Understanding nurses’ decision-making when managing weaning from mechanical ventilation: a study of novice and experienced critical care nurses in Scotland and Greece.

Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. Design A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation

‘Novice Teachers’ Views of an Introductory Workshop about Teaching in the Biosciences.

Seven regional networking events, aimed at supporting and developing ‘early stage’ novice university bioscience teachers were held across the UK. These workshops allowed 230 participants to reflect on teaching styles, learn about Higher Education Academy resources and discuss strategies to deal with a range of teaching situations. Post-event feedback was sought, and the results are presented in this paper. Feedback on the events was overwhelmingly positive, highlighting the need for such events to support the development of new teachers in higher education. Institutional training varies and these opportunities for sharing experiences, asking questions, networking and reflection on teaching practice were highly regarded. Most participants felt more confident about their teaching and believed that students were more directly engaged in their teaching after attending the events. Recommendations for support of this category of teacher include provision of discipline-specific events, opportunity for local area networking and support for the development of reflective practice in teaching and learning.

The development of entrepreneurial culture in a transition economy: an empirical model discussion.

This conceptual paper will focus on the presentation of the model developed from empirical, qualitative research covering 20 years of analysis on the relationship between culture and entrepreneurship in Poland. It is aimed at proposing a comprehensive framework that describes the development of entrepreneurial culture. In this empirical model culture is understood as a set of values and beliefs held by a social group that endorse and are conducive to entrepreneurial behaviour; while entrepreneurial behaviour is treated as an expected outcome and narrowed down to opening the company. The model proves that the differentiation between entrepreneurship (behaviour) and entrepreneurs (who demonstrate this behaviour) needs to be recognised in future research. The case of Poland offers a historical example, which can shed more light on the process of cultural change and the role of entrepreneurship and entrepreneurs in the development of entrepreneurial culture. In the case presented, the behaviour of entrepreneurs has been identified as the key factor leading to further development.