Tonia Crawford

A literature review of the language needs of nursing students who have English as a second/other language and the effectiveness of English language support programmes.

Australia is increasingly becoming a culturally diverse country, with this trend being reflected in nursing education as significant numbers of students enrol from backgrounds where English is a second/other language (ESL). These students will enable the provision of culturally competent care that a culturally diverse health system requires (Ohr et al., 2010), however they require significant levels of support to not only achieve academically in their nursing programme, but also to perform at the expected level during clinical placements (Boughton et al., 2010). Difficulties communicating with colleagues, patients and their families in the clinical setting have been identified among the challenges that ESL nurses face (Boughton et al., 2010; Jeong et al., 2011). A review of the literature indicates sporadic research into the education of nurses from ESL backgrounds. This paper discusses and raises awareness of common themes such as the challenges of adjusting to Western culture and using the advanced and technical English required by higher education and healthcare. This paper also discusses mixed results reported from a number of English language support programmes. This indicates a need for further research in this area to strengthen support for these nurses who can assist in the provision of culturally competent care.

Using problem-based learning in web-based components of nurse education

Problem-based learning (PBL) is a student-centred method of teaching, and is initiated by introducing a clinical problem through which learning is fostered by active inquisition (Tavakol and Reicherter, 2003). Using this teaching and learning strategy for web-based environments is examined from the literature for potential implementation in a Bachelor of Nursing program. In view of the evidence, students accessing online nursing subjects would seem to benefit from web-based PBL as it provides flexibility, opportunities for discussion and co-participation, encourages student autonomy, and allows construction of meaning as the problems mirror the real world. PBL also promotes critical thinking and transfer of theory to practice. It is recommended that some components of practice-based subjects such as Clinical Practice or Community Health Nursing, could be implemented online using a PBL format, which should also include a discussion forum to enable group work for problem-solving activities, and tutor facilitation.

Investigating the language needs of culturally and linguistically diverse nursing students to assist their completion of the bachelor of nursing programme to become safe and effective practitioners.

BACKGROUND Australia has an increasing number of nursing students from culturally and linguistically diverse backgrounds however problems communicating in the clinical setting, difficulty with academic writing and a tendency to achieve lower grades have been reported. OBJECTIVES To identify the language needs of culturally and linguistically diverse students, and evaluate the English language support programme to develop appropriate strategies and assist academic progression and clinical communication skills. DESIGN AND METHODS An action research approach was adopted and this paper reports findings from the first round of semi-structured individual interviews. The strategies suggested by the participants will subsequently be implemented and evaluated during the first cycle of action research. SETTING An Australian Bachelor of Nursing programme which has students from culturally and linguistically diverse backgrounds. PARTICIPANTS Eight second and third year students who have a primary language other than English. RESULTS Four strategies emerged from initial student interviews. The English language support programme to be conducted during semester breaks, ongoing focus on reading and writing but also to include some International English Language Testing System exam strategies and practice, increase the use of nursing specific language and context in the English language support programme, and informing or reminding lecturers of the impact of their lecture delivery style on learning for students from diverse backgrounds. CONCLUSION Themes emerging from the initial round of interviews inform both the implementation of the English language support programme and teacher delivery. It is hoped that implementing these strategies will support the English language development of nurses from diverse backgrounds. Proficient communication will more likely contribute to providing safe and effective culturally sensitive care in a culturally diverse health care environment. Additional cycles of action research may be conducted to further improve the programme.

An Intervention Aimed at Reducing Plagiarism in Undergraduate Nursing Students

Plagiarism is a current and developing problem in the tertiary education sector where students access information and reproduce it as their own. It is identified as occurring in many tertiary level degrees including nursing and allied health profession degrees. Nursing specifically, is a profession where standards and ethics are required and honesty is paramount. The aim of this study was to evaluate the change in nursing students knowledge and understanding of plagiarism before and after an educational intervention in their first semester of the Bachelor of nursing degree at a private college of higher education in Sydney, Australia. This study concluded that an educational intervention can increase knowledge and awareness of plagiarism among nursing students.

Impact of community based nurse-led clinics on patient outcomes, patient satisfaction, patient access and cost effectiveness: A systematic review

BACKGROUND The role and scope of nursing practice has evolved in response to the dynamic needs of individuals, communities, and healthcare services. Health services are now focused on maintaining people in their communities, and keeping them out of hospital where possible. Community based nurse-led clinics are ideally placed to work towards this goal. The initial impetus for these services was to increase patient access to care, to provide a cost-effective and high quality streamlined service. OBJECTIVES This systematic review aimed to identify the impact of nurse-led clinics in relation to patient outcomes, patient satisfaction, impact on patient access to services, and cost effectiveness. METHODS A review of community based nurse-led clinic research in Medline, CINAHL and Embase was undertaken using MeSH terms: Nurse-managed centres, Practice, Patterns, Nurse, Ambulatory Care, keywords: nurse-led clinic, nurse led clinic, community and phrases primary health care and primary care. Papers were appraised using the Joanna Briggs Appraisal criteria. RESULTS The final review comprised 15 studies with 3965 participants. Most studies explored patient satisfaction which was largely positive towards nurse-led clinics. Patient outcomes reported were typically from self-report, although some papers addressed objective clinical measures; again positive. Access was reported as being increased. Cost-effectiveness was the least reported impact measure with mixed results. CONCLUSIONS Nurse-led clinics have largely shown positive impact on patient outcomes, patient satisfaction, access to care and mixed results on cost-effectiveness. Future research evaluating NLCs needs to adopt a standardised structure to provide rigorous evaluations that can rationalise further efforts to set up community based nurse-led clinical services.

A systematic review examining the effectiveness of blending technology with team-based learning

BACKGROUND Technological advancements are rapidly changing nursing education in higher education settings. Nursing academics are enthusiastically blending technology with active learning approaches such as Team Based Learning (TBL). While the educational outcomes of TBL are well documented, the value of blending technology with TBL (blended-TBL) remains unclear. This paper presents a systematic review examining the effectiveness of blended-TBL in higher education health disciplines. OBJECTIVES This paper aimed to identify how technology has been incorporated into TBL in higher education health disciplines. It also sought to evaluate the educational outcomes of blended-TBL in terms of student learning and preference. METHOD A review of TBL research in Medline, CINAHL, ERIC and Embase databases was undertaken including the search terms, team based learning, nursing, health science, medical, pharmaceutical, allied health education and allied health education. Papers were appraised using the Critical Appraisal Skills Program (CASP). RESULTS The final review included 9 papers involving 2094 student participants. A variety of technologies were blended with TBL including interactive eLearning and social media. CONCLUSION There is limited evidence that blended-TBL improved student learning outcomes or student preference. Enthusiasm to blend technology with TBL may not be as well founded as initially thought. However, few studies explicitly examined the value of incorporating technology into TBL. There is a clear need for research that can discern the impact of technology into TBL on student preference and learning outcomes, with a particular focus on barriers to student participation with online learning components.

The consequences of diverse empathic responses in nurse-patient interactions: a discourse analysis

ABSTRACT Background: Empathy in healthcare interactions has been a focus of considerable research since the 1980s, and discourse analysis has been used more recently to identify how empathy is accomplished in interactions between healthcare professionals and their patients. However, there has been little research using naturally occurring nurse/patient interactions. Method: This study employs discourse analysis from an interactional sociolinguistic approach to examine and describe the interactional consequences of empathy during nurse-patient interactions. Results: The consequence of the display of empathy was an extended interaction with numerous affiliative responses by both parties, showing evidence of good rapport and a therapeutic relationship. This is compared to interactions where minimal affiliative responses are evident. The exchange with the patient is cut short with a quick return to the clinical agenda after a momentary acknowledgement of the patient’s concern. Where empathy is not displayed, the patient does not elaborate on concerns, thereby limiting the development of rapport and trust. The display of empathy has been linked to patient satisfaction and improved patient outcomes. Conclusion: Examining natural nurse-patient interactions allows for a greater understanding of the consequences of various communicative approaches and levels of engagement. This awareness can enable the development of stronger communicative competence of health professionals, enhancing professional practice and patient satisfaction.