A literature review to Examine the Validity and Reliability of group poster presentations as an assessment method of a module in an undergraduate nursing degree programme

The introduction of a poster presentation as a formative assessment method over a multiple choice examination after the first phase of a three phase “health and well-being” module in an undergraduate nursing degree programme was greeted with a storm of criticism from fellow lecturers stating that poster presentations are not valid or reliable and totally irrelevant to the assessment of learning in the module. This paper seeks to investigate these criticisms by investigating the literature regarding producing nurses fit for practice, nurse curriculum development and wider nurse education, the purpose of assessment, validity and reliability to critically evaluate the poster presentation as a legitimate assessment method for these aims.

Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU):A randomised, double-blind, placebo-controlled trial

Background: Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or coma. Methods: We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 h of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2·5 mg or 0·9% saline placebo intravenously every 8 h, irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days of treatment, whichever came first. Delirium was assessed using the confusion assessment method for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14 day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. Findings: 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0-10] vs 6 days [0-11] days; p=0·53). The most common adverse events were oversedation (11 patients in the haloperidol group vs six in the placebo group) and QTc prolongation (seven patients in the haloperidol group vs six in the placebo group). No patient had a serious adverse event related to the study drug. Interpretation: These results do not support the hypothesis that haloperidol modifies duration of delirium in critically ill patients. Although haloperidol can be used safely in this population of patients, pending the results of trials in progress, the use of intravenous haloperidol should be reserved for short-term management of acute agitation. Funding: National Institute for Health Research. © 2013 Elsevier Ltd.

The Hidden benefits of “poster presentation assessment”: Skill acquirement and learning; evaluated from the nursing students perspective

Introduction
This paper reports to an exercise in evaluating poster group work and poster presentation and the extra learning and skill acquisition that this can provide to nursing students, through a creative and stimulating assessment method. Much had been written about the benefits of using posters as an assessment method, yet there appears to be a lack of research that captures the student experience.
Aim
This evaluative study sought to evaluate the student experience by using a triangulation approach to evaluation:
Methodology
All students from the February 2015 nursing intake, were eligible to take part (80 students) of which 71 participated (n=71). The poster group presentations took place at the end of their first phase of year one teaching and the evaluation took place at the end of their first year as undergraduate. Evaluation involved;
1. Quantitative data by questionnaires
2. Qualitative data from focus group discussions
Results
A number of key themes emerged from analysis of the data which captured the “added value” of learning from the process of poster assessment including:
 Professionalism: developing time keeping skills, presenting skills.
 Academic skills: developing literature search, critic and reporting
 Team building and collaboration
Overall 88% agreed that the process furnished them with additional skills and benefits above the actual production of the poster, with 97% agreeing that these additional skills are important skills for a nurse.
Conclusion
These results would suggest that the process of poster development and presentation furnish student nurses with many additional skills that they may not acquire through other types of assessment and are therefore beneficial. The structure of the assessment encourages a self-directed approach so students take control of the goals and purposes of learning. The sequential organization of the assessment guides students in the transition from dependent to self-directed learners.

Is Our Students Learning - QuestionMark: Extending E-Assessment Systems for Adapative Marking and Feedback

Our key contribution is a flexible, automated marking system that adds desirable functionality to existing E-Assessment systems. In our approach, any given E-Assessment system is relegated to a data-collection mechanism, whereas marking and the generation and distribution of personalised per-student feedback is handled separately by our own system. This allows content-rich Microsoft Word feedback documents to be generated and distributed to every student simultaneously according to a per-assessment schedule.

The feedback is adaptive in that it corresponds to the answers given by the student and provides guidance on where they may have gone wrong. It is not limited to simple multiple choice which are the most prescriptive question type offered by most E-Assessment Systems and as such most straightforward to mark consistently and provide individual per-alternative feedback strings. It is also better equipped to handle the use of mathematical symbols and images within the feedback documents which is more flexible than existing E-Assessment systems, which can only handle simple text strings.

As well as MCQs the system reliably and robustly handles Multiple Response, Text Matching and Numeric style questions in a more flexible manner than Questionmark: Perception and other E-Assessment Systems. It can also reliably handle multi-part questions where the response to an earlier question influences the answer to a later one and can adjust both scoring and feedback appropriately.

New question formats can be added at any time provided a corresponding marking method conforming to certain templates can also be programmed. Indeed, any question type for which a programmatic method of marking can be devised may be supported by our system. Furthermore, since the student’s response to each is question is marked programmatically, our system can be set to allow for minor deviations from the correct answer, and if appropriate award partial marks.

UK consensus project on quality in palliative day services: developing a quality indicator set using the RAND/UCLA appropriateness method

Introduction
Evaluating quality of palliative day services is essential for assessing care across diverse settings, and for monitoring quality improvement approaches.

Aim
To develop a set of quality indicators for assessment of all aspects (structure, process and outcome) of care in palliative day services.

Methods
Using a modified version of the RAND/UCLA appropriateness method (Fitch et al., 2001), a multidisciplinary panel of 16 experts independently completed a survey rating the appropriateness of 182 potential quality indicators previously identified during a systematic evidence review. Panel members then attended a one day, face-to-face meeting where indicators were discussed and subsequently re-rated. Panel members were also asked to rate the feasibility and necessity of measuring each indicator.

Results
71 indicators classified as inappropriate during the survey were removed based on median appropriateness ratings and level of agreement. Following the panel discussions, a further 60 were removed based on appropriateness and feasibility ratings, level of agreement and assessment of necessity. Themes identified during the panel discussion and findings of the evidence review were used to translate the remaining 51 indicators into a final set of 27.

Conclusion
The final indicator set included information on rationale and supporting evidence, methods of assessment, risk adjustment, and recommended performance levels. Further implementation work will test the suitability of this ‘toolkit’ for measurement and benchmarking. The final indicator set provides the basis for standardised assessment of quality across services, including care delivered in community and primary care settings.

Reference

• Fitch K, Bernstein SJ, Aguilar MD, et al. The RAND/UCLA Appropriateness Method User’s Manual. Santa Monica, CA: RAND Corporation; 2001. http://www.rand.org/pubs/monograph_reports/MR1269

An Assessment of Psychological Need in Emergency Medical Staff in the Northern Health and Social Care Trust Area

Setting: Psychological stress is increasingly recognised within emergency medicine, given the environmental and clinical stressors associated with the specialism. The current study assessed whether psychological distress is experienced by emergency medical staff and if so, what is the expressed need within this population? Participants: Participants included ambulance personnel, nursing staff, doctors and ancillary support staff within two Accident and Emergency (A&E) departments and twelve ambulance bases within one Trust locality in NI (N = 107). Primary and secondary outcome measures: The General Health Questionnaire (GHQ-12, Goldberg, 1972, 1978), Secondary Traumatic Stress Scale (STSS, Bride, 2004) and an assessment of need questionnaire were completed and explored using mixed method analysis. Results: Results showed elevated levels of psychological distress within each profession except ambulance service clinical support officers (CSOs). Elevated levels of secondary trauma symptomatology were also found; the highest were within some nursing grades and junior doctors. Decreased enjoyment in job over time was significantly associated with higher scores. Analysis of qualitative data identified sources of stress to include low morale. A total of 65% of participants thought that work related stressors had negatively affected their mental health. Participants explored what they felt could decrease psychological distress including improved resources and psychoeducation. Conclusion: There were elevated levels of distress and secondary traumatic stress within this population as well as an expressed level of need, on both systemic and support levels.

An Assessment of How Nurse Practitioners Create Access to Primary Care in Canadian Residential Long-Term Care Settings

The aim of this paper is to explore the role and activities of nurse practitioners (NPs) working in long-term care (LTC) to understand concepts of access to primary care for residents. Utilizing the "FIT" framework developed by Penchanksy and Thomas, we used a directed content analysis method to analyze data from a pan-Canadian study of NPs in LTC. Individual and focus group interviews were conducted at four sites in western, central and eastern regions of Canada with 143 participants, including NPs, RNs, regulated and unregulated nursing staff, allied health professionals, physicians, administrators and directors and residents and family members. Participants emphasized how the availability and accessibility of the NP had an impact on access to primary and urgent care for residents. Understanding more about how NPs affect access in Canadian LTC will be valuable for nursing practice and healthcare planning and policy and may assist other countries in planning for the introduction of NPs in LTC settings to increase access to primary care.