Implementing elements of Schon's reflective practitioner in an undergraduate public relations program

While the internship unit in a public relations degree is often viewed as the foremost area of experiential learning it can fail to deliver significant learning outcomes for student and teacher. This paper explores the use of other activity-based learning (ABL) methods as implemented in the Deakin University public relations undergraduate degree. The paper applies Donald Schon's concept of the reflective practitioner to learning undertaken in an internship unit and compares this application to two other units where ABL is used and the focus is on creating a client-professional relationship. For the purpose of this paper information was analysed using the 2006 on-campus cohort only. The cohort was further refined to include those students who successfully completed the degree of BA in public relations. Student internship evaluation forms and unit records were viewed to gain statistical information.

Technical rationality and professional artistry in RD practice

This paper outlines the limitations of a technical rationalist approach to HRD practice without seeking to negate it. It then offers a complementary view based on Schon's notion of the reflective practitioner which exhorts HRD practitioners to embrace complexity and reflection. We outline, first, a number of dimensions of diversity which confer complexity upon HRD practice, and, second, a series of suggested questions that may aid the framing of practical problems in a more effective way than might be the case with a purely technical rationalist approach. We urge novice (and expert) HRD practitioners to adopt a mind set that is contemplative of the diversities that they may encounter in practice and which is conjectural with regard to how these diversities may impact upon problems and their solutions.

Reflections on the mentoring process with academics entering a 'new' educational experience

Purpose – Increasingly, academics new to higher education find themselves in a “publish or perish” environment, with little if any formal or informal support structures. This is a situation that many academics have faced and lamented. The discussion in this paper emanates from the objective of seeking to change this environment. The mentoring provided an opportunity to work collaboratively with accounting academics who are new to the higher education sector, and focuses on developing and/or enhancing a scholarly approach to teaching and learning.

Design/methodology/approach – The reflective practitioner model provides the theoretical framework that underpins this mentoring process. The discussion in this research paper provides an opportunity to explore this mentoring process, primarily aimed at developing and encouraging a scholarly approach to teaching and learning by academics new to the environment. Data on the process were collected using a survey questionnaire and as a result of informal discussions during the mentoring process.

Findings – The findings indicate an overall positive response to the process for both the mentor and the mentee and the achievement of the planned research outcomes.

Originality/value – The discussion in this paper outlines a framework and process that others may follow when mentoring academics entering a “new” educational experience.

Video capture : pre-service teacher reflection, assessment or both

This paper reports on a small trial with 6 pre-service teachers who videoed their own teaching practices. The pre-service teachers used the tool to reflect on practice and to enhance their own understandings of themselves as teachers. The initial footage was used to by the pre-service teachers to gauge quite specific elements of their teaching: for example, were they asking effective questions, or were they responding appropriately to questions children asked and as always, what management strategies seemed to be working? Critical feedback from other students was initially „less than critical‟, but again over time, this also appeared to sharpen as they had more opportunity to use the technology. Initial embarrassment of being on screen was replaced with a professional approach to seeing the video as a tool for providing the opportunity to systematically deconstruct practices and for providing concrete feedback for improvement. Used in conjunction with teaching preparation courses, the videoed segments of teaching practice could be used to highlight exemplars, to show what actually happens in classrooms and to explain certain practices. Cunningham and Benedetto (2002) state “Recent developments in digital video technologies permit teacher candidates to collect, review, and manipulate video to demonstrate their growth as a professional and as a reflective practitioner.” However, in the development of the trial, the issue was raised by the pre-service teachers that they would be interested in keeping the videos as evidence of their teaching competence to be used in applications for teaching positions. In the small trial, ethics permission had not been gained for that to happen, but it is certainly a valid and viable possibility for the future. Currently prospective employers have to rely on paper applications which respond to selection criteria, evidence from pre-service teachers‟ teaching rounds and the subjective impressions of an interview. If students were able to present a 5 minute segment of them teaching, it might count for much more than any other evidence. Video capture of teaching practice would provide potential employers with an indication of a pre-service teacher‟s management strategies, relationships with children and a snapshot of a pre-service teacher‟s instructional practice. The idea of video-capture as a tool for pre-service teachers to illustrate teaching capabilities will be more fully investigated in this paper.

The initiation and administration of drugs for advanced life support by critical care nurses in the absence of a medical practitioner

Current legislation does not permit the administration of first line resuscitation medications by suitably qualified Division 1 registered nurses (RNs) in the absence of a medical officer. This omission by the Drugs,  Poisons and Controlled Substances Act 1981 (Vic) and the Drugs, Poisons and The Controlled Substances Regulations 1995 (Vic) leaves many critical care nurses in a vulnerable legal position.

The primary aim of this study was to gauge the view of critical care nurses with respect to lobbying for change to the current legislation. In addition, the study aimed to explore and describe the educational preparation, practice perceptions and experiences of RNs working in critical care regarding cardiopulmonary resuscitation and the administration of first line advanced life support (ALS) medications in the absence of a medical officer. It was anticipated that data collected would demonstrate some of the dilemmas associated with the initiation and administration of ALS medications for practising critical care nurses and could be used to inform controlling bodies in order for them to gain an appreciation of the issues facing critical care nurses during resuscitation.

A mailout survey was sent to all members of the Victorian Branch of the Australian College of Critical Care Nurses (ACCCN). The results showed that the majority of nurses underwent an annual ALS assessment and had current ALS accreditation. Nurses indicated that they felt educationally prepared and were confident to manage cardiopulmonary resuscitation without a medical officer; indeed, the majority had done so. The differences in practice issues for metropolitan, regional and rural nurses were highlighted. There is therefore clear evidence to suggest that legislative amendments are appropriate and necessary, given the time critical nature of cardiopulmonary arrest. There was overwhelming support for ACCCN Vic. Ltd to lobby the Victorian government for changes to the law.

Evaluation of an on-line reflective journal in engineering education

Reflective thinking based on experiential learning is a key skill for the professional engineer. The use of a reflective learning journal is thought to be a valuable tool in developing reflexivity. An evaluation was undertaken of student perceptions of an on-line reflective journal introduced into an engineering management study unit.

A trial of nurse practitioner scope of practice

Aims. The aim of this paper is to report a trial to investigate the feasibility of the nurse practitioner role in local health service delivery and to provide information about the educational and legislative requirements for nurse practitioner practice.

Background. Nurse practitioners have been shown to offer a beneficial service and fill a gap in health care provision. However, the lack of publications describing, critiquing, or defending the way that existing nurse practitioner roles have been developed may lead to a lack of clarity in comparing the nurse practitioner scope of practice internationally. In Australia, credible exploratory research is needed to realize the potential of nurse practitioners to bridge the divide of inequitable distribution of health services. A trial of nurse practitioner services in the Australian Capital Territory provided an excellent opportunity to investigate these scope and continuity issues.

Methods. This was an observational analytic study using multiple data sources. Four models of nurse practitioner service were chosen from a competitive field of applications that were evaluated according to efficacy, feasibility, and sustainability across specified selection criteria. Each model in the trial included a clinical support team, with the nurse practitioner candidate 'working-into-the-role' and collecting demographic, clinical practice, patient outcome, and health service and consumer survey data over a 10 month period.

Findings. The trial identified the broad potential of the nurse practitioner role, its breadth and limitations, and its impact on selected health services in the Australian Capital Territory. Data from individual models were compared highlighting generic elements, and formed the basis for the development of the scope of practice for the Australian Capital Territory nurse practitioner models.

Conclusions. This study has validated a research-based, iterative process for initial development of nurse practitioner scope of practice for any Australian specialization. Importantly, the study concluded with the scope of practice as a finding, rather than commencing with it a priori. Although general areas of health care need and under-servicing were identified at the outset, the process tested both the expansion and parameters of the roles.

A historical review of the nurse practitioner role in Australia

Internationally, the nurse practitioner role has been shown to be cost-effective, safe, and instrumental in improving patient outcomes. The nurse practitioner role in Australia is in its infancy. Major stakeholders such as the nurses' boards and state departments of health throughout Australia were contacted to identify major policies and discussion papers. Database searches were conducted in CINAHL and EBSCOhost. Disparity between states exists in all facets of the nurse practitioner role, especially in definition of the role, scope of practice, educational qualifications, and specialized functions. Access to Medicare funding is unobtainable, resulting in inequity of access to health services for disadvantaged communities. The State Nurse Practitioner Taskforce Reports highlight the disparity between the role of nurse practitioner in each State of Australia and has led to fragmentation of the role at a national level. There is a need for consistency, which could be achieved if it were coordinated by a national nursing body with a voice in national health policy development and implementation

Satisfaction with general practitioner treatment of depression among residents of aged care facilities.

Objective: This article investigates consumer perspectives on the treatment for depression among older people in residential facilities. Method: Aged care residents who were aware of being treated for depression in the past 6 months (24 women and 7 men, mean age = 83 years) participated in an interview that assessed their perspective on treatments. Results: Although more than half of the participants in the sample reported overall satisfaction with the medical treatments received for depression, qualitative data provided indications of unsatisfactory service delivery, including perceptions of low treatment efficacy, short consultation times, the failure to assess affective symptomatology, and negative responses to residents’ disclosure of symptoms. Discussion: The findings are discussed in relation to previous research on consumer satisfaction with health services and issues that may be pertinent to the elderly depressed. Training for general practitioners providing treatment in aged care is indicated.

Emergency nurse practitioner care and emergency department patient flow: case-control study

Objective: The present study aimed to compare ED waiting times (for medical assessment and treatment), treatment times and length of stay (LOS) for patients managed by an emergency nurse practitioner candidate (ENPC) with patients managed via traditional ED care. Methods: A case–control design was used. Patients were selected using the three most common ED discharge diagnoses for ENPC managed patients: hand/wrist wounds, hand/wrist fractures and removal of plaster of Paris. The ENPC group (n = 102) consisted of patients managed by the ENPC who had ED discharge diagnoses as mentioned above. The control group (n = 623) consisted of patients with the same ED discharge diagnoses who were managed via traditional ED care. Results: There were no significant differences in median waiting times, treatment times and ED LOS between ENPC managed patients and patients managed via traditional ED processes. There appeared to be some variability between diagnostic subgroups in terms of treatment times and ED LOS. Conclusion: Patient flow outcomes for ENPC managed patients are comparable with those of patients managed via usual ED processes.

Development, reliability and validity of an instrument measuring the attitudes and knowledge of emergency department staff regarding the emergency nurse practitioner role

Introduction: The Emergency Department (ED) at The Northern Hospital is currently participating in the Victorian Department of Human Services funded Emergency Nurse Practitioner Project. This project aims to develop, implement and evaluate the Emergency Nurse Practitioner role in Victorian EDs. This led to a need to develop a specific data collection tool called The Northern Emergency Nurse Practitioner Staff Survey to examine the knowledge and attitudes of ED medical and nursing staff. This paper describes the development of The Northern Emergency Nurse Practitioner Staff Survey and presents the results of reliability and validity studies. Method: Twenty-five items were developed and piloted on a sample of 58 ED medical and nursing staff. Content and face validity were established by expert panel review. Reliability was established by tests of unidimensionality, exploratory factor analysis and internal consistency. Results: Four items were discarded because of low item to total correlation. Exploratory factor analysis of the remaining items revealed five factors with eigenvalues >1 and acceptable correlation coefficients that explained 76.7% of the variance. Cronbach’s coefficent α for these items was 0.926 indicating a high degree of internal consistency. The factors were titled to reflect the content domain of the items in each factor and the factors arranged in a logical sequence to form the final version of The Northern Emergency Nurse Practitioner Survey.

Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department

This study examined the emergency nurse practitioner candidate (ENPC) scope of practice in a Victorian emergency department (ED). The emergency nurse practitioner (ENP) role is relatively new in Victoria and the scope of the ENP(C) practice is yet to be defined. International research literature regarding the ENP role has focused on outcomes such as patient satisfaction, waiting times and/or ED length of stay, accuracy and adequacy of documentation, use of radiography, and patient education, health promotion and communication issues. A prospective exploratory design was used to conduct this cohort study. There were 476 ENPC-managed patients between 14 July 2004 and 31 March 2005 with an average age of 29 years. The majority (77.2%) of ENPC-managed patients were discharged from the ED. The majority of the ENPC time was devoted to clinical practice (55%) and development of clinical practice guidelines (25%). Of patients managed by the ENPC, 49.6% required medications, 51% required diagnostic imaging and 8.6% required pathology testing during their ED stay. The most common discharge referrals were made to local medical officers (73.5%) and the most common referrals made for patients requiring admission were made to the plastic surgery (37.3%) and orthopaedic (35.5%) units. Extensions to the current scope of emergency nursing practice are pivotal to effective management of specific patient groups by ENP. The ENP model of care is an important strategy for the management of increased service demands in Victoria; however, little is known about the scope of the ENPC practice and many outcomes of the ENP care are yet to be defined. Further research to better understand the relationships between ENP outcomes is required if the contribution that ENPs make to emergency care is to be accurately quantified.