Patrick A Crookes

Meaningful and engaging teaching techniques for student nurses: A literature review

Helping undergraduate nursing students to contextualise theory learnt in the classroom to their professional practice can be challenging for nurse educators. This article provides a critical review of contemporary literature that explores strategies and techniques that nurse educators within university settings have adopted to address this challenge. This review was conducted as part of a broader research project that involved interviewing nurse educators to explore how they attempt to make their teaching meaningful and engaging for student nurses. The data was analysed using thematic analysis and the intention is to share the wealth of ideas gleaned with other nurse educators, including in the form of an evidence-based inventory of teaching approaches found to be effective in enhancing the meaningfulness and engagement of content to nursing learners.

Mental health nursing education in preregistration nursing curricula: a national report.

The Australian Mental Health Nurse Education Taskforce conducted a national examination of mental health content of preregistration nursing curricula in order to develop a framework for including mental health in future curricula. This paper presents the qualitative findings from national consultations about the framework. Content analysis of data was undertaken, and the findings show four key themes. First, the mental health content of curricula should be increased; second, overall mental health nursing leadership should be strengthened; third, mental health consumer participation should be increased in all aspects of curricula; and finally, a repository should be established for mental health teaching resources.

Mental health content of comprehensive pre-registration nursing curricula in Australia

In 2008 the final report of the Mental Health Nurse Education Taskforce was released. This paper presents the findings of the report’s survey into the mental health content of generic pre-registration nursing curricula in Australia. A questionnaire was sent to all nursing schools providing pre-registration curricula. Results indicate curricula contained a wide range of mental health theory and clinical hours. While the majority of universities incorporated most of the 20 key topics recommended by the Mental Health Nurse Education Taskforce in their courses, few addressed issues such as Indigenous mental health. There was considerable competition for placements between universities, and concern about the quality of some placements. Nurse academics with formal qualifications in mental health and specialist clinical mental health nurses were mainly involved in teaching theory. Specialist mental health clinicians and clinical educators were the key groups engaged in students’ clinical education, and preceptorship was the most common form of clinical supervision. Consumers and carers had limited involvement in the development or provision of mental health content of pre-registration curricula. Greater attention is needed to increasing the mental health content in pre-registration curricula. Furthermore, initiatives should be developed to increase access to clinical placements and reduce competition for places between universities.

Patients Assessment of Chronic Illness Care (PACIC) in two Australian studies: structure and utility

AIMS To validate the Patients Assessment of Chronic Illness Care (PACIC) among patients with chronic disease in the Australian context and to examine the relationship between patient-assessed quality of care and patient and practice characteristics. METHODS Cross-sectional analysis of baseline data in two independent health service intervention studies that involved patients with type 2 diabetes, ischaemic heart disease and/or hypertension in general practice. The first study involved 2552 patients from 60 urban and rural general practices. The second involved 989 patients from 26 practices in Sydney. Patients were mailed a questionnaire, which included the PACIC and Short Form Health Survey. Factor analysis was performed and the factor scores and total PACIC were analysed using multi-level regression models against practice and patient characteristics. RESULTS Factor analysis revealed a two-factor solution with similar loading of PACIC items in both studies: one for shared decision making and self-management and the other for planned care. Practice characteristics were not related to PACIC scores. Scores were related to patient characteristics - education, retirement, type and number and duration of conditions. CONCLUSIONS The two-factor structure of the PACIC found in these Australian studies is different from the five-factor structure found in the US and the European studies. This may be related to differences in the way patients interact with the health system especially the use of Team Care plans. The association of total scores with patient characteristics was consistent with those found in other studies including a lack of association with gender, age and ethnicity. These findings should be taken into consideration when comparing patient-assessed quality of care between countries using this tool.

Teaching critical appraisal skills for Nursing research

BACKGROUND Evidence-based practice is a major focus in nursing, yet the literature continues to document a research-practice gap. Reasons for this gap stem partly from a lack of skills to critique and synthesize the literature, a lack of search skills and difficulty in understanding research articles, and limited knowledge of research by nursing professionals. METHOD An innovative and quality driven subject to improve critical appraisal and critical thinking skills was developed for the School of Nursing, Midwifery and Indigenous Health at the University of Wollongong, based on formative research with postgraduate students and supervisors. Through face-to-face and online teaching modules students worked through a structured process of analysing the key aspects of published papers using structured analysis tools for each study design. RESULTS Pre and post surveys of students found improvements in perceived knowledge of all key skills of critical appraisal. External independent evaluation determined that it was a high quality subject showing many hallmarks of good assessment practice and good practice in use of information and communication technology (ICT) in support of the learning outcomes.

Measuring research ‘impact’ for academic promotion: issues from the literature

Around the world, governments and the higher education sector are being asked to become more accountable for the money they spend on research funding. Research quality measurement exercises, such as the Excellence in Research for Australia initiative, use a number of agreed indicators to measure, analyse and report on various institution and discipline-based research outputs. This emphasis on the outputs of research as opposed to its longer term outcomes is having an effect on internal university policy and processes which can often operate negatively on individual staff career development and promotion. This article reports on a project aimed at more clearly articulating and defining the idea of research impact for academics by preparing a promotion application. Phase one of the project was an extensive international literature review and this article sets out the findings from this review, considers the difficulties for articulating and evidences impact at the individual level and makes some suggestions for how academic staff and units might begin to deal with the idea of research impact.

Engagement and academic promotion: a review of the literature

Universities in Australia are becoming increasingly concerned with their reputation as ‘engaged’ institutions. Yet there is significant confusion about what this idea of ‘engagement’ means and no clear way of measuring or reporting it. In part, this is because of the nature of engagement itself which is dependent on local context, partnerships and communities. This presents a difficulty for academic staff undertaking engaged work within institutions and stresses the need for institutions to develop internal processes that clearly articulate definitions of engagement, set out performance expectations and provide processes for the reward and recognition of the scholarship of engagement. In a sector increasingly concerned with the outputs of research as measurable by publication bibliometrics and grant income, the sometimes difficult to measure outcomes of engaged work can become relegated and dismissed. As part of a project to articulate performance expectations in the area of the scholarship of engagement for academic promotion at the University of Wollongong, researchers undertook an extensive international literature review to learn what had been done in this area previously and to identify issues of concern. This paper sets out the findings from this review, considers the implications of engaged scholarship for academic promotion and suggests some possible ways forward for institutions and staff working in this area.

The Teamwork Study: enhancing the role of non-GP staff in chronic disease management in general practice

There is evidence for a team-based approach in the management of chronic disease in primary health care. However, the standard of care is variable, probably reflecting the limited organisational capacity of health services to provide the necessary structured and organised care for this group of patients. This study aimed to evaluate the impact of a structured intervention involving non-GP staff in GP practices on the quality of care for patients with diabetes or cardiovascular disease. A cluster randomised trial was undertaken across 60 GP practices. The intervention was implemented in 30 practices with staff and patients interviewed at baseline and at 12-15 months follow up. The change in team roles was evaluated using a questionnaire completed by practice staff. The quality of care was evaluated using the Patient Assessment of Chronic Illness Care questionnaire. We found that although the team roles of staff improved in the intervention practices and there were significant differences between practices, there was no significant difference between those in the intervention and control groups in patient-assessed quality of care after adjusting for baseline-level score and covariates at the 12-month follow up. Practice team roles were not significantly associated with change in Patient Assessment of Chronic Illness Care scores. Patients with multiple conditions were more likely to assess their quality of care to be better. Thus, although previous research has shown a cross-sectional association between team work and quality of care, we were unable to replicate these findings in the present study. These results may be indicative of insufficient time for organisational change to result in improved patient-assessed quality of care, or because non-GP staff roles were not sufficiently focussed on the aspects of care assessed. The findings provide important information for researchers when designing similar studies.

Facilitating teamwork in general practice: moving from theory to practice

The aims of this paper are to describe the development of an intervention to improve teamwork and systems in general practice that support the care of patients with diabetes, ischaemic heart disease and hypertension and to identify the challenges to implementing the intervention. Effective teamwork in general practice encompasses general practitioners (GP), clinical and non-clinical staff, each with clearly defined roles and opportunities to provide feedback and input into how the practice is run and chronic disease managed. The intervention implemented in this study provided an opportunity for key members of general practice teams to work with a facilitator on changes to improve teamwork over three practice visits over 6–12 months. Facilitators had experience in practice support and goal setting, an understanding of the Medicare Items and knowledge about teamwork and systems. The visits focussed on the specific needs and capacities of each practice, assisting the team to set manageable goals and building systems that best utilise the systemic and human resources available. Successful implementation of sustained change depended on strong leadership in the practice and cooperation between team members as well as clear and achievable goals being set. Structured facilitation of teamwork in general practice should focus on goal setting and the development of leadership and communication rather than delivery of information or resources.

A Model of Adaptation of Overseas Nurses Exploring the Experiences of Japanese Nurses Working in Australia

Purpose: The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. Design: A qualitative study. Method: Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Results: Analysis of qualitative open-ended questions revealed the participants’ adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. Discussion: The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. Implications for Practice: The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.