Nurses' understanding of patient-centred care in Bhutan

Aim The purpose of the study was to explore nurses' perceptions and understanding of patient-centred care (PCC) in Bhutan. Background Nurses' perceptions and understanding of PCC in Bhutan are unknown. Methods A non-probability convenience sample was taken and a mixed method (quantitative and qualitative descriptive) used. Survey questionnaires were administered to 87 Bhutanese nurses in three types of hospitals -- the National Referral Hospital, the regional referral hospital and the district hospital. Descriptive statistics including frequency distribution, mean and standard deviation (SD) were used for analysis. Spearman's correlation coefficients were used to investigate relationships between demographic variables. Results The nursing labour force in Bhutan knows which behaviours are considered necessary for practising PCC. The mean (SD) rating of behaviours considered critical for practising PCC was 4.29 (0.22), five being the highest score. Bhutanese nurses described PCC, according to qualitative descriptive analysis, as being based on individual patient assessment (22/87 or 25% of respondents), using a holistic model of care (38/87 or 44%) that was based on evidence (38/87 or 44%). A higher level of education (79/87 or 91%) was found to be the main factor that would facilitate the development of PCC, while inadequate staffing, in terms of insufficient numbers of staff and lack of advanced practitioners (56/87 or 64%), was revealed as the main factor that hinders development of PCC. Conclusion Bhutanese nurses believed certain behaviours were critical to PCC. Reform of higher nursing education, putting an emphasis on PCC, would improve nursing practice and increase its scope.

Demonstrable professionalism : linking patient-centred care and revalidation

The move by the Medical Board of Australia to commence a conversation with the medical profession about revalidation reflects that patient-centred care is at the heart of good medical practice. Patients judge their doctors' commitment to them based on whether their individual interactions with doctors meet their needs. We argue that ensuring that doctors are continuing to perform at a level that the community regards as acceptable is a demonstration of an individual doctor's professionalism and thus their commitment to patient-centred care. This impacts on the profession as a whole, which needs to commit to what we call 'demonstrable professionalism' - the ongoing and active demonstration of performance that the community regards as acceptable. This needs to be supported by organisations in which doctors work, reflecting the importance of organisational context to clinical practice. Revalidation processes thus need both to reflect the work of doctors and be meaningful to the community. The move to consider revalidation of doctors by regulatory authorities should not be seen by the profession as a threat, but more as an opportunity to demonstrate the profession's commitment to patient-centred care

Time for change? Organisational study support and the full-time employee-part-time learner

This research project investigates how the experiences of full-time employees undertaking part-time tertiary study influence perceptions of the value of undertaking part-time study whilst working full-time.

Infusing instructional design principles into an active student-centred social learning framework

Social and participatory media offer a plethora of ways for students to communicate, collaborate, and learn in schools. Using a social learning approach, Casey (2013a) investigated ways that social media could be integrated into Australian public high school classrooms to enhance student learning. In the process, she developed a social learning framework as discussed in Casey (2013b). Similarly, Davidson-Shivers and Hulon (2013; Hulon & Daidson-Shivers, 2013) suggest ways to employ ID principles to prepare college instructors and pre-service teachers to integrate technology into classrooms. Prior to that, Davidson-Shivers with Rasmussen (2006) developed an instructional design (ID) model for creating effective Web-based learning environments. Through collaboration, Casey and Davidson-Shivers consider a wide range of social learning and instructional design principles and approaches to help develop frameworks for new media integration that can work within varying levels of education.

Training AAC users in user-centred design

User-centred design (UCD) with a focus on usability provides product developers with a design approach in which users are involved in every stage of the process: when gathering requirements; when evaluating alternative designs; and when evaluating interactive prototypes.The characteristics of people who use augmentative and alternative communication (AAC) make it difficult to follow a truly UCD approach, which in part may contribute to the high rejection of AAC devices. Training workshops have been delivered to introduce users and AAC professionals to the UCD process.Initial feedback indicates that they feel more empowered to evaluate systems and to engage in the design of new systems after attending the workshop.