Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing : a qualitative enquiry
- Maguire, Tessa, Garvey, Loretta, Ryan, Jo, Levett-Jones, Tracy, Olasoji, Michael, Willetts, Georgina
- Authors: Maguire, Tessa , Garvey, Loretta , Ryan, Jo , Levett-Jones, Tracy , Olasoji, Michael , Willetts, Georgina
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 2 (2023), p. 544-555
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- Description: Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to ‘own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team. © 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
- Authors: Maguire, Tessa , Garvey, Loretta , Ryan, Jo , Levett-Jones, Tracy , Olasoji, Michael , Willetts, Georgina
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 2 (2023), p. 544-555
- Full Text:
- Reviewed:
- Description: Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to ‘own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team. © 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
A systematic review of the effectiveness of empathy education for undergraduate nursing students
- Levett-Jones, Tracy, Cant, Robyn, Lapkin, Samuel
- Authors: Levett-Jones, Tracy , Cant, Robyn , Lapkin, Samuel
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Nurse Education Today Vol. 75, no. (2019), p. 80-94
- Full Text: false
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- Description: Objective: The objective of this systematic review was to identify, critically appraise and synthesize evidence for the effectiveness of empathy interventions in undergraduate nursing education. Design: A systematic review of literature. Data Sources: A three-stage systematic search of six electronic databases was conducted. Review Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. English language articles published between 2000 and 2018 were eligible. Methodological rigour was examined using the Medical Education Research Study Quality Instrument. Changes in empathy were assessed using Cohen's effect size correlation (r) and reported as effective when the variance was >0.2 standard deviations (r
- Seaton, Philippa, Levett-Jones, Tracy, Cant, Robyn, Cooper, Simon, Kelly, Michelle, McKenna, Lisa, Ng, Linda, Bogossian, Fiona
- Authors: Seaton, Philippa , Levett-Jones, Tracy , Cant, Robyn , Cooper, Simon , Kelly, Michelle , McKenna, Lisa , Ng, Linda , Bogossian, Fiona
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Collegian Vol. 26, no. 1 (2019), p. 194-203
- Full Text: false
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- Description: Background: There is unprecedented increase in use of simulation-based education in healthcare settings. The key driver is improving quality and safety in healthcare. To date, there is limited understanding of the degree to which this goal has been achieved. Aim: This scoping review aimed to explore the extent to which simulation-based education in healthcare has addressed and impacted contemporary patient safety priorities. Methods: Systematic searches of literature (2007–2016) were based on each of 10 patient safety priorities articulated in Australia's National Safety and Quality Health Service Standards and New Zealand's Health, Quality and Safety Indicators and markers. Included primary studies evaluated transferability to practice and/or behavioural change and improved patient outcomes, based on Kirkpatrick's training evaluation model Level 3 and Level 4. Findings: Fifteen papers met inclusion criteria. Studies aligned with four of ten National Safety and Quality Health Service Standards: (3). Preventing and controlling healthcare associated infections; (4). Medication safety; (6). Clinical handover; (9). Recognising and responding to clinical deterioration. The studies were indicative of potential for simulation-based education to have a significant impact on patient safety. Discussion: Studies that qualify as translational science, demonstrating changes in clinician behaviours and improved patient outcomes, are emerging. Little evidence from Australian and New Zealand contexts suggests that outcomes of simulation-based education in this region are not commensurate with the significant government investments. Conclusion: Translational studies, despite being difficult to design and conduct, should form part of a thematic, sustained and cumulative program of simulation-based research to identify translational science. © 2018 Australian College of Nursing Ltd
Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education : a systematic review
- Bogossian, Fiona, Cant, Robyn, Ballard, Emma, Cooper, Simon, Levett-Jones, Tracy, McKenna, Lisa, Ng, Linda, Seaton, Phillippa
- Authors: Bogossian, Fiona , Cant, Robyn , Ballard, Emma , Cooper, Simon , Levett-Jones, Tracy , McKenna, Lisa , Ng, Linda , Seaton, Phillippa
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 21-22 (2019), p. 3759-3775
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- Description: Aims and objectives: To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation-based education as substitution for clinical placement in prelicensure programmes. Background: Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. Methods: A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. Results: Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi-experimental and methodological quality was assessed as moderate to high with good to very good inter-rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr–2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer; no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. Conclusions: This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. Relevance to clinical practice: Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health. © 2019 John Wiley & Sons Ltd
- Authors: Bogossian, Fiona , Cant, Robyn , Ballard, Emma , Cooper, Simon , Levett-Jones, Tracy , McKenna, Lisa , Ng, Linda , Seaton, Phillippa
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 21-22 (2019), p. 3759-3775
- Full Text:
- Reviewed:
- Description: Aims and objectives: To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation-based education as substitution for clinical placement in prelicensure programmes. Background: Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. Methods: A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. Results: Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi-experimental and methodological quality was assessed as moderate to high with good to very good inter-rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr–2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer; no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. Conclusions: This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. Relevance to clinical practice: Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health. © 2019 John Wiley & Sons Ltd
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