Trends in Nursing

HIGH FIDELITY SIMULATION IN NURSING EDUCATION: CONSIDERATIONS FOR MEANINGFUL LEARNING

Anna-Marie Welman, Cynthia Spies — Sat, 09 Jul 2016 11:48:54 +0000

High fidelity simulation within nursing education continues to gain momentum. In sub-Saharan Africa vast amounts of money are invested towards the implementation of simulation to complement nursing education. Since the use of simulation is a fairly new addition to nursing education in developing countries, contextual research is necessary to ensure meaningful implementation in educational programmes. To meet the need for such research, two researchers explored the use of high fidelity simulation in a nursing school at a higher education institution in South Africa. The aim of the article was to discuss the insights gained on what students appreciated most about the high fidelity simulation learning experiences and what aspects should be improved to make the learning experience more meaningful. Qualitative data were gathered by means of focus group interviews, a module evaluation questionnaire and the nominal group technique. The unit of analysis comprised Baccalaureate and post-registration nursing groups.

From the data collected two broad categories emerged, namely students’ unpreparedness and aspects that students valued in terms of simulation. Unpreparedness was related to emotional, theoretical and technical aspects of simulation preparation.

To create meaningful learning experiences for students, it was recommended that a detailed orientation programme be provided. Orientation aspects should include the functions of high fidelity simulators and equipment used during simulation sessions. Students should be allowed to spend as much time as they need to familiarise themselves with the simulation environment. Educators should ensure that students understand the expected outcomes of simulation sessions and provide them with detailed information about simulation events. An agreement, whereby students and educators concur to maintain confidentiality about simulation and debriefing events should be included, since it enhances the psychological safety that students experience. It is important, through feedback, to rectify the mistakes that students make, but this should be done in a respectful manner, allowing students to share their experiences in a safe debriefing environment.

Utilization of objective structured clinical examination as an assessment strategy for undergraduate nursing students

Maureen Nokuthula Sibiya, Masamo Lekhuleni — Fri, 25 Nov 2016 12:51:37 +0000

The Objective Structured Clinical Examination (OSCE) has been widely and increasingly used since its inception in 1975. It was specifically focused on assessing the clinical skills of medical students. Since then the OSCE has been adapted for use in other health professional curricula, particularly nursing. At undergraduate level, three factors that indicate that OSCE is best used for the assessment of psychomotor skills are, firstly, that undergraduate nurses operate towards the novice end of the novice-expert continuum. Secondly, nurses must be sufficiently competent to practise their profession safely prior to clinical placement and, finally, the difficulties of replicating a real-world clinical environment in an examination context need to be acknowledged. This article, therefore, provides an overview of the utilisation of OSCE as an assessment tool for undergraduate nursing students. Different approaches to OSCE, preparation and planning for OSCE, scoring rubric, quality assurance strategies, advantage and disadvantages of this assessment approach are discussed.

SUGGESTED COMPETENCES FOR A PRECEPTOR TRAINING PROGRAMME

Yvonne Botma — Fri, 25 Nov 2016 12:53:50 +0000

Purpose: Facilitating learning in the clinical context is a complex act for which preceptors should be trained. However, there is no consensus on what should be included in a training programme for preceptors. The purpose of the article is to describe the competences of a preceptor that emanated from a consensus reaching process among nurse educators in South Africa.
Methodology: Nurse educators reached consensus on the core competences of a preceptor through nominal groups. Non-probability convenient sampling was used to sample nurse educators from universities as well as public and private nursing colleges. The two nominal groups generated data that were combined to identify the content of preceptor training programme.
Results: Key findings were that preceptors should be able to facilitate learning through a variety of techniques and perform valid and reliable assessment. Preceptors should support students in finding and implementing best available evidence of care for a specific patient.
Conclusion and recommendation: It is the responsibility of nursing education institutions to produce clinically competent nurses. A competent nurse is able to think critically, reason clinically, make sound clinical judgments, and reflect on the thinking processes applied. Preceptors, therefore, should support nursing students in these thinking processes and create opportunities where they can practice under supervision to become competent nurses. The training programme should enable preceptors to facilitating learning in the clinical environment through a variety of techniques, conduct valid and reliable assessments, and support students in implementing best practice guidelines.

SUPERVISION OF POST-GRADUATE STUDENTS IN HIGHER EDUCATION

Gisela Hildegard van Rensburg, Pat Mayers, Lizeth Roets — Fri, 25 Nov 2016 12:55:41 +0000

Knowledge transfer is an inevitable process in higher education where research outputs are largely associated with the production of Masters’ and Doctoral graduates. The supervision of postgraduate students at universities is therefore one of the core responsibilities of academics and is considered a measure of academic output. Supervision not only transfers research and related skills, but is also an intensive and interconnected form of educator-student engagement. The role of the supervisor in providing a supportive, constructive and engaged supervision process is important in the development of next generation practitioners who have the correct educational and skills mix to fulfil the future needs of the profession. The underlying principle of student support during supervision is that an experienced supervisor will be able to move through the learning processes with the student as this becomes appropriate. As the student gains competence in the basic skills of conducting research in a particular field of study, he or she will move to a deeper understanding of the nature and reality of that field. Research and, ultimately, high quality supervision of students, plays a pivotal role in the scholarship of discovery and the development of evidence-based practice.

CRITICAL APPRAISAL: ADEQUACY OF REPORTING STUDIES ON EARLY WARNING SCORE SYSTEMS

Una Kyriacos — Fri, 25 Nov 2016 12:57:42 +0000

Background: Routine monitoring of patients’ clinical and physiological status by nurses includes the use of vital signs (observations) charts for recording findings. Charts that incorporate early warning score (EWS) systems are designed to ‘track’ signs of deterioration and ‘trigger’ a rapid response. Published studies of EWS systems are of limited benefit if reporting of these studies is inadequate. Reporting guidelines are recommended to improve the quality of reporting.

Objective: To assess the adequacy of reporting studies on EWS systems.

Methods: All study designs published between 1 May 2007 and 23 May 2015 describing the use of EWS systems for detecting deterioration in adult patients on general medical and surgical wards were included. Data extraction was undertaken by one researcher.

Results: Of the 657 references identified from search terms, 596 articles were excluded leaving 61 articles for assessment. Most studies were published in non-nursing journals (47/61, 77.0%). Six of the 61 (9.8%) studies were reviews. The remaining 55 clinical studies on the use of EWS/MEWS systems were mostly observational (46/55, 83.6%) rather than experimental (9/55, 16.4%).

Reporting guidelines were used in 9.8% (6/61) of reviewed studies. Only the reviews but no clinical studies reported a search strategy. Electronic searches included mostly CINAHL (5/6, 83.3%), MEDLINE and The Cochrane Library (4/6, 66.7%). No meta-analyses were performed. Inclusion and exclusion criteria and reasons for exclusion of references were well reported in the reviews.

The most frequently reported range of physiological parameters (12/61, 19.7%) were respiratory rate, oxygen saturation, supplemental oxygen, heart rate, systolic blood pressure, temperature and level of consciousness.

Conclusion: Reporting of published studies on EWS systems reviewed for this critical appraisal, with the exception of reviews, was inadequate as most did not use reporting guidelines, limiting the use of study findings for developing clinical guidelines and in further research.

INTERPROFESSIONAL HEALTH EDUCATION TO IMPROVE COLLABORATION IN THE SOUTH AFRICAN CONTEXT: A REALIST REVIEW

Carin Maree, Heila van Wyk — Fri, 25 Nov 2016 12:44:51 +0000

Interprofessional education in health has been identified as a strategy to improve collaborative practice in health care. A need to move away from the training of the various professionals in silos has been identified as a mechanism to address the challenges and changes in the healthcare system. The implementation of interprofessional health education in the health disciplines for undergraduate students in order to promote teamwork among professionals and contribute to improved quality health outcomes is, however, complex and challenging to implement.
The purpose of this article is to identify how, by whom and when interprofessional health education for undergraduate students could be implemented in the South African context by means of a realist review. Interprofessional health education was explored in both developed and developing countries with the focus mainly on developing countries and South Africa in particular. The framework for action on interprofessional education and collaborative practice developed by the World Health Organisation (2010) was used as a reference.
The authors clarified concepts about interprofessional health education, taking into consideration studies about interprofessional education internationally as well as nationally. The intention in this paper is to guide the reader to understand the various measures, context and outcomes associated with the term ‘interprofessional health education’. The measures identified for interprofessional health education involved the following: infrastructure, resources, management, stakeholders’ attitudes, teamwork and educational principles. As far as the context is concerned, this differs from developing and developed countries, since the nature of both the health and education systems of these countries differ. Interprofessional health education should take place in a meaningful and relevant context that reflects current or future trends. The desired outcomes for interprofessional health education should include collaboration among health professionals, thus resulting in improved health care.

APPRECIATIVE EDUCATION TO ENHANCE QUALITY OUTPUTS THROUGH ASSESSMENT AND FEEDBACK PRACTICES

Isabella Maria Coetzee, Tanya Heyns — Fri, 25 Nov 2016 13:09:51 +0000

Higher education is experiencing a time of change that is rife with challenges. The times call for educators in the nursing profession to facilitate learning in a way that students are empowered to become future leaders in the profession. Appreciative inquiry is an emerging educational method that is used to bring about organisational transformation in the teaching and learning arena. It is an approach to learning where emphasis is laid on positive aspects about learning rather than negative aspects.

The purpose of this article is to explain how appreciative education is implemented in nursing education institutions including the assessment and feedback practices to enhance outputs.