Tactics for teaching evidence-based practice : improving self-efficacy in finding and appraising evidence in a master's evidence-based practice unit

Universal application of evidence-based practice (EBP) is far from a reality with many clinicians feeling ill equipped to adopt this approach in their clinical practice (Melnyk Fineout- Overholt, Feinstein, Sadler, & Green-Hernandez, 2008; Sherriff, Wallis, & Chaboyer, 2007) and, thus, to be an intelligent consumer of evidence (Ciliska, 2005). While recognizing the benefit of EBP, many health professionals have low confidence in their skills for using evidence in clinical settings (Nagy, Lumby, McKinley, &Macfarlane, 2001). Educational initiatives are often recommended for promoting adoption of EBP with much of the focus being on providing knowledge of associated processes. Levin, Melnyk, Fineout-Overholt, Barnes, and Vetter (2011) demonstrated that providing knowledge of EBP process alone does not increase clinicians’ confidence in their ability to apply EBP to their practice...

Managing peripheral intravenous devices in the adults' general surgical setting: a best practice implementation report

AIM The aim of this evidence-based practice (EBP) project was to promote adherence to the current best practice in monitoring and optimal replacement of peripheral intravenous device (PIVD). METHODS This EBP project took place in a 30-bed acute general surgical ward. Twenty in-patients with PIVD in situ for 4 days or more were recruited. There were five stages in the project: identification of EBP topic, criteria, sample and setting; baseline; dissemination of baseline audit results and identification of best practice barriers; identification of barriers to EBP and implementation of strategies promoting EBP; and postimplementation audit. RESULTS There were eight criteria in this project. The first audit showed moderate compliance in PIVD monitoring and optimal replacement. The project identified three barriers: lack of awareness of the current evidence-based guidelines, hospital policy not being aligned with current guidelines and no standard form of documentation. In order to overcome these barriers the following strategies were used: audit and feedback, interactive educational meetings, reminders and hospital policy change. The second audit showed minor improvements in each criterion. Compliance with documentation remained a challenge, possibly because of the lack of standardised documentation. DISCUSSION Although the project did not render us the results we aimed for, it was successful because it highlighted the current EBP in PIVD management. The major challenges of the project were time and the lack of opinion leaders in our project team. We felt that more time was needed to adapt to the practice change and standardised documentation could not be developed in such a short time period. Further, the role of the opinion leader proved to be vital in this project. We felt that had we recruited more than one opinion leader, the results would have been different.

Fusion of worlds : consumers’ self-narrative in a hybrid physical/digital world

As the Internet becomes deeply embedded into consumers’ daily life, the digital virtual world brings significant influence to consumers’ self and narrative. Prior studies look at consumer self from either from a certain online space or comparing consumers’ physical and digital virtual selves but not the integration of the physical/digital world. This paper aims to explore the meanings of the digital virtual space on consumers’ narrative as a whole (their interests, dreams, or subjectivity). We utilise a postmodern concept of the cyborg to understand the cultural complexity, subjective meanings of, and the extent to which the digital virtual space plays a role in consumers’ self-narrative. We conducted in-depth interviews and gathered three consumer narratives. Our findings indicate that consumers’ narrative contains important fragments from both physical and digital virtual worlds and their physical and digital virtual selves form a feedback loop that strengthen their overall narrative.

Implementing the self-management threshold learning outcome for law : some intentional design strategies from the current curriculum toolbox

There is a growing awareness of the high levels of psychological distress being experienced by law students and the practising profession in Australia. In this context, a Threshold Learning Outcome (TLO) on self-management has been included in the six TLOs recently articulated as minimum learning outcomes for all Australian graduates of the Bachelor of Laws degree (LLB). The TLOs were developed during 2010 as part of the Australian Learning and Teaching Council’s (ALTC’s) project funded by the Australian Government to articulate ‘Learning and Teaching Academic Standards’. The TLOs are the result of a comprehensive national consultation process led by the ALTC’s Discipline Scholars: Law, Professors Sally Kift and Mark Israel.1 The TLOs have been endorsed by the Council of Australian Law Deans (CALD) and have received broad support from members of the judiciary and practising profession, representative bodies of the legal profession, law students and recent graduates, Legal Services Commissioners and the Law Admissions Consultative Committee. At the time of writing, TLOs for the Juris Doctor (JD) are also being developed, utilising the TLOs articulated for the LLB as their starting point but restating the JD requirements as the higher order outcomes expected of graduates of a ‘Masters Degree (Extended)’, this being the award level designation for the JD now set out in the new Australian Qualifications Framework.2 As Australian law schools begin embedding the learning, teaching and assessment of the TLOs in their curricula, and seek to assure graduates’ achievement of them, guidance on the implementation of the self-management TLO is salient and timely.

The applicability of the Precaution Adoption Process Model for understanding self-regulatory driving behaviour among older drivers

1. Introduction The success of self-regulation, in terms of enhancing older drivers’ safety and maintaining their mobility, depends largely upon older drivers’ awareness of the declines in their driving abilities. Therefore, interventions targeted at increasing older drivers’ safety should aim to enhance their awareness of their physical, sensory and cognitive limitations. Moreover, previous research suggests that driving behaviour change may occur through stages and that interventions and feedback may be perceived differently at each stage. 2. Study aims To further understand the process of driving self-regulation among older adults by exploring their perceptions and experiences of self-regulation, using the PAPM as a framework. To investigate the possible impact of feedback on their driving on their decision making process. 3. Methodology Research tool: Qualitative focus groups (n=5 sessions) Recruitment: Posters, media, newspaper advertisement and emails Inclusion criteria: Aged 70 or more, English-speaking, current drivers Participants: Convenience sample of 27 men and women aged 74 to 90 in the Sunshine Coast and Brisbane city, Queensland, Australia. 4. Analysis Thematic analysis was conducted following the process outlined by Braun and Clarke (2006) to identify, analyse and report themes within the data. Four main themes were identified.

How Gordon Ramsay appeals to consumers : effects of self-concept clarity and celebrity meaning on celebrity endorsements

How do celebrities like Gordon Ramsay appeal to consumers? This article examines one explanation. We study how celebrities appeal to consumers in the context of celebrity chefs. We examine how a consumer's self-concept clarity (SCC) interacts with their perception of the meaning that a celebrity endorser possesses. An experiment comparing fictional ads endorsed by different celebrity chefs yields the surprising result that consumers with a clear sense of who they are (high-SCC consumers) are more influenced by an ad featuring a celebrity high in meaning (Ramsay), whereas low-SCC consumers are influenced to slightly higher levels by a celebrity with lower levels of celebrity meaning.

Consumer’s persistence in solving their own problem with self‐service technology

An increasing range of technology services are now offered on a self-service basis. However, problems with self-service technologies (SSTs) occur at times due to the technical error, staff error, or consumers’ own mistakes. Considering the role of consumers as co-producers in the SST context, we aim to study consumer’s behaviours, strategies, and decision making in solving their problem with SST and identify the factors contributing to their persistence in solving the problem. This study contributes to the information systems research, as it is the first study that aims to identify such a process and the factors affecting consumers’ persistence in solving their problem with SST. A focus group with user support staff has been conducted, yielding some initial results that helped to conduct the next phases of the study. Next, using Critical Incident Technique, data will be gathered through focus groups with users, diary method, and think-aloud method.

Exercise barriers self-efficacy : development and validation of a subcale for individuals with cancer-related lymphedema

Background No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers. Methods A lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale. Results The final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (> 0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach’s alpha=0.93) and test-retest reliability (ICC=0.67, p< 0.01). Conclusions A valid and reliable lymphedema-specific subscale has been developed to assess exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.

The Threshold Learning Outcome on self-management for the Bachelor of Laws degree : a proposed focus for teaching strategies in the first year law curriculum

The Australian Learning and Teaching Council (ALTC) Discipline Scholars for Law, Professors Sally Kift and Mark Israel, articulated six Threshold Learning Outcomes (TLOs) for the Bachelor of Laws degree as part of the ALTC’s 2010 project on Learning and Teaching Academic Standards. One of these TLOs promotes the learning, teaching and assessment of self-management skills in Australian law schools. This paper explores the concept of self-management and how it can be relevantly applied in the first year of legal education. Recent literature from the United States (US) and Australia provides insights into the types of issues facing law students, as well as potential antidotes to these problems. Based on these findings, I argue that designing a pedagogical framework for the first year law curriculum that promotes students’ connection with their intrinsic interests, values, motivations and purposes will facilitate student success in terms of their personal well-being, ethical dispositions and academic engagement.

Self and other in communication and cognition : the role of auto-communication and intersubjectivity in autopoiesis of psychic systems

By referring to Niklas Luhmann's theory of self-referential systems, Aldo Mascareño (2008, submitted for publication) gives an account of system-environment interrelatedness, explaining how social and individual constitute each other through the process of communication and co-creation of meanings. Two possible extensions to his account are discussed. Firstly, auto-communication within the system that happens without any external reference needs to be taken into account while describing the existence and constant re-creation of psychic systems. Secondly, in order for the system and environment or two systems to communicate, an imagined and temporary intersubjectivity between the two needs to be assumed.

Evaluating a web-based self-management intervention in patients with heart failure: A pilot study

This pilot study aimed to evaluate the feasibility of a web-based self-management intervention in patients with heart failure. The study consisted of two phases including developing the web-based application and examining its feasibility in a group of heart failure patients. The results of this study were consistent with the current literature which has failed to show the benefits of web-based interventions for chronic disease self-management. In the current thesis, therefore, issues influencing the effectiveness of the web-based interventions were analysed. Recommendations for improving effectiveness of the web-based applications were also provided.

Development and validation of the Self-Gifting Consumer Behaviour scale

Self-gifting consumer behaviour (SGCB) is on the rise as consumers seek reward and therapeutic benefits from their shopping experiences. SGCB is defined as personally symbolic, self-communication through special indulgences, which tend to be premeditated and highly context bound. Prior research into the measurement of this growing behavioural phenomenon has been fragmented because of differences in conceptualisation. This research builds upon the prior literature and through a series of qualitative and quantitative studies, develops a valid, multidimensional measure of SGCB that will be useful for future quantitative inquiry into self-gifting consumption.