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Australian rural and remote registered nurses' experiences of learning to provide antenatal services in general practice : A pilot study

- Mills, Jane, Birks, Melanie, Francis, Karen, Miles, Maureen, Jones, Janet

  • Authors: Mills, Jane , Birks, Melanie , Francis, Karen , Miles, Maureen , Jones, Janet
  • Date: 2010
  • Type: Text , Journal article
  • Relation: International Journal of Nursing Practice Vol. 16, no. 4 (2010), p. 319-325
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  • Description: This article reports on a pilot vocational study programme for provision of antenatal services in the general practice environment. The concurrent evaluation study assessed practice nurses' experiences of undertaking the pilot programme, the level and applicability of the content, and the mode of delivery. General practitioners' understanding of the role of the nurse in providing antenatal services, and the actual and potential impact of this new role on models of service delivery and care were also investigated. Women receiving care from practice nurses within this new model of service delivery and care were also of interest in this study. Findings showed that the current role of the general practice nurse in caring for pregnant women is restricted to assisting the general practitioner to complete their assessment of clients. Organizing clinical placement with a midwife was a major barrier to completing the pilot programme.

Clinical decision-making: midwifery students' recognition of, and response to, postpartum haemorrhage in the simulation environment

- Scholes, Julie, Endacott, Ruth, Biro, Mary Anne, Bulle, Bree, Cooper, Simon J., Miles, Maureen, Gilmour, Carole, Buykx, Penny, Kinsman, Leigh, Boland, Rosemarie, Jones, Janet, Zaidi, Fawzia

  • Authors: Scholes, Julie , Endacott, Ruth , Biro, Mary Anne , Bulle, Bree , Cooper, Simon J. , Miles, Maureen , Gilmour, Carole , Buykx, Penny , Kinsman, Leigh , Boland, Rosemarie , Jones, Janet , Zaidi, Fawzia
  • Date: 2012
  • Type: Text , Journal article
  • Relation: BMC Pregnancy and Childbirth Vol. 12, no. 19 (2012), p. 1-12
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  • Description: Background This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Methods Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. Results The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. Conclusions The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could be done whilst they awaited the emergency team. They did not necessarily serve to prompt the students' or help them plan care prospectively. The limitations of the study are critically explored along with the pedagogic implications for initial training and continuing professional development.

Cultural desire need not improve with cultural knowledge : A cross-sectional study of student nurses

- Isaacs, Anton, Raymond, Anita, Jacob, Elisabeth, Jones, Janet, McGrail, Matthew, Drysdale, Marlene

  • Authors: Isaacs, Anton , Raymond, Anita , Jacob, Elisabeth , Jones, Janet , McGrail, Matthew , Drysdale, Marlene
  • Date: 2016
  • Type: Text , Journal article
  • Relation: Nurse Education in Practice Vol. 19, no. (2016), p. 91-96
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  • Description: Cultural desire is considered to be a prerequisite for developing cultural competence. This study explored cultural desire among student nurses towards Aboriginal peoples and its association with participation in a one-semester unit on Aboriginal health through a cross-sectional survey. Our main outcome, cultural desire, was measured using two items level of agreement with Aboriginal health being an integral component of the nursing curriculum and an expressed interest in Aboriginal health. 220 (74.58%) student nurses completed the survey. Completing the Aboriginal Health and wellbeing unit did not influence students' opinions on inclusion of the unit as part of the nursing curriculum (odds ratio OR 0.73, 95% CI 0.43-1.29) or their overall cultural desire (mean difference = -0.69, 95% CI -1.29 to -0.08, p = 0.026). Students who completed the unit reported a higher understanding of Aboriginal health (OR = 2.35, 95% CI = 1.35-4.08) but lower interest levels in the subject (OR = 0.45, 95% CI: 0.24-0.84). Further research is necessary to explore how and when cultural desire might develop in nurses who are trained in cultural competence particularly in the contexts of post-colonial disparities and political conflict. © 2016 Elsevier Ltd.

Exploration of nursing degree students’ content expectations of a dedicated Indigenous health unit

- Jacob, Elisabeth, Raymond, Anita, Jones, Janet, Jacob, Alycia, Drysdale, Marlene, Isaacs, Anton

  • Authors: Jacob, Elisabeth , Raymond, Anita , Jones, Janet , Jacob, Alycia , Drysdale, Marlene , Isaacs, Anton
  • Date: 2016
  • Type: Text , Journal article
  • Relation: Collegian Vol. 23, no. 3 (2016), p. 313-319
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  • Description: Mandatory Aboriginal and Torres Strait Islander health units are included in all nursing education programmes in Australia to improve students’ knowledge, skills and attitudes towards Indigenous people in order to help address health inequities. This research explores content expectations of nursing students required to undertake Aboriginal and Torres Strait Islander health studies as part of a Bachelor of Nursing Degree at a rural university campus. A cross-sectional survey was undertaken to examine students’ opinions of course content of an Aboriginal health and wellbeing unit. Two hundred and ninety-four students across the three years of the degree were asked to complete the anonymous survey. Two hundred and forty-six students (83.6%) completed the survey. One hundred and thirty-nine students had completed, and 107 students were yet to undertake the unit. Qualitative content analysis of an open-ended survey question was used to interrogate the data. Four themes emerged from the data: cultural competence, disease implications and management, nursing care and other issues. Content expectations were consistent for students who were yet to undertake (pre) or had completed (post) the unit. Content expectations included Aboriginal and Torres Strait Islander culture (pre 30.4%–post 29.8%), Aboriginal and Torres Strait Islander health issues (pre 20.0%–post 23.7%) and understanding nursing care related issues (pre 15.7%–post 17.1%). Data findings were significant for enhancing the current unit. Students express the need for a safe learning environment in which to challenge beliefs and opinions. Course facilitators need to be sensitive to student populations and include content relevant to the programme being studied. Cultural immersion experiences may improve confidence in nursing Aboriginal and Torres Strait Islander people. © 2015 Australian College of Nursing Ltd

Managing women with acute physiological deterioration: student midwives performance in a simulated setting

- Cooper, Simon J., Bulle, Bree, Biro, Mary Anne, Jones, Janet, Miles, Maureen, Gilmour, Carole, Buykx, Penny, Boland, Rosemarie, Kinsman, Leigh, Scholes, Julie, Endacott, Ruth

  • Authors: Cooper, Simon J. , Bulle, Bree , Biro, Mary Anne , Jones, Janet , Miles, Maureen , Gilmour, Carole , Buykx, Penny , Boland, Rosemarie , Kinsman, Leigh , Scholes, Julie , Endacott, Ruth
  • Date: 2012
  • Type: Text , Journal article
  • Relation: Women and Birth Vol. 25, no. 3 (2012), p. e27-e36
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  • Description: Abstract Objective Midwives’ ability to manage maternal deterioration and ‘failure to rescue’ are of concern with questions over knowledge, clinical skills and the implications for maternal morbidity and, mortality rates. In a simulated setting our objective was to assess student midwives’ ability to assess, and manage maternal deterioration using measures of knowledge, situation awareness and skill, performance. Methods An exploratory quantitative analysis of student performance based upon performance, ratings derived from knowledge tests and observational ratings. During 2010 thirty-five student, midwives attended a simulation laboratory completing a knowledge questionnaire and two video, recorded simulated scenarios. Patient actresses wearing a ‘birthing suit’ simulated deteriorating, women with post-partum and ante-partum haemorrhage (PPH and APH). Situation awareness was, measured at the end of each scenario. Applicable descriptive and inferential statistical tests were, applied to the data. Findings The mean total knowledge score was 75% (range 46–91%) with low skill performance, means for both scenarios 54% (range 39–70%). There was no difference in performance between the scenarios, however performance of key observations decreased as the women deteriorated; with significant reductions in key vital signs such as blood pressure and blood loss measurements. Situation, awareness scores were also low (54%) with awareness decreasing significantly (t(32) = 2.247, p = 0.032), in the second and more difficult APH scenario. Conclusion Whilst knowledge levels were generally good, skills were generally poor and decreased as the women deteriorated. Such failures to apply knowledge in emergency stressful situations may be resolved by repetitive high stakes and high fidelity simulation.

Models of health service delivery in remote or isolated areas of Queensland: A multiple case study

- Birks, Melanie, Mills, Jane, Francis, Karen, Coyle, Meaghan, Davis, Jennifer, Jones, Janet

The decision-making processes adopted by rurally located mandated professionals when child abuse or neglect is suspected

- Francis, Karen, Chapman, Ysanne, Sellick, Kenneth, James, Ainsley, Miles, Maureen, Jones, Janet, Grant, Julie

Transforming the teaching of report writing in science and engineering through an integrated online learning environment, WRiSE (Write Reports in Science and Engineering)

- Drury, Helen, Jones, Janet

  • Authors: Drury, Helen , Jones, Janet
  • Date: 2010
  • Type: Text , Conference proceedings
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  • Description: This paper describes an ALTC (Australian Learning and Teaching Council) funded project, which addresses the development of students‟ report writing skills in science and engineering across the undergraduate years. The WRiSE project grew out of concerns about student performance in written assessments, as well as the need to improve graduate writing emphasised by employers and government. The project approach involved a collaborative team across two institutions. The team comprised language and learning specialists and discipline staff who developed learning materials and technical and eLearning specialists who converted these into online materials. Development followed a feedback spiral, which also involved student users. WRiSE is an integrated, freely available, student centred, online learning environment for report writing in nine discipline areas within science and engineering. In each discipline area, interactive learning materials have been developed to address both the product and process of report writing, as well as the concepts and content behind the reports students have to write. WRiSE is designed to meet the needs of students from diverse backgrounds who have had varying writing experiences as it can be accessed according to student needs. Evaluation of WRiSE has been positive in the areas of user friendliness and improved understanding and confidence in report writing. Those students who used WRiSE have attained significantly higher grades in their reports than students who did not use WRiSE.

Undergraduate midwifery students' sense of belongingness in clinical practice

- McKenna, Lisa, Gilmour, Carole, Biro, Mary Anne, McIntyre, Meredith, Bailey, Carolyn, Jones, Janet, Miles, Maureen, Hall, Helen, McLelland, Gayle

  • Authors: McKenna, Lisa , Gilmour, Carole , Biro, Mary Anne , McIntyre, Meredith , Bailey, Carolyn , Jones, Janet , Miles, Maureen , Hall, Helen , McLelland, Gayle
  • Date: 2013
  • Type: Text , Journal article
  • Relation: Nurse Education Today Vol. 33, no. 8 (2013), p.880-883
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  • Description: Summary Background Clinical placements form a large and integral part of midwifery education. While much has been written about nursing students' clinical placements, less is known about clinical experiences of undergraduate midwifery students. In nursing, belongingness has been demonstrated to be a key factor in clinical learning but little is known about this in midwifery education. Objectives This study sought to examine undergraduate midwifery students' sense of belongingness in their clinical practice. Design A quantitative design using an online questionnaire was employed. A tool adapted by Levett-Jones (2009a), and previously used with nursing students, was utilised to examine sense of belonging in undergraduate midwifery students. Participants Sixty undergraduate midwifery students from two campuses at one Australian university participated in the study. Students were drawn from a single Bachelor of Midwifery degree and a double Bachelor of Nursing/Bachelor of Midwifery degree. Methods On completion of a scheduled lecture, students were invited by one of the researchers to participate in the study by completing the online questionnaire and the link provided. Data were analysed using descriptive statistics. Results Midwifery students generally reported similar perceptions of belongingness with previous studies on nursing students. However, a few differences were noted that require further exploration to fully understand. Conclusions Midwifery students experienced a sense of belonging in their clinical placements. The findings contribute to understandings of the experiences for midwifery students and provide a foundation on which to develop future clinical placement experiences.
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