Testing the effectiveness of a Practice Development intervention on changing the culture of evidence based practice in an acute care environment

In this age of evidence-based practice, nurses are increasingly expected to use research evidence in a systematic and judicious way when making decisions about patient care practices. Clinicians recognise the role of research when it provides valid, realistic answers in practical situations. Nonetheless, research is still perceived by some nurses as external to practice and implementing research findings into practice is often difficult. Since its conceptual platform in the 1960s, the emergence and growth of Nursing Development Units, and later, Practice Development Units has been described in the literature as strategic, organisational vehicles for changing the way nurses think about nursing by promoting and supporting a culture of inquiry and research-based practice. Thus, some scholars argue that practice development is situated in the gap between research and practice. Since the 1990s, the discourse has shifted from the structure and outcomes of developing practice to the process of developing practice, using a Practice Development methodology; underpinned by critical social science theory, as a vehicle for changing the culture and context of care. The nursing and practice development literature is dominated by descriptive reports of local practice development activity, typically focusing on reflection on processes or outcomes of processes, and describing perceived benefits. However, despite the volume of published literature, there is little published empirical research in the Australian or international context on the effectiveness of Practice Development as a methodology for changing the culture and context of care - leaving a gap in the literature. The aim of this study was to develop, implement and evaluate the effectiveness of a Practice Development model for clinical practice review and change on changing the culture and context of care for nurses working in an acute care setting. A longitudinal, pre-test/post-test, non-equivalent control group design was used to answer the following research questions: 1. Is there a relationship between nurses' perceptions of the culture and context of care and nurses' perceptions of research and evidence-based practice? 2. Is there a relationship between engagement in a facilitated process of Practice Development and change in nurses' perceptions of the culture and context of care? 3. Is there a relationship between engagement in a facilitated process of Practice Development and change in nurses' perceptions of research and evidence-based practice? Through a critical analysis of the literature and synthesis of the findings of past evaluations of Nursing and Practice Development structures and processes, this research has identified key attributes consistent throughout the chronological and theoretical development of Nursing and Practice Development that exemplify a culture and context of care that is conducive to creating a culture of inquiry and evidence-based practice. The study findings were then used in the development, validation and testing of an instrument to measure change in the culture and context of care. Furthermore, this research has also provided empirical evidence of the relationship of the key attributes to each other and to barriers to research and evidence-based practice. The research also provides empirical evidence regarding the effectiveness of a Practice Development methodology in changing the culture and context of care. This research is noteworthy in its contribution to advancing the discipline of nursing by providing evidence of the degree to which attributes of the culture and context of care, namely autonomy and control, workplace empowerment and constructive team dynamics, can be connected to engagement with research and evidence-based practice.

Making the most of MiLK : harnessing the contemporary culture and interests of natural born cyborg

MiLK is a mobile learning kit that allows students and teachers to author their own place-based learning events using simple web and mobile technologies. We will demonstrate how MiLK has been used by a number of teachers in various contexts to connect students, curriculum and everyday environments. This workshop will introduce participants to the various MiLK tools and processes; including mapping, designing, playing and reviewing events, group journals, discussion forums, student profiles, and class profiles. We will focus on the role of place as a potential resource for curriculum design and delivery. The MiLK Team are looking for enthusiastic mobile technology champions to join us. No previous experience or training in this area is needed. This workshop is designed to be relevant to all KLAs. During this session teachers will have an opportunity to experiment with simple tools to create dynamic resources for their own classrooms.

The culture of the Christian school

In discussions of educational administration theory, school culture has emerged as a contentious construct characterized by polarized positions. The underlying tensions are between conflicting structuralist and post-structuralist perspectives. These have led to views of Christian school culture and school organization as being either, on the one hand, static, positivist, hierarchical, individualistic and capitalistic or, on the other, dynamic, coherentist, communally interdependent, service oriented and Christ-centered. All schools demonstrate an ethos or organizational culture by default if not by design. It is therefore imperative for Christian school administrators, educators, and the community to consciously define the aspects of school culture that reflect the shared biblical values of the Christian school community.

Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.

Fashion design research : research methodologies for emerging researchers [Abstract]

This paper attempts to address some fundamental issues faced by new and emerging researchers in the discipline of Fashion design. A culture of patchwork research methodology appears to have become the norm in an attempt to ‘fit’ fashion design research into an academic paradigm for the examination of readers from more traditional research fields such as Arts, Humanities, Science and Philosophy. Two key questions are discussed here; is it appropriate for fashion researchers to adopt and adapt existing research methodologies to find a scholarly, academic voice? Secondly; do these methodologies enable fashion design research to be effectively disseminated to professionals and fellow researchers within the discipline of fashion design?

Safety culture research, lead indicators, and the development of safety effectiveness indicators in the construction sector

Construction sector application of Lead Indicators generally and Positive Performance Indicators (PPIs) particularly, are largely seen by the sector as not providing generalizable indicators of safety effectiveness. Similarly, safety culture is often cited as an essential factor in improving safety performance, yet there is no known reliable way of measuring safety culture. This paper proposes that the accurate measurement of safety effectiveness and safety culture is a requirement for assessing safe behaviours, safety knowledge, effective communication and safety performance. Currently there are no standard national or international safety effectiveness indicators (SEIs) that are accepted by the construction industry. The challenge is that quantitative survey instruments developed for measuring safety culture and/ or safety climate are inherently flawed methodologically and do not produce reliable and representative data concerning attitudes to safety. Measures that combine quantitative and qualitative components are needed to provide a clear utility for safety effectiveness indicators.

Advancing design for sustainable food cultures

Our paper, “HCI & Sustainable Food Culture: A Design Framework for Engagement,” presented at the 2010 NordiCHI conference, introduced a design framework for understanding engagement between people and sustainable food cultures (Choi and Blevis, 2010). Our goal for this chapter “Advancing Design for Sustainable Food Cultures” is to expand our notion of this design framework and the programme of research it implies. This chapter presents the three elements of design framework for sustainability: (i) engagement across disciplines; (ii) engagement with and amongst users/non-users and; (iii) engagement for sustained usability. The uses a corresponding sample of photographic records of experiences that reflect three key issues in the current sustainable food domain: respectively, (i) context of food cultures, (ii) farmers’ markets, and (iii) producing food.

Culture-fair assessment : challenging Indigenous students through effortful mathematics teaching

This paper reports on a mathematics education research project centred on teachers’ pedagogical practices and capacity to assess Indigenous Australian students in a culture-fair manner. The project has been funded by the Australian Research Council Linkage program and is being conducted in seven Catholic and Independent primary schools in north Queensland. Our Industry Partners are Catholic Education and the Association of Independent Schools, Queensland. The study aims to provide greater understanding about how to build more equitable assessment practices to address the issue of underperforming Aboriginal and Torres Strait Islander (ATSI) students in regional and remote Australia. The goal is to identify ways forward by attending to culture-fair assessment practice. The research is exploring the attitudes, beliefs and responses of Indigenous students to assessment in the context of mathematics learning with particular focus on teacher knowledge in these educational settings in relation to the design of assessment tasks that are authentic and engaging for these students in an accountability context. This approach highlights how teachers need to distinguish the ‘funds of knowledge’ (González, Moll, Floyd Tenery, Rivera, Rendón, Gonzales & Amanti, 2008) that Indigenous students draw on and how teachers need to be culturally responsive in their pedagogy to open up curriculum and assessment practice to allow for different ways of knowing and being

Design Led Innovation : exploring the synthesis of needs, technologies and business models

The term Design is used to describe a wide range of activities. Like the term innovation, it is often used to describe both an activity and an outcome. Many products and services are often described as being designed, as they describe a conscious process of linking form and function. Alternatively, the many and varied processes of design are often used to describe a cost centre of an organisation to demonstrate a particular competency. However design is often not used to describe the ‘value’ it provides to an organisation and more importantly the ‘value’ it provides to both existing and future customers. Design Led Innovation bridges this gap. Design Led Innovation is a process of creating a sustainable competitive advantage, by radically changing the customer value proposition. A conceptual model has been developed to assist organisations apply and embed design in a company’s vision, strategy, culture, leadership and development processes.

Ways of telling : research methodology for fashion textiles design

Research methodology in the discipline of Art & Design has been a topic for much debate in the academic community. The result of such avid and ongoing discussion appears to be a disciplinary obsession with research methodologies and a culture of adopting and adapting existing methodologies from more established disciplines. This has eventuated as a means of coping with academic criticism and as an attempt to elevate Art & Design to a ‘real academic status’. Whilst this adoption has had some effect in tempering the opinion of Art & Design research from more ‘serious’ academics the practice may be concealing a deeper problem for this discipline. Namely, that knowledge transfer within creative practice, particularly in fashion textiles design practice, is largely tacit in nature and not best suited to dissemination through traditional means of academic writing and publication. ----- ----- There is an opportunity to shift the academic debate away from appropriate (or inappropriate) use of methodologies and theories to demonstrate the existence (or absence) of rigor in creative practice research. In particular, the changing paradigms for the definitions of research to support new models for research quality assessment (such as the RAE in the United Kingdom and ERA in Australia) require a re-examination of the traditions of academic writing and publication in relation to this form of research. It is now appropriate to test the limits of tacit knowledge. It has been almost half a century since Michael Polanyi wrote “we know more than we can tell” (Polanyi, 1967 p.4) at a time when the only means of ‘telling’ was through academic writing and publishing in hardcopy format. ----- ----- This paper examines the academic debate surrounding research methodologies for fashion textiles design through auto-ethnographic case study and object analysis. The author argues that, while this debate is interesting, the focus should be to ask: are there more effective ways for creative practitioner researchers to disseminate their research? The aim of this research is to examine the possibilities of developing different, more effective methods of ‘telling’ to support the transfer of tacit knowledge inherent in the discipline of Fashion Textiles Design.

The big picture : an integrated approach to fashion design education

This paper examines current teaching practice within the context of the Bachelor of Design (Fashion) programme at AUT University and compares it to the approach adopted in previous years. In recent years, staff on the Bachelor of Design (Fashion) adopted a holistic approach to the assessment of design projects similar to the successful ideas and methods put forward by Stella Lange at the FINZ conference, 2005. Prior to adopting this holistic approach, the teaching culture at AUT University was modular and divorced the development of conceptual design ideas from the technical processes of patternmaking and garment construction, thus limiting the creative potential of integrated project work. Fashion Design is not just about drawing pretty pictures but is rather an entire process that encapsulates conceptual design ideas and technical processes within the context of a target market. Fashion design at AUT being under the umbrella of a wider Bachelor of Design must encourage a more serious view of Fashion and Fashion Design as a whole. In the development of the Bachelor of Design degree at AUT, the university recognised that design education would be best serviced by an inclusive approach. At inception, Core Studio and Core Theory papers formed the first semester of the programme across the discipline areas of Fashion, Spatial Design, Graphic Design and Digital Design. These core papers reinforce the reality that there is a common skill set that transcends all design disciplines with the differentiation between disciplines being determined by the techniques and processes they adopt. Studio based teaching within the scope of a major design project was recognised and introduced some time ago for students in their graduating year, however it was also expected that by year 3 the student had amassed the basic skills required to be able to work in this way. The opinion concerning teaching these basic skills was that they were best serviced by a modular approach. Prior attempts to manage design project delivery leant towards deconstructing the newly formed integrated papers in order to ensure key technical skills were covered in enough depth. So, whilst design projects have played an integral part in the delivery of fashion design over the year levels, the earlier projects were timetabled by discipline and unconvincingly connected. This paper discusses how the holistic approach to assessment must be coupled with an integrated approach to delivery. The methods and processes used are demonstrated and some recently trialled developments are shown to have resulted in achieving the integrated approach in both delivery and assessment.

Subtropical design in South East Queensland : a handbook for planners, developers and decision makers

Subtropical Design in South East Queensland provides a direct link between climatic design, applied urban design and sustainable planning policy. The role that character and identity of a place plays in achieving environmental sustainability is explained. Values of local distinctiveness to do with climate, landscape and culture are identified and the environmental, social and economic benefits of applying subtropical design principles to planning are described. The handbook provides planners and urban designers with an understanding of how subtropical design principles apply within the different contexts of urban planning including the entire spectrum of urban scales from the regional scale, to the city, neighbourhood, street, individual building or site. Twelve interactive principles, and interrelated strategies, drawn predominantly from the body of knowledge of landscape architecture, architectural science and urban design are described in detail in text, and richly illustrated with diagrams and photographs.

Sustainable fashion textiles design : value adding through technological enhancement

A key concern in the field of contemporary fashion/textiles design is the emergence of ‘fast fashion’: best explained as "buy it Friday, wear it Saturday and throw it away on Sunday" (O'Loughlin, 2007). In this contemporary retail atmosphere of “pile it high: sell it cheap” and “quick to market”, even designer goods have achieved a throwaway status. This modern culture of consumerism is the antithesis of sustainability and is proving a dilemma surrounding sustainable practice for designers and producers in the disciplines (de Blas, 2010). Design researchers including those in textiles/fashion have begun to explore what is a key question in the 21st century in order to create a vision and reason for their disciplines: Can products be designed to have added value to the consumer and hence contribute to a more sustainable industry? Fashion Textiles Design has much to answer for in contributing to the problems of unsustainable practices on a global scale in design, production and waste. However, designers within this field also have great potential to contribute to practical ‘real world’ solutions. ----- ----- This paper provides an overview of some of the design and technological developments from the fashion/textiles industry, endorsing a model where designers and technicians use their transferrable skills for wellbeing rather than desire. Smart materials in the form of responsive and adaptive fibres and fabrics combined with electro active devices, and ICT are increasingly shaping many aspects of society particularly in the leisure industry and interactive consumer products are ever more visible in healthcare. Combinations of biocompatible delivery devices with bio sensing elements can create analyse, sense and actuate early warning and monitoring systems which can be linked to data logging and patient records via intelligent networks. Patient sympathetic, ‘smart’ fashion/textiles applications based on interdisciplinary expertise utilising textiles design and technology is emerging. An analysis of a series of case studies demonstrates the potential of fashion textiles design practitioners to exploit the concept of value adding through technological garment and textiles applications and enhancement for health and wellbeing and in doing so contribute to a more sustainable future fashion/textiles design industry.

Designing disruption : linking participatory design and design thinking in technology orientated industries

A vast proportion of companies nowadays are looking to design and are focusing on the end users as a means of driving new projects. However still many companies are drawn to technological improvements which drive innovation within their industry context. The Australian livestock industry is no different. To date the adoption of new products and services within the livestock industry has been documented as being quite slow. This paper investigates how disruptive innovation should be a priority for these technologically focused companies and demonstrates how the use of design led innovation can bring about a higher quality engagement between end user and company alike. A case study linking participatory design and design thinking is presented. Within this, a conceptual model of presenting future scenarios to internal and external stakeholders is applied to the livestock industry; assisting companies to apply strategy, culture and advancement in meaningful product offerings to consumers.