Assessing performance in critical care nursing practice using the Benner Novice to expert model: A pilot study

Background It is often believed that by ensuring the ongoing completion of competency documents and life-long learning in nursing practice guarantees quality patient care. This is probably true in most cases where it provides reassurances that the nursing team is maintaining a safe “generalised” level of practice. However, competency does not always promise quality performance. There are a number of studies that have reported differences in what practitioners know and what they actually do despite being deemed competent. Aim The aim of this study was to assess whether our current competency documentation is fit for purpose and to ascertain whether performance assessment needs to be a key component in determining competence. Method 15 nurses within a General ICU who had been on the unit <4 years agreed to participate in this project. Using participant observation and assessing performance against key indicators of the Benner Novice to Expert5 model the participants were supported and assessed over the course of a ‘normal’ nursing shift. Results The results were surprising both positively and negatively. First, the nurses felt more empowered in their clinical decision making skills; second, it identified individual learning needs and milestones in educational development. There were some key challenges identified which included 5 nurses over estimating their level of competence, practice was still very much focused on task acquisition and skill and surprisingly some nurses still felt dominated by the other health professionals within the unit. Conclusion We found that the capacity and capabilities of our nursing workforce needs continual ongoing support especially if we want to move our staff from capable task-doer to competent performers. Using the key novice to expert indicators identified the way forward for us in how we assess performance and competence in practice particularly where promotion to higher grades is based on existing documentation.

The effect of light on cognitive performance of partially sleep-deprived young drivers

Sleepiness remains a primary cause of road crashes, the major cause of death in young adults. Light is known to produce a direct alerting effect, but little is known about its effects on sleepy drivers. This study aimed to compare the effect of blue-green light and caffeine on young drivers’ cognitive performance after chronic-partial sleep loss.

Business process performance mining with staged process flows

Existing process mining techniques provide summary views of the overall process performance over a period of time, allowing analysts to identify bottlenecks and associated performance issues. However, these tools are not de- signed to help analysts understand how bottlenecks form and dissolve over time nor how the formation and dissolution of bottlenecks – and associated fluctua- tions in demand and capacity – affect the overall process performance. This paper presents an approach to analyze the evolution of process performance via a notion of Staged Process Flow (SPF). An SPF abstracts a business process as a series of queues corresponding to stages. The paper defines a number of stage character- istics and visualizations that collectively allow process performance evolution to be analyzed from multiple perspectives. The approach has been implemented in the ProM process mining framework. The paper demonstrates the advantages of the SPF approach over state-of-the-art process performance mining tools using two real-life event logs publicly available.

Corporate fraud culture: Re-examining the corporate governance and performance relation

We analyse the corporate governance and performance relation, when conditioning on corporate fraud, for fraud firms during 2000 – 2007. Fraud firms are identified as either self- reported fraud events, or subject to regulatory investigation. We use the inverse Mills ratio procedure to account for firms' (unobservable) fraud culture in the dynamic system GMM model of the performance- governance relation. We find that corporate governance is an endogenously determined characteristic that has no causal impact on firm performance when conditioning on fraud. Fraud is a significant regulatory event but its overall economic impact at the firm level is highly variable.

Weight bearing physical activity for performance and bone health in prepubertal girls

This study assessed the status of bone and cardiovascular health in young, prepubertal females (aged 9 to 11 years) during a school based intervention program involving weight bearing physical activity. A study of 10 months duration was conducted in four primary schools in the Melbourne suburbs. It involved a physical activity group (n=38) and an aged-matched control group (n=33). Baseline data including pubertal status, health-related fitness, bone mass and body composition were obtained pre and post the intervention programme. All children had their bone mineral density monitored. Bone mineral density and body composition measurements were performed by DXA using the Hologic QDR 2000 bone densitometer. At the completion of the program the activity group had accrued significantly greater bone mass at total body, lumbar spine, leg and femoral neck when expressed as BMC or BMD.

Social Audit for raising CSR Performance of Banking Corporations in Bangladesh

Corporations' commitment to their social responsibilities has long been a global concern with reference to sustainability, transparency and fair practice, which is of great concern to stakeholders. Corporations are expected to be responsible to the society they operate within and do business in a socially responsible manner.

The effect of a self-development coaching program on the psychological health and the academic performance among medical and dental students in Saudi Arabia

Observational studies have shown that medical and dental students have poor psychological health worldwide; however, few interventional studies have been used to test approaches to help students. This thesis used a randomised control trial study design to evaluate the effect of a self-development coaching program on psychological health and the academic performance among medical and dental students in Saudi Arabia. The outcomes indicated that these medical and dental students in Saudi Arabia experienced high levels of depression, anxiety and stress, and that the self-development coaching program was a promising intervention to improve students' psychological health.

Social enterprises: Examining accountability for social and financial performance

This research examined the influence commercial customers have on the social and financial accountability of social enterprises, specifically considering whether a dominant or diversified customer base impacts on social enterprise accountability. Findings revealed that social enterprise accountability was influenced by social enterprises' main stakeholder(s), not necessarily the dominant customer. Accountability practices focused on fulfilling social enterprises' main stakeholders' accountability demands, and reporting to them rather than reporting on performance to a broader range of stakeholders. This research enhances the understanding of stakeholder impact on social enterprises' accountability, and develops an understanding of accountability theory in a social enterprise context.

The influence of a novel simulated learning environment upon student clinical subjective refraction performance: A pilot study

Background: Optometry students are taught the process of subjective refraction through lectures and laboratory based practicals before progressing to supervised clinical practice. Simulated learning environments (SLEs) are an emerging technology that are used in a range of health disciplines, however, there is limited evidence regarding the effectiveness of clinical simulators as an educational tool. Methods: Forty optometry students (20 fourth year and 20 fifth year) were assessed twice by a qualified optometrist (two examinations separated by 4-8 weeks) while completing a monocular non-cycloplegic subjective refraction on the same patient with an unknown refractive error simulated using contact lenses. Half of the students were granted access to an online SLE, The Brien Holden Vision Institute (BHVI®) Virtual Refractor, and the remaining students formed a control group. The primary outcome measures at each visit were; accuracy of the clinical refraction compared to a qualified optometrist and relative to the Optometry Council of Australia and New Zealand (OCANZ) subjective refraction examination criteria. Secondary measures of interest included descriptors of student SLE engagement, student self-reported confidence levels and correlations between performance in the simulated and real world clinical environment. Results: Eighty percent of students in the intervention group interacted with the SLE (for an average of 100 minutes); however, there was no correlation between measures of student engagement with the BHVI® Virtual Refractor and speed or accuracy of clinical subjective refractions. Fifth year students were typically more confident and refracted more accurately and quickly than fourth year students. A year group by experimental group interaction (p = 0.03) was observed for accuracy of the spherical component of refraction, and post hoc analysis revealed that less experienced students exhibited greater gains in clinical accuracy following exposure to the SLE intervention. Conclusions: Short-term exposure to a SLE can positively influence clinical subjective refraction outcomes for less experienced optometry students and may be of benefit in increasing the skills of novice refractionists to levels appropriate for commencing supervised clinical interactions.

Enhancing skill acquisition and expertise in high performance programmes

Our research programme with elite athletes has investigated and implemented learning design from an ecological dynamics perspective, examining its effects on movement coordination and control and the acquisition of expertise. Ecological dynamics is a systemsoriented theoretical rationale for understanding the emergent relations in a complex system formed by each performer and a performance environment. This approach has identified the individual-environment relationship as the relevant scale of analysis for modelling how processes of perception, cognition and action underpin expert performance in sport (Davids et al., 2014; Zelaznik, 2014). In this chapter we elucidate key concepts from ecological dynamics and exemplify how they have informed our understanding of relevant psychological processes including: movement coordination and its acquisition, learning and transfer, impacting on practice task design in high performance programmes.

SME international performance in Latin America: The role of entrepreneurial and technological capabilities

SMEs from emerging markets in Latin America are increasingly engaging in internationalization. Nevertheless, there is limited research into how these firms achieve international performance. This study proposes and tests a conceptual model that considers managerial and technology-related capabilities and their impact on international performance of SMEs. The model uses confirmatory factor analysis (CFA) to develop the underlying multi-item constructs and structural equation modeling (SEM) to test the model with data from 233 Chilean SMEs. Specifically, the model considers the role of international entrepreneurial orientation and Internet capabilities on international market performance, taking into account the mediating effect of international entrepreneurial opportunity recognition and technology-related international networks. Results show that international entrepreneurial opportunity recognition and international networks mediate the relationship between international entrepreneurial orientation and Internet marketing capabilities on SME international performance.

Overcoming the challenges of building heritage projects: Improvements to time, scope and cost performance

This research was undertaken to encompass and identify challenges and impact factors that affect the successful outcomes of heritage building projects, especially those related to finding major causes of delays and cost overruns across projects in all Australian states. This project determined and analysed the causes of such delays and programme issues emanating from the planning and execution phases, whilst also analysing the requirements for management of multiple stakeholder relationships and the influence of unforeseen technical factors. The research proposes "call for action" guidance and was validated by experienced experts in heritage building projects in Australia. The proposed guidance is designed to ensure that realistic cost targets and delivery timeframes are set in future heritage projects, and necessary interventions made at appropriate project stages to ensure decisions are made that will help to prevent overtime and cost overuns.

Measuring the effects of mergers and acquisitions on the economic performance of real estate developers

Real estate developers in China are using mergers and acquisitions (M&As) to ensure their survival and competitiveness. However, no suitable method is yet available to assess whether such M&As provide enhanced value for those involved. Using a hybrid method of data envelopment analysis (DEA) and Malmquist total factor productivity (TFP) indices, this paper evaluates the short and medium term effects of M&As on acquirers’ economic performance with a set of 32 M&A cases occurring during 2000–2011 in China. The results of the analysis show that M&As generally have a positive effect on acquirers’ economic performance. Acquisitions on average experienced a steady growth in developer Malmquist TFP, a more progressive adoption of technology immediately after acquisition, a slight short-term decrease in technical efficiency after acquisition but followed by a marked increase in the longer term once the integration and synergy benefits were realised. However, there is no evidence to show whether developers achieved any short or long term scale efficiency improvements after M&A. The findings of this study provide useful insights on developer M&A performance from an efficiency and productivity perspective.