Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study

Objectives
This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients.

Design
Mixed-method multi-centre study.

Setting
High fidelity simulated acute clinical environment in three Australian universities.

Participants
A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study.

Method
In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance.

Results
Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%.

Conclusions
Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.

The effect of physical activity on psychological distress, cortisol and obesity: results of the farming fit intervention program

Background:
Rural and regional Australians have a higher likelihood of mental illness throughout their lifetime than people living in major cities, although the underlying reasons are not yet well defined. Additionally, rural populations experience more lifestyle associated co-morbidities including obesity, diabetes and cardiovascular disease. Research conducted by the National Centre for Farmer Health between 2004 and 2009 revealed a positive correlation between obesity and psychological distress among the farming community. Chronic stress is known to overstimulate the regulation of the hypothalamic-pituitary-adrenal (HPA) axis and cortisol secretion which are associated with abdominal adiposity. Increasing physical activity may normalise cortisol secretion and thereby positively impact both physical and mental health. This paper assesses the effects of increasing physical activity on obesity, health behaviors and mental health in Victorian farming men and women.

Methods:
Farming Fit was a six month quasi-experimental (convenience sample) longitudinal design control-intervention study. Overweight or obese (BMI ?25?kg/m2) farm men (n?=?43) and women (n?=?29) were recruited with demographic, health behaviors, anthropometric, blood pressure and biochemistry data collected at baseline and at a six months. Salivary cortisol and depression anxiety stress scale results were collected at baseline, three and six months. The intervention group (n?=?37) received a personalized exercise program and regular phone coaching to promote physical activity.

Results:
The intervention group showed significant reductions in body weight and waist circumference. Results indicated that following the six month exercise program, the intervention group were 2.64???0.65?kg lighter (p?<?0.001), had reduced waist circumference by 2.01???0.86?cm (p?=?0.02) and BMI by 0.97???0.22?kg/m2 (p?<?0.001) relative to the control group.

Conclusion:
Increasing physical activity altered measures of obesity in farm men and women but did not affect mental health measures or cortisol secretion levels.

A critical review of psychological instruments used in police officer selection

Purpose
The purpose of this paper is to critically examine the instruments used in the screening process, with particular attention given to supporting research validation. Psychological screening is a well-established process used in the selection of employees across public safety industries, particularly in police settings. Screening in and screening out are both possible, with screening out being the most commonly used method. Little attention, however, has been given to evaluating the comparative validities of the instruments used.

Design/methodology/approach
This review investigates literature supporting the use of the Minnesota Multiphasic Personality Inventory (MMPI), the California Personality Inventory (CPI), the Inwald Personality Inventory (IPI), the Australian Institute of Forensic Psychology's test battery (AIFP), and some other less researched tests. Research supporting the validity of each test is discussed.

Findings
It was found that no test possesses unequivocal research support, although the CPI and AIFP tests show promise. Most formal research into the validity of the instruments lacks appropriate experimental structure and is therefore less powerful as “evidence” of the utility of the instrument(s).

Practical implications
This research raises the notion that many current screening practices are likely to be adding minimal value to the selection process by way of using instruments that are not “cut out” for the job. This has implications for policy and practice at the recruitment stage of police employment.

Originality/value
This research provides a critical overview of the instruments and their validity studies rather than examining the general process of psychological screening. As such, it is useful to those working in selection who are facing the choice of psychological instrument. Possibilities for future research are presented, and development opportunities for a best practice instrument are discussed.

Book Review: Diabetes and wellbeing: Managing psychological and emotional challenges of diabetes types 1 and 2

Book Review in peer revewed Journal of Diabetes Nursing about the psychological and emotional challenges associated with living with Diabetes. The book is recommended to both health professionals and people with Diabetes.

Psychological Reflections on Post - Modernist Gothic Literature

The thesis consists of a creative component, two short stories, 'The Conservatory' and 'Psychosis', and a novella, 'The Lady of Tangiers', in the genre of Gothic fiction, and accompanying theoretical component with a psychological interpretation of literature, including theories of C.G.Jung, identifying psychological elements including symbolism of the unconscious, transformation and individuation in the short stories 'The Conservatory' and 'Psychosis', and an analysis of the novella 'The Lady of Tangiers', discussing the essay 'The Uncanny' by Sigmund Freud. The critical analysis and interpretation of the writing reflects the psychological development of the individual.

A qualitative evaluation of online chat groups for women completing a psychological intervention for female sexual dysfunction

Because of the embarrassment that can surround female sexual dysfunctions, online interventions offer an anonymous and private treatment alternative. Recently, an online cognitive-behavioral treatment for female sexual dysfunctions was evaluated. Although significant improvements were observed in sexual functioning, the treatment was primarily a behavioral intervention because of difficulties with engaging participants in cognitive therapy over e-mail. To address this limitation, the use of chat groups was incorporated into a new online treatment for female sexual dysfunctions—the PursuingPleasure program. Thirty-eight women participated in the PursuingPleasure chat groups. The goals of the chat groups were to address and overcome challenges as women progressed through PursuingPleasure and to create a social support network where group therapy processes could be used. The chat groups aimed to address misunderstandings, monitor changes, and receive feedback. A qualitative analysis of the chat groups revealed that they helped to facilitate the cognitive-affective aspects of the program, as well as fulfill their other intended functions. This study demonstrates how the use of chat groups in the online treatment of female sexual dysfunctions is a useful addition to Internet-based treatment. Feedback suggests that the chat groups were one of the most helpful aspects of the program, although a small group of women reported finding the groups unhelpful.