The primacy of vital signs – Acute care nurses’ and midwives’ use of physical assessment skills: A cross sectional study

BACKGROUND: Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. OBJECTIVES: To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. DESIGN: The study used a single-centre, cross-sectional survey design. SETTING and PARTICIPANTS: The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. METHODS: We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses’ Use of Physical Assessment scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value < .05 was considered significant for all analyses. RESULTS: Core skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F = 35.77, p < .001), lack of confidence (F = 5.52, p = .02), work area (F = 3.79, p = .002), and clinical role (F = 44.24, p < .001) were significant predictors of the extent of physical assessment skill use. CONCLUSIONS: The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses’ physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by early warning and rapid response systems may divert attention from and devalue comprehensive nursing assessment that could detect subtle changes in health status earlier in the patient's hospitalisation.

Mapping geographical knowledge and skills needed for pre-service teachers in teacher education

In Australia, for more than two decades, a ‘social science’ integrated framework was the favoured approach for delivering subjects such as history and geography. However, such interdisciplinary approaches have continued to attract criticism from various parts of the academic and public spheres and since 2009, a return to teaching the disciplines has been heralded as the ‘new’ way forward. Using discourse analysis techniques associated with Foucauldian archaeology, the purpose of this paper is to examine the Australian Curriculum: Geography document to ascertain the discourses necessary for pre-service teachers to enact effective teaching of geography in a primary setting. Then, based on pre-service teachers’ online survey responses, the paper investigates if such future teachers have the knowledge and skills to interpret, deliver and enact the new geography curriculum in primary classrooms. Finally, as teacher educators, our interest lies in preparing pre-service teachers effectively for the classroom so the findings are used to inform the content of a teacher education course for pre-service primary teachers.

Class participation as a learning and assessment strategy in law : facilitating students’ engagement, skills development and deep learning

Assessment has widely been described as being ‘at the centre of the student experience’. It would be difficult to conceive of the modern teaching university without it. Assessment is accepted as one of the most important tools that an educator can deploy to influence both what and how students learn. Evidence suggests that how students allocate time and effort to tasks and to developing an understanding of the syllabus is affected by the method of assessment utilised and the weighting it is given. This is particularly significant in law schools where law students may be more preoccupied with achieving high grades in all courses than their counterparts from other disciplines. However, well-designed assessment can be seen as more than this. It can be a vehicle for encouraging students to learn and engage more broadly than with the minimums required to complete the assessment activity. In that sense assessment need not merely ‘drive’ learning, but can instead act as a catalyst for further learning beyond what a student had anticipated. In this article we reconsider the potential roles and benefits in legal education of a form of interactive classroom learning we term assessable class participation (‘ACP’), both as part of a pedagogy grounded in assessment and learning theory, and as a platform for developing broader autonomous approaches to learning amongst students. We also consider some of the barriers students can face in ACP and the ways in which teacher approaches to ACP can positively affect the socio-emotional climates in classrooms and thus reduce those barriers. We argue that the way in which a teacher facilitates ACP is critical to the ability to develop positive emotional and learning outcomes for law students, and for teachers themselves.

‘Hiring a Nashville sensation’ : using narrative learning to develop the problem solving skills of contract law students

This article discusses the design of interactive online activities that introduce problem solving skills to first year law students. They are structured around the narrative framework of ‘Ruby’s Music Festival’ where a young business entrepreneur encounters various issues when organising a music festival and students use a generic problem solving method to provide legal solutions. These online activities offer students the opportunity to obtain early formative feedback on their legal problem solving abilities prior to undertaking a later summative assessment task. The design of the activities around the Ruby narrative framework and the benefits of providing students with early formative feedback will be discussed.

WIL-power: Developing journalism students' intercultural communications and international reporting skills on field trips to Vietnam

This article examines journalism students' learning experience that is intercultural, immersive and intensive. Accounts of 'intercultural' experience date back to Herodotus of Halicarnassus; 'immersion' is integral to contemporary practice in language learning; and 'intensive' delivery has been refined to an art by postgraduate business education. Together they can be grouped under the broader pedagogical concept of work-integrated learning (WIL). This article examines two WIL projects that involved field trips by journalism students to Vietnam in 2012 and 2014, and their implications for future WIL initiatives.

Creative labour and graduate outcomes : Implications for higher education and cultural policy

One of the principal ways that cultural and higher education policy and practice intersect is over a shared concern with the supply of talent and its employability and career sustainability. This article considers the multidisciplinary contributions to these debates, and then engages with these debates by drawing upon research from analyses of national Census data, and via granular empirical survey research into Australian creative arts graduates’ initial career trajectories. In so doing, it seeks to paint a more nuanced picture of graduate outcomes, the significance of creative skills and by extension creative education and training, and the various kinds of value that creative graduates add through their work. This evidence should assist in a closer affinity between the differing approaches to creative labour and the creative economy, and has implications for cultural and higher education policy.

Using a free online questionnaire to determine the skills, competencies and knowledge required to work in a digital library environment in Australia

This paper discusses the data collection technique used to determine the skills and knowledge required of academic librarians working in a digital library environment in Australia. The research was undertaken as part of the researcher’s master’s thesis conducted at Tallinn University. The data collection instrument used was a freely available online survey tool, and its advantages and disadvantages are discussed in terms of the desired outcomes and circumstances surrounding the thesis project. Decisions regarding the design of the questionnaire are also discussed.

Assessment of fundamental movement skills in childhood cancer patients

Background The improved treatment protocols and subsequent improved survival rates amongst childhood cancer patients has shifted the focus towards the long-term consequences arising from cancer treatment. Children who have completed cancer treatment are at a greater risk of delayed development, diminished functioning, disability, compromised fundamental movement skill (FMS) attainment and long term chronic health conditions. The aim of the study was to compare FMS of childhood cancer patients with an aged matched healthy reference group. Methods Pediatric cancer patients aged 5-8 years of age (n=26; median age 6.91 years), who completed cancer treatment (<5 years) at the Sydney Children’s Hospital were assessed performing 7 key FMS; sprint, side-gallop, vertical-jump, catch, over-arm throw, kick and leap. Results were compared to the reference group (n=430; 6.56 years). Results Childhood cancer patients scored significantly lower on 3 out of 7 FMS tests when compared to the reference group. These results equated to a significantly lower overall score for FMS. Conclusion This study highlighted the significant deficits in FMS within pediatric patients having completed cancer treatment. In order to reduce the occurrence of significant FMS deficits in this population, FMS interventions maybe warranted to assist in recovery from childhood cancer, prevent late effects and improve the quality of life in survivors of childhood cancer.

Comparison of baseline information literacy skills of undergraduate and graduate Nurses at the University of Queensland: a pilot study by health librarians

Pilot studies are conducted to explain the baseline information literacy skills prevailing in the undergraduate and graduate nurses at the University of Queensland. The analyses reveal a significant difference between the skills of both the nurses, hence demonstrating the need for the development of new information literacy workshops. The author also presents various teaching strategies that can be adopted for an effective skill development of these nurses.

An enquiry into the professional competence of inclusive education teachers in Beijing: Attitudes, knowledge, skills, and agency

Attitudes, knowledge, and skills are widely recognised as the three pillars of professional competence of inclusive education teachers. Studies emerging from the Chinese context consider these three pillars important for the practice of Learning in Regular Classrooms—an idiosyncratic Chinese form of inclusive education. Our mixed methods study reveals that agency is the fourth pillar of the professional competence for inclusive education teachers in Beijing, China. Results from comparative analysis indicate that the level of teachers’ agency is significantly lower than that of their attitudes, knowledge, and skills. We offer some implications for policy and practice in inclusive education.

Teaching independent learning skills in the first year: A positive psychology strategy for promoting law student well-being

Empirical evidence in Australia and overseas has established that in many university disciplines, students begin to experience elevated levels of psychological distress in their first year of study. There is now a considerable body of empirical data that establishes that this is a significant problem for law students. Psychological distress may hamper a law student’s capacity to learn successfully, and certainly hinders their ability to thrive in the tertiary environment. We know from Self-Determination Theory (SDT), a conceptual branch of positive psychology, that supporting students’ autonomy in turn supports their well-being. This article seeks to connect the literature on law student well-being and independent learning using Self-Determination Theory (SDT) as the theoretical bridge. We argue that deliberate instruction in the development of independent learning skills in the first year curriculum is autonomy supportive. It can therefore lay the foundation for academic and personal success at university, and may be a protective factor against decline in law student psychological well-being.

Exploring an innovative educational approach to facilitating student nurses' clinical-reasoning skills in North Sulawesi Province, Indonesia

This study examined the effect of an educational intervention utilizing principles of cognitive apprenticeship on students’ ability to apply clinical reasoning skills within the context of a purpose-built clinical vignette. A quasi-experimental, non-equivalent control-group design was used to evaluate the effect of the educational intervention on students’ accuracy, inaccuracy and self-confidence in clinical reasoning. This study makes an important contribution to nursing education by providing evidence to understand how best to facilitate nursing students’ development of clinical reasoning.

Peer mentoring for radiotherapy planning skills development: A pilot study

Introduction: This study aimed to determine the potential role and guidelines for implementation of skill-based peer mentoring for radiotherapy planning education. Methods: After four weekly mentoring sessions, both Year 3 mentors (n=9) and Year 2 mentees (n=9) were invited to complete a short online questionnaire relating to the impact of the initiative. The tool contained a mixture of Likert-style questions concerning student enjoyment and perceived usefulness of the initiative as well as more qualitative open questions that gathered perceptions of the peer mentoring process, implementation methods and potential future scope. Results: Several key discussion themes related to benefits to each stakeholder group, challenges arising, improvements and potential future directions. There were high levels of enjoyment and perceived value of the mentoring from both sides with 100% of the 18 respondents enjoying the experience. The informal format encouraged further learning, while mentors reported acquisition of valuable skills and gains in knowledge. Conclusions: Peer mentoring has a valuable and enjoyable role to play in radiotherapy planning training and helps consolidate theoretical understanding for experienced students. An informal approach allows for students to adopt the most appropriate mentoring model for their needs while providing them with a free space to engender additional discussion.

Early mathematical learning: Number processing skills and executive function at 5 and 8 years of age

This research investigated differences and associations in performance in number processing and executive function for children attending primary school in a large Australian metropolitan city. In a cross-sectional study, performance of 25 children in the first full-time year of school, (Prep; mean age = 5.5 years) and 21 children in Year 3 (mean age = 8.5 years) completed three number processing tasks and three executive function tasks. Year 3 children consistently outperformed the Prep year children on measures of accuracy and reaction time, on the tasks of number comparison, calculation, shifting, and inhibition but not on number line estimation. The components of executive function (shifting, inhibition, and working memory) showed different patterns of correlation to performance on number processing tasks across the early years of school. Findings could be used to enhance teachers’ understanding about the role of the cognitive processes employed by children in numeracy learning, and so inform teachers’ classroom practices.