The palliative care link nurse role in nursing homes: barriers and facilitators

Aim. This paper is a report of a study to explore link nurses' views and experiences regarding the development, barriers and facilitators to the implementation of the role in palliative care in the nursing home.
Background. The delivery of palliative care in nursing homes is widely advocated; one approach is to develop the link nurse role to cascade good practice and training to nurses and other care staff to enhance patient care.
Method. A descriptive qualitative study was conducted with a purposive sample of 14 link nurses from 10 nursing homes in Northern Ireland during 2006. Three focus groups, composed of all Registered Nurses currently acting as link nurses in their nursing homes participated, and the data were audio recorded, fully transcribed and content analysed.
Findings. The link nurse system shows potential to enhance palliative care within nursing homes. However, link nurses experienced a number of difficulties in implementing education programmes. Facilitators of the role included external support, monthly meetings, access to a resource file and peer support among link nurses themselves. Lack of management support, a transient workforce and lack of adequate preparation for link nurses were barriers to fulfilling this role.
Conclusion. Whilst palliative care link nurses can improve care for residents in nursing homes, consideration must be given to overcome the types of barriers identified in order to enable the link nurse system to function effectively. © 2008 The Authors.

Primary Reflex Persistence in Children With Partial Hearing

Persistence of the asymmetrical tonic neck reflex (ATNR) was examined in children with partial hearing (aged 6–12 years). Core literacy skills were also assessed. Three groups of children were selected from three schools with special units for children with partial hearing. All children completed an upright ATNR test protocol and standardized tests of reading and spelling. Children with partial hearing had significant levels of ATNR persistence, and significant reading and spelling difficulties. The findings suggest that persistence of an early sub-cortical reflex system may be associated with some of the motor and cognitive difficulties experienced by children with partial hearing.

How well do midwives use skills and knowledge in examining newborns?

Physical examination of the newborn (PEN) was established as part of postnatal care in the late 1960s. The role of discharging babies within the first 72 hours of birth was traditionally undertaken by junior doctors. Currently midwives, nurses, advanced nurse practitioners, and health visitors are being trained to undertake the PEN (NHS Screening Programmes, 2010). However, only a fraction of midwives utilize their acquired skills in clinical practice. A survey by Townsend et al (2004) showed that 2% of babies in England were examined by midwives while 83% were examined by junior doctors.This study aimed to evaluate how well midwives who undertook the PEN course between 2002 and 2005 (n = 40) at a large London University utilized the skills acquired on the course. Questionnaires with a series of open and closed questions were sent out by post followed by phone and email reminders. The eight that responded were midwives. All respondents said they were appropriately trained and felt well prepared for their role to examine babies. However, they felt they were not provided with opportunities to use the skills. Guidelines based on this extended role are available in the workplace but only a few midwives seemed to have negotiated time to implement these and may need greater managerial support for the role.

A systematic review protocol on the use of online learning and blended learning for teaching clinical skills to undergraduate health professional students

Aim: This paper is a review protocol that will be used to identify, critically appraise and synthesize the best current evidence relating to the use of online learning and blended learning approaches in teaching clinical skills in undergraduate nursing.

Background: Although previous systematic reviews on online learning versus face to face learning have been undertaken (Cavanaugh et al. 2010, Cook et al. 2010), a systematic review on the impact of online learning and blended learning for teaching clinical skills has yet to be considered in undergraduate nursing. By reviewing nursing students’ online learning experiences, systems can potentially be designed to ensure all students’ are supported appropriately to meet their learning needs.

Methods/Design: The key objectives of the review are to evaluate how online-learning teaching strategies assist nursing students learn; to evaluate the students satisfaction with this form of teaching; to explore the variety of online-learning strategies used; to determine what online-learning strategies are more effective and to determine if supplementary face to face instruction enhances learning. A search of the following databases will be made MEDLINE, CINAHL, BREI, ERIC and AUEI. This review will follow the Joanna Briggs Institute guidance for systematic reviews of quantitative and qualitative research.

Conclusion: This review intends to report on a combination of student experience and learning outcomes therefore increasing its utility for educators and curriculum developers involved in healthcare education.

Student teachers' experiences of initial teacher preparation in England:Core themes and variation

Drawing on data generated via large-scale survey and in-depth interview methods, this article reports findings which show that being a student teacher in early-twenty-first-century England is a demanding personal experience which requires considerable engagement and commitment in the face of built-in challenges and risks, and which engenders, for many, highly charged affective responses. Student teachers are centrally concerned during this time with their (changing) identities, their relationships with others and the relevance of course provision. Findings also indicate that, in some respects, student teachers’ accounts of their experiences are systematically differentiated according to a number of factors, notably the initial teacher preparation route being followed, their age, and their prior conceptions and expectations of teaching and of learning to teach. These findings are situated in the broader literature on teacher development and some implications for teacher educators are discussed. © 2008 Taylor & Francis

Basic and Employability Skills

This is the editorial opening paper to a special issue of the International Journal of Training and Development focusing on basic skills and employability

The efficacy of a CDIO based integrated curriculum as preparation for professional practice in product design and development

The School of Mechanical and Aerospace Engineering at Queen’s University Belfast started BEng and MEng degree programmes in Product Design and Development (PDD) in 2004. Intended from the outset to be significantly different from the existing programmes within the School the PDD degrees used the syllabus and standards defined by the CDIO Initiative as the basis for an integrated curriculum. Students are taught in the context of conceiving, designing, implementing and operating a product. Fundamental to this approach is a core sequence of Design-Build-Test (DBT) experiences which facilitates the development of a range of professional skills as well as the immediate application of technical knowledge gained in strategically aligned supporting modules.
The key objective of the degree programmes is to better prepare students for professional practice. PDD graduates were surveyed using a questionnaire developed by the CDIO founders and interviewed to examine the efficacy of these degree programmes, particularly in this key objective. Graduate employment rates, self assessment of graduate attributes and examples of work produced by MEng graduates provided positive evidence that their capabilities met the requirements of the profession. The 24% questionnaire response rate from the 96 graduates to date did not however facilitate statistically significant conclusions to be drawn and particularly not for BEng graduates who were under represented in the response group. While not providing proof of efficacy the investigation did provide a good amount of useful data for consideration as part of a continuous improvement process.

How does involvement of a hospice nurse specialist impact on the experience on informal caring in palliative care? Perspectives of middle-aged partners bereaved through cancer

The aim of this study was to retrospectively explore partners' understandings and experiences in relation to caring for a loved one with a terminal illness, with a particular focus on the role of the hospice nurse specialist (HNS). Participants were purposively sampled and recruited through HNS gatekeepers. Seven middle-aged, bereaved partners participated in semi-structured, qualitative interviews. The interviews were audio recorded and transcribed verbatim and data were analysed using thematic content analysis. Five main themes emerged regarding the impact of the HNS on informal caring: ‘the ambivalence of caring’, ‘the HNS as a “confidante” in caring’, ‘the HNS as a “champion” in support’, ‘the work of the HNS – an unseen benefit’ and ‘being prepared for death and bereavement’. Findings from this study offer new insights into how involvement of a HNS impacts on the ability of carers to perform their role as an informal caregiver. Results highlight a crucial need for carers to have a clear understanding of all aspects of the HNS role so that full benefit is derived from their input. Recruitment of experienced and knowledgeable nurses is paramount, but equally important for carers is the supportive aspect of the role for which nurses need to demonstrate excellent communication skills and an intuitive, caring approach.

Language Teacher Education in Ireland, North and South

The European Union considers modern languages among the basic skills or key competencies required by all its citizens and is concerned to promote excellence in the teaching and learning of languages as well as greater diversity in the range of languages available to learners in the Member States, as witnessed by the recent European Commission Action Plan, Promoting Language Learning and Linguistic Diversity: An Action Plan 2004-2006. This consideration, the changing socio-cultural demography of Ireland, the need for more joined-up thinking in the context of language teaching in schools, and in the context of language teacher education in particular, form the back-drop to the paper. Among the challenges facing modern/world languages’ education in Ireland identified in the paper are, lack of a languages’ policy, lack of a languages’ strategy, and lack of an integrated language curriculum and by implication, a whole school approach to language teaching and learning. The paper refers to positive signs that are occurring in this context as well, e.g. official recognition to Irish as a working language in the European Union and in the Official Languages Act in Ireland (2003). The paper reports on the recent first ever all Ireland cross-border conference in the context of language teacher education. It outlines the background, aims, and content of the conference that includes findings from a study about the impact of autonomous language teaching and learning supported by the European Language Portfolio in the context of post-primary language teacher education in Ireland. The paper shows data from the first ever survey on language teacher education provision, policy and practice across colleges in Ireland, North and South. Initial teacher education is on the cusp of change. This paper highlights several key issues facing language teacher education. This paper has implications for Irish as well as international readers, and is aimed at supporting all those who want to bring about improvement in this important area.

Development of an objective structured clinical examination (OSCE) to assess formulation and extemporaneous dispensing skills in MPharm undergraduates

Background: The use of Objective Structured Clinical Examination (OSCE) in Pharmacy has been explored; however this is the first attempt in Queen’s University School of Pharmacy, Belfast to assess students via this method in a module where chemistry is the main discipline.

Aims: To devise an OSCE to assess undergraduate ability to check extemporaneously dispensed products for clinical and formulation errors. This activity also aims to consider whether it is a viable method of assessment in such a science-based class, from a staff and student perspective.

Method: Students rotated around a number of stations, performing a check of the product, corresponding prescription and formulation record sheet detailing the theory behind the formulation. They were assessed on their ability to spot intentional mistakes at each one.

Results: Of the 79 students questioned, 95% indicated that OSCE made them aware of the importance of the clinical check carried out by the pharmacist. Nearly all of the undergraduates (72 out of 79) felt that OSCE made them aware of the type of mistakes that students make in class. Most (5 out of 7) of the academic team members strongly agreed that it made students aware of ‘point of dispensing’ checks carried out by pharmacists, in addition to helping them to prepare for their exam.

Conclusion: OSCE assesses both scientific and formulation skills, and has increased the diversity of assessment of this module, bringing with it many additional benefits for the undergraduates since it measures their ability to exercise professional judgement in a time- constrained environment and, in this way, mirrors the conditions many pharmacists work within.

Taiwanese Learners’ Motivation and Attitude Towards Completing an Online Distance Education Course During a One Year Industrial Placement

This mixed methods study investigated language learning motivation in an one-year e-learning course for technological university students to bridge the geographical divide between students on industrial placements when studying graded readers using an e-learning course to improve their English competence and to pass the General English Proficiency Test. Data was collected through questionnaires and course feedback. The results of this study extend Gardner’s socio-educational model in an e-learning environment by adding the new category, Computer Attitudes, which was proven to be highly correlated with Motivation. Although the low proficiency English students had good computer skills, their habits of using the computer for entertainment and their lack of the skill of “technological communication efficacy” caused increased anxiety when using computers and thus provided them with a lower computer confidence over time. Consequently, it is recommended that sound e-learning training should be provided to all of the students prior to embarking on an e-leaning course so that these learners can benefit from online language learning in the future.

History taking and clinical examination skills from a stoma nurse’s perspective

Comprehensive history-taking and clinical examination skills are examples of role development for a stoma care nurse specialist. Comprehensive history-taking is a thorough exploration of a patient's presenting complaint and the gathering of subjective information, while clinical examination is the gathering of objective information from a head-to-toe assessment or a focused assessment of a particular body system. This paper demonstrates the application of comprehensive history-taking and gastrointestinal clinical examination skills by the stoma care nurse in a clinical community setting, and explores their advantages and disadvantages in stoma care practice.

Advocacy in pain management: the role of the anaesthetic nurse specialist

Peri-operative nursing practice is constantly changing and demanding specialist knowledge, skills and expertise to embrace these changes. All patients in need of anaesthesia are entitled to the same high quality peri-operative care and therefore those assisting the anaesthetist must be competent and effective practitioners. With this in mind the authors shall give a reflective account highlighting the role of Anaesthetic Nurse Specialist (ANS) in promoting leadership within the peri-operative environment and how it can be nurtured and facilitated to achieve professional autonomy and promote patient advocacy.

Anaesthetic nurse specialist role: leading and facilitation in clinical practice

Leadership and its effectiveness is becoming more prevalent within the nursing profession with anaesthetic nurse specialists showing their ability to lead, inspire and motivate others to work towards a shared vision in the rapidly changing peri-anaesthesia environment. Anaesthetic nurse specialists must therefore be aware of their personal leadership skills and continually develop these within clinical practice. They are also well placed regarding the facilitation of learning.