Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.

Parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: Instrument reliability and validity

BACKGROUND: Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. OBJECTIVES: To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. METHODS: The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. SETTING AND PARTICIPANTS: A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. RESULTS: Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. CONCLUSIONS: Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.

Initial psychometric evaluation of the Wayfinding Effectiveness Scale

This study evaluates three versions of the Wayfinding Effectiveness Scale (WES), developed to differentiate problems of wayfinding and wandering behavior of community-residing elders with dementia (EWD), in 266 dyads (EWD and caregiver) recruited from Alzheimer's Association chapters. Factor analyses yield a five-factor solution (explained variance = 62.6%): complex wayfinding goals, analytic strategies, global strategies, simple wayfinding goals, and being stimulus bound. Overall, internal consistencies are high: WES (.94-.95), and subscales are stable across all versions. Testretest reliability is acceptable for the overall WES and two subscales (complex and simple wayfinding goals) for the care recipient current behavior version. Construct validity is supported by the pattern of correlations among subscales and analyses of variance (ANOVAs) showing significant differences among the care recipient (current vs. prior behavior) and caregiver versions overall and for all subscales. Results support the WES as a valid and reliable measure of wayfinding effectiveness in persons with dementia.

Generalised self-efficacy in relation to the life transitions of adult learners in a university setting : towards a narrative constructivist model of self-regulation

This paper demonstrates a model of self-regulation based on a qualitative research project with adult learners undertaking an undergraduate degree. The narrative about the participant’s life transitions, co-constructed with the researcher, yielded data about their generalised self-efficacy and resulted in a unique self-efficacy narrative for each participant. A model of self-regulation is proposed with potential applications for coaching, counselling and psychotherapy. A narrative method was employed to construct narratives about an individual’s self-efficacy in relation to their experience of learning and life transitions. The method involved a cyclical and iterative process using qualitative interviews to collect life history data from participants. In addition, research participants completed reflective homework tasks, and this data was included in the participant’s narratives. A highly collaborative method entailed narratives being co-constructed by researcher and research participants as the participants were guided in reflecting on their experience in relation to learning and life transitions; the reflection focused on behaviour, cognitions and emotions that constitute a sense of self-efficacy. The analytic process used was narrative analysis, in which life is viewed as constructed and experienced through the telling and retelling of stories and hence the analysis is the creation of a coherent and resonant story. The method of constructing self-efficacy narratives was applied to a sample of mature aged students starting an undergraduate degree. The research outcomes confirmed a three-factor model of self-efficacy, comprising three interrelated stages: initiating action, applying effort, and persistence in overcoming difficulties. Evaluation of the research process by participants suggested that they had gained an enhanced understanding of self-efficacy from their participation in the research process, and would be able to apply this understanding to their studies and other endeavours in the future. A model of self-regulation is proposed as a means for coaches, counsellors and psychotherapists working from a narrative constructivist perspective to assist clients facing life transitions by helping them generate selfefficacious cognitions, emotions and behaviour.

Towards a method of constructing self-efficacy narratives.

This paper outlines a method of constructing narratives about an individual’s self-efficacy. Self-efficacy is defined as “people’s judgments of their capabilities to organise and execute courses of action required to attain designated types of performances” (Bandura, 1986, p. 391), and as such represents a useful construct for thinking about personal agency. Social cognitive theory provides the theoretical framework for understanding the sources of self-efficacy, that is, the elements that contribute to a sense of self-efficacy. The narrative approach adopted offers an alternative to traditional, positivist psychology, characterised by a preoccupation with measuring psychological constructs (like self-efficacy) by means of questionnaires and scales. It is argued that these instruments yield scores which are somewhat removed from the lived experience of the person—respondent or subject—associated with the score. The method involves a cyclical and iterative process using qualitative interviews to collect data from participants – four mature aged university students. The method builds on a three-interview procedure designed for life history research (Dolbeare & Schuman, cited in Seidman, 1998). This is achieved by introducing reflective homework tasks, as well as written data generated by research participants, as they are guided in reflecting on those experiences (including behaviours, cognitions and emotions) that constitute a sense of self-efficacy, in narrative and by narrative. The method illustrates how narrative analysis is used “to produce stories as the outcome of the research” (Polkinghorne, 1995, p.15), with detail and depth contributing to an appreciation of the ‘lived experience’ of the participants. The method is highly collaborative, with narratives co-constructed by researcher and research participants. The research outcomes suggest an enhanced understanding of self-efficacy contributes to motivation, application of effort and persistence in overcoming difficulties. The paper concludes with an evaluation of the research process by the students who participated in the author’s doctoral study.

Understanding the optimal learning environment in palliative care

The learning experiences of student nurses undertaking clinical placement are reported widely, however little is known about the learning experiences of health professionals undertaking continuing professional development (CPD) in a clinical setting, especially in palliative care. The aim of this study, which was conducted as part of the national evaluation of a professional development program involving clinical attachments with palliative care services (The Program of Experience in the Palliative Approach [PEPA]), was to explore factors influencing the learning experiences of participants over time. Thirteen semi-structured, one-to-one telephone interviews were conducted with five participants throughout their PEPA experience. The analysis was informed by the traditions of adult, social and psychological learning theories and relevant literature. The participants' learning was enhanced by engaging interactively with host site staff and patients, and by the validation of their personal and professional life experiences together with the reciprocation of their knowledge with host site staff. Self-directed learning strategies maximised the participants' learning outcomes. Inclusion in team activities aided the participants to feel accepted within the host site. Personal interactions with host site staff and patients shaped this social/cultural environment of the host site. Optimal learning was promoted when participants were actively engaged, felt accepted and supported by, and experienced positive interpersonal interactions with, the host site staff.

Self-narratives of children : using digital journals

This paper takes the position that children are at risk of being marginalised when research methods are not tailored to their requirements. In particular, children who are negotiating early adolescence are presented as an ideal group for involvement with narrative research approaches that attempt to be flexible and creative. With the premise that the need to juggle multiple realities within complex societal structures is challenging and isolating for such children, narrative methods offer a promising mode of access to their individual realities. Children's own self-narratives in the form of email journal entries are proposed as research tools that can help to minimise issues arising from resistance to adults and problems of shared vocabulary that may occur using more traditional methods. Digital journaling, as a means of capturing self-narratives, can provide a convenient space for young people to generate and share their own personal accounts of their lives and their experiences that can also serve to inform others. Guidelines are offered for how to manage a journaling project that is not reliant on children's physical presence within school settings. Digital journals are thus described as multi-function mechanisms that can support personal growth as well as promote shared understandings and social fairness between adults and children.

Embracing diversity : empowering preservice teachers for teaching gifted and talented students

This study investigated preservice teachers’ perceptions for teaching and sustaining gifted and talented students while developing, modifying and implementing activities to cater for the diverse learner. Participants were surveyed at the end of a gifted and talented education program on their perceptions to differentiate the curriculum for meeting the needs of the student (n=22). SPSS data analysis with the five-part Likert scale indicated these preservice teachers agreed or strongly agreed they had developed skills in curriculum planning (91%) with well-designed activities (96%), and lesson preparation skills (96%). They also claimed they were enthusiastic for teaching (91%) and understanding of school practices and policies (96%). However, 46% agreed they had knowledge of syllabus documents with 50% claiming an ability to provide written feedback on student’s learning. Furthermore, nearly two-thirds suggested they had educational language from the syllabus and effective student management strategies. Preservice teachers require more direction on how to cater for diversity and begin creating sustainable societies by building knowledge from direct GAT experiences. Designing diagnostic surveys associated with university coursework can be used to determine further development for specific preservice teacher development in GAT education. Preservice teachers need to create opportunities for students to realise their potential by involving cognitive challenges through a differentiated curriculum. Differentiation requires modification of four primary areas of curriculum development (Maker, 1975) content (what we teach), process (how we teach), product (what we expect the students to do or show) and learning environment (where we teach/our class culture). Ashman and Elkins (2009) and Glasson (2008) emphasise the need for preservice teachers, teachers and other professionals to be able to identify what gifted and talented (GAT) students know and how they learn in relation to effective teaching. Glasson (2008) recommends that educators keep up to date with practices in pedagogy, support, monitoring and profiling of GAT students to create an environment conducive to achieving. Oral feedback is one method to communicate to learners about their progress but has advantages and disadvantages for some students. Oral feedback provides immediate information to the student on progress and performance (Ashman & Elkins, 2009). However, preservice teachers must have clear understandings of key concepts to assist the GAT student. Implementing teaching strategies to engage innovate and extend students is valuable to the preservice teacher in focusing on GAT student learning in the classroom (Killen, 2007). Practical teaching strategies (Harris & Hemming, 2008; Tomlinson et al., 1994) facilitate diverse ways for assisting GAT students to achieve learning outcomes. Such strategies include activities to enhance creativity, co-operative learning and problem-solving activities (Chessman, 2005; NSW Department of Education and Training, 2004; Taylor & Milton, 2006) for GAT students to develop a sense of identity, belonging and self esteem towards becoming an autonomous learner. Preservice teachers need to understand that GAT students learn in a different way and therefore should be assessed differently. Assessment can be through diverse options to demonstrate the student’s competence, demonstrate their understanding of the material in a way that highlights their natural abilities (Glasson, 2008; Mack, 2008). Preservice teachers often are unprepared to assess students understanding but this may be overcome with teacher education training promoting effective communication and collaboration in the classroom, including the provision of a variety of assessment strategies to improve teaching and learning (Callahan et al., 2003; Tomlinson et al., 1994). It is also critical that preservice teachers have enthusiasm for teaching to demonstrate inclusion, involvement and the excitement to communicate to GAT students in the learning process (Baum, 2002). Evaluating and reflecting on teaching practices must be part of a preservice teacher’s repertoire for GAT education. Evaluating teaching practices can assist to further enhance student learning (Mayer, 2008). Evaluation gauges the success or otherwise of specific activities and teaching in general (Mayer, 2008), and ensures that preservice teachers and teachers are well prepared and maintain their commitment to their students and the community. Long and Harris (1999) advocate that reflective practices assist teachers in creating improvements in educational practices. Reflective practices help preservice teachers and teachers to improve their ability to pursue improved learning outcomes and professional growth (Long & Harris, 1999). Context This study is set at a small regional campus of a large university in Queensland. As a way to address departmental policies and the need to prepare preservice teachers for engaging a diverse range of learners (see Queensland College of Teachers, Professional Standards for Teachers, 2006), preservice teachers at this campus completed four elective units within their Bachelor of Education (primary) degree. The electives include: 1. Middle years students and schools 2. Teaching strategies for engaging learners 3. Teaching students with learning difficulties, and 4. Middle-years curriculum, pedagogy and assessment. In the university-based component of this unit, preservice teachers engaged in learning about middle years students and schools, and gained knowledge of government policies pertaining to GAT students. Further explored within in this unit was the importance of: collaboration between teachers, parents/carers and school personnel in supporting middle years GAT students; incorporating challenging learning experiences that promoted higher order thinking and problem solving skills; real world learning experiences for students and; the alignment and design of curriculum, pedagogy and assessment that is relevant to the students development, interests and needs. The participants were third-year Bachelor of Education (primary) preservice teachers who were completing an elective unit as part of the middle years of schooling learning with a focus on GAT students. They were assigned one student from a local school. In the six subsequent ninety minute weekly lessons, the preservice teachers were responsible for designing learning activities that would engage and extend the GAT students. Furthermore, preservice teachers made decisions about suitable pedagogical approaches and designed the assessment task to align with the curriculum and the developmental needs of their middle years GAT student. This research aims to describe preservice teachers’ perceptions of their education for teaching gifted and talented students.

Self-service technology and the moderating effects of consumer characteristics

The incidence of self-service technology, where the consumer delivers the service themselves using technology, is increasing in the service encounter. One area that is under-explored is the potential impact of self-service technology on consumer satisfaction and affective commitment. Accordingly, this paper presents an empirical study that investigates the relative impact of self-service technology on consumer satisfaction (both overall and transaction-specific) and affective commitment, accounting for the moderating effects of consumer characteristics. The results highlight the importance of personal service for evaluations of satisfaction and commitment, and the importance of social competency as a moderator in this relationship. An understanding of these consumer perceptions will allow organisations to develop strategies to deliver the services expected by their consumers, improving consumer satisfaction and commitment.

Grade A Taipei junior high school principals’ self-reported leadership practices

The principal’s leadership and curriculum development are considered the core elements for creating a high performing junior high school. In Taiwan, mathematics curriculum reform has been an ongoing topic since 1994. The pedagogy, classroom interactions, and the underlying philosophy of mathematics education have varied with different versions of guidelines. These changes inevitably increase the requirement for principals’ leadership in order to effectively implement the curriculum reform. Principals’ leadership is essential to the success of the implementation in their school. This study aimed to explore and identify the leadership of junior high school principals whose schools had been judged by the Taipei City Government as Grade A junior high schools. Principals’ implementations of the reformed mathematics curriculum were used as examples to generate insights of their leadership. This study drew upon a multiple-case study approach. Data were collected from interviews, observations, and documentations. Bass and Avolio’s (1997) full range leadership theory provided a structure for gaining insight into these principals’ leadership practices. Five Grade A Taipei junior high school principals participated and shared their leadership concepts and experiences. Findings revealed that the leadership preferences of the five principles varied considerably. Management by exception-active, contingent reward, individualised consideration, and idealised influence were Grade A Taipei junior high school principals’ preferred leadership practices. In addition, principals’ leadership strategies associated with these practices were identified. These principals had adopted a range of leadership strategies according to the staff and school needs. Results of this study have implications for both Taiwanese principals and education departments. Principals can enhance their leadership by gaining more understanding about the Grade A principals’ leadership practices and strategies. Taiwanese education departments can improve school leadership training programs by focusing on these practices and strategies, which may also lead to more effective strategies for implementing national curriculum reform.

A three year outcome evaluation of a theory based drink driving education program

This study reports on the impact of a "drink driving education program" taught to grade ten high school students. The program which involves twelve lessons uses strategies based on the Ajzen and Madden theory of planned behavior. Students were trained to use alternatives to drink driving and passenger behaviors. One thousand seven hundred and seventy-four students who had been taught the program in randomly assigned control and intervention schools were followed up three years later. There had been a major reduction in drink driving behaviors in both intervention and control students. In addition to this cohort change there was a trend toward reduced drink driving in the intervention group and a significant reduction in passenger behavior in this group. Readiness to use alternatives suggested that the major impact of the program was on students who were experimenting with the behavior at the time the program was taught. The program seems to have optimized concurrent social attitude and behavior change.

Strategies to engage engineering students in group project work

Project focused group work is significant in developing social and personal skills as well as extending the ability to identify, formulate and solve engineering problems. As a result of increasing undergraduate class sizes, along with the requirement for many students to work part-time, group projects, peer and collaborative learning are seen as a fundamental part of engineering education. Group formation, connection to learning objectives and fairness of assessment has been widely reported as major issues that leave students dissatisfied with group project based units. Several strategies were trialled including a study of formation of groups by different methods across two engineering disciplines over the past 2 years. Other strategies involved a more structured approach to assessment practices of civil and electrical engineering disciplines design units. A confidential online teamwork management tool was used to collect and collate student self and peer assessment ratings and used for both formative feedback as well as assessment purposes. Student satisfaction and overall academic results in these subjects have improved since the introduction of these interventions. Both student and staff feedback highlight this approach as enhancing student engagement and satisfaction, improved student understanding of group roles, reducing number of dysfunctional groups whilst requiring less commitment of academic resources.

Randomised controlled trial of an automated, interactive telephone intervention to improve type 2 diabetes self-management (Telephone-Linked Care Diabetes Project) : study protocol

Background: An estimated 285 million people worldwide have diabetes and its prevalence is predicted to increase to 439 million by 2030. For the year 2010, it is estimated that 3.96 million excess deaths in the age group 20-79 years are attributable to diabetes around the world. Self-management is recognised as an integral part of diabetes care. This paper describes the protocol of a randomised controlled trial of an automated interactive telephone system aiming to improve the uptake and maintenance of essential diabetes self-management behaviours. ---------- Methods/Design: A total of 340 individuals with type 2 diabetes will be randomised, either to the routine care arm, or to the intervention arm in which participants receive the Telephone-Linked Care (TLC) Diabetes program in addition to their routine care. The intervention requires the participants to telephone the TLC Diabetes phone system weekly for 6 months. They receive the study handbook and a glucose meter linked to a data uploading device. The TLC system consists of a computer with software designed to provide monitoring, tailored feedback and education on key aspects of diabetes self-management, based on answers voiced or entered during the current or previous conversations. Data collection is conducted at baseline (Time 1), 6-month follow-up (Time 2), and 12-month follow-up (Time 3). The primary outcomes are glycaemic control (HbA1c) and quality of life (Short Form-36 Health Survey version 2). Secondary outcomes include anthropometric measures, blood pressure, blood lipid profile, psychosocial measures as well as measures of diet, physical activity, blood glucose monitoring, foot care and medication taking. Information on utilisation of healthcare services including hospital admissions, medication use and costs is collected. An economic evaluation is also planned.---------- Discussion: Outcomes will provide evidence concerning the efficacy of a telephone-linked care intervention for self-management of diabetes. Furthermore, the study will provide insight into the potential for more widespread uptake of automated telehealth interventions, globally.

Information dependencies between architects and services engineers for early design evaluation : a framework for an energy design tool for architects

Effective strategies for the design of effi cient and environmentally sensitive buildings require a close collaboration between architects and engineers in the design of the building shell and environmental control systems at the outset of projects. However, it is often not practical for engineers to be involved early on in the design process. It is therefore essential that architects be able to perform preliminary energy analyses to evaluate their proposed designs prior to the major building characteristics becoming fi xed. Subsequently, a need exists for a simplifi ed energy design tool for architects. This paper discusses the limitations of existing analysis software in supporting early design explorations and proposes a framework for the development of a tool that provides decision support by permitting architects to quickly assess the performance of design alternatives.