that although no improvement in measurable learning outcomes could be conclusively demonstrated there was some evidence that those students using the intelligent agent system demonstrated more positive learning experiences and a deeper conceptualisation of the issues. This would suggest that a comparative multimethod experimental evaluation strategy, although complex (and not without its shortcomings) may help provide a more comprehensive analysis of students learning experience, and provide a useful picture of the student’s perceptions of CBL tools. This novel approach may be of particular relevance where the justification of a specific technological aspect of an e‐learning application is required. The value of developing and using an experimental strategy to evaluate a specific technological aspect of a computer based learning (CBL) application is discussed.