Centre for Postgraduate Nursing

Title. Critical incident technique: a user's guide for nurse researchers Aim. This paper is a description of the development and processes of the critical incident technique and its applicability to nursing research, using a recentlyconducted study of the Australian nursing workforce as an exemplar. Issues are raised for consideration prior to the technique being put into practice. Background. Since 1954, the critical incident technique has been used to study people's activities in a variety of professions. This five-step technique can be modified for specific settings and research questions. The fruitfulness of a study using the technique relies on gaining three important pieces of information. First, participants' complete and rich descriptions of the situation or event to be explored; secondly, the specific actions of the person/s involved in the event to aid understanding of why certain decisions were made; thirdly, the outcome of the event, to ascertain the effectiveness of the behaviour. As in other qualitative methodologies, an inductive analysis process can be used with the critical incident technique. Findings. Rich contextual information can be obtained using this technique. It generates information and uncovers tacit knowledge through assisting participants to describe their thought processes and actions during the event. Use of probing questions that determine how participants take part in certain events, or act in the ways they do, greatly enhances the outcome. A full interpretation of the event can only occur when all its aspects are provided. Conclusion. The critical incident technique is a practical method that allows researchers to understand complexities of the nursing role and function, and the interactions between nurses and other clinicians.

Increasingly eLearning, and multimedia resources are blending with other forms of clinical education to provide experiences that maximise both foundational learning for Health Professionals, and learning-readiness for the application of this knowledge in clinical areas. Academics within the School of Nursing and Midwifery work with a health-focused team of flexible delivery specialists to develop resources for a diverse student group. Best practice instructional design, experienced clinical practitioners, and the latest technology have allowed the school to bridge the gap. This presentation will showcase a range of eLearning activities developed for an undergraduate curriculum delivered in a multi-campus environment. A commitment to using technology such as targeted audio and video, 3D animation, and interactive flash programming to support pedagogy, provides an opportunity to deliver high quality learning activities. Yes Yes

Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent. Recent developments in mobile technology, such as mobile phone and tablet computer apps, could help in developing a platform for the delivery of self-management interventions that are adaptable, of low cost, and easily accessible. We conducted a systematic review to assess the effectiveness of mobile phone and tablet apps in self-management of key symptoms of long-term conditions. We searched PubMed, Embase, EBSCO databases, the Cochrane Library, and The Joanna Briggs Institute Library for randomized contro...

In a recent editorial, we examined the research outputs of 150 Australian nursing and midwifery professors (McKenna et al., 2018) identifying publication metrics on par with, and sometimes above those of professors in the UK (Watson, McDonagh, & Thompson, 2017). Because global university rankings are heavily weighted towards research, there has been pressure on universities and on academics to maximize research performance (Nguyen, Rambaldi, & Tang, 2017). Although many Australian universities have increasingly focused on education delivery, and despite the need for a strong evidence base for learning and teaching, academics are often cautioned against focusing too heavily on educational research. As a group of collaborative educational researchers (www.esscollaborative.org/), this led us to consider whether a focus on educational research may limit or enhance an academic career.

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.

There is no shortage of innovation in eLearning. Committed educators globally are developing individual courses to meet the needs of students and particular subject matter. However, the more challenging task is to sustain, maintain and spread these innovative ways of teaching across whole programs, entire schools, and the large institutions that characterise higher learning. This presentation shares the strategies and experiences of an Australian multi-campus School of Nursing and Midwifery that has implemented a blended learning approach across its entire undergraduate nursing program. Bringing together an eLearning coordinator, academics, expert clinicians, an educational designer, AV specialists, programmers, and graphic and multimedia designers has enabled us to not only produce quality, integrated learning resources across the curriculum, but to sustain and enhance our eLearning initiatives by developing a community of practice.

A catastrophic earthquake measuring 6.3 on the Richter scale struck the Christchurch, New Zealand Central Business District on February 22, 2012, abruptly disrupting the business of teaching and learning at Christchurch Polytechnic Institute of Technology. This paper presents the findings from a study undertaken about the complexity of delivering an educational programme in the face of this traumatic natural event. Nine interconnected themes emerged from this multiple method study: communication, decision making, leader- and follower-ship, balancing personal and professional responsibilities, taking action, preparedness and thinking ahead, all within a disruptive and uncertain context. Sustainable responses that maximise business continuity, and provide solutions to practical challenges, are among the study-s recommendations.

This study describes the impact of a sudden, traumatic natural disaster on a bachelor of nursing programme, and the capacity and processes required to minimise disruption to programme delivery and student learning. This descriptive case study, undertaken across 2011-2012, collected data through interviews, a survey and artefact collection. Six key themes emerged from the inductive and descriptive statistical analyses: context; communication; leadership and followership; decision making; the need to balance shifting priorities around professional responsibilities and personal imperatives; and taking action and action plans. The conclusions reached emphasise safety as the first priority, encourage personal risk mitigation, and emphasise the importance of ongoing support and flexibility for all staff and students as well as the need for clear communication and decision-making. What is perhaps most important to take from this experience is that a plan does not, by itself, equal prepared...

Supplemental material, Supplemental_material_Table_3 for An Evidence-Based Checklist for Improving Scoping Review Quality by Simon Cooper, Robyn Cant, Michelle Kelly, Tracy Levett-Jones, Lisa McKenna, Philippa Seaton and Fiona Bogossian in Clinical Nursing Research

Background and objective: Clinical Educators frequently use in-situ simulation-based experiences (SBE) to improve the skill and competency of healthcare professionals. The aim of the experience is to improve the quality of patient care and, ultimately, patient outcomes. The facilitator plays a key role in the in-situ SBE as they provide structure, guidance, and support, to help learners achieve the educational outcomes. However, they often face barriers concerning preparation for their role, time release from clinical duties, time to facilitate an effective debrief, and space constraints. The aim of this research was to gain insights into the opportunities and barriers educators face when facilitating in-situ simulations.Methods: A qualitative descriptive design utilising semi-structured interviews with twelve clinical educators who had facilitated in-situ SBE's in the acute care environment within a hospital facility. Interview data was analysed utilising a general inductive ap...

Introduction: The Rural Inter-Professional Simulation Course (RiSC) in New Zealand is a 3-day immersive course that brings rural doctors and nurses together to practise emergency and trauma skills using workshops and a simulation-enhanced interprofessional experience (SEIPE). The course aims to increase practitioners’ psychomotor skills, communication, teamwork and leadership skills through simulation-based learning and translate this into the management of trauma in rural settings. Methods: This study employed an exploratory, descriptive design to explore transfer of learning from RiSC into clinical practice 8 months post course participation. Six registered nurses who participated in RiSC took part in semi-structured interviews. The transcribed interviews were analysed using a general inductive approach. Results: The nurses valued the learning experience in RiSC and used the skills they learnt in clinical practice, however factors such as their perception of the authenticity of th...

Simulation is a teaching and learning strategy that is increasingly used in nursing education to prepare students for the clinical workplace. The Collaboration in Clinical Simulation project addressed the need in New Zealand undergraduate nursing education to enhance teaching and learning quality in simulation by creating a collaborative community of practice. While the Schools of Nursing in New Zealand have differing levels of equipment, resources and staffing allocation to simulation; this project considered the use of teaching and learning simulation strategies across the range of simulation fidelity and modalities. The Collaboration in Clinical Simulation project has produced guidelines for teaching and learning for effective simulation with undergraduate nursing students (refer section 2 of this document), based on a literature review (refer section 3). The collaboration and its outcomes are described in a separate document (Edgecombe, Seaton, Monahan, Meyer, Le Page and Erlam,...

ngā māramatanga hē hei hīkoi tuatahi mō te akoranga whakawhiti mōhiotanga, me te whakapiki i te whakawhitinga kōrero me te mahi hei tira. Ngā kupu matua: pāhekoheko, whakawhiti kōrero, akoranga whakawhiti umanga, ngā ākonga tākuta, ngā ākonga tapuhi, i mua o te rēhita, te whakahoahoa.

Disentangling the relative roles of males, females and their interactive effects on competitive fertilization success remains a challenge in sperm competition. In this study, we apply a novel experimental framework to an ideally suited externally fertilizing model system in order to delineate these roles. We focus on the chinook salmon, Oncorhynchus tshawytscha, a species in which ovarian fluid (OF) has been implicated as a potential arbiter of cryptic female choice for genetically compatible mates. We evaluated this predicted sexually selected function of OF using a series of factorial competitive fertilization trials. Our design involved a series of 10 factorial crosses, each involving two 'focal' rival males whose sperm competed against those from a single 'standardized' (non-focal) rival for a genetically uniform set of eggs in the presence of OF from two focal females. This design enabled us to attribute variation in competitive fertilization success among focal males, females (OF) and their interacting effects, while controlling for variation attributable to differences in the sperm competitive ability of rival males, and male-by-female genotypic interactions. Using this experimental framework, we found that variation in sperm competitiveness could be attributed exclusively to differences in the sperm competitive ability of focal males, a conclusion supported by subsequent analyses revealing that variation in sperm swimming velocity predicts paternity success. Together, these findings provide evidence that variation in paternity success can be attributed to intrinsic differences in the sperm competitive ability of rival males, and reveal that sperm swimming velocity is a key target of sexual selection.