Using ‘think aloud’ as a strategy for improving clinical reasoning in high fidelity case-based simulation for undergraduate nursing students.

Theme Paper for Curriculum innovation and enhancement theme AIM: This paper reports on a research project that trialled an educational strategy implemented in an undergraduate nursing curriculum. The project aimed to explore the effectiveness of ‘think aloud’ as a strategy for improving clinical reasoning for students in simulated clinical settings. BACKGROUND: Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting (Lasater, 2007). Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students (Banning, 2008, Lee and Ryan-Wenger, 1997). This project used the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students were assisted to uncover cognitive approaches to assist in making effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection about their practice. MEHODS: In semester 2 2011 at QUT, third year nursing students undertook high fidelity simulation (some for the first time), commencing in September of 2011. There were two cohorts for strategy implementation (group 1= used think aloud as a strategy within the simulation, group 2= no specific strategy outside of nursing assessment frameworks used by all students) in relation to problem solving patient needs. The think aloud strategy was described to students in their pre-simulation briefing and allowed time for clarification of this strategy. All other aspects of the simulations remained the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). Ethics approval has been obtained for this project. RESULTS: Results of a qualitative analysis (in progress- will be completed by March 2012) of student and facilitator reports on students’ ability to meet the learning objectives of solving patient problems using clinical reasoning and experience with the ‘think aloud’ method will be presented. A comparison of clinical reasoning learning outcomes between the two groups will determine the effect on clinical reasoning for students responding to patient problems. CONCLUSIONS: In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs.

Changing the discourse of women’s work : challenges and future directions

Theoretical work on the career development of women has travelled a journey from critique to creation. Early work responded to and criticised a literature that focused on theorising male roles in a workplace that was conceptualised as providing vertical career paths primarily for middle class males. Theorists have criticised the limitations of this theorising on the basis of gender, ability and social class variables - to name just a few. More recently theorists are creating new constructions and frameworks to enable a more holistic understanding of career, applicable to both women and men. This book provides a history of theorising about women's careers, in addition to presenting a focus on current empirical and theoretical work which contributes to current understandings of women's working lives. It has both mapped the current discourse and suggests challenges for future work. This chapter will provide a synthesis of the key issues presented in the book and pose some challenges for future work.

Brisbane : creative city, cinema city?

Brisbane stands at the cross roads of many major economic, social and cultural opportunities as it positions itself as a cosmopolitan, globally networked metropolis of the twenty-first century. In order to link and leverage the existing screen industries infrastructure into Brisbane’s creative city’s plans, the paper argues for a re-think of the existing policy frameworks that support Australian screen culture and the national screen industries. Instead of remaining premised on a separation of these two activities the paper argues for a greater recognition of the overlaps occurring in both production and consumption of screen content. By acknowledging the impact new media technologies and social behaviours and the way they are re-shaping media consumption and media production practices, film and media policy could be better positioned to complement the emerging creative city policy frameworks that are being fostered in a city like Brisbane. The paper argues that reconsideration of the culture/industry separation that characterizes contemporary policy settings underpinning Australian media and screen production assistance would not only assist in identifying crucial synergies within a creative city policy it would also invigorate policy settings for the screen industries and enable them to connect more efficiently to a shifting film and media production and consumption landscape.

Exploring shared services from an IS perspective : a literature review and research agenda

Shared services have gained significance as an organizational arrangement, in particular for support functions, to reduce costs, increase quality and create new capabilities. The Information Systems (IS) function is amenable to sharing arrangements and information systems can enable sharing in other functional areas. However, despite being a promising area for IS research, literature on shared services in the IS discipline is scarce and scattered. There is still little consensus on what shared services is. Moreover, a thorough understanding of why shared services are adopted, who are involved, and how things are shared is lacking. In this article, we set out to progress IS research on shared services by establishing a common ground for future research and proposing a research agenda to shape the field based on an analysis of the IS literature. We present a holistic and inclusive definition, discuss the primacy of economic-strategic objectives so far, and introduce conceptual frameworks for stakeholders and the notion of sharing. We also provide an overview of the theories and research methods applied. We propose a research agenda that addresses fundamental issues related to objectives, stakeholders, and the notion of sharing to lay the foundation for taking IS research on shared services forward.

Towards a Dynamic IS Function

With the growing importance of IS for organizations and the continuous stream of new IT developments, the IS function in organizations becomes more critical but is also more challenged. For example, how should the IS function deal with the consumerization of IT or what is the added value of the IS function when it comes to SaaS and the Cloud? In this paper we argue that IS research is in need of a dynamic perspective on the IS function. The IS function has to become more focused on building and adapting IS capabilities in a changing environment. We discuss that there has been an overreliance on the Resource Based View so far for understanding the IS function and capabilities and introduce Dynamic Capabilities Theory as an additional theoretical perspective, which has only been limitedly addressed in IS literature yet. We present a first conceptualization of the dynamic IS function and discuss IS capabilities frameworks and individual IS capabilities from a dynamic perspective. These initial insights demonstrate the contribution of a dynamic perspective on the IS function itself.

A new research agenda into community-based protest in construction

Many countries face enormous development challenges in adapting to demographic change, urbanisation and emerging issues such as housing affordability and climate change. These challenges are best resolved in consultation with communities rather than in conflict with them. A rich tradition of research and intellectual frameworks exist in the fields of urban geography and planning to understand and manage community concerns during the pre-development approval stages of new projects. However current theoretical frameworks are inadequate in construction management and a new research agenda is needed to develop conceptual frameworks to guide thinking about the role of communities in the construction process. By discussing the components of such a model, it is concluded that this would require a fundamental shift in thinking which challenges traditional structuralist paradigms. A new constructivist paradigm is presented that conceives community consultation as a negotiation process which does not stop at the pre-development planning stages but which continues over the entire life of a project.

Land use planning and the airport metropolis

Australian airports have emerged as important urban activity centres over the past decade as a result of privatisation. A range of reciprocal airport and regional impacts now pose considerable challenges for both airport operation and the surrounding urban and regional environment. The airport can no longer be managed solely as a specialised transport entity in isolation from the metropolis that it serves. In 2007 a multidisciplinary Australian Research Council Linkage Project (LP 0775225) was funded to investigate the changing role of airports in Australia. This thesis is but one component of this collaborative research effort. Here the issues surrounding the policy and practice of airport and regional land use planning are explored, analysed and detailed. This research, for the first time, assembles a distinct progression of the wider social, economic, technological and environmental roles of the airport within the Australian airport literature from 1914 – 2011. It recognises that while the list of airport and regional impacts has grown through time, treatment within practice and the literature has largely remained highly specialised and contained within disciplinary paradigms. The first publication of the thesis (Chapter 2) acknowledges that the changing role of airports demands the establishment of new models of airport planning and development. It argues that practice and research requires a better understanding of the reciprocal impacts of airports and their urban catchments. The second publication (Chapter 3) highlights that there is ad hoc examination and media attention of high profile airport and regional conflict, but little empirical analysis or understanding of the extent to which all privatised Australian airports are intending to develop. The conceptual and methodological significance of this research is the development of a national land use classification system for on-airport development. This paper establishes the extent of on-airport development in Australia, providing insight into the changing land use and economic roles of privatised airports. The third publication (Chapter 4) details new and significant interdependencies for airport and regional development in consideration of the progression of airports as activity centres. Here the model of an ‘airport metropolis’ is offered as an organising device and theoretical contribution for comprehending the complexity and planning of airport and regional development. It delivers a conceptual framework for both research and policy, which acknowledges the reciprocal impacts of economic development, land use, infrastructure and governance ‘interfaces’. In a timely and significant concurrence with this research the Australian Government announced and delivered a National Aviation Policy Review (2008 – 2009). As such the fourth publication (Chapter 5) focuses on the airport and urban planning aspects of the review. This paper also highlights the overall policy intention of facilitating broader airport and regional collaborative processes. This communicative turn in airport policy is significant in light of the communicative theoretical framework of the thesis. The fifth paper of the thesis (Chapter 6) examines three Australian case studies (Brisbane, Adelaide and Canberra) to detail the context of airport and regional land use planning and to apply the airport metropolis model as a framework for research. Through the use of Land Use Forums, over 120 airport and regional stakeholders are brought together to detail their perspectives and interactions with airport and regional land use planning. An inductive thematic analysis of the results identifies three significant themes which contribute to the fragmentation of airport and regional and land use planning: 1) inadequate coordination and disjointed decision-making; 2) current legislative and policy frameworks; and 3) competing stakeholder priorities and interests. Building on this new knowledge, Chapter 7 details the perceptions of airport and local, state and territory government stakeholders to land use relationships, processes and outcomes. A series of semi-structured interviews are undertaken in each of the case studies to inform this research. The potential implications for ongoing communicative practice are discussed in conclusion. The following thesis represents an incremental and cumulative research process which delivers new knowledge for the practical understanding and research interpretation of airport and regional land use planning practice and policy. It has developed and applied a robust conceptual framework which delivers significant direction for all stakeholders to better comprehend the relevance of airports in the urban character and design of our cities.

Is there an international obligation to prosecute pirates

Combating piracy at sea and apprehending pirates have been a long-standing problem for the global community. Increasing acts of piracy off the coast of Somalia have prompted the UN Security Council to intervene in the matter. The Council, through several resolutions, has authorised states to take action against Somali pirates in the territorial waters and land territory of Somalia and recently adopted a resolution urging all states to fully implement relevant international conventions in their domestic legal systems. However, despite the Security Council's intervention in the matter most states are still reluctant to prosecute Somali pirates in their domestic courts. Considering the most recent Security Council resolution and existing international law, this article examines whether there is an international obligation to criminalise piracy under domestic legal frameworks and to prosecute pirates in domestic courts. It submits that existing international law arguably imposes an obligation to prosecute pirates, at least in certain circumstances, and the recently adopted Security Council resolution reinforces this obligation.

Simplified method for including spatial correlations in mean-field approximations

Biological systems involving proliferation, migration and death are observed across all scales. For example, they govern cellular processes such as wound-healing, as well as the population dynamics of groups of organisms. In this paper, we provide a simplified method for correcting mean-field approximations of volume-excluding birth-death-movement processes on a regular lattice. An initially uniform distribution of agents on the lattice may give rise to spatial heterogeneity, depending on the relative rates of proliferation, migration and death. Many frameworks chosen to model these systems neglect spatial correlations, which can lead to inaccurate predictions of their behaviour. For example, the logistic model is frequently chosen, which is the mean-field approximation in this case. This mean-field description can be corrected by including a system of ordinary differential equations for pair-wise correlations between lattice site occupancies at various lattice distances. In this work we discuss difficulties with this method and provide a simplication, in the form of a partial differential equation description for the evolution of pair-wise spatial correlations over time. We test our simplified model against the more complex corrected mean-field model, finding excellent agreement. We show how our model successfully predicts system behaviour in regions where the mean-field approximation shows large discrepancies. Additionally, we investigate regions of parameter space where migration is reduced relative to proliferation, which has not been examined in detail before, and our method is successful at correcting the deviations observed in the mean-field model in these parameter regimes.

Rejuvenating lost and disused space within Fortitude Valley : a study into the effectiveness of urban greenery in subtropical public space

An issue gaining prominence in our urban environments in the notion of lost space, the undesirable urban areas that are in need of redesign, commonly caused by a focus on development as individual architectural entities, without a greater view of the urban environment as a holistic entity. Within the context of South East Queensland, the suburb of Fortitude Valley has been earmarked for development as an extension of the current CBD. With lost and disused spaces already existing throughout the suburb due to rapid growth and mismatched developments, recent planning regimes have proposed rejuvenation in the form of proposals that echo typologies from other Australian regions, such as the laneway typology from Melbourne. Opportunities exist in these spaces for design approaches that relate specifically to the individual and unique subtropical character of the area. This research explores the relationship between innovative approaches towards urban greenery as a means to rejuvenate lost and disused public space, and its suitability within a subtropical climate, specifically focused within the suburb of Fortitude Valley. A trend gaining prominence is the notion of biophilic cities; cities that integrate urban greenery as a means to provide vibrant public spaces, and meet the growing aesthetic, social, cultural and economic needs of our cities. Through analysis of case studies showcasing greenery in an inventive way, observations of public using subtropical public space, and a discussion of the current policy frameworks at place within Fortitude Valley, innovative uses of urban greenery is proposed as viable placemaking technique in subtropical urban environments.

Land use conflict across the airport fence : competing urban policy, planning and priority in Australia

Land use planning within and surrounding privatised Australian capital city airports is a fragmented process as a result of: current legislative and policy frameworks; competing stakeholder priorities and interests; and inadequate coordination and disjointed decision-making. Three Australian case studies are examined to detail the context of airport and regional land use planning. Stakeholder Land Use Forums within each case study have served to inform the procedural dynamics and relationships between airport and regional land use decision-making. This article identifies significant themes and stakeholder perspectives regarding on-airport development and broader urban land use policy and planning. First, it outlines the concept of the “airport city” and examines the model of airport and regional “interfaces.” Then, it details the policy context that differentiates on-airport land use planning from planning within the surrounding region. The article then analyses the results of the Land Use Forums identifying key themes within the shared and reciprocal interfaces of governance, environment, economic development and infrastructure. The article concludes by detailing the implications of this research to broader urban planning and highlights the core issues contributing to the fragmentation of airport and regional land use planning policy.

Tracing the influence of non-narrative film and expanded cinema sound on experimental music

This study surveys and interrogates key conceptual frameworks and artistic practises that flow through the distinct but interconnected traditions of non-narrative film and experimental music, and examines how these are articulated in my own creative sound practise.

ICT shared services in the higher education sector : foundations, benefits, success factors and issues

Universities are more and more challenged by the emerging global higher education market, facilitated by advances in Information and Communication Technologies (ICT). This requires them to reconsider their mission and direction in order to function effectively and efficiently, and to be responsive to changes in their environment. In the face of increasing demands and competitive pressures, Universities like other companies, seek to continuously innovate and improve their performance. Universities are considering co-operating or sharing, both internally and externally, in a wide range of areas to achieve cost effectiveness and improvements in performance. Shared services are an effective model for re-organizing to reduce costs, increase quality and create new capabilities. Shared services are not limited to the Higher Education (HE) sector. Organizations across different sectors are adopting shared services, in particular for support functions such as Finance, Accounting, Human Resources and Information Technology. While shared services has been around for more than three decades, commencing in the 1970’s in the banking sector and then been adopted by other sectors, it is an under researched domain, with little consensus on the most fundamental issues even as basic as defining what shared services is. Moreover, the interest in shared services within Higher Education is a global phenomenon. This study on shared services is situated within the Higher Education Sector of Malaysia, and originated as an outcome resulting from a national project (2005 – 2007) conducted by the Ministry of Higher Education (MOHE) entitled "Knowledge, Information Communication Technology Strategic Plan (KICTSP) for Malaysian Public Higher Education"- where progress towards more collaborations via shared services was a key recommendation. The study’s primary objective was to understand the nature and potential for ICT shared services, in particular in the Malaysian HE sector; by laying a foundation in terms of definition, typologies and research agenda and deriving theoretically based conceptualisations of the potential benefits of shared services, success factors and issues of pursuing shared services. The study embarked on this objective with a literature review and pilot case study as a means to further define the context of the study, given the current under-researched status of ICT shared services and of shared services in Higher Education. This context definition phase illustrated a range of unaddressed issues; including a lack of common understanding of what shared services are, how they are formed, what objectives they full fill, who is involved etc. The study thus embarked on a further investigation of a more foundational nature with an exploratory phase that aimed to address these gaps, where a detailed archival analysis of shared services literature within the IS context was conducted to better understand shared services from an IS perspective. The IS literature on shared services was analysed in depth to report on the current status of shared services research in the IS domain; in particular definitions, objectives, stakeholders, the notion of sharing, theories used, and research methods applied were analysed, which provided a firmer base to this study’s design. The study also conducted a detailed content analysis of 36 cases (globally) of shared services implementations in the HE sector to better understand how shared services are structured within the HE sector and what is been shared. The results of the context definition phase and exploratory phase formed a firm basis in the multiple case studies phase which was designed to address the primary goals of this study (as presented above). Three case sites within the Malaysian HE sector was included in this analysis, resulting in empirically supported theoretical conceptualizations of shared services success factors, issues and benefits. A range of contributions are made through this study. First, the detailed archival analysis of shared services in Information Systems (IS) demonstrated the dearth of research on shared services within Information Systems. While the existing literature was synthesised to contribute towards an improved understanding of shared services in the IS domain, the areas that are yet under-developed and requires further exploration is identified and presented as a proposed research agenda for the field. This study also provides theoretical considerations and methodological guidelines to support the research agenda; to conduct better empirical research in this domain. A number of literatures based a priori frameworks (i.e. on the forms of sharing and shared services stakeholders etc) are derived in this phase, contributing to practice and research with early conceptualisations of critical aspects of shared services. Furthermore, the comprehensive archival analysis design presented and executed here is an exemplary approach of a systematic, pre-defined and tool-supported method to extract, analyse and report literature, and is documented as guidelines that can be applied for other similar literature analysis, with particular attention to supporting novice researchers. Second, the content analysis of 36 shared services initiatives in the Higher Education sector presented eight different types of structural arrangements for shared services, as observed in practice, and the salient dimensions along which those types can be usefully differentiated. Each of the eight structural arrangement types are defined and demonstrated through case examples, with further descriptive details and insights to what is shared and how the sharing occurs. This typology, grounded on secondary empirical evidence, can serve as a useful analytical tool for researchers investigating the shared services phenomenon further, and for practitioners considering the introduction or further development of shared services. Finally, the multiple case studies conducted in the Malaysian Higher Education sector, provided further empirical basis to instantiate the conceptual frameworks and typology derived from the prior phases and develops an empirically supported: (i) framework of issues and challenges, (ii) a preliminary theory of shared services success, and (iii) a benefits framework, for shared services in the Higher Education sector.

Cell migration and proliferation on homogeneous and non-homogeneous domains : modelling on the scale of individuals and populations

Cell migration is a behaviour critical to many key biological effects, including wound healing, cancerous cell invasion and morphogenesis, the development of an organism from an embryo. However, given that each of these situations is distinctly different and cells are extremely complicated biological objects, interest lies in more basic experiments which seek to remove conflating factors and present a less complex environment within which cell migration can be experimentally examined. These include in vitro studies like the scratch assay or circle migration assay, and ex vivo studies like the colonisation of the hindgut by neural crest cells. The reduced complexity of these experiments also makes them much more enticing as problems to mathematically model, like done here. The primary goal of the mathematical models used in this thesis is to shed light on which cellular behaviours work to generate the travelling waves of invasion observed in these experiments, and to explore how variations in these behaviours can potentially predict differences in this invasive pattern which are experimentally observed when cell types or chemical environment are changed. Relevant literature has already identified the difficulty of distinguishing between these behaviours when using traditional mathematical biology techniques operating on a macroscopic scale, and so here a sophisticated individual-cell-level model, an extension of the Cellular Potts Model (CPM), is been constructed and used to model a scratch assay experiment. This model includes a novel mechanism for dealing with cell proliferations that allowed for the differing properties of quiescent and proliferative cells to be implemented into their behaviour. This model is considered both for its predictive power and used to make comparisons with the travelling waves which result in more traditional macroscopic simulations. These comparisons demonstrate a surprising amount of agreement between the two modelling frameworks, and suggest further novel modifications to the CPM that would allow it to better model cell migration. Considerations of the model’s behaviour are used to argue that the dominant effect governing cell migration (random motility or signal-driven taxis) likely depends on the sort of invasion demonstrated by cells, as easily seen by microscopic photography. Additionally, a scratch assay simulated on a non-homogeneous domain consisting of a ’fast’ and ’slow’ region is also used to further differentiate between these different potential cell motility behaviours. A heterogeneous domain is a novel situation which has not been considered mathematically in this context, nor has it been constructed experimentally to the best of the candidate’s knowledge. Thus this problem serves as a thought experiment used to test the conclusions arising from the simulations on homogeneous domains, and to suggest what might be observed should this non-homogeneous assay situation be experimentally realised. Non-intuitive cell invasion patterns are predicted for diffusely-invading cells which respond to a cell-consumed signal or nutrient, contrasted with rather expected behaviour in the case of random-motility-driven invasion. The potential experimental observation of these behaviours is demonstrated by the individual-cell-level model used in this thesis, which does agree with the PDE model in predicting these unexpected invasion patterns. In the interest of examining such a case of a non-homogeneous domain experimentally, some brief suggestion is made as to how this could be achieved.

From evidence to action: a shared leadership approach

This paper proposes an organisational effectiveness model that applies the theoretical frameworks of shared leadership, appreciative inquiry, and knowledge creation. Similar to many libraries worldwide, Auraria Library technical services department struggled to establish efficient and effective workflow for electronic resources management. The library purchased an Electronic Resource Management System, as the literature suggests; however, this technology-enabled system did not resolve workflow issues. The Auraria Library case study demonstrates that a technical services division can successfully reorganize personnel, reassign responsibilities, and measure outcomes within an evidencebased shared leadership culture, which invites and enables participants to identify problems and create solutions amidst a dynamically changing electronic resources environment.