The role of nurse educators in student clinical education in Saudi Arabia

Introduction: Clinical education is considered a significant part of the learning process for nursing students. There is, however, no research that has explored this area of learning in Saudi Arabia. Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the role of nurse educators in student clinical education in Saudi Arabia. Method: Using Glaserian grounded theory methods the data were derived from 14 face-to-face interviews with nurse educators from both hospital and faculty settings in King Abdu-Aziz University (KAU) and King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category Redefining Identity Work and its two constituent categories Questioning the Situation and Creating Role Identity. The core and sub- categories were generated through a theoretical exploration of the identity work of nurse educators in Saudi Arabia. Conclusion: The social identity of the nurse educators was mediated culturally and socially within the hospital and university contexts and Saudi Arabian culture. In light of an increased understanding of the identity and role of nurse educators in clinical education in Saudi Arabia, the research presents implications and recommendations that may contribute to the development of nursing education as a coherent health care profession that is perceived as a desirable career option for Saudi women and men.

Encouraging, assisting, and time to eat : comparison of mealtime assistance interventions in elderly medical inpatients

BACKGROUND: The prevalence of protein-energy malnutrition in older adults is reported to be as high as 60% and is associated with poor health outcomes. Inadequate feeding assistance and mealtime interruptions may contribute to malnutrition and poor nutritional intake during hospitalisation. Despite being widely implemented in practice in the United Kingdom and increasingly in Australia, there have been few studies examining the impact of strategies such as Protected Mealtimes and dedicated feeding assistant roles on nutritional outcomes of elderly inpatients. AIMS: The aim of this research was to implement and compare three system-level interventions designed to specifically address mealtime barriers and improve energy intakes of medical inpatients aged ≥65 years. This research also aimed to evaluate the sustainability of any changes to mealtime routines six months post-intervention and to gain an understanding of staff perceptions of the post-intervention mealtime experience. METHODS: Three mealtime assistance interventions were implemented in three medical wards at Royal Brisbane and Women's Hospital: AIN-only: Additional assistant-in-nursing (AIN) with dedicated nutrition role. PM-only: Multidisciplinary approach to meals, including Protected Mealtimes. PM+AIN: Combined intervention: AIN + multidisciplinary approach to meals. An action research approach was used to carefully design and implement the three interventions in partnership with ward staff and managers. Significant time was spent in consultation with staff throughout the implementation period to facilitate ownership of the interventions and increase likelihood of successful implementation. A pre-post design was used to compare the implementation and nutritional outcomes of each intervention to a pre-intervention group. Using the same wards, eligible participants (medical inpatients aged ≥65 years) were recruited to the preintervention group between November 2007 and March 2008 and to the intervention groups between January and June 2009. The primary nutritional outcome was daily energy and protein intake, which was determined by visually estimating plate waste at each meal and mid-meal on Day 4 of admission. Energy and protein intakes were compared between the pre and post intervention groups. Data were collected on a range of covariates (demographics, nutritional status and known risk factors for poor food intake), which allowed for multivariate analysis of the impact of the interventions on nutritional intake. The provision of mealtime assistance to participants and activities of ward staff (including mealtime interruptions) were observed in the pre-intervention and intervention groups, with staff observations repeated six months post-intervention. Focus groups were conducted with nursing and allied health staff in June 2009 to explore their attitudes and behaviours in response to the three mealtime interventions. These focus group discussions were analysed using thematic analysis. RESULTS: A total of 254 participants were recruited to the study (pre-intervention: n=115, AIN-only: n=58, PM-only: n=39, PM+AIN: n=42). Participants had a mean age of 80 years (SD 8), and 40% (n=101) were malnourished on hospital admission, 50% (n=108) had anorexia and 38% (n=97) required some assistance at mealtimes. Occasions of mealtime assistance significantly increased in all interventions (p<0.01). However, no change was seen in mealtime interruptions. No significant difference was seen in mean total energy and protein intake between the preintervention and intervention groups. However, when total kilojoule intake was compared with estimated requirements at the individual level, participants in the intervention groups were more likely to achieve adequate energy intake (OR=3.4, p=0.01), with no difference noted between interventions (p=0.29). Despite small improvements in nutritional adequacy, the majority of participants in the intervention groups (76%, n=103) had inadequate energy intakes to meet their estimated energy requirements. Patients with cognitive impairment or feeding dependency appeared to gain substantial benefit from mealtime assistance interventions. The increase in occasions of mealtime assistance by nursing staff during the intervention period was maintained six-months post-intervention. Staff focus groups highlighted the importance of clearly designating and defining mealtime responsibilities in order to provide adequate mealtime care. While the purpose of the dedicated feeding assistant was to increase levels of mealtime assistance, staff indicated that responsibility for mealtime duties may have merely shifted from nursing staff to the assistant. Implementing the multidisciplinary interventions empowered nursing staff to "protect" the mealtime from external interruptions, but further work is required to empower nurses to prioritise mealtime activities within their own work schedules. Staff reported an increase in the profile of nutritional care on all wards, with additional non-nutritional benefits noted including improved mobility and functional independence, and better identification of swallowing difficulties. IMPLICATIONS: The PhD research provides clinicians with practical strategies to immediately introduce change to deliver better mealtime care in the hospital setting, and, as such, has initiated local and state-wide roll-out of mealtime assistance programs. Improved nutritional intakes of elderly inpatients was observed; however given the modest effect size and reducing lengths of hospital stays, better nutritional outcomes may be achieved by targeting the hospital-to-home transition period. Findings from this study suggest that mealtime assistance interventions for elderly inpatients with cognitive impairment and/or functional dependency show promise.

The role of nurse educators in student clinical education in Saudi Arabia

Background Clinical education is considered a significant part of the learning process for nursing students. There is, however, no research that has explored this area of learning in Saudi Arabia. Theoretical Framework Informed by a symbolic interactionist framework, this research explored the role of nurse educators in student clinical education in Saudi Arabia. Method Using Glaserian grounded theory methods the data were derived from 14 face-to-face interviews with nurse educators from both hospital and faculty settings in King Abdu-Aziz University (KAU) and King Abdu-Aziz University Hospital (KAUH). Findings The findings of the research are represented in the core category Redefining Identity Work and its two constituent categories Questioning the Situation and Creating Role Identity. The core and sub- categories were generated through a theoretical exploration of the identity work of nurse educators in Saudi Arabia. Conclusion The social identity of the nurse educators was mediated culturally and socially within the hospital and university contexts and Saudi Arabian culture. In light of an increased understanding of the identity and role of nurse educators in clinical education in Saudi Arabia, the research presents implications and recommendations that may contribute to the development of nursing education as a coherent health care profession that is perceived as a desirable career option for Saudi women and men.

Methods and consequences of suicide attempts among Australian students

Schweitzer et al. previously published a paper in the Australian and New Zealand Journal of Psychiatry which provided prevalence rates on suicidal ideation and behaviour among university students [1]. We wish to provide an update on extensions of our previously published work. In our previous publication we indicated the relatively high percentage of students who reported suicide-related behaviour over the past 12 months (6.6%). This figure is very similar to a more recent study undertaken in the UK where 6% of student respondents reported suicide attempts [2]. As a follow up, we investigated this finding further in studies undertaken in 1994 and 1997 by asking fresh samples of University of Queensland first-year undergraduates who responded positively to the question ‘I have made attempts to kill myself’ (in the past year), to provide additional data relating to the methods employed in their suicide attempts and the consequences following their suicide attempt in terms of level of injury and medical care received...

Prevalence of depressive symptoms as elicited by Patient Health Questionnaire (PHQ-9) among medical trainees in Oman

Background Despite the increasing recognition that medical training tends to coincide with markedly high levels of stress and distress, there is a dearth of validated measures that are capable of gauging the prevalence of depressive symptoms among medical residents in the Arab/Islamic part of the world. Objective The aim of the present study is two-fold. First is to examine the diagnostic validity of the Patient Health Questionnaire (PHQ-9) using an Omani medical resident population in order to establish a cut-off point. Second is to compare gender, age, and residency level among Omani Medical residents who report current depressive symptomatology versus those who report as non-depressed according to PHQ-9 cut-off threshold. Results A total of 132 residents (42 males and 90 females) consented to participate in this study. The cut-off score of 12 on the PHQ-9 revealed a sensitivity of 80.6% and a specificity of 94.0%. The rate of depression, as elicited by PHQ-9, was 11.4%. The role of gender, age, and residency level was not significant in endorsing depression. Conclusion This study indicated that PHQ-9 is a reliable measure among this cross-cultural population. More studies employing robust methodology are needed to confirm this finding.

Queer, student, activism

Queer student activists are a visible aspect of Australian tertiary communities. This chapter explores the findings of interviews with eight queer student in which they discuss their understandings of queer student activism and the way they see the university setting shaping the production queer student media. The findings draw out two themes: visibility and access and participation. These discussions illustrate how the intersections of queer, student, activism, and their associated contexts, create a particular type of activism. This chapter thus contributes to queer history by demonstrating how one specific cultural subset does queer activism.

Evaluating the impact of high risk foot training on undergraduate podiatry students

Background Diabetes is the leading cause of high risk foot (HRF) complications, admissions and lower limb amputation. Best practice training of podiatrists is known to have a beneficial impact on such outcomes; however, there has been a paucity of studies into undergraduate diabetes podiatry training. The primary aim of this paper was to investigate the changes in final year podiatry students’ confidence, knowledge and clinical practice in the management of HRF complications. Methods This was a prospective longitudinal study of final year podiatry students (n=25) at the Queensland University of Technology. All participants throughout 2011 undertook an intervention of a series of “hands on” HRF workshops, on-campus clinics and external clinical rotations. Outcome measures included customised confidence and knowledge surveys in HRF management across four time points. A timed simulated case scenario was used to evaluate changes in clinical practice at two time points. Friedman and Wilcoxon Signed Rank Tests were used to calculate differences between time points Results Overall improvements between the first and last time points were demonstrated in 20/21 confidence items (p<0.001), 12/27 clinical practice items (p<0.05) and 3/12 knowledge items (p<0.001). Although 8/12 knowledge items recorded high baseline scores of over 80%. Conclusions Overall, it appears student confidence and clinical practice improved with the introduction of designated HRF activities, whilst knowledge remained high. This suggests “hands on” practice and not didactic lectures improve students’ clinical confidence and practice. Results from the 2012 student cohort will also be presented at this conference.

A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose

Objectives To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. Design, Setting, and Participants A single group pre–post feasibility trial with 11 participants (3 male and 8 female; aged 42–65 years) with elevated blood glucose. Intervention Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. Main Outcome Measures Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms. Results There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference −1.05, p<0.001), waist circumference (−2.80 cm, p<0.05), and systolic (−11.64 mm Hg, p<0.01) and diastolic blood pressure (−9.73 mm Hg, p<0.001), as well as in HbA1c (−0.32%, p<0.01), insulin resistance (−0.53, p<0.05), stress (−2.27, p<0.05), depressive symptoms (−3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). Conclusions The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.

Mastering medical terminology online workbook

Key Features: "Aligns to Mastering Medical Terminology: Australia and New Zealand. Self-test to practise and revise combining forms, word roots, prefixes and suffixes. Crossword puzzles, anagrams and label-the-diagram exercises Also available iOS/Android app featuring audio glossary, flashcards and MCQs."--publisher website

Teacher, parent and student perceptions of the motives of cyberbullies

Understanding the motivation of students who cyberbully is important for both prevention and intervention efforts for this insidious form of bullying. This qualitative exploratory study used focus groups to examine the views of teachers, parents and students as to the motivation of students who cyberbully and who bully in other traditional forms. In addition, these groups were asked to explain their understanding of what defines bullying and cyberbullying. The results suggested that not only were there differences in definitions of cyberbullying and bullying between the three groups, but also that there were differences in perceptions of what motivates some youth to cyberbully. The implications of these results are discussed for both prevention and intervention strategies.

Systematic evaluation of GoSoapBox in tertiary education : a student response system for improving learning experiences and outcomes

There is currently a wide range of research into the recent introduction of student response systems in higher education and tertiary settings (Banks 2006; Kay and Le Sange, 2009; Beatty and Gerace 2009; Lantz 2010; Sprague and Dahl 2009). However, most of this pedagogical literature has generated ‘how to’ approaches regarding the use of ‘clickers’, keypads, and similar response technologies. There are currently no systematic reviews on the effectiveness of ‘GoSoapBox’ – a more recent, and increasingly popular student response system – for its capacity to enhance critical thinking, and achieve sustained learning outcomes. With rapid developments in teaching and learning technologies across all undergraduate disciplines, there is a need to obtain comprehensive, evidence-based advice on these types of technologies, their uses, and overall efficacy. This paper addresses this current gap in knowledge. Our teaching team, in an undergraduate Sociology and Public Health unit at the Queensland University of Technology (QUT), introduced GoSoapBox as a mechanism for discussing controversial topics, such as sexuality, gender, economics, religion, and politics during lectures, and to take opinion polls on social and cultural issues affecting human health. We also used this new teaching technology to allow students to interact with each other during class – both on both social and academic topics – and to generate discussions and debates during lectures. The paper reports on a data-driven study into how this interactive online tool worked to improve engagement and the quality of academic work produced by students. This paper will firstly, cover the recent literature reviewing student response systems in tertiary settings. Secondly, it will outline the theoretical framework used to generate this pedagogical research. In keeping with the social and collaborative features of Web 2.0 technologies, Bandura’s Social Learning Theory (SLT) will be applied here to investigate the effectiveness of GoSoapBox as an online tool for improving learning experiences and the quality of academic output by students. Bandura has emphasised the Internet as a tool for ‘self-controlled learning’ (Bandura 2001), as it provides the education sector with an opportunity to reconceptualise the relationship between learning and thinking (Glassman & Kang 2011). Thirdly, we describe the methods used to implement the use of GoSoapBox in our lectures and tutorials, and which aspects of the technology we drew on for learning purposes, as well as the methods for obtaining feedback from the students about the effectiveness or otherwise of this tool. Fourthly, we report cover findings from an examination of all student/staff activity on GoSoapBox as well as reports from students about the benefits and limitations of it as a learning aid. We then display a theoretical model that is produced via an iterative analytical process between SLT and our data analysis for use by academics and teachers across the undergraduate curriculum. The model has implications for all teachers considering the use of student response systems to improve the learning experiences of their students. Finally, we consider some of the negative aspects of GoSoapBox as a learning aid.

Screening Queensland University of Technology second year architecture student films

Research Statement: In 2011 The State Library of Queensland in collaboration with Queensland University of Technology School of Design held a screening of six student urban films shot on location in several inner-city sites under my supervision. The films are now a permanent "exhibit" on The Edge State Library electronic site. The students were directed to explore the realist film ethos, which forms a platform for the research project, in its focus on the nonrepresentational aesthetics of the street, the unfinished and the sensory. The research demonstrates that film is a powerful instrument for the urban imaginary, for screening the city.

Student focus and prioritization of design parameters in first-year engineering design projects

BACKGROUND Research on engineering design is a core area of concern within engineering education and a fundamental understanding of how engineering students approach and undertake design is necessary in order to develop effective design models and pedagogies. Understanding the factors related to design experiences in education and how they affect student practice can help educators as well as designers to leverage these factors as part of the design process. PURPOSE This study investigated the design practices of first-year engineering students’ and their experiences with a first-year engineering course design project. The research questions that guided the investigation were: 1. From a student perspective, what design parameters or criteria are most important? 2. How does this perspective impact subsequent student design practice throughout the design process? DESIGN/METHOD The authors employed qualitative multi-case study methods (Miles & Huberman, 1994) in order to the answer the research questions. Participant teams were observed and video recorded during team design meetings in which they researched the background for the design problem, brainstormed and sketched possible solutions, as well as built prototypes and final models of their design solutions as part of a course design project. Analysis focused on explanation building (Yin, 2009) and utilized within-case and cross-case analysis (Miles & Huberman, 1994). RESULTS We found that students focused disproportionally on the functional parameter, i.e. the physical implementation of their solution, and the possible/applicable parameter, i.e. a possible and applicable solution that benefited the user, in comparison to other given parameters such as safety and innovativeness. In addition, we found that individual teams focused on the functional and possible/ applicable parameters in early design phases such as brainstorming/ ideation and sketching. When prompted to discuss these non-salient parameters (from the student perspective) in the final design report, student design teams often used a post-hoc justification to support how the final designs fit the parameters that they did not initially consider. CONCLUSIONS This study suggests is that student design teams become fixated on (and consequently prioritize) certain parameters they interpret as important because they feel these parameters were described more explicitly in terms how they were met and assessed. Students fail to consider other parameters, perceived to be less directly assessable, unless prompted to do so. Failure to consider other parameters in the early design phases subsequently affects their approach in design phases as well. Case studies examining students’ study strategies within three Australian Universities illustrate similarities with some student approaches to design.

Australian Medical Liability [Second Edition]

"Australian Medical Liability is a comprehensive handbook focusing on medical liability in the context of the civil liability legislation across Australia. This thoroughly revised second edition provides a detailed and in depth commentary on the elements of medical liability caselaw and legislation."--Libraries Australia