Julia Gale

Student nurse selection and predictability of academic success: The Multiple Mini Interview project

BACKGROUND With recent reports of public enquiries into failure to care, universities are under pressure to ensure that candidates selected for undergraduate nursing programmes demonstrate academic potential as well as characteristics and values such as compassion, empathy and integrity. The Multiple Mini Interview (MMI) was used in one university as a way of ensuring that candidates had the appropriate numeracy and literacy skills as well as a range of communication, empathy, decision-making and problem-solving skills as well as ethical insights and integrity, initiative and team-work. OBJECTIVES To ascertain whether there is evidence of bias in MMIs (gender, age, nationality and location of secondary education) and to determine the extent to which the MMI is predictive of academic success in nursing. DESIGN A longitudinal retrospective analysis of student demographics, MMI data and the assessment marks for years 1, 2 and 3. SETTINGS One university in southwest London. PARTICIPANTS One cohort of students who commenced their programme in September 2011, including students in all four fields of nursing (adult, child, mental health and learning disability). METHODS Inferential statistics and a Bayesian Multilevel Model. RESULTS MMI in conjunction with MMI numeracy test and MMI literacy test shows little or no bias in terms of ages, gender, nationality or location of secondary school education. Although MMI in conjunction with numeracy and literacy testing is predictive of academic success, it is only weakly predictive. CONCLUSIONS The MMI used in conjunction with literacy and numeracy testing appears to be a successful technique for selecting candidates for nursing. However, other selection methods such as psychological profiling or testing of emotional intelligence may add to the extent to which selection methods are predictive of academic success on nursing.

Cognitive behaviour therapy: an evidence-based clinical framework for working with dysfunctional thoughts

This paper discusses and illustrates three evidence-based clinical strategies that could be used to work with modifying clients’ dysfunctional thoughts. An effective strategy in shifting the clients dysfunctional thought is to engage the client in an examination of the logic of his/her dysfunctional thinking and to develop objective and abstract thinking that the client could relate to his/her personal experience/problem. Another useful strategy is to help the client to realize the consequences of holding on to his/her dysfunctional thinking and the potential benefits of changing. The purpose of the present paper is to discuss the conceptual and practical issues that underpin an evidence-based clinical framework for working with dysfunctional thoughts. This framework will be of interest to practitioners and counsellor working in diversity of settings such as schools, university and college counselling centres, mental health clinics and hospitals.

The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews

BackgroundNurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing.MethodsReviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised.ResultsNine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant.ConclusionsIn making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave.Trial registrationPROSPERO Registration 17 March 2015: CRD42015017613.

Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews

Background: Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. Objective: We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. Method: We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Results: Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. Conclusion: We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.