Maura MacPhee

Strengthening communication education in an undergraduate nursing curriculum.

As effective communication is an essential professional competency that is conceptualized and developed during undergraduate education, the purpose of this study was to investigate and reinforce the role of communication in the nursing undergraduate curriculum. Analysis of faculty and student focus group discussions revealed the benefit of purposefully structuring and explicitly articulating communication education throughout the undergraduate curriculum for increased accessibility and visibility of communication education, expanded ranges of available teaching and learning methods and resources, and strengthened ability to address undermining mixed communication messages. These findings have implications for how to specifically include communication education in a learning-centered undergraduate curriculum.

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.

The role of social support networks for rural hospital nurses: supporting and sustaining the rural nursing work force.

ObjectiveThis survey study describes the workplace social support networks of rural hospital nurses in one geographic region of Colorado. This rural sample was compared with data from a sample of urban hospital nurses in Colorado. BackgroundSocial support networks influence nurses’ satisfaction and retention. Nursing recruitment and retention is especially critical in rural areas where it takes healthcare facilities 60% longer than urban facilities to fill nursing vacancies. Little is known about rural nurses’ social support networks. MethodsThe Social Network Questionnaire (SNQ) was mailed to all nurses within one rural region of Colorado. Descriptive, correlational and comparative statistics were used to evaluate the structure and function of these nurses’ networks. ResultsThe nurses’ networks were predominantly peer-based, but managers provided significant functional supports. The types of support provided by managers depended on the managers’ placement in the nurses’ networks. Some managers provided only performance feedback, and other managers offered physical assistance and emotional support. Rural nurses expected more guidance from management than did their urban counterparts. ImplicationsThis sample of nurses clearly delineated the types of leadership styles most beneficial to them. Communication of roles and expectations between staff and management can enhance nursing satisfaction in the workplace setting.

Strategies and tools for managing change.

Continuous change in complex healthcare environments is a challenge for nurse leaders, but it can also be a boon. Change can leverage the introduction of innovations that improve the quality of care delivery. It all depends on how change is managed. The author describes major leadership strategies and tools to effectively manage change, particularly innovative changes that result in better outcomes for patients, staff, and the organization.

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.

Developing a practice-academic partnership logic model.

This article will describe a testable logic model for practice-academic partnerships. The model can be used to build collaborative practice capacity between academic and practice partners. A deductive approach was used to construct a logic model based on the best theoretical evidence in the research literature. The model was tested and refined over the course of a year, based on the collection of inductive evidence to support the theoretical models components and linkages. This article will describe how the logic model served to guide School of Nursing faculty and nurse leaders from a local, urban community hospital through the process of establishing a successful partnership. Specific examples of the models inputs, activities, outputs, and outcomes are provided. The partnership is actively engaged 2 years after the initial pilot of the logic model. Significant outcomes have included a new clinical placement model, affiliate academic appointments for practice educators, and research collaborations.

Global health care leadership development: trends to consider

This paper provides an overview of trends associated with global health care leadership development. Accompanying these trends are propositions based on current available evidence. These testable propositions should be considered when designing, implementing, and evaluating global health care leadership development models and programs. One particular leadership development model, a multilevel identity model, is presented as a potential model to use for leadership development. Other, complementary approaches, such as positive psychology and empowerment strategies, are discussed in relation to leadership identity formation. Specific issues related to global leadership are reviewed, including cultural intelligence and global mindset. An example is given of a nurse leadership development model that has been empirically tested in Canada. Through formal practice-academic-community collaborations, this model has been locally adapted and is being used for nurse leader training in Hong Kong, Taiwan, and Brazil. Collaborative work is under way to adapt the model for interprofessional health care leadership development.

A clinical tool for nonorganic failure-to-thrive feeding interactions

An interdisciplinary team of professionals developed and piloted a clinical tool, the Feeding Checklist, for assisting observations of feeding interactions with nonorganic failure-to-thrive (NOFTT) clients. The piloting process involved two phases. During the development phase, content validity and reliability were established with three NOFTT experts. The tool was compared with a standardized feeding interaction assessment instrument to determine concurrent validity. Both tools revealed similar behavior patterns significantly differentiating between NOFTT and Thriving dyads. The results also concurred with NOFTT literature findings. During the second phase of the study, pediatric nursing staff significantly improved the nursing documentation of NOFTT feeding interactions when using the Feeding Checklist.

Online knowledge networking: what leaders need to know.

Knowledge networks (KNs) are leadership tools that can increase social capital and innovation in and across organizations. Communities of practice often emerge from successful KNs. Electronic or online KNs can maximize efficiency and effectiveness of communications and collaboration. The authors describe the benefits associated with KNs. They provide an overview of the development, facilitation, and evaluation of online KNs. An example of a nursing leadership online KN illustrates the key considerations involved in the KN process.