Lucia Cadorin

Instruments measuring meaningful learning in undergraduate healthcare students: a systematic review protocol

AIM To establish the psychometric properties of instruments to measure learning outcomes in healthcare students. BACKGROUND Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge. Meaningful learning produces a long-term change in knowledge and skills, which is underpinned by willingness to learn and experience and it is exclusively built by the learner. DESIGN Systematic psychometric review protocol developed from Cochrane Effective Practice and Organization of Care guidance. METHOD Searches of MEDLINE, CINAHL, SCOPUS, ERIC, PsycINFO, Cochrane Library, Psychology & Behavioral Sciences Collection Database between 1990-2013. Selected studies will be evaluated with the Consensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. RESULTS The systematic review will produce a synthesis of the data related to the instruments that measure learning outcomes. These data will help us decide which tools to use and identify the state of knowledge in this field. CONCLUSIONS Measuring learning outcomes is very important for the large amount of human and financial resources employed in educating and training health professionals and this requires reliable and valid instruments.

An integrative review of the characteristics of meaningful learning in healthcare professionals to enlighten educational practices in health care

Knowledge does not transfer automatically, but requires an active, personal progress through meaningful learning. As posited by the constructivist paradigm, the aim of this study was to identify the characteristics of meaningful learning by analysing definitions and correlated methods found in the literature.

Instruments for measuring meaningful learning in healthcare students: a systematic psychometric review.

AIM To identify, evaluate and describe the psychometric properties of instruments that measure learning outcomes in healthcare students. BACKGROUND Meaningful learning is an active process that enables a wider and deeper understanding of concepts. It is the result of an interaction between new and prior knowledge and produces a long-standing change in knowledge and skills. In the field of education, validated and reliable instruments for assessing meaningful learning are needed. DESIGN A psychometric systematic review. DATA SOURCES MEDLINE CINAHL, SCOPUS, ERIC, Cochrane Library, Psychology & Behavioural Sciences Collection Database from 1990-December 2013. REVIEW METHOD Using pre-determined inclusion criteria, three reviewers independently identified studies for full-text review. Then they extracted data for quality appraisal and graded instrument validity using the Consensus-based Standards for the selection of the health status Measurement INstruments checklist and the Psychometric Grading Framework. RESULTS Of the 57 studies identified for full-text review, 16 met the inclusion criteria and 13 different instruments were assessed. Following quality assessment, only one instrument was considered of good quality but it measured meaningful learning only in part; the others were either fair or poor. The Psychometric Grading Framework indicated that one instrument was weak, while the others were very weak. No instrument displayed adequate validity. CONCLUSIONS The systematic review produced a synthesis of the psychometric properties of tools that measure learning outcomes in students of healthcare disciplines. Measuring learning outcomes is very important when educating health professionals. The identified tools may constitute a starting point for the development of other assessment tools.

Student perspectives on: Does nursing have a future?

Our answer is ‘‘Yes, Nursing does have a future’’ . . . if our society perceives its usefulness, it will ask for its professional services, and if nurses will know how to value their own competences so that they may respond effectively to the new and changing needs of the population. The population’s future healthcare demand is increasing due to emerging global phenomena such as aging and chronic illnesses, causing serious issues of financial sustainability in many countries. In the future, along with the hospital services, there will be the need to have a well-structured network of community services to ensure healthcare continuum to all. In addition, there could be a change in the composition of the different professional profiles within the health workforce, with less physicians and the need to rethink the roles and the scopes of practice of other health professionals. Many studies have highlighted the important role nurses play, especially highly educated nurses, in improving patient outcomes. More nurse practitioners will have to provide besides care, taking directly care of patients (or better persons) and their informal carers/caregivers. There will be no future for nursing if its deep relationship is lost with the sick person (the ‘‘infirm,’’ which is the root of the Italian word for nurse ‘‘infermiere’’) and does not rediscover the great value of caring for the human body, according to the concept of ‘‘embodiment.’’ Nursing actions must continue to bear a high ethical value paying attention to the dignity and autonomy of the person, to the vision of the human being seen both individually and globally, and to the defense of human life in any circumstance and condition. Higher education needs to be reinforced, especially in the clinical field, so that it may stimulate innovation and research, as well as prepare professionals capable of providing high-quality care. It must be able to prove what is the added value and the real advantages of a nurse’s independent professional practice within the framework of healthcare systems that are radically changing. This scenario also offers new opportunities for the development of nursing, which would, however, need to be supported by its leadership to generate and value new competences. The latter would need to be addressed in order to respond effectively to the new and changing healthcare needs of the population and at the same time be pragmatic and flexible enough to adapt to new contexts and situations. The ethical conduct expected from nurses redeems them from the old role of mere executors of prescriptions made by others and encourages nurses to develop and assert their dignity as professionals, equipped with their own relational, educational, and technical competences.

Ethical dimensions of paediatric nursing: A rapid evidence assessment:

Background: Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, ‘What are the most common ethical dimensions and competences related to paediatric nursing?’ Research design: A rapid evidence assessment. Method: According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Findings: Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Conclusion: Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses’ perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.

Instruments evaluating the self-directed learning abilities among nursing students and nurses: a systematic review of psychometric properties

BackgroundModern healthcare institutions are continuously changing, and Self-Directed Learning (SDL) abilities are considered a prerequisite for both nursing students and nurses in order to be proactive about these demanding challenges. To date, no systematic reviews of existing instruments aimed at detecting and critically evaluating SDL abilities have been published. Therefore, the aims of this review are: 1) identify the instruments for assessment of SDL abilities among nursing students and nurses; 2) critically evaluate the methodological studies quality; and 3) compare the psychometric properties of the available instruments.MethodsA psychometric-systematic-review was performed. CDSR, CINAHL, ERIC, MEDLINE, PROSPERO, SCOPUS databases were searched without restrictions in time and setting. All primary studies involving nursing students or nurses, written in English and aimed at validating SDL assessment tools, were included. Studies retrieved were evaluated according to the COnsensus-based-Standards for the selection of health Measurement-INstruments (COSMIN) panel. Study inclusion, data extraction and quality assessment were performed by researchers independently.ResultsEleven studies were included and four tools based on Knowles’s theory have emerged: 1) the Self-Directed Learning Readiness Scale; 2) the Self-Directed Learning Readiness Scale for Nursing Education; 3) the Self-Rating Scale of Self-Directed Learning, and 4) the Self-Directed Learning Instrument. A few psychometric properties have been considered in each study, from two to four out of the ten required. The quality of the methodologies used was in general, from fair to poor with the exception of one instrument (the Self-Directed-Learning-Instrument). The psychometric proprieties that emerged across the tools were good in general: the Cronbach α was from 0.73 to 0.91; structural validities have also reported good indexes both in the explorative and in the confirmative factor analyses.ConclusionsOn the basis of the findings, the Self-Directed-Learning-Instrument can be recommended for the assessment of SDL abilities among nursing students and nurses, given the excellent methodology quality adopted in estimating the psychometric properties. However, rigorous study designs aimed at estimating psychometric properties of tools in wide samples of nursing students and nurses across different stages of professional life, from undergraduate education to professional maturity, in different cultural, educational, and work settings, are strongly recommended.