H Bridgman

The evidence for ‘flipping out’: A systematic review of the flipped classroom in nursing education

BACKGROUND The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of todays students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula. OBJECTIVES The aims of this systematic review were to examine how the flipped classroom has been applied in nursing education and outcomes associated with this style of teaching. DATA SOURCES Five databases were searched and resulted in the retrieval of 21 papers: PubMed, CINAHL, EMBASE, Scopus and ERIC. REVIEW METHODS After screening for inclusion/exclusion criteria, each paper was evaluated using a critical appraisal tool. Data extraction and analysis were completed on all included studies. RESULTS This systematic review screened 21 titles and abstracts resulting in nine included studies. All authors critically appraised the quality of the included studies. Five studies were identified and themes identified were: academic performance outcomes, and student satisfaction implementing the flipped classroom. CONCLUSIONS Use of the flipped classroom in higher education nursing programmes yielded neutral or positive academic outcomes and mixed results for satisfaction. Engagement of students in the flipped classroom model was achieved when academics informed and rationalised the purpose of the flipped classroom model to students. However, no studies in this review identified the evaluation of the process of implementing the flipped classroom. Studies examining the process and ongoing evaluation and refinement of the flipped classroom in higher education nursing programmes are warranted.

Integrating Health Behavior Theory and Design Elements in Serious Games

Background Internet interventions for improving health and well-being have the potential to reach many people and fill gaps in service provision. Serious gaming interfaces provide opportunities to optimize user adherence and impact. Health interventions based in theory and evidence and tailored to psychological constructs have been found to be more effective to promote behavior change. Defining the design elements which engage users and help them to meet their goals can contribute to better informed serious games. Objective To elucidate design elements important in SPARX, a serious game for adolescents with depression, from a user-centered perspective. Methods We proposed a model based on an established theory of health behavior change and practical features of serious game design to organize ideas and rationale. We analyzed data from 5 studies comprising a total of 22 focus groups and 66 semistructured interviews conducted with youth and families in New Zealand and Australia who had viewed or used SPARX. User perceptions of the game were applied to this framework. Results A coherent framework was established using the three constructs of self-determination theory (SDT), autonomy, competence, and relatedness, to organize user perceptions and design elements within four areas important in design: computer game, accessibility, working alliance, and learning in immersion. User perceptions mapped well to the framework, which may assist developers in understanding the context of user needs. By mapping these elements against the constructs of SDT, we were able to propose a sound theoretical base for the model. Conclusions This study’s method allowed for the articulation of design elements in a serious game from a user-centered perspective within a coherent overarching framework. The framework can be used to deliberately incorporate serious game design elements that support a user’s sense of autonomy, competence, and relatedness, key constructs which have been found to mediate motivation at all stages of the change process. The resulting model introduces promising avenues for future exploration. Involving users in program design remains an imperative if serious games are to be fit for purpose.

Evaluating the effects of mindfulness-based interventions for informal palliative caregivers: A systematic literature review.

Background: There is a need to identify proactive, evidence-based interventions to support informal palliative caregivers. Mindfulness-based interventions, evidenced in the literature as providing physical and mental health benefits for diverse populations, may have application in the setting of palliative caregiving. Aim: To describe, evaluate and synthesise the peer-reviewed literature on the effects of mindfulness-based interventions for informal palliative caregivers. Design: A Systematic Literature Review according to the Preferred Reporting Items for Systematic Review and Meta Analyses guidelines and a Narrative synthesis. Data sources: The Cochrane Library, CINAHL, MEDLINE, PsycINFO and EMBASE databases, searched from inception to February 2014 and references of included studies. Results: A total of 13 articles, reporting 10 studies (n = 432 participants) were included. All studies were conducted in the last 5 years. Dementia caregivers were the most frequently researched population (n = 7). Results suggest that mindfulness-based interventions are feasible and acceptable to offer to informal palliative caregivers and may provide benefit, particularly in terms of reducing depression and caregiver burden and increasing quality of life. However, effects were not as robust as findings in the wider mindfulness intervention literature. Conclusion: This is the first systematic literature review on this topic. Results suggest both feasibility and potential benefit. Further qualitative research is required to explore the outcomes identified by informal caregivers themselves as the reduced magnitude of effect may suggest that we are not measuring the right outcomes in this context. This would inform more sensitive outcome measures for future intervention studies and guide the development and application of mindfulness-based models in this area.

Interprofessional practice and learning in a youth mental health service: a case study using network analysis

Abstract Few studies have examined interprofessional practice (IPP) from a mental health service perspective. This study applied a mixed-method approach to examine the IPP and learning occurring in a youth mental health service in Tasmania, Australia. The aims of the study were to investigate the extent to which staff were networked, how collaboratively they practiced and supported student learning, and to elicit the organisation’s strengths and opportunities regarding IPP and learning. Six data sets were collected: pre- and post-test readiness for interprofessional learning surveys, Social Network survey, organisational readiness for IPP and learning checklist, “talking wall” role clarification activity, and observations of participants working through a clinical case study. Participants (n = 19) were well-networked and demonstrated a patient-centred approach. Results confirmed participants’ positive attitudes to IPP and learning and identified ways to strengthen the organisation’s interprofessional capability. This mixed-method approach could assist others to investigate IPP and learning.

The pregnancy journey for women with type 1 diabetes: a qualitative model from contemplation to motherhood

The purpose of this study is to describe and develop a model of the pregnancy journey for women with type 1 diabetes.

The role of resilience in the recovery of the burn-injured patient: an integrative review

Severe burn injuries are catastrophic life events resulting in significant physical and psychological effects. With long periods of hospitalization and rehabilitation, burn survivors encounter many issues, including an altered body image and loss of function and independence that subsequently influence quality of life and the family unit. Consequently, resilience has been identified as a fundamental concept that facilitates the adaptability required to navigate the lengthy and complex recovery process. However, over time, the notion of resilience has shifted from a static, innate trait to a fluid and multidimensional concept. Here, we review the evidence surrounding the role of resilience in the recovery of burn injury. This integrative review was based on a systematic search of five electronic databases. Of the 89 articles identified, ten primary research papers met the inclusion criteria. Three key themes were identified encompassing relational strengths, positive coping, and the resistance to trauma symptoms that are fundamental constructs associated with developing and sustaining resilience that resonate with the broader literature on burn recovery. However, limited evidence is currently available within the burns context. While resilience appears to be a vital component influencing the recovery from burns trauma, it still remains a broad construct within the burns framework. Regular assessment of resilience in burn-injured patients is recommended in clinical practice in addition to longitudinal and intervention studies to best inform patient care.

The benefits and challenges of academic writing retreats: an integrative review

ABSTRACT The immediate drivers to increase publication outputs in higher education are government and research funding, organisational status, performance expectations and personal career aspirations. Writing retreats are one of a range of strategies used by universities to boost publication output. The aims of this integrative review were to synthesise the available evidence, identify the attributes, benefits and challenges of academic writing retreats and examine the components that facilitate publication output. The review was based on a systematic search of six electronic databases. Of the 296 articles identified, 11 primary research papers met the inclusion criteria. Thematic analysis of the data highlighted a raft of personal, professional and organisational benefits of writing retreats. The five key elements of writing retreats conducive to increasing publication output were protected time and space; community of practice; development of academic writing competence; intra-personal benefits and organisational investment. Participants involved achieved greater publication outputs, particularly when provided ongoing support. Further research is required to examine more substantively the feasibility of writing retreats, their cost-effectiveness and the features that increase publication outcomes.

Rural Art Roadshow: a travelling art exhibition to promote mental health in rural and remote communities

Abstract The Rural Art Roadshow was designed to build community resilience, reduce stigma and promote a positive image of mental health in rural Tasmania, Australia by show-casing a travelling exhibition of art submitted by Tasmanian community members affected by mental illness. The project combined the benefits of art as therapy, and the art show as a community event to increase social inclusion, and facilitate positive conversations about mental health.

Health and Well-Being of International University Students, and Comparison with Domestic Students, in Tasmania, Australia

International students comprise an increasingly larger proportion of higher education students globally. Empirical evidence about the health and well-being of these students is, however, limited. We sought to examine the health and well-being of international students, primarily from Asian countries, attending the University of Tasmania, Australia, using domestic students as a comparison group. Ethics approval was given to invite (via email) all currently enrolled students to participate in the study by completing a pilot-tested, online survey. The survey was completed by 382 international students (response rate = 8.9%) and 1013 domestic students (9.2%). Independent samples t-tests, analysis of variance (ANOVA) and chi-square tests were used for bivariate comparisons between international and domestic students, and between subgroups of international students. Regression models were used to examine the associations between student status (international vs. domestic) and health outcomes, controlling for demographic and enrolment variables. International students, particularly male students, were found to be at increased risk of several adverse health outcomes while also being less likely to seek help for mental health and related problems. The findings indicate the need for accessible, targeted, culturally-sensitive health promotion and early intervention programs.